Objective:To study cardiovascular sequelae of post-COVID-19 patients with moderate to severe computed tomography(CT)severity score.Methods:A prospective,non-randomized,observational study was conducted on 100 post-COV...Objective:To study cardiovascular sequelae of post-COVID-19 patients with moderate to severe computed tomography(CT)severity score.Methods:A prospective,non-randomized,observational study was conducted on 100 post-COVID-19 patients with moderate to severe CT severity scores from January 2021 to December 2021.Fifty-nine were male[mean age(54.1±12.2)years]and 41 were female[mean age(46.9±15.1)years].Patients with previous cardiovascular disease,previous chronic lung disease,and pre-existing primary or secondary pulmonary hypertension were excluded.Patients were examined,and serial electrocardiogram and 2D echocardiography were performed to detect any cardiovascular abnormality.Results:Post-COVID-19 patients had persistent symptoms,the most common being fatigue(59%).Most of these symptoms were relieved on follow-up.A rise in systolic,diastolic blood pressure,and pulse rate was observed.The electrocardiographic evaluation revealed ST-T segment changes,sinus tachycardia,ventricular hypertrophy,and arrhythmias among a considerable number of patients.On echocardiography,left ventricular diastolic dysfunction was most common(43%).Pulmonary hypertension,as evidenced by elevated pulmonary artery systolic pressure,was seen in 15%of patients.Conclusions:The present findings reveal an increased incidence of cardiovascular complications after recovery from COVID-19 infection in those without pre-existing cardiovascular or chronic lung disease.展开更多
Since its emergence in 2019,it has become apparent that coronavirus 2019(COVID-19)infection can result in multi systemic involvement.In addition to pulmonary symptoms,hepatobiliary involvement has been widely reported...Since its emergence in 2019,it has become apparent that coronavirus 2019(COVID-19)infection can result in multi systemic involvement.In addition to pulmonary symptoms,hepatobiliary involvement has been widely reported.Extent of hepatic involvement ranges from minor elevation in liver function tests(LFTs)to significant hepatocellular or cholestatic injury.In majority of cases,resolution of hepatic injury or improvement in LFTs is noted as patients recover from COVID-19 infection.However,severe biliary tract injury progressing to liver failure has been reported in patients requiring prolonged intensive care unit stay or mechanical ventilation.Due to the timing of its presentation,this form of progressive cholestatic injury has been referred to as COVID-19 cholangiopathy or post-COVID-19 cholangiopathy,and can result in devastating consequences for patients.COVID-19 cholangiopathy is recognized by dramatic elevation in serum alkaline phosphatase and bilirubin and radiologic evidence of bile duct injury.Cholangiopathy in COVID-19 occurs weeks to months after the initial infection and during the recovery phase.Imaging findings and pathology often resemble bile duct injury associated with primary or secondary sclerosing cholangitis.Etiology of COVID-19 cholangiopathy is unclear.Several mechanisms have been proposed,including direct cholangiocyte injury,vascular compromise,and cytokine release syndromes.This review summarizes existing data on COVID-19 cholangiopathy,including reported cases in the literature,proposed pathophysiology,diagnostic testing,and long-term implications.展开更多
Aims: The present study aims to compare the assessment of work ability based on the use of the Work Ability Index (WAI) with another questionnaire base only on the use of WAI’s first item, termed as the “Work Abilit...Aims: The present study aims to compare the assessment of work ability based on the use of the Work Ability Index (WAI) with another questionnaire base only on the use of WAI’s first item, termed as the “Work Ability Score” (WAS). Study design: A cohort of 384 Spanish workers included in a Post COVID-19 condition or persistent COVID-19 multicenter research was utilized. Place and Duration of Study: This cohort was enlisted in four hospitals (Hospital Universitario 12 de Octubre, Madrid;Hospital Universitario Virgen Macarena, Sevilla, Andalucía;Hospital Universitario Gregorio Marañón, Madrid and Complejo Asistencial Universitario de Salamanca, Castilla y León), since 2021 until 2022. Methodology: 384 Spanish workers (176 men and 208 women;aged 20 to 70 years) with Post COVID-19 condition or persistent COVID-19 were included. Descriptive analysis of primary scores was conducted. Given the non-normal distribution of data, the Mann-Whitney and Kruskal-Wallis tests were employed. Spearman and Kendall correlations were employed to assess the relationship between WAI and WAS, also used weighted Kappa to estimate the degree agreement between WAI and WAS. Logistic regression models were utilized to study determinants influencing WAI and WAS, categorized as poor or moderate. Results: WAI had an average score of 32.98 (SD = 10.28), whereas WAS had an average of 5.95 (SD = 2.77). Significant differences were observed in both WAI and WAS across the same variables. Strong and statistically significant correlations were evident between WAI and WAS (rs = 0.83, p < 0.001). All the variables used in the logistic regression model (gender, the sector employment, and previous chronic diseases) were statistically significant in both questionnaires. Conclusion: WAS questionnaire could be used as a tool for reliable assessment of work ability among Spanish workers with Post COVID-19 condition or Persistent CO-VID-19.展开更多
