Purpose: Post-pandemic management of COVID-19 infections and any emergent outbreaks is as an endemic disease remains a public health concern. Vaccine hesitancy may continue to hamper efforts to respond any new disease outbreaks and future epidemics. This qualitative study aimed to explore factors influencing covid-19 vaccine acceptance and hesitancy in Kenya too gain deeper insights on this issue. Methods: The study was implemented in Western Kenya using key informant interviews. Fourteen (14) key informants were purposively selected for the study. All interviews were transcribed and analyzed using thematic analysis. Interpretation of findings was done within the framework of the Health Belief Model. Key findings: Knowledge was a critical factor in combatting misinformation and fostering vaccine acceptance among participants in this study. Misinformation included rumors that the vaccine lowers immunity and was intended for population control. Cues to action included influence from political and opinion leaders and observing the loss of life among unvaccinated individuals. Perceived barriers to vaccine uptake included fear of vaccine safety, side effects, long waiting times at that time of our study, fear of contracting the COVID-19 at vaccination sites, family/spousal influence on vaccine uptake and fear of the unknown with the vaccine. Conclusion: Findings from this study provides insight into areas for targeted strategies for managing Covid-19 vaccinations and future pandemics. Within the framework of the Health Belief Model, this study identified salient barriers and facilitators of COVID-19 vaccine hesitancy that may be helpful to inform future pandemic response.

.Background: Clostridioides difficile infections (CDI) vary in severity from mild diarrhea to life-threatening conditions like pseudomembranous colitis or toxic megacolon, often leading to sepsis and death. The COVID-19 pandemic prompted changes in healthcare practices, potentially affecting CDI incidence, though reported data are inconclusive. We studied factors influencing CDI incidence and outcomes at a university hospital throughout the COVID-19 pandemic years. Methods: We conducted a retrospective study on all adult hospitalized CDI cases from January 1, 2020, to December 31, 2022. We collected demographic information, comorbid conditions, and concurrent infections. Results: While overall CDI and COVID-19 rates decreased in 2022, a nota-ble increase in CDI infections was observed among oncological patients and those undergoing some aggressive treatments, such as colon or gastroscopies. The prevalence of comorbidities remained unmodified, and there were declines in prior gastrointestinal surgeries and proton pump inhibitor prescriptions. Factors associated with patient fatality or prolonged hospitaliza-tion included older age, cancer, chronic kidney disease, higher Charlson and McCabe indices, elevated C-reactive protein, and low albumin concentrations. Conclusion: Our study shows the evolving landscape of CDI during the COVID-19 pandemic and emphasizes the impact of de-layed diagnoses and treatments exacerbated by telemedicine adoption. Identified risk factors for CDI-related mortality or prolonged hospital stays underscore the importance of targeted inter-ventions in high-risk populations.

The emergence of the H3N2 influenza virus in 1968 marked a significant event as it crossed the species barrier. Since then, ongoing mutational dynamics have led to the formation of antigenic clusters, prompting the World Health Organization to advocate for regular updates to H3N2 vaccines. Research in the Western Pacific region underscores the necessity for heightened awareness and effective control strategies. Stemming from avian influenza A, the 1968 H3N2 influenza pandemic resulted in the deaths of one million people globally, with its seasonal variants primarily affecting older individuals and causing severe illness due to antigenic drift. To address the challenge of vaccine efficacy against H3N2 mutations, researchers are exploring innovative strategies such as precise antigenic material administration, controlled release patterns, understanding immune system mechanisms, and glycan engineering. This review comprehensively examines various aspects of the Influenza A (H3N2) virus, encompassing its virological characteristics, evolutionary trends, global epidemiology, vaccination strategies, antiviral interventions, and emerging diagnostic approaches. It underscores the impact of antigenic variation on vaccine design and effectiveness, seasonal outbreak patterns, pandemic potential, and the interplay between viral factors and host immune responses. Moreover, the review evaluates antiviral therapies and the issue of drug resistance, emphasising the necessity for multidisciplinary approaches involving researchers, healthcare professionals, and policymakers to comprehend H3N2 and enhance public health interventions.

COVID-19 pandemic disproportionately affected seven South Asian countries because of rampaging virus and weak health system response. Vaccination commenced in all countries during early 2021, once the vaccines became available in the international market. Vaccines were donated by international development partners, friendly countries and procured utilizing domestic resources and financial support from various agencies. All countries opted for a phasing of the vaccination by prioritizing high risk populations which included health care personnel, front line workers and elderly with comorbidities. Seven vaccines that had WHO emergency authorization usage were utilized in South Asia. India produced more than 2.4 billion doses of AstraZeneca vaccine and has indigenously developed five COVID-19 vaccines. Vaccine inequity was obvious and characterized by fewer people in South Asia vaccinated with single dose vis a vis the developed countries. Vaccine hesitancy was another obstacle that kept the vaccination rates low. Difficult to reach areas in Afghanistan, Bhutan, Maldives, Nepal could not fully access vaccines. South Asian countries need to strengthen their health system for efficient deployment of vaccines in future health emergencies. At the same time the global agencies and developed countries must address the issue of vaccine access to low-income countries to mitigate the impact of pandemic all over the world.

Background: Vaccine hesitancy was one of India's problems after the COVID-19 vaccine roll-out. Earlier studies carried out to understand people's perception of the vaccine were mainly based on online or offline community-based surveys. These studies do not help to understand the actions taken by people towards vaccination. Hence, this study has been designed to understand the exact behavior of people toward the vaccine. Methods: Age-wise, the population was sub-grouped into three groups, above 18 years, 12-14 years, and 15-18 years. The data analysis has been done using cumulative coverage of vaccines in the said age groups. Results: The study shows a substantial population has missed second and booster doses of vaccine at the state, regional, and national levels in all three age groups. Even for the states that have shown the smallest number of people who missed their dose, their number is in the thousands. Conclusion: Further research is needed to know, in total population, how many people have not even taken a single dose of vaccine. Policy-level efforts are needed to cover the entire population of the country for at least a single dose and vulnerable populations, for additional booster doses after primary doses.

The COVID-19 pandemic has shown varying effects on adolescents’ mental health, psychosocial functioning, risk behaviours, and victimisation. This study aims to examine the changes reported by a sample of Swedish adolescents (N=1607) at the end of the first year of the pandemic in relation to these factors. Data was collected with an electronic survey between September 2020 and February 2021, targeting upper-secondary high school students (aged 15-19 years). The results indicate a relatively low overall impact of the pandemic on Swedish upper-secondary school students, with notable gender differences. Compared to females, a higher percentage of male adolescents reported experiencing elevated levels of anxiety, depression, sleep disturbances, anger, and increased illicit drug use as consequences of the pandemic. In contrast, females demonstrated an increase in several salutogenic behaviours. Victimisation rates generally decreased during this period. These findings underscore the importance of heightened awareness among professionals within schools, social services, and healthcare settings regarding the distinct challenges encountered by a larger portion of male adolescents during the COVID-19 pandemic in Sweden.

Background: The effect of COVID-19 infection, versus the indirect effect of the pandemic on body composition remains unclear. This study investigates long-term changes in body composition in COVID–19 survivors compared to a contemporary control group. Method: This is a prospective study involving adults who had a pre-pandemic whole-body DXA scan (DXA#1) performed between 2017 and 2019. Participants were asked to return for a repeat whole-body DXA scan (DXA#2) after the pandemic. Detailed data were collected including medical and COVID history. Inflammation markers and fasting lipids were measured. For those participants who had a COVID-19 infection between the 2 DXAs, DXA#2 was acquired at least one year after COVID-19 infection. Results: Overall, 160 adults were enrolled; 32.5% females, 51.8% non-white, with mean age of 43.2 years. Half (n=80) of the participants had documented COVID infection between their 2 DXA scans (COVID+ group), and the other half never had COVID. COVID-negative participants had an increase in annualized trunk fat (g) [922.5 vs. 159.7; P=0.01], total fat (g) [1564.3 vs. 199.9; P=0.2], and LBM (g) [974.9 vs. -64.5; P=0.0002], when compared to COVID+ group. However, among the COVID+ group, no differences were seen in annualized trunk fat, total fat mass, or LBM between those with PASC and without (p>0.05). Conclusion: During the pandemic, both COVID-19-survivors and COVID-negative groups exhibited increases in weight, and total and trunk fat, likely associated with pandemic-linked lifestyle modifications. However, only COVID-19-survivors had a decline in lean body mass over the same period, regardless of PASC symptoms.

The susceptible-infected-recovered-vaccinated-deceased (SIRVD) epidemic compartment model extends the SIR model to include the effects of vaccination campaigns and time-dependent fatality rates on epidemic outbreaks. It encompasses the SIR, SIRV, SIRD, and SI models as special cases, with individual time-dependent rates governing transitions between different fractions. We investigate a special class of exact solutions and accurate analytical approximations for the SIRVD and SIRD compartment models. While the SIRVD and SIRD equations pose complex integro-differential equations for the rate of new infections and the fractions as a function of time, a simpler approach considers determining equations for the sum of ratios for given variations. This approach enables us to derive fully exact analytical solutions for the SIRVD and SIRD models. For nonlinear models with a high-dimensional parameter space, such as the SIRVD and SIRD models, analytical solutions, exact or accurately approximative, are of high importance and interest: not only as suitable benchmarks for numerical codes, but especially as they allow us to understand the critical behavior of epidemic outbursts as well as the decisive role of certain parameters. In the second part of our study, we apply a recently developed analytical approximation for the SIR and SIRV models to the more general SIRVD model. This approximation offers accurate analytical expressions for epidemic quantities, such as the rate of new infections and the fraction of infected persons, particularly when the cumulative fraction of infections is small. The distinction between recovered and deceased individuals in the SIRVD model affects the calculation of the death rate, which is proportional to the infected fraction in the SIRVD/SIRD cases but often proportional to the rate of new infections in many SIR models using a posteriori approach. We demonstrate that the temporal dependence of the infected fraction and the rate of new infections differs when considering the effects of vaccinations and when the real-time dependence of fatality and recovery rates diverge. These differences are highlighted for stationary ratios and gradually decreasing fatality rates. \Revised{The case of stationary ratios allows one to construct a new powerful diagnostics method to extract analytically all SIRVD model parameters from measured COVID-19 data of a completed pandemic wave.

C. auris is a newly emerging yeast, raising public health concerns due to its outbreak potential, lack of protocols for decontamination and isolation of patients or contacts, increased resistance to common antifungals and associated high mortality. This research aimed to describe the challenges related to identifying the outbreak, limiting further contamination, and treating affected individuals. We retrospectively analysed all cases of C. auris detected between October 2022 and August 2023, but our investigation focused on a three-month-long outbreak in the department of cardio-vascular surgery and the related intensive care unit. Along with isolated cases in different wards, we identified 13 patients who became infected or colonized in the same area and time, even though the epidemiological link could be traced only in 10 patients, according to the epidemiological investigation. In conclusion, our study emphasizes the substantial challenge encountered in clinical practice when attempting to diagnose and limit the spread of an outbreak. Therefore, it is crucial to promptly apply contact precaution measures and appropriate environmental cleaning, from the first case detected positive.

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.

This study examined the tourism spatial distribution of nine cities in the Fujian province and assessed the impacts of COVID-19. The modified gravity model found that it was widely dispersed, with uneven and relatively independent tourism development in different cities. The social network analysis showed that tourism connections across cities were significantly reduced after the pandemic. The impacts of brand awareness and transport accessibility on spatial networks were positive in pre-pandemic but became negative during the pandemic. In contrast, tourist volume had negative impacts on spatial networks in pre-pandemic but had positive ones during the pandemic. Tourism resources and market performance had significantly positive impacts in the post-pandemic era. These findings provide advice on tourism recovery and destination management in coping with future critical events. It also contributes to the theoretical gravity framework in tourism and the research scope of the social networks analysis at the city level.

The COVID-19 pandemic halted progress in global vaccine coverage and disrupted routine childhood vaccination practices worldwide. While there is ample evidence of vaccination declines experienced during the pandemic, it is less clear how low-income countries were affected. We executed a systematic review to synthesize the current literature on impacts to routine childhood vaccinations in low-income countries from January 1, 2020 to February 8, 2023. We collected data using an extraction form on Covidence and assessed the quality of studies included in the review using the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool. Effect estimates for changes in vaccination during the pandemic were reported and summarized. Factors that influenced changes were grouped into descriptive themes. Thirteen studies, encompassing 18 low-income countries and evaluating 15 vaccines at varying doses, were included in the final review. We found that routine childhood vaccinations during the COVID-19 pandemic varied considerably by vaccine type, location, and phase of the pandemic. Nine different themes were identified as factors that influenced changes in vaccination. Documenting past experiences and lessons learned is crucial for informing preparedness efforts in anticipation of future public health emergencies. Failure to effectively address these things in the next public health emergency could result in a recurrence of declining routine childhood vaccinations.

Purpose: This study analysed the impact of the COVID-19 pandemic on the diagnosis of malignant neoplasia of the bronchus and lung. Cases diagnosed in the Burgos region in the year prior to the official declaration of the pandemic were compared with those in the year after the pandemic. The research sought to identify whether there was a decrease in the number of cases during the pandemic, and whether this may have led to a delay in diagnosis, reflected in more advanced stages of the disease. Mortality and survival time in each of the periods were also analysed.

