BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making.One analytical technique that can be helpfu...BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making.One analytical technique that can be helpful in uncertain situations is clinical judgment.Clinicians must deal with contradictory information,lack of time to make decisions,and long-term factors when emergencies occur.AIM To examine the ethical issues healthcare professionals faced during the coronavirus disease 2019(COVID-19)pandemic and the factors affecting clinical decision-making.METHODS This pilot study,which means it was a preliminary investigation to gather information and test the feasibility of a larger investigation was conducted over 6 months and we invited responses from clinicians worldwide who managed patients with COVID-19.The survey focused on topics related to their professional roles and personal relationships.We examined five core areas influencing critical care decision-making:Patients'personal factors,family-related factors,informed consent,communication and media,and hospital administrative policies on clinical decision-making.The collected data were analyzed using the χ^(2) test for categorical variables.RESULTS A total of 102 clinicians from 23 specialties and 17 countries responded to the survey.Age was a significant factor in treatment planning(n=88)and ventilator access(n=78).Sex had no bearing on how decisions were made.Most doctors reported maintaining patient confidentiality regarding privacy and informed consent.Approximately 50%of clinicians reported a moderate influence of clinical work,with many citing it as one of the most important factors affecting their health and relationships.Clinicians from developing countries had a significantly higher score for considering a patient's financial status when creating a treatment plan than their counterparts from developed countries.Regarding personal experiences,some respondents noted that treatment plans and preferences changed from wave to wave,and that there was a rapid turnover of studies and evidence.Hospital and government policies also played a role in critical decision-making.Rather than assessing the appropriateness of treatment,some doctors observed that hospital policies regarding medications were driven by patient demand.CONCLUSION Factors other than medical considerations frequently affect management choices.The disparity in treatment choices,became more apparent during the pandemic.We highlight the difficulties and contradictions between moral standards and the realities physicians encountered during this medical emergency.False information,large patient populations,and limited resources caused problems for clinicians.These factors impacted decision-making,which,in turn,affected patient care and healthcare staff well-being.展开更多
BACKGROUND The coronavirus disease 2019(COVID-19)pandemic had a profound societal impact in the United States which was associated with a decrease in overall life expectancy and an increase in substance abuse and fire...BACKGROUND The coronavirus disease 2019(COVID-19)pandemic had a profound societal impact in the United States which was associated with a decrease in overall life expectancy and an increase in substance abuse and firearm injury.Our under-standing of changes in mortality trends during the pandemic and its effect on organ availability for transplantation is limited.AIM To examine the trends of substance abuse and firearm injury fatalities during COVID-19 and a potential correlation with organ transplantation.METHODS Crude rates of population-based deaths among adults(18-75 years)from firearm injury and substance abuse from the period of 2014-2021 were obtained from centers of disease control wide-ranging online data for epidemiologic research database.Crude rates of causes of donor(18-75 years)deaths from 2014-2021 were obtained from the united network for organ sharing database.RESULTS Average annual percentage change(AAPC)deaths among the United States population were 16.4%from substance abuse and 3.4%from firearm injury.AAPC in cause of death among organ donors was 10.9%from drug intoxication and 2.1%from firearm injury.There was a significant(P<0.001)and progressive increase in mortality from both causes during the pandemic(2020-2021)and significant correlation(P<0.001)between population and donor causes of death.COVID-19 exacerbated trends in substance abuse and firearm mortality with a consequent increase in organ donation from donors who died from these two causes.CONCLUSION Identifying the socioeconomic and regional disparities associated with increase in deaths from substance abuse and firearms can help guide post-pandemic healthcare policies and mitigate their impact on organ transplantation.展开更多
The coronavirus disease(COVID-19)pandemic introduced significant psychosocial stressors for morticians in South Africa,yet their coping mechanisms remain underexplored.This study investigated how South African morticia...The coronavirus disease(COVID-19)pandemic introduced significant psychosocial stressors for morticians in South Africa,yet their coping mechanisms remain underexplored.This study investigated how South African morticians(N=10,Black males)coped with these stressors during the pandemic through semi-structured interviews.Interpretative phenomenological analysis(IPA)informed thematic analysis identifiedfive themes:(i)death overload distress associated with trauma and fear of exposure;(ii)insomnia due to worry,workload,and fear of infection;(iii)stigmatisation from community avoidance and negative perceptions;(iv)social isolation and anxiety related to emotional disconnection,personal protective equipment(PPE)shortages,and workload demands;and(v)adaptive coping mechanisms such as acceptance,resilience,external support,and religious faith,alongside less beneficial maladaptive strategies.Findings highlight the importance of targeted mental health services,psychoeducation,and social inclusion programmes to support morticians managing psychosocial stress during community health crises.展开更多