BACKGROUND Pulmonary arterial hypertension(PAH)is a disease of the arterioles resulting in an increased resistance in pulmonary circulation with associated high pressures in the pulmonary arteries,causing irreversible...BACKGROUND Pulmonary arterial hypertension(PAH)is a disease of the arterioles resulting in an increased resistance in pulmonary circulation with associated high pressures in the pulmonary arteries,causing irreversible remodeling of the pulmonary arterial walls.Coronavirus disease 2019(COVID-19)has been associated with development of new onset PAH in the literature leading to symptoms of dyspnea,cough and fatigue that persist in spite of resolution of acute COVID-19 infection.However,the majority of these cases of COVID related PAH were diagnosed using echocardiographic data or via right heart catheterization in mechanically ventilated patients.CASE SUMMARY Our case is the first reported case of COVID related PAH diagnosed by right heart catheterization in a non-mechanically ventilated patient.Right heart catheterization has been the gold standard for diagnosis of pulmonary hypertension.Our patient had right heart catheterization four months after her initial COVID-19 infection due to persistent dyspnea.CONCLUSION This revealed new onset PAH that developed following her infection with COVID-19,an emerging sequela of the infection.展开更多
Background: Mental health has been impaired and at risk due to the worldwide COVID-19 pandemic. The consequences due to confinement impacted every scenario, which directly influenced the daily routine of nurse student...Background: Mental health has been impaired and at risk due to the worldwide COVID-19 pandemic. The consequences due to confinement impacted every scenario, which directly influenced the daily routine of nurse students;in each setting students faced stressors that trigger fear, anxiety and others, since being in confinement learning of topics moved to the home, laboratory practices in hospitals were cancelled leaving the room that is uncertain up to their return to in-person activities. It is important to highlight the need for innovation and strengthening of theoretical-pedagogic aspects centered at the student’s context as a human being with their own needs and problems, who will interact with others in the continuous process of health-illness. Objective: the aim was to identify the stressors in the nurse students’ formation in the new normality post-COVID-19. Methods: Qualitative and phenomenological research with 27 participants aged 20 - 25 years, nurse students of a public university. The information collection was through four focal groups of 6-7 members each, data analysis was done according to Miles & Huberman after signed informed consent of each participant, and authorized by the chairperson of the Nurse’ career. Results: Category 1, Cumulative stressors with sub-categories 1.1 Uncertainty, 1.2 Isolation, 1.3 Invisibility, 1.4 Mockery, 1.5 Exclusion. Category 2, Expectancy states with sub-categories 2.1 Low self-esteem, 2.2 Insecurity, 2.3 Anxiety, 2.4 Depression, 2.5 Temporary leave, 2.6 Search for authenticity. Category 3, Internalization processes with sub-categories 3.1 Social rejection, 3.2 Self-censorship, 3.3 Discrediting, 3.4 Disempowerment. Category 4, Academic aspects affected with sub-categories 4.1 Deficient studying habits, 4.2 Deficient assimilations of knowledge, 4.3 Archived knowledge in the computer, 4.4 Absence of practice in previous semesters. Conclusion: Once identified the stressors in nurse students in the new normality post-COVID-19, it will allow the creation of settings that help in getting confidence for students, i.e., a safe surrounding promotes the development of abilities and competencies during formation, as well as recommendations of teachers in the classroom and laboratories that contribute to filling space that students perceive as empty, and to intensifying the companionship in clinical settings where students perceive most aggressiveness.展开更多
At the end of 2019,the sudden outbreak of the COVID-19 epidemic brought great challenges to the world,and China's tourism industry suffered an unprecedented heavy blow.Exploring the impact of the epidemic on touri...At the end of 2019,the sudden outbreak of the COVID-19 epidemic brought great challenges to the world,and China's tourism industry suffered an unprecedented heavy blow.Exploring the impact of the epidemic on tourism consumption structure has become a research focus in the post-epidemic era.In this study,based on Shandong Tourism Statistics Handbook from 2018 to 2020,taking Shandong Province as an example,the changes of total tourism revenue and tourism consumption structure in Shandong Province before and after the COVID-19 epidemic were compared to predict the development of tourism in Shandong Province in the post-epidemic era and find out existing problems,and optimization paths were put forward for the development of tourism in Shandong Province in the post-epidemic era.展开更多