COVID-19 has brought unprecedented challenges and exacerbated existing work-related struggles resulting in heightened occupational stress and impacted work performance among health caregivers. This study utilised the transactional model of stress and coping to explore the coping strategies adopted by radiology health caregivers during the pandemic with the aim to provide baseline data for enhancing preparedness and development of interventions to support staff during future health crises. A qualitative, interpretative phenomenological analysis (IPA) methodology coupled with constructivist and interpretivist philosophical views were utilised in a multi-method context to conduct semi-structured interviews and focus group discussions among 24 radiology health caregivers in the eThekwini district of KwaZulu-Natal, South Africa. Data were transcribed verbatim and manually analysed using the IPA framework. The radiology health caregivers highlighted resilience, adaptability and identified emotion-focused and problem-focused coping as their mostly preferred strategies of dealing with COVID-19 related mental distress. These included accepting professional responsibilities and duties, social coping, spiritual therapy, adaptive behavioural coping, escape-avoidance and solution-oriented approaches. The findings can guide radiology departments in developing bespoke mental health interventions to support radiology health caregivers during any future health crises.

In this study, we aimed to determine the trend of antimicrobial resistance pattern of pathogens isolated in samples collected from patients hospitalized in the intensive care unit (ICU), in selected periods before and after COVID-19. A retrospective study of bacterial pathogens was performed on 1267 patients. The resistance patterns were analyzed using Vitek 2 Compact system. Positive-bacterial culture data of 1695 samples from pre-COVID-19 period and 1562 from post-COVID-19 period were obtained. The most frequently isolated in both periods were Staphylococcus aureus and Klebsiella spp. Klebsiella spp. had a statistically significant increase in resistance rates in the post COVID-19 period, against colistin, gentamicin and aztreonam. For E. coli strains, it was registered a significant increase against colistin and a significant decrease against levofloxacin and imipenem. For Acinetobacter spp. strains it was observed a significant increase against colistin. More than 50% from the Staphylococcus aureus strains were MRSA with statistically significant increases in antimicrobial resistance rate in the post-COVID-19 period against doxycycline, linezolid, rifampicin and teicoplanin. The study revealed a significantly increasing trend of the antimicrobial resistance rate of Gram-negative pathogens (Klebsiella spp., Acinetobacter spp.) against certain antibiotics, including those used only in cases where there are no other therapeutic options.

(1) Background: Since the pandemic, adolescent girls have increasingly faced mental health challenges. We examined prevalence trends and associated risk factors for depression among adolescent girls. 2) Methods: Data for girls aged 12 to 17 years (N=4346) from the 2021 cross-sectional National Survey on Drug Use and Health were analyzed. Factors associated with depression were examined using multiple regression analysis. (3) Results: Rates of severe depression were significantly higher (p<.001) in older girls (adjusted odds ratio [AOR]: 1.63, 1.61, those who did not have authoritative parents (AOR: 3.40), and those with negative school experiences (AOR: 4.03). Black and Asian/Native Hawaiian or other Pacific Islanders were less likely to report severe depression than white girls. As previously reported, non-White girls were significantly less likely to receive treatment for depression (p<.05). Parents’ characteristics and school experiences had no effect on the likelihood of receiving mental health treatment. (4) Conclusion: Depression has become increasingly common among American adolescent girls, who are now three times as likely as adolescent boys to have had recent experiences with depression. Our results show that family structure, parenting style, and negative school experiences significantly contribute to the rate of depression and that treatment disparities exist with regard to race and ethnicity.

Avian Influenza viruses (AIVs) has posed a significant pandemic threat since their discovery. This review mainly focuses on the epidemiology, virology, and pathogenesis, and treatments of avian influenza viruses. We delve into the global spread, past pandemics, clinical symptoms, severity, and immune response related to AIVs. The review also discusses various control measures, including antiviral drugs, vaccines, and potential future directions in influenza treatment and prevention. Lastly, by summarizing the insights from the previous pandemic control, this review aims to direct effective strategies for managing future influenza pandemics.

A microfinance scheme has emerged as a crucial tool in reducing poverty gaps in many developing countries. A notable player in the arena is Amanah Ikhtiar Malaysia (AIM), a pioneer in microfinancing in Malaysia since 1987. AIM’s microfinance program injects small-scale businesses, particularly benefiting single mother entrepreneurs, contributing to capacity-building and empowerment. However, the advent of the COVID-19 pandemic, coupled with Movement Control Order (MCO), has adversely affected various business sectors and vulnerable groups, including single mothers engaged in microfinancing enterprises. This study employs primary data to assess the impact of AIM’s microfinancing programs on single-mother entrepreneurs during the crisis. Utilizing a quantitative approach with a two-stage sampling process involving 422 respondents in urban areas, the research evaluates the relationship between empowerment indicators (economic, social, digital, and psychological) and management and governance aspects of program effectiveness. The findings reveal that the microfinancing program’s overall effectiveness, economic, digital and psychological empowerment indicators, and program management are at a moderate level, while social empowerment is high. Economic and digital empowerment, along with effective management, positively and significantly influence program effectiveness, whereas social empowerment has a negative and significant impact. The study concludes with recommendations for enhancing AIM’s microfinance program, equipping single mother entrepreneurs to better navigate future challenges, and informing policy formulation related to their empowerment.

The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) infection has required a complete change in the management of patients with gastrointestinal disease who needed to undergo endoscopic procedures. In the second year of the COVID-19 pandemic, due to restrictions for elective endoscopic procedures a large number of cancer patients were prevented from early diagnosis of several digestive cancers, which has led to a serious burden in the health system which nowadays needs to be dealt with. We designed a prospective study that included patients in whom access to elective endoscopic examinations during the COVID-19 pandemic has been delayed. Our aim was to investigate the impact of the COVID-19 pandemic on the diagnosis rate of digestive tract malignancies in the context of a health crisis management that generates an ethical dilemma regarding the balance of utilitarianism versus deontology. Our study shows that the decrease in the number of newly diagnosed gastrointestinal cancers by endoscopy and biopsy during the pandemic restrictions and the delay in diagnosis have hads a clear impact on stage migration due to disease progression.

Background and Objectives: The COVID-19 pandemic influenced the management of patients with immune mediated rheumatic and musculoskeletal diseases (imRMDs) in various ways. The goal of our systematic review was to determine the influence of the first period of the COVID-19 pandemic on the management of imRMDs. Materials and Methods: Systematic literature search of PubMed, Cochrane and Embase databases, including studies with adult patients on the influence of the COVID-19 pandemic on management of imRMDs. There were no restrictions regarding to study-design except for systematic reviews and case reports that were excluded as well as articles on the disease outcomes in case of SARS-CoV-2 infection. Two reviewers screened the studies for inclusion, and, in case of disagreement, consensus was reached after discussion. Results: A total of 5969 potentially relevant studies were found, and, after title, abstract and full-text screening, 35 studies were included with data from 182’746 patients and 2018 rheumatologists. Non-availability of drugs, e.g., hydroxychloroquine and tocilizuab, was frequent (16–69% of patients). Further, medication non-adherence was reported among patients with different RMDs and between different drugs in 4–46% of patients. Changes to preexisting medication were reported in up to 33% of patients (e.g. reducing dose of steroids or cessation of biological disease-modifying antirheumatic drugs). Physical in-office consultations and laboratory testing decreased and as a consequence newly implemented remote consultations increased greatly with an increase of up to 80%. Conclusion: The COVID-19 pandemic influenced the management of imRMDs, especially at the beginning. Influences were wide-ranging, affecting availability of pharmacies, adherence to medication or medication changes, doctor visits and laboratory testing. New systems of care were set up, including virtual clinics and video consultations. These new forms of health care delivery should be spread and implemented worldwide to routine clinical practice to be ready for future pandemics.

The literature is scarce in the evaluation of Behçet’s disease (BD) among individuals during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Then, an epidemiological study was conducted using the data from 46 hospitalized patients with BD and coronavirus disease (COVID)-19 representing a prevalence of 2,11 patients per 100,000 inhabitants. From the study sample, 58.7% (27 patients) were female, and 67.4% (31 patients) were White. The main symptoms were fever (40; 87.0%), cough (38; 82.6%), dyspnea (35; 76.1%), and peripheral saturation below 95% (35%, 76.1%). The need for intensive care unit support occurred for 39.1% (18) patients. Also, 21.7% (10) patients needed invasive ventilatory support and 47.8% (22) needed non-invasive ventilatory support. A total of 73.9% (34) of patients lived, and 26.1% (12) of patients died. Only the presence of respiratory discomfort [37.9% vs. 5.9%] was more common among those who died. Patients with BD were not at an increased risk of worse COVID-19 outcomes in Brazil.

In the year in which the world "stopped" due to the pandemic, many people didn't have that option and had to keep moving as the only alternative to survive. One of the main destinations in South America, during the quarantine measures established around the world, was Brazil, especially because of the crisis Venezuela went through in the second half of the 2010s. Throughout the research, we observed measures that were applied by the Brazilian government on the grounds of public health issues or cases of health risks related to COVID-19. An analysis of the first measures published by the Brazilian government reveals an effort to securitize borders, which at the same time restricted the government's responsibility to fulfil its role of protecting migrants in need.

The COVID-19 pandemic and tuberculosis have epidemiological similarities, being transmitted airborne, favored by direct contact, crowded environments and vulnerable biological status. We performed a retrospective study of 45 cases of pulmonary tuberculosis associated with COVID-19 (TB+COV+) compared to 45 cases with tuberculous monoinfection (TB+COV-), hospitalized during 2021-2022. The demographic characteristics were similar in the two groups, predominating men, a median age of 51 years, living in rural areas, medium level of education and smoking. Common symptoms of the two groups were cough, weight loss, profuse sweating, loss of appetite and hemoptysis, while fever, headache, myo-arthralgias and digestive symptoms characterized the TB+COV+ forms. The scores of radiological lesions in the TB+COV+ compared to TB+COV- group were significantly higher and persistent, revealing more frequent bilateral extensive lung lesions. There were no significant differences in the biological parameters between the two groups. Mortality was 2.2%, regardless of the association of COVID-19. The frequency of infections with Clostridioides difficile was higher in TB+COV+ cases. In conclusion, the co-infection of COVID-19 had an impact on the clinical and biological expression of tuberculosis diagnosed in a pandemic context.

The impact of COVID-19 pandemic on the cardiovascular healthcare services in Croatia has not been systematically examined. In this study, we compared utilization and provision of cardiovascular services in Croatia during the pre-pandemic period (2017 to end of 2019) and pandemic period (2020 to end of 2021) by using large nationwide data from the Croatian Health Insurance Fund, an institution covering 95% of all insurance claims in Croatia. We report that the use of advanced heart failure treatment modalities increased while the number of coronary angiographies decreased while the number of performed percutaneous coronary interventions remained similar, even increasing in the setting of acute myocardial infarction, comparing pandemic to pre-pandemic period. Similarly, the number of transcatheter aortic valve implantations increased significantly during the pandemic era. There was a significant increase in laboratory diagnostic testing with troponin and natriuretic peptide assays during the pandemic period while the use of most cardiovascular services remained stable or only slightly decreased, compared to pre-pandemic period. These data suggest that Croatian cardiovascular healthcare services during COVID-19 pandemic showed resilience and managed to maintain or even increase the number of various diagnostic and interventional procedures despite the widespread societal and logistical challenges encountered during pandemic.

Abstract: (1) Background: Post-COVID syndrome is defined as symptoms that occur simultane-ously with or after COVID-19 infection, last for 12 weeks, and are not due to another diagnosis. Limited data are available on people’s long-term quality of life (QoL) following COVID-19 infection. The aim of this cross-sectional study was to investigate long-term QoL after COVID-19 among employees of the St. Josef Hospital in Paderborn, Germany, and to identify risk factors. (2) Methods: A monocentric, cross-sectional study was conducted using the validated and digitized WHOQOL-BREF questionnaire via Netigate® between 10/2022 and 02/2023. Data on QoL and global health status were collected in the following four domains: physical health, mental health, social relationships, and environment. (3) Results: The response rate was 73.84% (923/1250). Furthermore, 63.45% of hospital staff respondents reported at least one persistent symptom after COVID-19 infection, leading to significant differences in QoL. Pre-existing conditions, persistent symptoms, and disability after COVID-19 infection, as well as high BMI, no partnership, and low educational level were found to significantly contribute to long-term low QoL. (4) Conclusions: Obesity, lack of partnership, and a low level of education were independent risk factors for lower QoL post-COVID-19 infection in this cohort of hospital staff. Further multicenter studies are re-quired to validate the incidence and their suitability as independent risk factors for post-COVID syndrome.

In 2020, following the World Health Organization's declaration of COVID-19 as a pandemic, dental practices faced unprecedented disruptions globally. This retrospective cross-sectional study, conducted at a leading university dental hospital in the Lisbon Metropolitan Area, investigated the impact of these disruptions on dental caries. The study, spanning June 2019 to June 2021, included a full-mouth X-ray examination, along with sociodemographic, behavioral, and medical data. Our sample comprised 3,380 participants (2,007 females and 1,373 males), aged 18 to 99 years, divided into pre-lockdown and post-lockdown groups. We employed the Decayed, Missing, and Filled Teeth (DMFT) index to measure dental caries. Our findings revealed that nearly 90% of participants in both groups experienced dental caries, indicating a statistically significant difference between the pre-lockdown and post-lockdown periods. However, the impact of COVID-19 confinement varied among different demographic sectors, with age, educational background, and professional status emerging as the key determinants. This study highlights the need for a more nuanced understanding of the impact of the pandemic on oral health, emphasizing the role of sociodemographic factors in shaping dental health outcomes during such global health crises.