Infection caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV2)virus,responsible for the coronavirus disease 2019(COVID-19)pandemic,induces symptoms including increased inflammatory response,severe ...Infection caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV2)virus,responsible for the coronavirus disease 2019(COVID-19)pandemic,induces symptoms including increased inflammatory response,severe acute respiratory syndrome(SARS),cognitive dysfunction like brain fog,and cardiovascular defects.Long-term effects of SARS-CoV2 COVID-19 syndrome referred to as post-COVID-19 syndrome on age-related progressive neurodegenerative disorders such as Alzheimer's disease remain understudied.Using the targeted misexpression of individual SARS-CoV2 proteins in the retinal neurons of the Drosophila melanogaster eye,we found that misexpression of nonstructural protein 3(Nsp3),a papain-like protease,ablates the eye and generates dark necrotic spots.Targeted misexpression of Nsp3 in the eye triggers reactive oxygen species production and leads to apoptosis as shown by cell death reporters,terminal deoxynucleotidyl transferase(TdT)dUTP Nick-end labeling(TUNEL)assay,and dihydroethidium staining.Furthermore,Nsp3 misexpression activates both apoptosis and autophagy mechanism(s)to regulate tissue homeostasis.Transient expression of SARS-CoV2 Nsp3 in murine neuroblastoma,Neuro-2a cells,significantly reduced the metabolic activity of these cells and triggers cell death.Misexpression of SARS-CoV2 Nsp3 in an Alzheimer's disease transgenic fly eye model(glass multiple repeats[GMR]>amyloidβ42)further enhances the neurodegenerative rough eye phenotype due to increased cell death.These findings suggest that SARS-CoV2 utilizes Nsp3 protein to potentiate cell death response in a neurodegenerative disease background that has high pre-existing levels of neuroinflammation and cell death.展开更多
Background:Adult patients with congenital heart disease(ACHD)might be at high risk of Coronavirus disease-2019(COVID-19).This study aimed to report on a one-year tertiary center experience regards COVID-19 infection i...Background:Adult patients with congenital heart disease(ACHD)might be at high risk of Coronavirus disease-2019(COVID-19).This study aimed to report on a one-year tertiary center experience regards COVID-19 infection in ACHD patients.Methods:This is a one-year(March-2020 to March-2021)tertiary-center retrospective study that enrolled all ACHD patients;COVID-19 positive patients’medical records,and management were reported.Results:We recorded 542 patients,205(37.8%)COVID-19-positive,and 337(62.2%)COVID-19-negative patients.Palliated single ventricle and Eisenmenger syndrome patients were more vulnerable to COVID-19 infection(P<0.05*).Cardiovascular COVID-19 complications were arrhythmias in 47(22.9%)patients,heart failure in 39(19.0%)patients,cyanosis in 12(5.9%)patients,stroke/TIA in 5(2.4%)patients,hypertension and infective endocarditis in 2(1.0%)patients for each,pulmonary hypertension and pulmonary embolism in 1(0.5%)patient for each.11(5.4%)patients were managed with home isolation,147(71.7%)patients required antibiotics,32(15.6%)patients required intensive care unit(ICU),8(3.9%)patients required inotropes,7(3.4%)patients required mechanical ventilation,and 2(1.0%)patients required extracorporeal membrane oxygenation(ECMO).Thromboprophylaxis was given to all 46(22.4%)hospitalized patients.American College of Cardiology/American Heart Association classification revealed that complex lesions,and FC-C/D categories were more likely to develop severe/critical symptoms,that required mechanical ventilation and ECMO(P<0.05*).Mortality was reported in 3(0.6%)patients with no difference between groups(P=0.872).193(35.6%)patients were vaccinated.Conclusions:COVID-19 infection in ACHD patients require individualized risk stratification and management.Eisenmenger syndrome,single ventricle palliation,complex lesions,and FC-C/D patients were more vulnerable to severe/critical symptoms that required ICU admission,mechanical ventilation,and ECMO.The vaccine was mostly tolerable.展开更多
Introduction: Mucormycosis is a common fungal infection in India even before the COVID-19 pandemic. The incidence of Mucor mycosis has entered public consciousness in response to an outbreak of cases in India during C...Introduction: Mucormycosis is a common fungal infection in India even before the COVID-19 pandemic. The incidence of Mucor mycosis has entered public consciousness in response to an outbreak of cases in India during COVID-19 pandemic. Mortality is unacceptably high, reaching 80% in some case series. Prompt diagnosis is crucial because treatment initiation is time-critical due to the rapid progression of the infection. Direct KOH mount is a simple, rapid, inexpensive point-of-care test, which requires minimum technical aids. Interpretation of KOH smears requires some amount of experience. The present study was to evaluate the sensitivity and specificity of Direct Microscopical examination by KOH preparation of suspected Mucor mycosis samples taking the fungal culture as gold standard. Material and Methods: 230 samples were received in Microbiology Department from May 2021 to August 2021 from the patients suspected of Mucor mycosis. Samples were processed for KOH preparation