The study delves into the critical examination of the Size of Loss distribution patterns in the context of auto insurance during pre- and post-pandemics, emphasizing their profound influence on insurance pricing and regulatory frameworks. Through a comprehensive analysis of the historical Size of Loss data, insurers and regulators gain essential insights into the probabilities and magnitudes of insurance claims, informing the determination of precise insurance premiums and the management of case reserving. This approach aids in fostering fair competition, ensuring equitable premium rates, and preventing discriminatory pricing practices, thereby promoting a balanced insurance landscape. The research further investigates the transformative impact of the COVID-19 pandemic on these Size of Loss patterns, given the substantial shifts in driving behaviors and risk landscapes. Also, the research contributes to the literature by addressing the need for more studies focusing on the implications of the COVID-19 pandemic on pre- and post-pandemic auto insurance loss patterns, thus offering a holistic perspective encompassing both insurance pricing and regulatory dimensions.

The eating behaviors of young people underwent substantial changes due to the COVID-9 19 pandemic. This study addresses the understanding of pandemic impacts on perceived psycho-10 logical and physical well-being exploring the connection between self-perceived eating behavior 11 quality and chronic stress. A sample of Portuguese young people aged 15-26 years (N=951), com-12 pleted a self-report questionnaire assessing socio-demographic data, perception of eating quality 13 behavior, appetite, stress, well-being and optimism. The results reveal gender differences, with 14 males scoring higher in well-being and optimism, while females exhibit elevated appetite and 15 chronic stress scores, and also reveals negative links between age group and eating quality and 16 chronic stress, and positive links between eating quality and well-being. Well-being emerges as a 17 significant predictor of stress in middle and oldest young adults that maintain or increase quality of 18 eating behaviors, while optimism plays a paradoxical role in predicting higher stress in younger 19 adults with reduced eating quality. These results emphasize the need to consider eating behaviors 20 and stress among young adults as an investment in global public health, given the significant rep-21 resentation of young adults in the population, to mitigate long-term health risks. Effectively reduc-22 ing detrimental eating behaviors and stress in these demographic groups can enhance overall well-23 being and longevity.

On February 24, 2022 Russia started the full-scale invasion of Ukraine, which created an unprecedented number of refugees. To estimate the influence of this humanitarian disaster on the COVID-19 pandemic dynamics, the averaged daily numbers of cases and reproduction numbers in Ukraine, the UK, Poland, Germany, the Republic of Moldova, and in the whole world were calculated for the period February-April 2022. The registered numbers of cases were compared with ones calculated with the use of the generalized SIR-model and corresponding parameter identification procedure for the previous epidemic waves in Ukraine, Poland, Germany, and the world. Since before February 24, 2022 the estimation of the number of infectious persons per capita in Ukraine 3.6 times exceeded the global figure, the increase of the number the new cases and the pandemic duration was expected. In March 2022 the increase of the averaged number of new cases in the UK, Germany, and worldwide was visible. A simple formula to estimate the effective reproduction number based on the smoothed accumulated numbers of cases is proposed. The results of calculations agree with the figures presented by John Hopkins University and demonstrate a short-term growth of the reproduction number in the UK, Poland, Germany, Moldova, and worldwide in March 2022.

The SARS-CoV2 Pandemic affected the global epidemiology of respiratory infections, including Respiratory Syncytial Virus (RSV), thanks to state governments’ implementation of mitigation strategies, like the promotion of face masks and lockdowns. However, after the Pandemic, the dramatic resurge of these diseases was reported worldwide. Our retrospective study, involving three Spoke Pediatric Departments, includes all the infants under one year of age hospitalized for RSV bronchiolitis in a period before the Pandemic period (2017-2020), during the SARS-CoV2 Pandemic (2020-2021) and after the Pandemic (2021-2023). The primary aim was to analyse the temporal trend of RSV in the three periods. Then, clinical and epidemiological characteristics were analysed to highlight clinical differences in the patients affected, in the severity of the in-fections and in the short-term outcomes. Ultimately, we analysed the RSV prevalence in the global bronchiolitis hospitalization in the same over reported periods. Overall, we included 237 patients. Before the Pandemic, the peak was recorded in January and February while after the Pandemic, the peak was in November and December. A higher prevalence of RSV was demon-strated after the Pandemic compared to the period before the Pandemic; no difference in severity was reported overall. In conclusion, an increase in RSV cases after the Pandemic has been demonstrated with an anticipated peak, while no differences were recorded in severity.

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.

PURPOSE: Our research interrogates Professor Peter Doherty’s warning to Australians in April 2020 that ‘COVID-19 is just as lethal as the Spanish flu’. METHODS: We identified the epicentres of both pandemics, namely metropolitan Sydney in 1919 and metropolitan Melbourne in 2020. Using original sources, we compared the lethality of COVID-19 in these two cities. Lethality was measured by the number and rate of hospitalisations and deaths per 100,000 of population. Using these two measures, we diagnosed the waves of infection, their severity at various points in time and the cumulative impact of the viruses by the end of our in-depth study period, i.e. 30 September in 1919 and 2020. RESULTS: Spanish Flu in 1919 was more than 30 times more lethal than COVID-19 in 2020. The hospital admission and death rates of COVID-19 in Melbourne in 2020 constituted a small fraction of the devastation wrought by the Spanish Flu in Sydney in 1919. The patterns and lethality of the pandemic waves were also strikingly different. DISCUSSION AND CONCLUSION: Both pandemics broke out with the arrival of unknown pathogens against which vaccines and antivirals did not exist. Professor Doherty’s warning was perhaps taken seriously and that partly explains the findings of this study. Containing infection in 1919 and 2020 threw the burden on nonpharmaceutical interventions (NPIs) such as ‘protective sequestration’ (quarantine), contact tracing, lockdowns and masks. We discuss the effectiveness of these. Despite the failures of genomic analysis and the weaknesses of the contact tracing system due to mismanagement, it was persistent and detailed contact tracing that provided the best explanation for why NPIs in 2020 were more effective than in 1919 and therefore contributed to the lower lethality of the COVID-19 pandemic in its first year.

The COVID-19 pandemic necessitated a profound shift to online education, impacting students across various educational levels. This research, drawing from a comprehensive survey of 1,000,000 students, delves into the surge in demand for online education during the pandemic and its potential enduring implications. The study scrutinizes factors steering this transition, the perceived effectiveness of online education, challenges encountered by students, and their anticipated preferences for the future. Results unveil nuanced perspectives among K-12, undergraduate, and postgraduate students, with safety, flexibility, and accessibility emerging as pivotal influencers. The findings offer valuable insights into challenges faced and future preferences, enlightening educational stakeholders about the dynamic needs of students and contributing to the ongoing evolution of the post-pandemic educational landscape.

Because the including of human anatomy forms the foundation for clinical medicine, it has contributed a pivotal role in medical education for many centuries. Thus with advancements in the science of modern, current day medicine, its continued place in the medical school curriculum deserves careful attention. In an attempt to provide guidance to decision-makers involved in clinical anatomy curriculum development at the medical school level, the Educational Affairs Committee of the American Association of Clinical Anatomists (AACA) developed this document, which defines the contours of a gross anatomy curriculum leading to the M.D. or D.O. degree. The main body of the document sets forth the anatomical concepts as well as the subject matter a student should master prior to graduation from medical school. Gross anatomy dissection is still a crucial topic in graduate and medical school. The nature and content of gross anatomy, which was historically regarded as a core course in the first year of medical education in MBBS, MD, DO, and some PhD and Graduate curricula as well as in other disciplines of selective graduate education and non-allopathic medical programs, have been significantly impacted by emerging challenges in the pedagogy of delivering medical education in the past ten years. A seemingly ever-increasing emphasis on additional modules in molecular biology, emerging pharmacotherapeutics and pathophysiology content have resulted in a condensation and apparent erosion of previously allotted classroom and laboratory hours in the gross anatomy curriculum. In addition, an imposition of financial constraints and a decreasing availability of sufficient cadaver donations to support gross anatomy dissection labs has also occurred in some locations. An innovative clinically focused cadaveric anatomy program is described which has improved the delivery and content retention of medical and graduate students and has become one of the most sought-after modules in the revised clinically oriented curriculum and has been deemed highly relevant to current medical education and graduate studies.

This article examines air sampling as an environmental surveillance strategy for early pathogen detection and offers a preliminary comparison of air and wastewater surveillance. Air sampling involves collecting bioaerosols to analyze the microbial composition of the air, utilizing techniques like PCR and metagenomic sequencing. Air sampling appears especially promising for detecting respiratory pathogens and highly transmissible pandemic agents, as these spread primarily via aerosols and droplets. The article details various air sampling techniques, their efficiency, and practical considerations, categorizing them into filtration, impaction, impingement, electrostatic precipitation, and condensation methods. It also explores the composition of airborne microbes, emphasizing the low concentration of viral nucleic acids and the challenges this poses for metagenomic sequencing. The selection of sampling locations, including indoor environments and airplanes, is discussed as critical for effective pathogen detection. Finally, the article contrasts air and wastewater sampling, concluding that while both methods should ideally be explored as layered defenses, air sampling does not collectively appear more promising than wastewater sampling.

In the context of the H1N1 pandemic and the Pandemrix vaccination campaign, an increased number of narcolepsy cases were noted in several countries. In Sweden, this phenomenon was attributed to the effect of the Pandemrix vaccination in the first place. Interestingly, Denmark, a neighboring country, also had an increased incidence during this period, despite a low vaccination rate. Additionally, studies from China indicated that narcolepsy could occur as a consequence of the H1N1 infection itself. Against these background factors, and due to the clinical impression that narcolepsy patients who were vaccinated tend to dominate in the Swedish narcolepsy polyclinic, we performed an analysis of the increase with a specific interest in age and sex distribution. We also aimed to validate the origin of the excess cases, post hoc. Materials & Methods: The data for narcolepsy patients (ICD code G 47.4) distributed by sex and age at 5-year intervals, annually between 2005 and 2017, was retrieved from the National Patient Register. Information on the total population was collected from the Swedish Population Register and was used for calculations of the narcolepsy prevalence. Results: The number of narcolepsy cases increased markedly from 2009 to 2014 compared to the period before 2009. A particular increase in 2011 among children and teenagers was observed, which resulted in increased cases among the age group 20-39 years in the following years. The sex ratio did not change significantly during the study period. The excess cases found in our study exceeded the number of patients who so far (December 2023) received economic compensation for vaccine side effects (n=450). Conclusions: Our results confirm an association between the increased prevalence of narcolepsy cases and the Pandemrix vaccination. Consequently, the effect of the virus itself cannot be ruled out as a contributing factor. The delayed timing in diagnostics is crucial when determining the number of cases with onset during the pandemic.

The pandemic was an enormous experience all over the world. The type of living, working and study were changed irreversibly. Facing the opportunity to establish old frames of education in universities is impossible. The adoption of new ways of teaching and assessments reveal their convenience and in the same way their weak points. In response to that stage, on 14 December 2022, the EU parliament accepted the "Digital Decade Policy Programme 2030", for the establishment of a digital transformation community (EU 2022). Trakia University had an online assessment system, quizzes for self-training, and final exams, developed in 2008 on Moodle virtual learning environment. During the pandemic, online exams and lectures were conducted using platforms like BigBlueButton in Moodle or Google Meets. The article gives the results of online exams before, during, and after the pandemic. The outcome, without doubt, displays the lowering knowledge level or performance during the social isolation due to COVID-19, and after, and the reasons are discussed. During the second year of the pandemic was mentioned also a high dropout of students. Now the situation is returning to the previous levels, before the pandemic, but the quality of education is not yet reached. The article values the grades results of session exams and has the intention to clarify the influence of the pandemic period on the excellence of high institution education.

Violence against women or gender-based violence (GBV) is a major public health issue facing women and girls in different settings and is reported to have worsened globally during the COVID-19 pandemic. Despite the impact of the COVID-19 pandemic on increased violence against women in general, which has been reported in many settings globally, there is a paucity of evidence of its impact on violence against highly vulnerable women living with HIV or tuberculosis (TB). Using a qualitative design, this study aimed to explore the views and experiences of women living with HIV (n=19) or TB (n=23) in Timor Leste regarding the GBV they faced during the COVID-19 pandemic. They were recruited using the snowballing sampling technique. Data were collected using one-on-one in-depth interviews and focus group discussions. The five steps of qualitative data analysis suggested in Ritchie and Spencer’s analysis framework were employed to guide the analysis of the findings. Findings indicated that women in this study experienced intensified physical, verbal, sexual and psychological violence by their partners, spouses, in-laws, and parents or other family members during the COVID-19 pandemic. Several prominent risk factors that worsened violence against women during the pandemic were (i) HIV or TB-positive status, (ii) traditional gender roles or responsibilities and expectations, (iii) economic and financial difficulties reflected in the loss of jobs and incomes due to the pandemic, and (iv) individual factors such as jealousy and increased alcohol drinking developed during the lockdowns. The findings underscore the urgent need for multifaceted interventions to address GBV, which should encompass challenging traditional gender norms, addressing economic inequalities, and targeting individual-level risk factors. The findings also indicate the need for the development of robust monitoring and evaluation systems to assess the effectiveness of policies and interventions addressing GBV where the results can inform future improvement. The findings also indicate the need to include GBV in the protocol or guidelines for HIV and TB management. Future large-scale quantitative studies to capture the magnitude and specific drivers of GBV against women living with HIV and TB during the pandemic are recommended.

While most published research on COVID-19 focused in a few countries and especially during the second wave of the pandemic and the vaccination period, we turn to the first wave (march-May 2020) to examine sentiment and emotions expressed by Twitter users in Greece. We use computational methods combining opinion mining and the application of a modified emotion lexicon with Social Network Analysis to explore the subtleties behind an overarching negative sentiment. Our analysis has shown that popular sentiment isn’t stable nor monolithic, since underlying emotions may be a better predictor of attitudes during a crisis.

Influenza is well-known to have a considerable influence on healthcare system, therefore, vaccination plays a significant role in dealing with severe consequences. Close attention is paid to the development of tetravalent adjuvanted vaccines, containing antigens of two influenza A subtypes (H1N1, H3N2) and two influenza B subtypes (Victoria, Yamagata) to increase the effectiveness of influenza prevention. In this work we present the results of pre-clinical study of innovative subunit tetravalent candidate influenza vaccine, with addition of betulin as adjuvant, TetraFluBet. The study was conducted using female BALB/c mice, male and female mongrel rats and guinea pigs. TetraFluBet and commercially available vaccines were injected intraperitoneally twice in a 14-day interval after intranasal infection with 5LD50 and 10LD50. Chronic toxicity was assessed by immunohistochemistry of extracted organs and by hematological and biochemical blood parameters. Protectivity and immunogenicity were evaluated using hemagglutination inhibition and microneutralization with MDCK assays. Chronic toxicity study did not reveal any side effects of candidate TetraFluBet vaccine on both rats and guinea pigs. One vaccination dose of TetraFluBet provided 100% protectivity against all 4 influenza subtypes and significantly increased neutralizing antibody activity in response to immunization of influenza subtypes. Pre-clinical candidate vaccine TetraFluBet confirmed its safety along with specific activity, showed high immunogenicity and can be recommended for further clinical studies.

The COVID-19 pandemic has disrupted healthcare worldwide, potentially impacting disease management. This cross-sectional study assessed the influence of COVID-19 on diabetes self-management in 341 Saudis with type 2 diabetes using the Diabetes Self-Management Questionnaire (DSMQ). The DSMQ contains 16 items across 4 domains assessing glucose management, dietary control, physical activity, and healthcare use. Three additional items measured the perceived overall impact of COVID-19. Total DSMQ scores were significantly higher in patients aged &gt;60 years versus younger groups. Scores were significantly lower in patients diagnosed for 1-5 years versus longer durations. Patients on insulin had higher glucose management subscores than oral medication users. Overall, DSMQ scores were higher than the pre-pandemic Saudi population and Turkish post-pandemic findings. DSMQ results suggest that while COVID-19 negatively impacted some self-management domains, Saudi patients upheld relatively good diabetes control during the pandemic. Further research is warranted on specific barriers to optimize diabetes care during public health crises.

Historically, macrophages have been long implicated in the control of the severity of infectious diseases. This has been based on the observations of a higher risk of severe disease and death upon rechallenge with viral variants due to antibody dependent enhance-ment (ADE) of infection into macrophages. The question remains as to what can account for this potent heterologous protection in macrophages? Here it is argued that the elusive defense mechanism of M1-like pro-inflammatory macrophages may pertain to a novel virus anti-virus response. This system initiates with high replication of human endogenous retrovirus K102 (HERV-K102), a non-pathogenic, protector foamy retrovirus of humans which generates M1-like pro-inflammatory foamy macrophages, glycolysis, and epigenetic changes, all characteristic of trained immunity. This virus-anti-virus system kills virally infected cells by several mechanisms, amplifies the innate interferon response via ‘viral mimicry’, has many unique components that interfere with exoge-nous virus replication, and may be especially adept at neutralizing enveloped exogenous pandemic viruses, such as SARS-CoV-2 and HIV-1. The goal of this treatise is to introduce the multifaceted HERV-K102 protector system, to illustrate how SARS-CoV-2 may target the HERV-K102 protector system by ADE, and to explore how this innate defense system may be exploited for pandemic preparedness.

In this inclusive review article, the focus is on navigating the dynamic landscape of literature education, particularly the profound pedagogical shifts observed in the aftermath of the pandemic. The article synthesizes global insights, delving into how educators have adapted to hybrid models and embraced digital tools, fundamentally transforming the reading, analysis, and engagement with literary works. Exploring the integration of digital tools in literature education, the review uncovers the transformative impact of technology on traditional pedagogies. It analyzes the challenges and opportunities inherent in adapting literature education to the digital era, emphasizing the need for inclusive practices and adaptability. The article concludes by suggesting future research directions, encompassing AI integration, inclusive practices, cultural variations, long-term effects of hybrid models, and effective pedagogical strategies for technology integration. With a comprehensive approach, this review not only summarizes the current state of literature education but also discusses its implications, offering a holistic understanding of the contemporary educational landscape and setting the stage for future research endeavors.

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.

Background. The SARS-CoV-2pandemic has become the greatest public health challenge worldwide. Intensive research started to develop vaccines and by the late 2020 vaccination campaign started. Objective. Collecting information from European countries, how and in what extent were family physicians/general practitioners/FPs/GPs involved in the vaccinations-campaign in 2021 and how was it organized at national level. Method. A short questionnaire was distributed through the secretariats of WONCA-Europe and the European Forum for Primary Care. Results. In most of the countries participation of FPs/GPs was compulsory. The vaccination was usually centrally organized by governmental authorities. At the beginning (web-based) registration of patients was required, mainly at national level. By the mid of 2021, vaccination on walk in basis became available in almost every country for the first and for the booster injections. The remunerations of GPs/FPs were differed, in some countries without extra payment. The Pfizer’s vaccine was used in all countries; while in 9 countries not EMA approved vaccines were also used in primary care settings and at vaccination centres. In some countries, professional homepages helped the GPs. The involvement of PHC providers did not correlate to the vaccination coverage of the entire population of the respective countries. It was the highest in the more developed countries with higher living standard, where participation of GPs was voluntary and appropriate financial incentives were offered for them. Conclusion. The vaccination campaign was a professional and logistic challenge and an excellent performance of PC providers. Experiences gained could be used in the future to manage similar pandemic challenges.

Background: Coronavirus disease (COVID-19) has caused one of the worst global pandemics in recent decades. It has disrupted education systems worldwide, leading to a forced shift from traditional face-to-face to blended or fully distanced learning, requiring a higher level of student readiness for self-directed learning (SDL) and a more internal locus of control (LOC). Objective: This study explored the relationship between locus of control and level of readiness for SDL among Saudi nursing students and whether the COVID-19 pandemic has impacted this relation-ship. Methods: a cross-sectional correlational descriptive study was conducted to survey 277 Saudi nursing students enrolled in the bachelor program at one of the reputable universities in Saudi Arabia. An E-questionnaire containing two scales, the Self-Directed Learning Readiness Scale for Nursing Education, and the Locus of Control Scale, was used to collect data in addition to the selected participants’ characteristics. Results: Nursing students had a moderate-to-low level of readiness for SDL (mean = 144.0), and the majority had an external LOC. There was a significant association between the locus of control and level of readiness for self-directed learning (r = 0.19*, p = 0.001), and the internal locus of control was more significantly associated with self-directed learning (r = 0.22*, p = 0.0001) than with external locus of control. Conclusion: The study findings indicate a propensity of respondents towards an external locus of control, whereas most of the respondents’ reported levels of readiness ranged between low and moderate across all dimensions of self-directed learning. This study was not registered.

Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory infections in young children worldwide. RSV-associated deaths in children are underreported in Bangladesh. We analyzed hospital-based surveillance data on severe acute respiratory infections (SARI) in under-five children before (August 2009–February 2020) and during the COVID-19 pandemic (March 2020–March 2022). Using the World Health Organization definition, we identified SARI cases in 14 tertiary-level hospitals. Nasopharyngeal and oropharyngeal swabs were collected for real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) testing of six respiratory viruses, including RSV. SARI deaths during the pandemic (2.6%, 66) were higher than pre-pandemic (1.8%, 159; p<0.001). Nearly half of pandemic deaths (47%) had underlying respiratory viruses, similar to the pre-pandemic rate (45%). RSV detection in deaths was consistent pre-pandemic (13%, 20/159) and during the pandemic (12%, 8/66). Children aged <6 months constituted 57% (16) of RSV-related deaths. Evaluating interventions like maternal vaccination and infant monoclonal antibody prophylaxis is crucial to address RSV, a major contributor to under-five SARI deaths.

This paper delves into the essential role of local communities in mitigating climate change in the post-pandemic landscape, with a specific focus on Barangay Acmac, Iligan City, Philippines. Employing a qualitative research approach, the study integrates in-depth literature reviews, informal interviews with participants (B-Part 1 to B-Part 20), meticulous observations, and thematic analysis. The research has uncovered crucial insights, including variations in community climate change awareness that emphasize the necessity of comprehensive education and awareness campaigns. It highlights the significance of community-driven initiatives, adaptation, and resilience as key elements in addressing climate change. Collaborative efforts between local government officials and the community are showcased as effective instruments of climate change mitigation, yet challenges persist, including addressing the perceived powerlessness of some community members. The methodology, participants, and theoretical framework offer a robust foundation for exploring community responses to climate change. Drawing from a diverse theoretical framework, this study presents a comprehensive understanding of the climate change and pandemic intersection. The findings firmly establish that local communities are pivotal players in the global endeavor to mitigate climate change, underscoring the need for collective action, extensive education, and shared responsibility. The post-pandemic era presents a unique opportunity for local communities, policymakers, barangay officials, and residents to champion climate education, foster community-driven initiatives, and empower individuals to enact change at the grassroots level. The collaborative spirit observed in Barangay Acmac in 2022 serves as a model for communities worldwide, offering a blueprint for addressing similar challenges. Overall, this paper concludes with a resounding call to action, advocating for the recognition of local communities as the driving force in climate change mitigation, stressing that the power to combat climate change resides within these communities. The time for action is now, and local communities are the catalysts of this essential mission.

Abstract: The COVID-19 pandemic significantly disrupted global healthcare systems. The impacts of SARS-CoV-2 infection on urticaria and its management are unknown. To collect information about patients with urticaria infected with SARS-CoV-2 and to investigate the impact of SARS-CoV-2 infection on urticaria severity, course, and treatment to better support recovery. This was a questionnaire-based study of patients with urticaria infected with SARS-CoV-2. Changes in urticaria severity (measured with the urticaria activity score (UAS)), course, and treatment were assessed before, during, and after SARS-CoV-2 infection. Mean (± SD) UAS scores were 5.17 ± 1.67, 4.23 ± 1.98, and 4.37 ± 1.93 before, during, and after SARS-CoV-2 infection, respectively (F = 8.839, p < 0.01). The median (IQR) wheal score was 0.464 (0.464, 0.763), 0.464 (0.138, 0.763), and 0.464 (0.138, 0.763) before, during, and after infection, respectively (Kruskal-Wallis H-test, H=12.230, p = 0.02). The median (IQR) pruritus score was 0.695 (0.395, 0.695), 0.394 (0.123, 0.695), and 0.394 (0.123, 0.695) before, during, and after infection, respectively (Kruskal-Wallis H-test, H = 21.001, p < 0.01). Within the limitations of a questionnaire study, urticaria appears to improve during SARS-CoV-2 infection, worsens slightly after recovery, and the frequency of Western medicine use increases.

This paper presents a study of human blood sera samples, collected in various regions of the Russian Federation, with regard to both vaccine and pandemic avian influenza viral strains. Just before the 2022-2023 epidemic season, herd immunity to seasonal influenza A viruses was reportedly lower than before the COVID-19 pandemic. Since no stable circulation of A/H5Nx and A/H9N2 influenza in the human population was observed during this period, we believe 100% vaccination against seasonal influenza is necessary for employees of poultry farms and other organizations, closely connected to the breeding and processing of poultry. In addition to protection against seasonal influenza, vaccination can hamper the emergence of new viral variants, driven by genome reassortment, during simultaneous infection of humans with seasonal human and animal influenza viruses.

Air pollution is one of the biggest problems of this age, not only it contributes to climate change but also it has a negative effect on public and individual health due to rising morbidity and mortality. There are various contaminants that play a significant role in human disease. Numerous toxins are released into the environment as a result of anthropogenic activities including burning fossil fuels for transportation and electricity generation. In order to assist decision-makers in finding a long-term solution for improving environmental quality and population health status, NO2 pollution monitoring and regulation is an essential task. Based on data acquired from Sentinel-5P, the study presented a comparison of NO2 measurements in Sentinel-5P and ground-based stations over the urban area of Fujairah during 2021 and comparison analysis of the tropospheric NO2 column spatial configuration over urban area of Fujairah during comparable periods of pre, mid and post Covid-19 pandemic era as 2019, 2020 and 2021, respectively. These findings demonstrate remarkable tropospheric NO2 column number density decreases even of 85% in the busier areas of emirate of Fujairah during the pandemic era. Sentinel-5P measurements draw attention to the significant reduction in NO2 pollution over Fujairah during the COVID-19 lockdown where we had less traffic, which is supported by ground stations-based calculations.

The Single Site Order – a policy restricting staff from working at multiple long-term care homes – was mandated by the Public Health Agency of Canada to control the spread of COVID-19 in long-term care homes, where nearly 70% of COVID-19-related deaths in Canada occurred. This mixed methods study assesses the impact of Single Site Order on long-term care residents in British Columbia. Interviews were conducted (residents (n=6), family members (n=9), staff (n=18), and leadership (n=10) from long-term care homes (n=4)) and analyzed using thematic analysis. Administrative data was collected between April 2019 – March 2020 and April 2020 – March 2021 and analyzed using descriptive statistics and data visualization. Qualitative and quantitative data were triangulated and demonstrate staffing challenges became worse during implementation of the SSO resulting in the mental and physical health deterioration of LTC residents. Qualitative data demonstrated decreased time for personalized and proactive care, increased communication challenges, and increased loneliness and isolation. Quantitative data showed a decline in activities of daily living, increased antipsychotic medication use, pressure ulcers, behavioural symptoms, and an increase in falls. Addressing staff workload and staffing shortages during SSO-related policy implementation is essential to avoid resident health deterioration.

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.