using different concentrations of KOH like 20% and 40% till all tissues get digested. Samples were cultured also in Sabourauds dextrose agar (SDA) medium. Results of microscopy and culture were statistically analyzed using SPSS software version 23. Result: Sensitivity of KOH preparation was 67%, specificity was 87%. Positive predictive value was 76% and negative predictive value was 81% and accuracy was 80% when compared with the fungal culture. Discussion: Direct microscopic examinations using KOH preparation are the simplest, cheapest method used for the diagnosis of mycotic infections. This study is valuable in establishing a reliable method for early information on diagnosis of Mucor mycosis that may be crucial for determining appropriate therapy for the successful treatment of Mucor mycosis patients. Conclusion: KOH examination plays an important role in the diagnosis of Mucor mycosis suspected patients during COVID-19 pandemic era when compared with fungal culture which is a gold standard test in diagnosis of Fungal infection. It is the simplest and cheapest method that can be developed easily with minimal infrastructure or human resources in resource-limited countries during the COVID-19 era.展开更多
Background: Earlier back at the beginning of COVID-19, the acute phase of infection was variable from one patient to another causing different symptoms. However, many patients are still suffering from Post COVID-19 Sy...Background: Earlier back at the beginning of COVID-19, the acute phase of infection was variable from one patient to another causing different symptoms. However, many patients are still suffering from Post COVID-19 Syndrome. Hence, this study aimed to assess the persistence of symptoms in patients who recovered from COVID-19 in the Qassim Region, Saudi Arabia. Methodology: A descriptive cross-sectional study of 413 confirmed PCR test-positive covid-19 patients enrolled in this study from the Ministry of Health Electronic Surveillance System (HESN). The Yorkshire Rehabilitation Scale (C19-YRS) checklist was used to record patients’ symptoms, functioning, and disability. Data were analyzed by the SPSS program. Functional and patient-reported outcome measures were correlated with certain items from C19-YRS, the severity of symptoms. Its distribution-based methods were used for responsiveness over time. The scaling and targeting assumptions were satisfied, and internal consistency was high (Cronbach’s α = 0.843). Results: After 4 weeks of infection, 50% of patients reported persistent symptoms such as laryngeal complications, 43.8% Swallowing changes, 31.3% fatigue, 18.8% pain, 18.8% loss of appetite, 12.5% breathlessness, and 6.3% depression, Moreover, 18.8% of patients experienced reduced mobility. At the beginning of the COVID-19 infection, fever was the most common complaint 332 (80.4%), followed by 267 (64.6%) fatigue, and loss of smell 230 (55.7%). The severity of the breathlessness symptoms was exaggerated during the patients’ walking or climbing stairs. Patients who were admitted to an intensive care unit (n = 5) were significantly elderly (P Conclusion: The study examined the severity of post covid syndrome by patients’ responsiveness to the scale items in C19-YRS. The majority of COVID-19 symptoms were still present but significantly reduced after 4 weeks of infection. Follow-up and long-term management of physical and psychological symptoms of hospitalized and non-hospitalized patients are very important.展开更多
自2020年世界卫生组织(World Health Organization,WHO)正式宣布新型冠状病毒肺炎疫情成为全球大流行之后,全球114个国家或区域受到不同程度的影响。后疫情时代的到来要求各国采取新的疫情防控措施,以应对未来可能出现的问题和挑战。为...自2020年世界卫生组织(World Health Organization,WHO)正式宣布新型冠状病毒肺炎疫情成为全球大流行之后,全球114个国家或区域受到不同程度的影响。后疫情时代的到来要求各国采取新的疫情防控措施,以应对未来可能出现的问题和挑战。为帮助我国在后疫情时代巩固几年来的防疫成果并获取更大的发展窗口,本文探析了全球疫情变化及各国主要防治政策的变化,总结归纳了我国疫情防治政策的发展变迁,提出适应我国国情的以家庭为核心的新型精准防控措施。展开更多
Wastewater-based surveillance serves as a supplementary approach to clinical surveillance of COVID-19 during the epidemic.This study aimed to track the prevalence of the disease and the viral genetic variability throu...Wastewater-based surveillance serves as a supplementary approach to clinical surveillance of COVID-19 during the epidemic.This study aimed to track the prevalence of the disease and the viral genetic variability through wastewater-based surveillance in the post-epidemic era.Between January to December 2023,samples were collected from the influent lines of two wastewater treatment plants(WWTPs),concentrated using PEG8000,and subjected to detection of the target genes ORF 1ab and N of SARS-CoV-2 via reverse transcriptional quantitative PCR(RT-qPCR).For next-generation sequencing(NGS),high-quality samples from both wastewater and clinical patients were selected.Weekly analysis were performed using R software to evaluate the correlation between the SARSCoV-2 RNA concentrations in wastewater and positive rate of reported cases,indicating a positive correlation.Genetic diversity patterns of SARS-CoV-2 in wastewater resembled those in the patient source based on Principal Coordinates Analysis(PCoA)with three clusters for different stages.The rise of RNA concentration in wastewater indicates the growth of cases and the emergence of new variants,serving as an early warning of potential viral mutations,disease outbreaks even possible epidemics.Furthermore,the genomic surveillance of wastewater could help identify new variants that may not be captured through population monitoring,especially when sample sizes are insufficient.Consequently,surveillance of SARS-CoV-2 in municipal wastewater has emerged as a reliable,earlywarning monitoring system for COVID-19 in the post-epidemic era.展开更多