The COVID-19 pandemic has unveiled the critical role that supercomputers play in addressing global health crises. This perspective article explores the transformative impact of supercomputing in pandemic response, highlighting how these powerful machines have transitioned from crisis management tools to essential components of preparedness strategies. In this article, we examine the key contributions of supercomputers in combating the pandemic, including their ability to accelerate scientific research, facilitate data analysis, model complex scenarios, and optimize resource allocation. Furthermore, we delve into the role of supercomputing in strengthening public health infrastructure and preparedness. We analyze the lessons learned from the pandemic and emphasize the need for proactive investment in supercomputing capabilities, data infrastructure, and computational expertise as a crucial element of pandemic preparedness efforts. By harnessing the potential of supercomputers, countries can establish robust computational frameworks that enable real-time monitoring, early detection, and effective response to future outbreaks. Moreover, we address the challenges faced by supercomputing initiatives, including the need for enhanced international collaboration, equitable access to computing resources, and the ethical considerations associated with data privacy and security. We discuss potential strategies to overcome these challenges and foster a global network of interconnected supercomputing centers dedicated to pandemic preparedness and response. Finally, we highlight ongoing research and development efforts aimed at advancing supercomputing technologies, such as exascale computing and quantum computing, and their potential to revolutionize pandemic response. We emphasize the importance of sustained investment in research and development to ensure that supercomputing remains at the forefront of future pandemic preparedness strategies.

The impact of the COVID-19 pandemic and the quarantine measures on children and adolescents’ hospitalization psychiatric has been poorly studied, especially in Italy, the first European country to adopt social restrictions. To fill this gap, this retrospective study examined changes in admissions to our child and adolescent psychiatry ward from the emergency department during the two COVID-19 quarantine periods in Italy (March to June 2020; October 2020 to January 2021) compared with two reference periods (defined as 12 months prior to the respective quarantine periods). Specifically, we examined data on the number of inpatients and the distribution of psychopathological disorders (i.e., psychosis, mood disorder) and self-injurious behaviors. The results revealed significantly fewer admissions during the first quarantine period relative to the first reference period and, conversely, significantly more admissions during the second quarantine period relative to the second reference period. Of note, the results showed an increased frequency of mood disorders, non-suicidal self-injurious behaviors and suicidal ideation during the quarantine periods, compared to the reference periods. The findings underline the need to focus on the psychopathological profile of children and adolescents with patient-tailored therapeutic interventions and suggest the importance of developing psychological healthcare services for future emergency periods..

The COVID-19 pandemic, has underscored the critical importance of sustainability across various sectors, particularly within the global economy and corporate responses to pandemic-induced challenges. Companies worldwide have grappled with unprecedented financial and operational hardships, pushing some to the brink of closure. A crucial dimension of sustainability in this context pertains to corporate financing policies. Analyzing how the pandemic has impacted these policies reveals significant insights. Government support has been instrumental in mitigating pandemic-induced disruptions, but often proved insufficient for severely affected companies. Companies, seeking financial resilience, turned to state-guaranteed lines of credit as a lifeline. Additionally, moratoriums on existing credits provided temporary relief, but long-term consequences, particularly regarding corporate indebtedness. As companies adapted financing strategies, corporate indebtedness increased. Coupled with rising interest rates in late 2022, corporate financing costs surged, emphasizing the need for sustainable financial approaches addressing both short-term crises and long-term stability. In conclusion, corporate sustainability during the ongoing COVID-19 pandemic necessitates a comprehensive approach. Governments must provide adequate support, companies should pursue sustainable financing solutions, and a careful consideration of the long-term consequences of financial policy changes is essential. Prioritizing sustainability in the corporate sector prepares businesses for future crises while safeguarding global economic stability.

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.

COVID-19 pandemic outbreak challenged the global public health in last couple of years. Throughout the pandemic period, numbers of mutant strains of SARS- CoV-2 created challenges for the infected patients with diverse pathophysiology and immune response. Variant of Concern (VOC) alpha (B.1.1.7), delta (B.1.617.2) and omicron (B.1.1.529) grew most notable for causing the epidemiological manifestations, which eventually caused elevated infectivity resulting in significant mortality. This review indicates the comparative analysis of the immune-pathophysiological mechanisms in respect to the aforementioned strains of SARS-CoV-2.

(1) Background: The COVID-19 pandemic significantly affected worldwide, with varying responses implemented to control its spread. This study aimed to compare the epidemic data compiled by the World Health (2) Methods: Organization to understand the impact of the measures adopted by each country on the mortality rate. The increase or decrease in the number of confirmed cases was understood in logarithmic terms, for which logarithmic growth rates “K” were used. The mortality rate was calculated as the percentage of deaths from the confirmed cases, which was also used for logarithmic comparison. (3) Results: Countries that effectively detected and isolated patients had a mortality rate 10 times lower than those that did not. Although strict lockdowns were once effective, they could not be implemented on an ongoing basis. In fact, after their cancelation, large outbreaks occurred because of medical breakdowns. The virus variants mutated with increased infectivity, which impeded the measures that were once effective, including vaccinations. Although the designs of mRNA vaccines were renewed, they could not keep up with the virus mutation rate. The only effective defence was steadily identifying and isolating patients. (4) Conclusions: These findings have crucial implications for the complete containment of the pandemic and future pandemic preparedness.

This study intricately explores the evolving tapestry of Christmas celebrations in a post-pandemic era, where tradition delicately intertwines with technology. The literature review presents a global panorama of Christmas observances, delving into varied religious perspectives. Within this exploration, a Southeast Asian country discreetly initiates its festivities as early as September—a nuanced response to the profound significance of Christmas. Navigating the digital age, the paper dissects the impact of virtual gatherings, the surge in e-commerce, and digital church services on festive traditions. Employing diverse research methods, including thematic analysis, nuanced insights are synthesized from extensive literature reviews, interviews, and observations. Scrutinizing challenges posed by the digital divide, the erosion of personal connections in virtual gatherings, and sustainability concerns in online celebrations, the qualitative research methodology reveals the interplay between tradition and technology. The paper contemplates the future of Christmas in this transformative era, offering implications for future celebrations, technology developers, policymakers, and beyond. This endeavor invites contemplation on the dynamic interplay shaping the festive landscape and prompting reflection on future celebrations.

Background: Nurses are essential members of the healthcare workforce and were among the first line carers for patients in community and hospital settings during the COVID-19 pandemic. As a result, they were at a heightened risk of contracting the disease, resulting in a significant number of reported deaths among them. Several preventive measures were adopted to contain the spread of this potentially lethal virus. This study aims to explore the knowledge, attitudes, and practices (KAP) of nurses regarding hand hygiene, mask wearing, and social distancing measures in healthcare settings in Barbados during the COVID-19 pandemic. Method: An online survey of nurses working in public hospitals and polyclinics (public primary care clinics) of Barbados from December 2020 to July 2021, was conducted. Participants completed a questionnaire capturing socio-demographic information and knowledge and practices related to hand hygiene, using face masks, and social distancing . Each correct response received one mark. Overall knowledge scores were categorized as poor (<60%), average (60-80%), or good (>80-100%). Results: Of 192 participants, the majority were female (82.8%) and had >5 years of experience (82%). Findings revealed that 45.8% had poor knowledge of hand hygiene, and the knowledge of 43.8% of respondents was average. Multivariable logistic regression showed that, after adjustment for age and gender, registered nurses had 2.1 times increased odds (95% CI 1.0, 4.2) of having good knowledge compared to other nursing categories. Regarding mask-wearing, 53.6% of nurses had average and 27.1% had good knowledge. Multivariable logistic regression showed that, after adjustment for age and gender, registered nurses had 3.3 times increased odds (95% CI 1.5, 7.4) of having good knowledge compared to nursing assistants. 68.6% of respondents followed the correct steps of handwashing every time, and 98.3% wore a mask in public places. More than half of the nurses (51.2%) kept a safe distance from others to avoid spreading SARS-CoV-2; one-third were in a crowded place(s) in the past three months, and 55.8% usually followed guidelines for social isolation as recommended by WHO. Conclusion: The study identified knowledge deficiencies related to hand hygiene and wearing masks among nurses. It is imperative to provide additional training on infection control measures.

Similarly to a phoenix, SARS-CoV-2 has appeared periodically in waves. The new variants that appeared through mutations have during the 4 years of the pandemic suppressed earlier variants, causing new waves of the pandemic. The Omicron BA.2.86 Pirola variant is the latest in the sequence of SARS-CoV-2 variants, which appeared in 2023. The BA.2.86 variant has started to spread rapidly and we are witnesses of a new epidemic wave. In this short period, an increased infectivity was noticed, which results in rapid spreading and decreased pathogenicity, which results in a lower number of severe cases. However, in the public there is a fear of further development of the epidemic. This analysis was made with the goal to assess the risks in the period of late 2023. Mutations that were developed by the BA.2.86 variant have led to a change in empirical formula and thermodynamic properties. It seems that there is no ground for fear of an extensive spreading of severe forms, but there are reasons for caution and monitoring of the spreading of the epidemic and potential appearance of new mutations.

In conclusion, this qualitative exploration has unveiled the profound and essential impact of music on psychological well-being, especially in the post-pandemic world. Through in-depth literature reviews, informal interviews, and observations with thirty CAS participants from SMC, the researcher uncovered ten salient themes that collectively illustrate music's multifaceted role as a potent remedy. These findings showcase how music serves as an emotional outlet, a cognitive enhancer, and a source of inspiration. The emotional depth and spiritual resonance participants associate with music underscore its capacity to address diverse human needs, making it an indispensable tool in navigating the complexities of our post-pandemic reality. Moreover, the cognitive benefits observed, such as improved concentration and focus, are particularly pertinent in the context of remote work and education, highlighting music's necessity in our daily lives. Additionally, this study emphasizes the vital role of virtual music communities in fostering social connections, even amidst physical isolation, further underscoring the enduring relevance of music in these challenging times. This research contributes to the expanding knowledge of music's impact on well-being, offering a holistic perspective encompassing spiritual, emotional, social, and cognitive dimensions. It enriches existing music psychology theories and invites further exploration into the mechanisms underpinning music's diverse effects. These insights have practical implications for fields such as mental health, education, and remote work, where music can be utilized as an essential tool for stress reduction and emotional regulation. This is highlighted further in the Suggested songs that can help sought the mind, body, spirit and soul. Looking ahead, future research could delve deeper into the long-term impact of music engagement on well-being and explore the universality of music's benefits through cross-cultural studies. Overall, music, as illuminated by this study, stands as a timeless and indispensable companion, offering solace, inspiration, vitality, and connection in the face of any contemporary challenges.

Purpose: This study investigated the impact of the COVID-19 pandemic on mental health, quality of life, and family functioning in a sample of the general female population, exploring difficulties encountered in managing family and work responsibilities and burden of care when taking care of a loved one. The study was moreover aimed at investigating factors capable of influencing severe depressive symptomatology in the context of socio-demographics, traumatic events, individual vulnerability, and family functioning. Method: During a weekend devoted to Mental Health initiatives (October 8-10, 2021), 211 women were interviewed (47% exposed to the 2009 L’Aquila earthquake). Results: More than 50% of the sample reported a higher complexity in managing their lives during the COVID-19 pandemic compared to their previous routine, with no statistically significant differences between working women and non-workers, although the latter obtained higher scores for depressive symptomatology and poorer quality of life. Compared to non-caregivers, women caregivers (22.3%) in charge of the care of loved ones affected by physical (10.9%) or psychiatric disabilities (11.4%) complained of a poorer quality of life, with those caring for people affected by mental disorders seeming to experience a more significant worsening. Approximately 20% of the total sample reported severe depressive symptomatology. Previous access to mental health services (O.R. 10.923), low level of education (O.R. 5.410) and difficulties in management of their everyday lives during the COVID-19 pandemic (O.R. 3.598) were found to be the main variables predictive of severe depressive psychopathology. Old age, good problem-solving skills and ability to pursue personal goals were identified as protective factors. Conclusions: The COVID-19 pandemic underlined the need for support for emotionally vulnerable women with pre-existing mental health conditions, partly reflecting the cumulative effects of traumas.

Background: An analysis of the pages of the WHO website on the influenza pandemic revealed changes in the use of the term "pandemic" that occurred in 2009 and 2011. Materials and methods: Since the cause of the change in the description of a pandemic on the WHO website in 2009 and 2011 is not clear, analyses of the literature related to the epidemics and pandemics, WHO documents, WHO website, and articles published in journals and the Internet have been done.Results: Until early May 2009, the description of the pandemic focused on "enormous numbers of cases and deaths." On May 6, 2009, a new description of the pandemic was published, focusing on the prevalence of the disease, but in 2011 it reverted to the initial one without any comments. From the perspective of the WHO document issued in 2009, the declaration of a swine flu pandemic in June 2009 seemed justified. However, considering the previous pandemic history, common sense, and the consequences of declaring a pandemic for a disease not accompanied by a high number of cases and high mortality, it was a premature move.Conclusion: Since the primary factor hindering the development of a pandemic is the effectiveness of treating infectious diseases, but not a definition of a pandemic, to minimize the likelihood of a new pandemic, it is necessary to improve the quality of special medical education and to study and adapt to modern conditions all effective drugs and methods used in the past.