文摘Objective:To study cardiovascular sequelae of post-COVID-19 patients with moderate to severe computed tomography(CT)severity score.Methods:A prospective,non-randomized,observational study was conducted on 100 post-COVID-19 patients with moderate to severe CT severity scores from January 2021 to December 2021.Fifty-nine were male[mean age(54.1±12.2)years]and 41 were female[mean age(46.9±15.1)years].Patients with previous cardiovascular disease,previous chronic lung disease,and pre-existing primary or secondary pulmonary hypertension were excluded.Patients were examined,and serial electrocardiogram and 2D echocardiography were performed to detect any cardiovascular abnormality.Results:Post-COVID-19 patients had persistent symptoms,the most common being fatigue(59%).Most of these symptoms were relieved on follow-up.A rise in systolic,diastolic blood pressure,and pulse rate was observed.The electrocardiographic evaluation revealed ST-T segment changes,sinus tachycardia,ventricular hypertrophy,and arrhythmias among a considerable number of patients.On echocardiography,left ventricular diastolic dysfunction was most common(43%).Pulmonary hypertension,as evidenced by elevated pulmonary artery systolic pressure,was seen in 15%of patients.Conclusions:The present findings reveal an increased incidence of cardiovascular complications after recovery from COVID-19 infection in those without pre-existing cardiovascular or chronic lung disease.
文摘Since its emergence in 2019,it has become apparent that coronavirus 2019(COVID-19)infection can result in multi systemic involvement.In addition to pulmonary symptoms,hepatobiliary involvement has been widely reported.Extent of hepatic involvement ranges from minor elevation in liver function tests(LFTs)to significant hepatocellular or cholestatic injury.In majority of cases,resolution of hepatic injury or improvement in LFTs is noted as patients recover from COVID-19 infection.However,severe biliary tract injury progressing to liver failure has been reported in patients requiring prolonged intensive care unit stay or mechanical ventilation.Due to the timing of its presentation,this form of progressive cholestatic injury has been referred to as COVID-19 cholangiopathy or post-COVID-19 cholangiopathy,and can result in devastating consequences for patients.COVID-19 cholangiopathy is recognized by dramatic elevation in serum alkaline phosphatase and bilirubin and radiologic evidence of bile duct injury.Cholangiopathy in COVID-19 occurs weeks to months after the initial infection and during the recovery phase.Imaging findings and pathology often resemble bile duct injury associated with primary or secondary sclerosing cholangitis.Etiology of COVID-19 cholangiopathy is unclear.Several mechanisms have been proposed,including direct cholangiocyte injury,vascular compromise,and cytokine release syndromes.This review summarizes existing data on COVID-19 cholangiopathy,including reported cases in the literature,proposed pathophysiology,diagnostic testing,and long-term implications.
文摘Aims: The present study aims to compare the assessment of work ability based on the use of the Work Ability Index (WAI) with another questionnaire base only on the use of WAI’s first item, termed as the “Work Ability Score” (WAS). Study design: A cohort of 384 Spanish workers included in a Post COVID-19 condition or persistent COVID-19 multicenter research was utilized. Place and Duration of Study: This cohort was enlisted in four hospitals (Hospital Universitario 12 de Octubre, Madrid;Hospital Universitario Virgen Macarena, Sevilla, Andalucía;Hospital Universitario Gregorio Marañón, Madrid and Complejo Asistencial Universitario de Salamanca, Castilla y León), since 2021 until 2022. Methodology: 384 Spanish workers (176 men and 208 women;aged 20 to 70 years) with Post COVID-19 condition or persistent COVID-19 were included. Descriptive analysis of primary scores was conducted. Given the non-normal distribution of data, the Mann-Whitney and Kruskal-Wallis tests were employed. Spearman and Kendall correlations were employed to assess the relationship between WAI and WAS, also used weighted Kappa to estimate the degree agreement between WAI and WAS. Logistic regression models were utilized to study determinants influencing WAI and WAS, categorized as poor or moderate. Results: WAI had an average score of 32.98 (SD = 10.28), whereas WAS had an average of 5.95 (SD = 2.77). Significant differences were observed in both WAI and WAS across the same variables. Strong and statistically significant correlations were evident between WAI and WAS (rs = 0.83, p < 0.001). All the variables used in the logistic regression model (gender, the sector employment, and previous chronic diseases) were statistically significant in both questionnaires. Conclusion: WAS questionnaire could be used as a tool for reliable assessment of work ability among Spanish workers with Post COVID-19 condition or Persistent CO-VID-19.