Background: The potential impact of the pandemic on mental health should not be overlooked, especially among vulnerable populations such as women who gave birth during the COVID-19 pandemic. The aim of the study was to assess the mental health status of women who gave birth during a pandemic and to examine the possible links between the onset of depressive disorder symptoms in close proximity to the time of delivery and the socio-demographic conditions, health status and obstetric circumstances of the patients. Materials and Methods: The study is a cross-sectional survey conducted from 01.03.2020 to 01.03.2023, during the period of SARS-CoV-2 (COVID-19) pandemic, based on a retrospective evaluation of 860 postpartum women. The screening tool used to assess symptoms of postpartum depression was the Edinburgh Postnatal Depression Rating Scale (EPDS) questionnaire. The questionnaire was completed both in the Obstetrics and Gynaecology Clinical Sections I and II of the "Pius Brînzeu" County Emergency Hospital from Timisoara, Romania and online using Google Forms. Results: The highest severity of postpartum depression symptoms was observed during the COVID-19 pandemic. The results of the study conducted during the period of SARS-CoV-2 pandemic (COVID-19) showed that the prevalence of major postpartum depressive disorder (EPDS ≥ 13) was 54.2% (466 patients), while 15.6% (134) had minor depressive disorder (10 &lt; EPDS ≤ 12) in the first year after delivery. Comparing these results with those obtained in research conducted before the onset of the pandemic period shows an alarming increase in the prevalence of postpartum depression. Risk factors associated with postpartum depression included type of delivery, level of education, socio-economic conditions, health status, age, background, personal obstetric history (number of abortions on demand, parity). Conclusions: The effects of the pandemic on mental health are of particular concern for women in the first year after childbirth. Observing these challenges and developing effective measures to prepare our health system early can help and facilitate effective mental health screening for postpartum women, promoting maternal and child health.

During the pandemic, nurses experienced anger that stemmed from a sense of threat, frustration or even a sense of injustice. The purpose of this study was to examine the relationship between vaccination hesitancy, anger, cynicism and medical mistrust among nurses, as there are no relevant studies in the literature. The study was conducted online by completing self-report questionnaires. The Dimensions of Anger Reactions-5, the 8-item "Cynical Distrust" scale and the Medical Mistrust Multiformat Scale were used. For vaccination hesitancy, two questions with a 5-point scale were used; one question examining hesitancy to get vaccinated with the COVID-19 vaccine, and another question examining hesitancy to get vaccinated with the influenza vaccine. 387 nurses (66 men and 321 women) participated in the study. Nurses showed statistically greater hesitancy for the COVID-19 vaccine compared to hesitancy for the influenza vaccine. The variation in Vaccine Hesitancy was explained by the scores in the Medical Mistrust Multiformat Scale, the Dimensions of Anger Reactions and the Cynical Distrust Scale. The Medical Mistrust Multiformat Scale mediated the relationship between Cynical Distrust Scale and Total Vaccine Hesitancy. The Dimensions of Anger Reactions Scale significantly moderated the indirect effect of Cynical Distrust Scale on Total Vaccine Hesitancy through the Medical Mistrust Multiformat Scale. In conclusion, it is highly likely that anger is involved in reported vaccine hesitancy both by activating schemas of distrust in others and by adopting antisystemic views of mistrust in the medical system.

Flood is one of the most common disaster in Assam.The situation gets worse when pandemic hits the place during the flood time. The paper indicates about women’s flood related lived experiences during pandemic. It is thought that floods will increase the global burden of disease, morbidity, mortality, social and economic disruptions, and will place a continuing stress on health services, especially in low-resource countries. Natural disaster hampers both the men and women. Pandemic means the disease whose prevalence has been all over the world. Covid 19 has been the recently developed pandemic that touches each and every corner of the world. But within such obstruction, both the male and female’s lived experiences of health might be different from each other. This paper articulates the gendering lived experiences of pandemic during the time of flood. However here an attempt has been made to understand women’s negotiation with their everyday life during such time and whether different social, political and cultural capital have been significant factors as far as the negotiation is concerned that has also been discussed through this study. However, on the descriptive note, narrative analysis has been done to understand the women’s negotiation in their everyday life.The study is conducted at different places of Nalbari and Golaghat Districts of Assam. All interviews were audio-recorded, transcribed, translated into English and qualitative analysis was done . How disaster made adverse impact on women's everyday life that has been tried to understand through this paper. Keywords- Flood. Pandemic, Lived Experiences, Women, Everyday.

In the evolving landscape of higher education, St. Michael's College (SMC) recognizes the significant impact of the COVID-19 pandemic on student welfare. This paper emphasizes the critical importance of addressing mental health, time management, and stress in the college environment, underlining their influence on academic success and personal growth. The call to action urges students to prioritize their well-being. Diverse cultural and religious perspectives, including Islam, emphasize the importance of a balanced mind and body. The wide-ranging literature review uncovers empirically supported strategies for mental health, time management, and stress reduction. Personal autonomy emerges as crucial in addressing these challenges. This study underscores the importance of these dimensions, calls for student action, and highlights the diversity of perspectives contributing to holistic well-being.

There are strong indications that the built environment intertwines consistently with the advent of Covid-19 and the need for post-disaster recovery. The advent of the Covid-19 pandemic has exerted adverse effects on both human and global developments; while the efforts to combat this menace call for an integrated human social capital index. This research seeks to adequately enhance the comprehension of how the built environment can be enhanced through resilience in the backdrop of the Covid-19 pandemic. The study's goal is to investigate the impact of a resilient built environment on increasing resilience in the aftermath of the Covid-19 pandemic in Nigeria. Overall, the quantitative study test the impact of four built environments resilience indices (Built Environment capitals; Disaster management indices, Awareness of the Covid-19 Pandemic, and Built Environment adaptive strategies) on Human social capital and Covid-19 pandemic Indices. This study reveals the role of human social capital in achieving a resilient built environment in the wake of Covid 19 pandemic in Nigeria. Also, built environment capitals, disaster management indices, and awareness on the Covid-19 have indirect effects on Covid-19 pandemic indices through the human social capital. The implication of the study is useful for Post-Covid 19 recovery; which is important for future planning of the built environment in Nigeria.

There are two purposes for this article. The first purpose is to perform a reiew of previous research on global supply chain management (GSCM) principles that can adapt and survive adversity, such as the COVID-19 pandemic. The second purpose is to put forth a conceptual framework for the GSCM that is sustainable in the event of future turbulence similar to that experienced during the COVID-19 pandemic. With regard to the issues raised, the article posits the following questions. Is there, perhaps, a sustainable post-COVID-19 pandemic GSCM? Can the COVID-19 pandemic-related international logistics system (GSC) turbulences be predicted with certainty using these sustainable post-COVID-19 pandemic GSCM concepts? Putting it all together, the paper concludes that, while debatable, sustainable GSCM is feasible and can be accomplished utilizing JIT, supply chain mitigation, and supply chain visibility, as demonstrated by the manufacturing firms referenced in the article.

This qualitative exploratory study employs purposeful and maximum variation sampling to explore Mother Ignacia del Espíritu Santo's spiritual journey and the devotion of RVM Sisters. Gathering thirty participants offers a diverse range of perspectives, providing insights into the local community. Thematic analysis highlights their impact during the pandemic in Iligan City. Ignacian spirituality spreads through education, retreat, other ministries and digital adaptation by the RVM Sisters. Through in-depth literature reviews, interviews, and observations, the researcher uncovers Mother Ignacia's journey, resonating with modern spirituality. RVM Sisters adapt during the pandemic, inspiring hope in words and in action. Their humility despite their accomplishments is particularly inspiring. This transformative journey holds significance, illuminating resilience in a post-COVID-19 context. The study contributes to literature and suggests amplifying RVM Sisters' influence. Overall, in a pandemic-stricken world, it emphasizes spirituality's role as a beacon of strength and compassion, inspiring revitalization. The essence of Mother Ignacia and the RVM Sisters' spiritual expedition serves as a celestial inspiration, guiding local residents toward compassion, fortitude, and collective renewal.

Sepsis is a life-threatening condition caused by the body's overwhelming response to an infection, such as pneumonia or urinary tract infection. It occurs when the immune system releases cytokines into the bloodstream, triggering widespread inflammation. If not treated, it can lead to organ failure and death. Unfortunately, sepsis has a high mortality rate, with studies reporting rates ranging from 20% to over 50%, depending on the severity and promptness of treatment. According to the World Health Organization (WHO), the annual death toll in the world is about 11 million. One of the main toxins responsible for inflammation induction are lipopolysaccharides (LPS, endotoxin) from Gram-negative bacteria, which ranks among the most potent immunostimulants found in nature. Antibiotics are consistently prescribed as a part of anti-sepsis-therapy. However, antibiotic therapy (i) is increasingly ineffective due to resistance development and (ii) most antibiotics are unable to bind and neutralize LPS, a prerequisite to inhibit the interaction of endotoxin with its cellular receptor complex, namely Toll-like receptor 4 (TLR4)/MD-2, responsible for the intracellular cascade leading to pro-inflammatory cytokine secretion. The pandemic virus SARS-CoV-2 has infected hundreds of millions of humans worldwide since its emergence in 2019. The COVID-19 (Coronavirus disease-19) caused by this virus is associated with high lethality, particularly for elderly and immunocompromised people. As of August 2023, nearly 7 million deaths were reported worldwide due to this disease. According to some reported studies, upregulation of TLR4 and the subsequent inflammatory signaling detected in COVID-19 patients “mimics bacterial sepsis”. Furthermore, the immune response to SARS-CoV-2 was described by others as “mirror image of sepsis”. Similarly, the cytokine profile in sera from severe COVID-19 patients was very similar to those suffering from the acute respiratory distress syndrome (ARDS) and sepsis. Finally, the severe COVID-19 infection was frequently accompanied by bacterial co-infections, as well as by the presence of significant LPS concentrations. These data indicate similarity and interdependences of both syndromes, but also significant differences which will be discussed in the present review.

At the beginning of 2020, with the onset of the pandemic, the traditional learning environment for learners drastically changed globally. Since then, most students/teachers have started and practiced distance and virtual learning/teaching. Thus, a technological breakthrough in virtual learning has followed. In connection with this, many countries worldwide have commenced allocating additional financing and funds for educational institutions' technological improvement and development. The long-term stay in distance learning has revealed and highlighted new problems students face: their knowledge level has decreased, they lack socialization skills, and they face psychological and physical health problems. Due to this negative impact on students, a need to research and evaluate how much the EU countries allocated to solve the distance learning-caused problems and what programs or models they prepared has emerged and encouraged further studies. The research has found that many countries increased their allocations very minimally, e.g., 0.0.1%, but some increased their available budgets to 32%. Notably, most countries did not separate distance learning exit funding from distance learning preparation funding. Based on the problems the countries saw, only a few states identified withdrawal from distance learning as a problem. Considering this, we set ourselves the goal to evaluate exit models from distance learning and allocated funding amounts. The following objectives were planned to achieve the goal: · to evaluate the global practice of exit from distance learning; · to determine the scope of funding for pandemic management; · to evaluate the amounts of funding allocated to manage pandemic-caused consequences and the GDP ratio. Research methods: mathematical-statistical analysis, empirical analysis, and analysis of scientific literature.

This study delves into the dynamic intersection of artificial intelligence (AI) and English Language Teaching (ELT) within the post-pandemic educational landscape. Grounded in Constructivism, Connectivism, and Technological Pedagogical Content Knowledge (TPACK), this research explores how AI integration impacts language instruction efficiency, benefits and challenges perceived by St. Michael's College students, differences in learning outcomes, and its potential to address the digital divide. Employing a qualitative approach, the study employs a rigorous method that includes intensive in-depth reviews of literature, maximum purposeful sampling, informal interviews, observation, and thematic analysis. Through these methods, data was collected from 30 participants, leading to the identification of five key themes. Findings suggest that AI enhances instructional efficiency, offers personalized learning experiences, and bridges gaps in remote settings. However, challenges and the importance of pedagogical balance emerged. The study underscores the need for adaptive pedagogical strategies to fully harness AI's potential. Future directions and limitations are discussed, emphasizing the study's implications for shaping the future of ELT.

The post-pandemic landscape has ushered in a transformative phase in education, compelling a profound reexamination of the humanities' role. This study navigates the multifaceted dimensions of humanities education, including its response to digital transformation, interdisciplinary methodologies, emotional intelligence cultivation, inclusivity efforts, and its forward trajectory. Employing qualitative methods, including innovative approaches such as advanced data analysis techniques, intensive in-depth literature reviews, maximum purposeful sampling, informal interviews among thirty (30) participants from SMC, observation, and thematic analysis, this research captures diverse perspectives. Leveraging evolving research methodologies, the study resonates implications for educators and institutions, envisioning a humanities education poised for resilience and responsiveness, sculpted by the pandemic's challenges and the potential it has unveiled.

In the present study, we aimed to assess the prevalence and the relationships between alexithymia, burnout and hopelessness in a large sample of healthcare workers (HCWs) during the third wave of Covid-19 in Italy. Alexithymia was evaluated by the Italian version of the 20-item Toronto Alexithymia Scale (TAS-20), hopelessness was measured using the Beck Hopelessness Scale (BHS) and irritability (IRR), depression (DEP) and anxiety (ANX) were evaluated with the Italian version of Irritability‚ Depression‚ Anxiety Scale (IDA). This cross-sectional study recruited a sample of 1445 HCWs from a large urban healthcare facility in Italy from 1 June—31 May 2021. Comparison between individuals positive (n=214, 14.8%) or not for alexithymia (n=1231, 85.2%) controlling for age, gender and working seniority revealed that positive subjects showed higher scores on BHS, MBI, IRR, DEP and ANX than not positive ones (p<0.001). In the linear regression model, higher working seniority and higher MBI, DEP, ANX and TAS-20 scores were associated with higher hopelessness. In conclusion, increased hopelessness was associated with higher burnout and alexithymia. Comprehensive strategies should be implemented to support HCWs mental health and mitigate the negative consequences of alexithymia, burnout, and hopelessness

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.

The main objective of this article was to evaluate the repercussions of the crises resulting from the COVID-19 pandemic and the war in Ukraine on changes in the European Union's reliance on energy raw material imports, particularly from Russia. Furthermore, several specific objectives were outlined: to ascertain the EU's energy balance and any alterations therein, to identify changes in the concentration of energy raw material imports among EU countries during the crises, to determine the level and fluctuations in energy raw material import dependence within the EU and individual member states throughout the crises, and lastly, to assess changes in the concentration of energy raw material imports from Russia in EU countries during the crises. The research encompassed all 27 EU Member States as of 31st December 2022, and the examination period spanned from 2010 to 2022. The information sources included relevant literature on the subject and data sourced from Eurostat. In conducting the analysis and presenting the data, several methodologies were employed, including descriptive, tabular, and graphical techniques. Additionally, quantitative measures such as the Gini structure concentration coefficient and concentration analysis through the Lorenz curve were utilized. During the COVID-19 pandemic, the EU experienced a slight reduction in dependence on energy raw material imports. However, this reduction was short-lived and mainly attributed to the decrease in energy demand caused by the pandemic. Conversely, the war in Ukraine had a substantial impact, leading to a notable surge in energy raw material imports as a result of stockpiling efforts and the need to safeguard against further disruptions in the energy market. Notably, the EU's reliance on energy imports from Russia was already considerable. Following the outbreak of the conflict in Ukraine, imports of oil, petroleum products, and solid fossil fuels experienced significant decline due to imposed sanctions. Nonetheless, restrictions on natural gas imports were comparatively less severe.

This study aimed to analyze areas of concern and support of the Austrian general population two years into the COVID-19 pandemic. A representative sample (N = 1,031) of the Austrian general population was surveyed online between April 19 and 26, 2022. A qualitative study design was used to explore the factors of most considerable current concern (question 1) and the most important sources of support (question 2). The responses to the two open-ended questions were evaluated using conventional content analysis and categories were formed according to the frequency of the answers. The analysis revealed that inflation and finances (30% of participants) and the war in Ukraine (22%) were the greatest sources of concern, followed by mental health (10%), and physical health (10%). Factors such as social contacts within and outside the family were mentioned most frequently as sources of support (36% of participants), followed by recreational activities (23%) and attitudes and abilities (22%). Compared to data collected at the end of the first year of the pandemic (between December 23, 2020, and January 4, 2021), concerns about one's financial situation was now mentioned more frequently (30,4% vs. 8,5%). On the other hand, different types of pandemic-related concerns were less often mentioned. Social contacts and recreation were mentioned as the most important sources of support at both time points (46% and 36% of the participants). Results suggest that the economic concerns are lagging behind the restrictions imposed by the pandemic. In addition, the impending war in Ukraine seems to have a relevant impact on mental health in Austria. Further nuanced qualitative research, particularly involving vulnerable groups like low-income individuals and the unemployed, is crucial.

Mental health impacts of COVID-19 pandemic have received a great deal of attention by policymakers for the management of present and future cases of the pandemic, especially as new COVID-19 variant cases are on the rise. Thus, this study seeks to conduct a systematic review to address the following research questions: (1) What are the mental health impacts of COVID-19 in the empirical literature? (2) Which categories of people are at higher risk of the mental health impacts of the pandemic based on the extant literature? A sample of 35 studies out of 196 potential studies (from various databases, including Scopus, Google Scholar, , Research Gate, PubMed, , and libraries, from 2020 to 2022) were used after a comprehensive literature search and thorough assessment based on PRISMA-P guidelines. The study reveals that the pandemic has led to severe cases of mental health challenges such as depression, anxiety, post-traumatic stress disorder, psychological disorders, mood disorders, and insomnia. The review identified groups such as health workers, patients with pre-existing psychiatric or mental health issues, COVID-19 survivors, patients with underlying health conditions, and the elderly as the most vulnerable groups to mental health challenges from the pandemic.

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.

When “hijacked” by compulsive behaviors that affect the reward and stress centers of the brain, functional changes in dopamine circuitry occur as the consequence of pathological brain adaptation. As a brain explanans for mental health, with a central functional role in behavioral regulation from healthy reward seeking to pathological adaptation to stress in response to adversity, we may use dopamine regulation in interaction with other brain mechanisms, as discussed herein, to gather a deeper insight into environmentally triggered mental health changes to understand, for example, specific behavioral changes observed during and after the COVID-19 pandemic. Pandemic-related adversities, the stresses they engendered, and the long lockdown periods where people had to rely on digital tools to get feed-back rewards via the internet can be seen as the major triggers of changes in motivation and reward seeking behavior worldwide. The pathological adaptation of dopamine-mediated reward circuitry in the brain offers a highly plausible explanation why, when pushed by fate and circumstance into a physiological brain state of anti-reward, human behavior and mental health changes almost inevitably depending on individual vulnerability to stress. A unified conceptual account that places dopamine function at the centre of the current global mental health context is proposed.

This study aimed to explore the experiences of teachers in the recovery of educational skills. Specifically, ten teachers of Andap National High School are selected for the in-depth interview. This study employed a qualitative-phenomenological research design of which in-depth interview (IDI) was used in gathering the data. The study utilized phenomenological approach to study a particular phenomenon concerning the post-pandemic experiences of teachers in the implementation of the face-to-face classes. After gathering sufficient amount of data through the conduct of in-depth interviews, thematic analysis was used to analyse further the results and to check the disparities and similarities of all responses gathered. This was the time wherein responses were categorized and organized into themes. The findings of the study revealed that the challenges encountered of educational skills recovery were sources of learning materials, learning gaps, learners characteristics, difficulty with comprehension and lack of interest. It was also revealed that the most challenging teaching experiences in the recovery of educational skills were catching attention, learning gaps, communicating to students, need for remedial instruction, retroactive interference and difficulty in understanding English Language. They frequently have to quickly convert lesson material they had intended to teach in a classroom setting to any learning modality implemented. Further, adjust and learn new trend, provide opportunities to develop new skills, helps to manage stress, improved educational outcomes, become well-rounded teacher, networking and learning and continue doing responsibilities helped in these insights had in confronting challenges brought by the pandemic.

The Covid-19 pandemic and the subsequent implementation of lockdown measures have significantly impacted global electricity consumption, necessitating accurate energy consumption forecasts for optimal energy generation and distribution during a pandemic. In this study, we propose a new forecasting model called the Multivariate Multilayered LSTM with Covid-19 case injection ($\proposedModel$) for improved energy forecast during the next occurrence of a similar pandemic. We utilize data from commercial buildings in Melbourne, Australia during the Covid-19 pandemic to predict energy consumption and evaluate the model's performance against commonly used methods such as LSTM, Bi-LSTM, Linear Regression, Support Vector Machine and the previously published work of Multilayered LSTM (M-LSTM). The proposed forecasting model was analyzed using the following metrics of mean percent absolute error (MPAE), normalized root mean square error (NRMSE), and $R^2$ score values. The model $\proposedModel$ demonstrates superior performance, achieving the lowest MPAE values of 0.061, 0.093, and 0.158 for data sets from 3 different buildings, respectively. Our results highlight the improved precision and accuracy of the model, providing valuable information for energy management and decision-making during the challenges posed by the occurrence of a pandemic like Covid-19 in the future.

New Jersey was among the first states impacted by the COVID-19 pandemic, with one of the highest overall death rates in the nation. Nevertheless, relatively few reports have been published focusing specifically on New Jersey. Here we report on molecular, clinical, and epidemiologic observations from the largest healthcare network in the state, in a cohort of vaccinated and unvaccinated individuals with laboratory-confirmed SARS-CoV-2 infection. We conducted molecular surveillance of SARS-CoV-2-positive nasopharyngeal swabs collected in nine hospitals from December 2020 through June 2022, using both whole genome sequencing (WGS) and a real-time RT-PCR screening assay targeting spike protein mutations found in variants of concern (VOC) within our region. De-identified clinical data were obtained retrospectively, including demographics, COVID-19 vaccination status, ICU admission, ventilator support, mortality, and medical history. Statistical analyses were performed to identify associations between SARS-CoV-2 variants, vaccination status, clinical outcomes, and medical risk factors. A total of 5,007 SARS-CoV-2-positive nasopharyngeal swabs were successfully screened and/or sequenced. Variant screening identified three predominant VOC, including Alpha (n =714), Delta (n =1,877), and Omicron (n =1,802). Omicron isolates were further sub-typed as BA.1 (n =899), BA.2 (n =853), and BA.4/BA.5 (n =50); the remaining 614 isolates were classified as “Other”. Approximately 31.5% (1,577/5,007) of the samples were associated with vaccine breakthrough infections, which increased in frequency following the emergence of Delta and Omicron. Severe clinical outcomes included ICU admission (336/5007 = 6.7%), ventilator support (236/5007 = 4.7%), and mortality (430/5007 = 8.6%), with increasing age being the most significant contributor to each (p &lt;0.001). Unvaccinated individuals accounted for 79.7% (268/336) of ICU admissions, 78.3% (185/236) of ventilator cases, and 74.4% (320/430) of deaths. Highly significant (p &lt;0.001) increases in mortality were observed in individuals with cardiovascular disease, hypertension, cancer, diabetes, and hyperlipidemia, but not with obesity, thyroid disease, or respiratory disease. Significant differences (p &lt;0.001) in clinical outcomes were also noted between SARS-CoV-2 variants, including Delta, Omicron BA.1, and Omicron BA.2. Vaccination was associated with significantly improved clinical outcomes in our study, despite an increase in breakthrough infections associated with waning immunity, greater antigenic variability, or both. Underlying comorbidities contributed significantly to mortality in both vaccinated and unvaccinated individuals, with increasing risk based on the total number of comorbidities. Real-time RT-PCR-based screening facilitated timely identification of predominant variants using a minimal number of spike protein mutations, with faster turnaround time and reduced cost compared to WGS. Continued evolution of SARS-CoV-2 variants will likely require ongoing surveillance for new VOCs, with real-time assessment of clinical impact.

Objectives: The aim of our study was to evaluate patients after suicide attempts treated at the Department of Trauma Surgery for Children before and after the outbreak of the Covid-19 pandemic. Material and methods: Retrospective review of the medical database at equal time intervals of 24 months to identify patients treated before and after the COVID-19 was done. Thorough analysis including injury mechanism, medical procedures, history of previous mental disorders or suicidal behavior was performed. Furthermore, results were compared with the Polish police suicide statistics. Results: Based on our retrospective review we found 4 patients treated in our department before the pandemic and 10 patients treated after COVID-19 outbreak. The group before SARS-Cov-2 era consisted of three girls and one boy with a mean age of 14.97 (12.7-17.6). The group treated in the pandemic crisis consisted of 8 boys and 2 girls, the mean age was 15.49 (10.8-17.2). In the pre-COVID-19 group, 2 out of 4 patients had received psychiatric treatment before, but none had attempted suicide before. In the COVID-19 group, 6 out of 10 patients had previously received psychiatric treatment, moreover 3 of them attempted suicide before. Based on our analysis, the number of individuals who displayed suicidal attempts has raised. Between 2018 and 2021 the largest number of suicides concerned the 13-18 y.o. group, both for the Silesian Voivodeship (H=9.374; p=0.0092) and for the whole country (H= 10.203; p=0.0061). Conclusions: 1. Results of our study indicate that the pandemic may have caused a wide range of negative mental health consequences for young individuals; 2. During the SARS-Cov-2 era, we observed an alarming 2.5-fold increase in the number of patients treated after suicide attempts at the children's orthopedic trauma department; 3. Suicide attempts in children are often related with high energy trauma.

The occurrence of the COVID-19 pandemic has affected all aspects of our routine life. Here, we briefly reveal the less paid attention aspect, vocabulary. We extracted words from online news outlets during the first three months of the pandemic. The extracted words included many aspects, which we categorised into eight classes according to their functions and implications. We found out the top three dominant classes of vocabularies with the highest frequency compared to others, namely medical, economic and governance. The temporality in the pandemic timeline was vital in making sense of the predominant vocabulary. This paper is a rare preliminary report which provides a valuable insight into future articles with much more comprehensive data and analysis.

Life is supported by metabolism, a vital physiological activity. It guarantees enough energy available to power every cellular activity. The primary cellular substrate, glucose, is where the majority of the energy needed by the cell to support all other life activities and the growth of living creatures is derived. The quality of life is greatly impacted by any disease or flaw that alters the metabolism of glucose. There is no known cure for the metabolic illness known as diabetes. As diabetes is so varied, the only effective treatments would be based on precision medicine and a molecular strategy. This review covers a wide range of topics, including the ability to recognize the various forms of diabetes, the anthropogenic and genetic influence of the cause of diabetes, the severity of the various forms of diabetes, its potential existential risk, the disease burden, and clinical methods for diagnosing them. The most recent research goes on to recommend ways to ameliorate the disease, including diet-based management, biotherapies, and other individual lifestyle choices. Futuristic therapy using molecular biology approach was suggested. Recent research found a direct correlation between an individual's lifestyle and the rate of gene mutation in diabetes. There is an existential risk associated with the sickness as the rate of the spread of the disease among population globally is faster than the world's population growth rate. It is possible to think of diabetes as a silent pandemic.

The lockdown implemented to tackle the spread of the COVID-19 pandemic had a positive impact on air quality. Globally, studies have shown that the air pollutants levels reduced temporally during the restriction measures. In this study, we evaluated the impact of COVID-19 restrictions on the air quality of Western Macedonia, Greece, using the hourly concentrations of PM2.5 and PM10 along with meteorological data from the Air Quality Monitoring Stations (AQMS) operated by the Lignite Center of Western Macedonia. In Western Macedonia, previous studies have identified that there is a general reduction in air pollutants levels during the last decade due to coal phase-out plan for power generation. During the lockdown the levels of PM2.5 and PM10 decreased further. However, reduced emissions from the local mining activities and lignite-fired power plant electricity generation, as well as the weather conditions seems to contribute to improving air quality.