文摘BACKGROUND Pulmonary arterial hypertension(PAH)is a disease of the arterioles resulting in an increased resistance in pulmonary circulation with associated high pressures in the pulmonary arteries,causing irreversible remodeling of the pulmonary arterial walls.Coronavirus disease 2019(COVID-19)has been associated with development of new onset PAH in the literature leading to symptoms of dyspnea,cough and fatigue that persist in spite of resolution of acute COVID-19 infection.However,the majority of these cases of COVID related PAH were diagnosed using echocardiographic data or via right heart catheterization in mechanically ventilated patients.CASE SUMMARY Our case is the first reported case of COVID related PAH diagnosed by right heart catheterization in a non-mechanically ventilated patient.Right heart catheterization has been the gold standard for diagnosis of pulmonary hypertension.Our patient had right heart catheterization four months after her initial COVID-19 infection due to persistent dyspnea.CONCLUSION This revealed new onset PAH that developed following her infection with COVID-19,an emerging sequela of the infection.
文摘Background: Mental health has been impaired and at risk due to the worldwide COVID-19 pandemic. The consequences due to confinement impacted every scenario, which directly influenced the daily routine of nurse students;in each setting students faced stressors that trigger fear, anxiety and others, since being in confinement learning of topics moved to the home, laboratory practices in hospitals were cancelled leaving the room that is uncertain up to their return to in-person activities. It is important to highlight the need for innovation and strengthening of theoretical-pedagogic aspects centered at the student’s context as a human being with their own needs and problems, who will interact with others in the continuous process of health-illness. Objective: the aim was to identify the stressors in the nurse students’ formation in the new normality post-COVID-19. Methods: Qualitative and phenomenological research with 27 participants aged 20 - 25 years, nurse students of a public university. The information collection was through four focal groups of 6-7 members each, data analysis was done according to Miles & Huberman after signed informed consent of each participant, and authorized by the chairperson of the Nurse’ career. Results: Category 1, Cumulative stressors with sub-categories 1.1 Uncertainty, 1.2 Isolation, 1.3 Invisibility, 1.4 Mockery, 1.5 Exclusion. Category 2, Expectancy states with sub-categories 2.1 Low self-esteem, 2.2 Insecurity, 2.3 Anxiety, 2.4 Depression, 2.5 Temporary leave, 2.6 Search for authenticity. Category 3, Internalization processes with sub-categories 3.1 Social rejection, 3.2 Self-censorship, 3.3 Discrediting, 3.4 Disempowerment. Category 4, Academic aspects affected with sub-categories 4.1 Deficient studying habits, 4.2 Deficient assimilations of knowledge, 4.3 Archived knowledge in the computer, 4.4 Absence of practice in previous semesters. Conclusion: Once identified the stressors in nurse students in the new normality post-COVID-19, it will allow the creation of settings that help in getting confidence for students, i.e., a safe surrounding promotes the development of abilities and competencies during formation, as well as recommendations of teachers in the classroom and laboratories that contribute to filling space that students perceive as empty, and to intensifying the companionship in clinical settings where students perceive most aggressiveness.
文摘At the end of 2019,the sudden outbreak of the COVID-19 epidemic brought great challenges to the world,and China's tourism industry suffered an unprecedented heavy blow.Exploring the impact of the epidemic on tourism consumption structure has become a research focus in the post-epidemic era.In this study,based on Shandong Tourism Statistics Handbook from 2018 to 2020,taking Shandong Province as an example,the changes of total tourism revenue and tourism consumption structure in Shandong Province before and after the COVID-19 epidemic were compared to predict the development of tourism in Shandong Province in the post-epidemic era and find out existing problems,and optimization paths were put forward for the development of tourism in Shandong Province in the post-epidemic era.
基金supported by 1RO1EY032959-01 from NIHSchuellein Chair Endowment FundSTEM Catalyst Grant from the University of Dayton(all to AS)。
文摘Infection caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV2)virus,responsible for the coronavirus disease 2019(COVID-19)pandemic,induces symptoms including increased inflammatory response,severe acute respiratory syndrome(SARS),cognitive dysfunction like brain fog,and cardiovascular defects.Long-term effects of SARS-CoV2 COVID-19 syndrome referred to as post-COVID-19 syndrome on age-related progressive neurodegenerative disorders such as Alzheimer's disease remain understudied.Using the targeted misexpression of individual SARS-CoV2 proteins in the retinal neurons of the Drosophila melanogaster eye,we found that misexpression of nonstructural protein 3(Nsp3),a papain-like protease,ablates the eye and generates dark necrotic spots.Targeted misexpression of Nsp3 in the eye triggers reactive oxygen species production and leads to apoptosis as shown by cell death reporters,terminal deoxynucleotidyl transferase(TdT)dUTP Nick-end labeling(TUNEL)assay,and dihydroethidium staining.Furthermore,Nsp3 misexpression activates both apoptosis and autophagy mechanism(s)to regulate tissue homeostasis.Transient expression of SARS-CoV2 Nsp3 in murine neuroblastoma,Neuro-2a cells,significantly reduced the metabolic activity of these cells and triggers cell death.Misexpression of SARS-CoV2 Nsp3 in an Alzheimer's disease transgenic fly eye model(glass multiple repeats[GMR]>amyloidβ42)further enhances the neurodegenerative rough eye phenotype due to increased cell death.These findings suggest that SARS-CoV2 utilizes Nsp3 protein to potentiate cell death response in a neurodegenerative disease background that has high pre-existing levels of neuroinflammation and cell death.
文摘Background:Adult patients with congenital heart disease(ACHD)might be at high risk of Coronavirus disease-2019(COVID-19).This study aimed to report on a one-year tertiary center experience regards COVID-19 infection in ACHD patients.Methods:This is a one-year(March-2020 to March-2021)tertiary-center retrospective study that enrolled all ACHD patients;COVID-19 positive patients’medical records,and management were reported.Results:We recorded 542 patients,205(37.8%)COVID-19-positive,and 337(62.2%)COVID-19-negative patients.Palliated single ventricle and Eisenmenger syndrome patients were more vulnerable to COVID-19 infection(P<0.05*).Cardiovascular COVID-19 complications were arrhythmias in 47(22.9%)patients,heart failure in 39(19.0%)patients,cyanosis in 12(5.9%)patients,stroke/TIA in 5(2.4%)patients,hypertension and infective endocarditis in 2(1.0%)patients for each,pulmonary hypertension and pulmonary embolism in 1(0.5%)patient for each.11(5.4%)patients were managed with home isolation,147(71.7%)patients required antibiotics,32(15.6%)patients required intensive care unit(ICU),8(3.9%)patients required inotropes,7(3.4%)patients required mechanical ventilation,and 2(1.0%)patients required extracorporeal membrane oxygenation(ECMO).Thromboprophylaxis was given to all 46(22.4%)hospitalized patients.American College of Cardiology/American Heart Association classification revealed that complex lesions,and FC-C/D categories were more likely to develop severe/critical symptoms,that required mechanical ventilation and ECMO(P<0.05*).Mortality was reported in 3(0.6%)patients with no difference between groups(P=0.872).193(35.6%)patients were vaccinated.Conclusions:COVID-19 infection in ACHD patients require individualized risk stratification and management.Eisenmenger syndrome,single ventricle palliation,complex lesions,and FC-C/D patients were more vulnerable to severe/critical symptoms that required ICU admission,mechanical ventilation,and ECMO.The vaccine was mostly tolerable.
文摘Introduction: Mucormycosis is a common fungal infection in India even before the COVID-19 pandemic. The incidence of Mucor mycosis has entered public consciousness in response to an outbreak of cases in India during COVID-19 pandemic. Mortality is unacceptably high, reaching 80% in some case series. Prompt diagnosis is crucial because treatment initiation is time-critical due to the rapid progression of the infection. Direct KOH mount is a simple, rapid, inexpensive point-of-care test, which requires minimum technical aids. Interpretation of KOH smears requires some amount of experience. The present study was to evaluate the sensitivity and specificity of Direct Microscopical examination by KOH preparation of suspected Mucor mycosis samples taking the fungal culture as gold standard. Material and Methods: 230 samples were received in Microbiology Department from May 2021 to August 2021 from the patients suspected of Mucor mycosis. Samples were processed for KOH preparation using different concentrations of KOH like 20% and 40% till all tissues get digested. Samples were cultured also in Sabourauds dextrose agar (SDA) medium. Results of microscopy and culture were statistically analyzed using SPSS software version 23. Result: Sensitivity of KOH preparation was 67%, specificity was 87%. Positive predictive value was 76% and negative predictive value was 81% and accuracy was 80% when compared with the fungal culture. Discussion: Direct microscopic examinations using KOH preparation are the simplest, cheapest method used for the diagnosis of mycotic infections. This study is valuable in establishing a reliable method for early information on diagnosis of Mucor mycosis that may be crucial for determining appropriate therapy for the successful treatment of Mucor mycosis patients. Conclusion: KOH examination plays an important role in the diagnosis of Mucor mycosis suspected patients during COVID-19 pandemic era when compared with fungal culture which is a gold standard test in diagnosis of Fungal infection. It is the simplest and cheapest method that can be developed easily with minimal infrastructure or human resources in resource-limited countries during the COVID-19 era.