The use of food waste disposers in gastronomical facilities influence the municipal wastewater composition. Ground food waste poses problems in the operation of the sewerage network and generates high electric energy consumption in wastewater treatment plants (WWTP). The study aimed to determine, for five towns with a PE of 4,000 to 220,000, the volumes of catering waste discharged to the WWTPs. The towns differed in the number of inhabitants, beds in hotel and catering places. The calculations were made based on data received from the operators of WWTP. The pollutant concentrations in 2019, were compared with data from the "pandemic" year - 2020. The loads of catering waste entering the sewerage system in 2019 ranged from 32.7 to 1062 tons. In town with the largest tourist base, the BOD value in 2020 accounted for 62.3% of 2019 value. In the largest town, the annual energy consumption for food waste treatment could be up to 2,539,770 kWh. If the waste was fermented, it could be obtained up to 1,376,650 m3 of methane. There is a strong need for implementing a collection system for food waste from catering facilities and its fermentation to produce methane, which can be used for energy purposes.

Severe Acute Respiratory Syndrome Coronavirus - 2 (SARS-CoV-2), later renamed Coronavirus Disease 2019 (COVID-19) was first identified in Wuhan, China, in early December 2019. Initially, the China office of the World Health Organization was informed of numerous cases of pneumonia of unidentified etiology in Wuhan, Hubei Province on December 31, 2019. This would subsequently result in a global pandemic with over 76 million confirmed cases of COVID-19 and 6.9 million deaths reported to the WHO. We have analyzed most of the data published since the beginning of the pandemic to compile this comprehensive review of SARS-CoV-2. We look at the core ideas, such as the etiology, epidemiology, pathogenesis, clinical symptoms, diagnostics, histopathologic findings, consequences, therapies, and vaccines. We have also included the long-term effects and myths associated with some therapeutics of COVID-19. This study comprehensively assesses of the SARS-CoV-2 virology, vaccines, medicines, and significant variants identified during the pandemic. Our review article is intended to provide medical practitioners with a better understanding of the fundamental sciences, clinical treatment, and prevention of COVID-19. As of June 2023, this paper contains the most recent data made accessible.

Abstract: The COVID-19 pandemic has disrupted global energy markets and caused significant socio-economic impacts worldwide. The pandemic has also impacted the energy sector, with demand for energy reducing due to lockdowns and reduced economic activity. Hence, this paper aims to provide a comprehensive and analytical review of the impact of COVID-19 on the energy sector and discuss the potential role of artificial intelligence (AI) in mitigating some of these effects. This review examines the changes in energy demand patterns resulting from the pandemic and the implications for the energy industry, including the shifts in policymaking, communication, digital technology, energy conversion, environmental, energy market, and power system operation. The analysis of the energy pattern is discussed according to the timeframes which include pre-, mid-, and post-pandemic periods. Furthermore, we explore how AI can be used to improve energy efficiency, optimize energy use, and reduce energy wastages. The potential for AI to contribute to developing more efficient and sustainable energy systems has also been addressed. Lastly, we highlighted AI’s challenges, which play a significant role in the energy sector's response to the COVID-19 pandemic. The recommendations for AI applications in the energy sector for the transition to a more sustainable energy future are outlined. Information corroborated in this review is expected to provide important guidelines for crafting future research areas and directions in preparing the energy sector for any unforeseen circumstances or pandemic-like situations.

The COVID-19 pandemic has become the largest public health crisis since the 1918 influenza pandemic. Despite the extensive research conducted on the SARS-CoV-2 virus in humans, little is still known about animal-related transmission and its consequences. Therefore, this study contributed to a better understanding of this issue by focusing on the serological survey of SARS-CoV-2 in samples from the serum bank of the Bovine Virology Laboratory at the Biological Institute of São Paulo, as well as horses and dogs from the Military Police of the State of São Paulo, and tapirs and bats from the states of Mato Grosso do Sul and São Paulo. To achieve this, the possible presence of anti-SARS-CoV-2 antibodies in domestic and wild animal species was evaluated using the ID Screen® "SARS-CoV-2 Double Antigen Multi Species" ELISA test (ID-Vet.®), following the manufacturer's recommendations. The findings of this study demonstrate a higher occurrence of anti-SARS-CoV-2 antibodies in domestic animals compared to wild animals, as well as different antibody profiles among the species analyzed, with horses showing a wide range of seroconversion comparable to humans.

Balanced fear supports human rational decision making and useful behavioral responses. In contrast, overwhelming, persistent, and unbalanced fear can paralyze the individual and result in heightened anxiety, lack of cognitive flexibility, fear-based public compliance and serious mental health issues. Psychobiotics research has established that a healthy microbiome is required for balanced fear and mental health protection via control of fear extinction. The recent Covid-19 pandemic featured daily, persistent, fear-of-a single contagion conditioning on a global scale paired with various behavioral mandates (e.g., lockdowns of the healthy, masks, isolation from environmental microbes and each other) that degraded the human microbiome and isolated us from each other and useful environmental microbes. It also ignored the historic role of secondary bacterial pathobionts, in pandemic deaths. This narrative review examines how institutional promotion of fear-of-a single contagion, lack of balanced risk communication, and appalling disregard of our fundamental nature (as majority-microbial human superorganisms) resulted in problems rather than solutions. This review concludes that government-public health-media promotion of pervasive fear and microbiome-degrading behaviors: 1) increased public compliance, 2) reduced cognitive flexibility, and 3) increased risk of mental health conditions. It further argues that microbiome-first public health should be embraced to ensure that human freedom, rather than paralyzing fear, dominates our future.

The purpose of this work was to longitudinally investigate the dynamic evolution of vaccine hesitancy towards both COVID-19 and influenza. We followed a cohort of 479 adult patients at Udine Hospital (Italy) having in common a medical history of SARS-CoV-2 infection in 2020, during the first and most impactful pandemic wave. Vaccine attitude was assessed through standardized telephone interviews performed at 12 and 18 months after the acute illness. The background of the survey was represented by COVID-19 vaccination campaign, started with the approval of the first vaccine in December 2020 and bolstered by the introduction of Green Pass in July 2021, in a context where anti-vaccination beliefs and mistrust in healthcare system were rising. The first interview reported the success of the 2020/21 seasonal influenza immunization with 46.8% (224/479) of the participants showing a positive attitude, especially the elderly and people with comorbidities (p&lt; 0.001). The investigation conducted at 18 months showed a drastic drop in flu shot acceptance (30/166, 18.1%), the reluctance being justified by the feeling of protection regardless of prevention (55.8%) and by concerns regarding vaccines safety and efficacy (23.3%). In parallel, a great increase in vaccinations against SARS-CoV2 occurred after the introduction of Green Pass (72.9% vs 26.7%), although only a minority of the participants identified in the restrictions induced by the certification the leading incentive to get immunized (22.3%). Vaccine hesitancy remains a dynamic and complex phenomenon, which is difficult to overcome with incentive or obligatory strategies alone. The purpose of achieving vaccine compliance should always take into account the social and political context, as well as the role of personal opinions and emotions.

Health services research is a multidisciplinary discipline that aims to improve population health by studying healthcare services' organization, delivery, and financing. Over time, the field has worked to define its boundaries and establish a set of core research topics and methods addressing population wellbeing, access, quality, and cost. Although the influence of health technology is significant, our literature survey on health services research showed that SCs in general—containing their management, cost, and policy—had received little attention. Importantly, our assessment also showed that the system’s readiness to handle supply policy and supply device deficiencies like those encountered during pandemic was hardly ever mentioned. Reduced open areas and water bodies, deteriorating infrastructure, and changes in the biological morphology all affect cities’ uncontrollable and unplanned growth. Urban amenities, facilities, and healthcare services were unevenly distributed due to this unchecked urban population development. In light of this, this research suggests two reliable models for site selection issues for one of Hong Kong’s main hospitals. Levels of uncertainty, infeasibility tolerance, and reliability are taken into consideration. Then, two categories of uncertainty—symmetric and bound-ed—were examined. As a result, the challenge of scheduling in uncertainty has been considered, and potential solutions have been presented using a specified probability distribution function. The paper concludes by introducing the specific justice and health problems and outlining four typical strategies. In order to ensure that medications and other healthcare supplies are produced, distributed, and given to patients, a vast network of systems, components, and procedures must be effectively managed. This research contributes in this regard. Also, its grantee fairness in health systems and the populations health locally, nationally, and globally. It highlights health inequity, advances the measurement of health inequity, and promotes public dialogues on health inequity.

Nebulized thrombolysis offers locally targeted therapy with potentially lower bleeding risk than systemic administration for coronavirus disease 2019 (COVID-19) respiratory failure. In a proof-of-concept safety study, adult patients with COVID-19-induced respiratory failure and a <300mmHg PaO2/FiO2 (P/F) ratio, requiring invasive mechanical ventilation (IMV) or non-invasive respiratory support (NIRS) received nebulized rt-PA in two cohorts (C1 and C2), alongside standard of care during the first two UK COVID-19 waves. Matched historical controls (MHC; n=18) were used in C1. Safety co-primary endpoints were treatment-related bleeds and fibrinogen reduction to <1.0–1.5 g/L. A dose escalation strategy for improved efficacy with the least safety concerns was determined in C1 for use in C2; patients were stratified by ventilation type to receive 40–60 mg rt-PA per day for ≤14 days. Nine patients in C1 (IMV, 6/9; NIRS, 3/9) and 26 in C2 (IMV, 12/26; NIRS, 14/26) received nebulized rt-PA for a mean (SD) of 6.7 (4.6) and 9.1(4.6) days, respectively. Four bleeding events (one severe and three mild) in three patients were considered treatment-related. No significant fibrinogen reductions were reported. Greater improvement in mean P/F ratio from baseline to end of study was observed in C1 compared with MHC [C1; 154 to 299 vs MHC; 154 to 212). In C2, there was no difference in the baseline P/F ratio of NIRS and IMV patients. However, a larger improvement in P/F ratio was observed in NIRS patients [NIRS; 126 to 240 vs IMV; 120 to 188) and they required fewer treatment days (NIRS; 7.86 vs IMV; 10.5). Nebulized rt-PA appears to be well-tolerated, showing a trend of improved oxygenation and faster recovery in patients with acute COVID-19-induced respiratory failure requiring respiratory support; this effect was more pronounced in the NIRS group. Further investigation is required to study the potential of this novel treatment approach.

Context. During the COVID-19 pandemic, patient care was mainly organised around the hospital. Pre-hospital care has, to our knowledge, never been evaluated. Objective: To evaluate the impact of pre-hospital pathways on hospitalisation during the last part of the pandemic. Design. This was a monocentric retrospective analysis of prospectively collected medical records. Data from patients admitted to our institute between 1 February and 7 March 2022 were analysed. Main Outcome Measure(s): The primary outcomes were defined as the number of hospitalisations, resuscitations, and deaths at the time of interview and in the subsequent 30 days. The main explanatory variables were times from onset of symptoms to care, age, gender, News2 score, comorbidities, and pre-hospital pathways and their duration. Results: Three pre-hospital pathways have been identified: a pathway in which the patient consults a general practitioner for a test (PHP1); a pathway in which the patient consulted for care (PHP2); and no pre-hospital pathway and direct admission to hospital (PHP3). Factors independently associated with outcome (hospitalisation) were being male (OR 95% CI; 2.21 [1.01–4.84], p=0,04), News2 score (OR 95% CI; 2.04 [1.65–2.51], p<0.001), obesity (OR 95% CI; 3.45 [1.48–8.09], p=0.005), D-dimers > 0.5 µg/ml (OR 95% CI; 3.45 [1.47–8.12], p=0.005), prolonged time from symptoms to hospital care (PHP duration) (OR 95% CI; 1.07 [1.01–1.14], p=0.03). All things being equal, patients with a “PHP2” pre-hospital pathway had a higher probability of hospitalisation compared to those with a “PHP3” pre-hospital pathway (OR 95% CI; 4.31 [1.48–12.55], p=0.007). Conclusions. Along with recognised risk factors such as gender, News 2 score, and obesity, the patient’s pre-hospital pathway is an important risk factor associated with hospitalisation.

The COVID-19 epidemic and the measures adopted to contain it have had a significant impact on energy patterns throughout the world. The pandemic and movement restrictions led to unpredictable fluctuations in power systems demand and the fuel price for a delayed period. Monkeypox, another viral disease, appeared during the post-COVID period. It is assumed that the outbreak of monkeypox is unlikely due to the implication of preventive measures experienced by COVID-19. At the same time, the probability of an epidemic cannot be blindly overlooked. This paper aims to examine and analyze historical data to look at how much petroleum fuel was used for generating power and how the price of petroleum fuel changed over seven years, from January 2016 to August 2022. This period covers the time before the COVID-19 pandemic, during the pandemic, and after the pandemic. Several time-series forecasting models, including all four benchmark methods (Mean, Naïve, Drift, and Snaïve), Seasonal and Trend decomposition using Loess (STL), Exponential Smoothing (ETS), and Autoregressive Integrated Moving Average (ARIMA) methods have been applied for both fuel consumption and price prediction. The best forecasting method for fuel price and consumption has been identified among these methods. The paper also utilizes the ARIMAX model by incorporating multiple exogenous variables, such as monthly mean temperature, mean fuel price, and mileage of vehicles traveling during a certain period of pandemic lock-down. It will assist in capturing the non-smooth and stochastic pattern of fuel consumption and price due to the pandemic by separating the seasonal influence and thus provide a prediction of the consumption pattern in the event of any future pandemic.