文摘Background: Earlier back at the beginning of COVID-19, the acute phase of infection was variable from one patient to another causing different symptoms. However, many patients are still suffering from Post COVID-19 Syndrome. Hence, this study aimed to assess the persistence of symptoms in patients who recovered from COVID-19 in the Qassim Region, Saudi Arabia. Methodology: A descriptive cross-sectional study of 413 confirmed PCR test-positive covid-19 patients enrolled in this study from the Ministry of Health Electronic Surveillance System (HESN). The Yorkshire Rehabilitation Scale (C19-YRS) checklist was used to record patients’ symptoms, functioning, and disability. Data were analyzed by the SPSS program. Functional and patient-reported outcome measures were correlated with certain items from C19-YRS, the severity of symptoms. Its distribution-based methods were used for responsiveness over time. The scaling and targeting assumptions were satisfied, and internal consistency was high (Cronbach’s α = 0.843). Results: After 4 weeks of infection, 50% of patients reported persistent symptoms such as laryngeal complications, 43.8% Swallowing changes, 31.3% fatigue, 18.8% pain, 18.8% loss of appetite, 12.5% breathlessness, and 6.3% depression, Moreover, 18.8% of patients experienced reduced mobility. At the beginning of the COVID-19 infection, fever was the most common complaint 332 (80.4%), followed by 267 (64.6%) fatigue, and loss of smell 230 (55.7%). The severity of the breathlessness symptoms was exaggerated during the patients’ walking or climbing stairs. Patients who were admitted to an intensive care unit (n = 5) were significantly elderly (P Conclusion: The study examined the severity of post covid syndrome by patients’ responsiveness to the scale items in C19-YRS. The majority of COVID-19 symptoms were still present but significantly reduced after 4 weeks of infection. Follow-up and long-term management of physical and psychological symptoms of hospitalized and non-hospitalized patients are very important.
文摘自2020年世界卫生组织(World Health Organization,WHO)正式宣布新型冠状病毒肺炎疫情成为全球大流行之后,全球114个国家或区域受到不同程度的影响。后疫情时代的到来要求各国采取新的疫情防控措施,以应对未来可能出现的问题和挑战。为帮助我国在后疫情时代巩固几年来的防疫成果并获取更大的发展窗口,本文探析了全球疫情变化及各国主要防治政策的变化,总结归纳了我国疫情防治政策的发展变迁,提出适应我国国情的以家庭为核心的新型精准防控措施。
基金supported by the Key Technology Research and Development Program of the Science and Technology Department of Sichuan Province(China)(2021YFS0064)the Youth Innovation Research Project by the Sichuan Medical Association(China)(Q22017)the Science Foundation of the Health and Family Planning Commission of Chengdu(China)(22056).
文摘Wastewater-based surveillance serves as a supplementary approach to clinical surveillance of COVID-19 during the epidemic.This study aimed to track the prevalence of the disease and the viral genetic variability through wastewater-based surveillance in the post-epidemic era.Between January to December 2023,samples were collected from the influent lines of two wastewater treatment plants(WWTPs),concentrated using PEG8000,and subjected to detection of the target genes ORF 1ab and N of SARS-CoV-2 via reverse transcriptional quantitative PCR(RT-qPCR).For next-generation sequencing(NGS),high-quality samples from both wastewater and clinical patients were selected.Weekly analysis were performed using R software to evaluate the correlation between the SARSCoV-2 RNA concentrations in wastewater and positive rate of reported cases,indicating a positive correlation.Genetic diversity patterns of SARS-CoV-2 in wastewater resembled those in the patient source based on Principal Coordinates Analysis(PCoA)with three clusters for different stages.The rise of RNA concentration in wastewater indicates the growth of cases and the emergence of new variants,serving as an early warning of potential viral mutations,disease outbreaks even possible epidemics.Furthermore,the genomic surveillance of wastewater could help identify new variants that may not be captured through population monitoring,especially when sample sizes are insufficient.Consequently,surveillance of SARS-CoV-2 in municipal wastewater has emerged as a reliable,earlywarning monitoring system for COVID-19 in the post-epidemic era.