The popularity of traditional healing practices on social media during the COVID-19 pandemic challenged the discourse diffused by the Ministry of Health in Morocco.This created a struggle in the public sphere between ...The popularity of traditional healing practices on social media during the COVID-19 pandemic challenged the discourse diffused by the Ministry of Health in Morocco.This created a struggle in the public sphere between a scientific discourse on health care constructed by the Ministry of Health and a culturally conservative discourse propagated by practitioners of traditional healing.This paper explores how both discourses were competing to shape public opinion about the best health-care practices to end the COVID-19 pandemic in Morocco.The data was collected from Facebook and You Tube based on criteria of social-media functionalities.The data was analysed using multimodal critical discourse analysis followed by a process of coding and category development.The results of the study reveal that shaping public opinion about ways to deal with the COVID-19 pandemic in Morocco was characterized by the success of traditional health-care discourse in a counter-hegemonic struggle with the discourse of the Ministry of Health.This discourse was conservative,as it cherished an online Muslim identity of social-media users by relying on ideologically constructed argumentation and discursive strategies in representing prophetic medicine as the best health-care practice to end the pandemic.展开更多
Background:Prosocial behavior plays a crucial role in improving interpersonal relationships and social well-being,especially in times of crisis.The COVID-19 pandemic caused a severe humanitarian crisis,prompting gover...Background:Prosocial behavior plays a crucial role in improving interpersonal relationships and social well-being,especially in times of crisis.The COVID-19 pandemic caused a severe humanitarian crisis,prompting governments to implement measures such as social confinement.The main objective of the study was to analyze the psychological and sociodemographic variables that may predict prosocial behavior during quarantine.Methods:The sample consisted of 172 participants from Spain,divided into two groups based on whether they reported an increase in prosocial behaviors during quarantine.An online survey was administered to analyze the psychological and sociodemographic variables.Results:Overall,results demonstrate that emotional regulation,morality and age may predict prosocial behavior.Conclusions:Understanding the predictors of prosocial behavior during social crises is crucial for devising effective policies aimed at fostering community resilience and support networks,with particular attention to factors such as the capacity to regulate emotions,morality,and age.展开更多
This study investigated the variations in summer and winter PM_(2.5)concentrations and chemical composition in urban Xi'an before and during the COVID-19 pandemic restrictions.During the pandemic restrictions,summ...This study investigated the variations in summer and winter PM_(2.5)concentrations and chemical composition in urban Xi'an before and during the COVID-19 pandemic restrictions.During the pandemic restrictions,summer daytime PM_(2.5)concentrations remained comparable to pre-pandemic levels,while a reduction was noted at nighttime.Conversely,winter experienced a significant increase in both daytime and nighttime PM_(2.5)concentrations.Chemical composition analysis revealed reductions in secondary inorganic ion concentrations but notable increases in crustal matter concentrations during the pandemic restrictions,particularly evident in winter.The reductions in secondary inorganic ion concentrations were likely due to decreased emissions of corresponding anthropogenic precursors in summer,while linked to reductions in transformation efficiencies in winter.The heightened crustal matter concentrations were likely attributed to increased contributions of long-range air mass transport from dusty regions,especially prevalent in winter.Source apportionment using positive matrix factorization analysis provided quantitative insights into the distinct source profiles contributing to PM_(2.5)before and during the pandemic restrictions,with secondary inorganic-rich sources decreasing and dust-related sources increasing during the pandemic restrictions.Additionally,combustion sources,primarily from coal and biomass burning,showed higher contributions during winter.In conclusion,this study underscores the complex interplay between anthropogenic and natural factors influencing PM_(2.5)levels in Xi'an.Efforts to mitigate PM_(2.5)pollution should prioritize reducing anthropogenic emissions and implementing measures to control dust emissions,particularly when dust-related sources significantly contribute to elevated PM_(2.5)concentrations.These findings provide valuable insights into developing effective strategies for addressing the PM_(2.5)pollution problem in Xi'an.展开更多
Mental health disorders have emerged as a critical global health challenge,profoundly impacting individuals,communities,and societies worldwide.The prevalence of mental health problems has been steadily increasing,wit...Mental health disorders have emerged as a critical global health challenge,profoundly impacting individuals,communities,and societies worldwide.The prevalence of mental health problems has been steadily increasing,with~1 in 8 people,equivalent to 970 million individuals suffering from a mental disorder in 2019(https://vizhub.healthdata.org/gbd-results).Anxiety and depressive disorders are predominant,contributing significantly to the burden of mental health issues,according to the World Health Organization.The COVID-19 pandemic has further exacerbated this situation.It led to a notable upsurge in anxiety and major depressive disorders in 2020.Estimates indicate a 26%rise in anxiety and a 28%increase in depression within that year(https://www.who.int/publications/i/item/WHO-2019-nCoVSci_Brief-Mental_health-2022.1)[1].展开更多
BACKGROUND In the initial stages of the coronavirus disease 2019(COVID-19)pandemic,healthcare workers(HCWs)who were immunologically naive to COVID-19,were exposed to a highly transmissible virus.AIM To compare infecti...BACKGROUND In the initial stages of the coronavirus disease 2019(COVID-19)pandemic,healthcare workers(HCWs)who were immunologically naive to COVID-19,were exposed to a highly transmissible virus.AIM To compare infection risk among HCWs in high-risk(HR)and low-risk(LR)areas.METHODS Data on reverse transcriptase-polymerase chain reaction confirmed clinical infection and samples for nucleocapsid,and spike protein antibodies were collected at five time-points(T1 to T5)from HCWs in the emergency department and intensive care unit(HR group)and pre-clinical and para-clinical areas(LR).For the sero-study,only participants who provided at least one baseline sample and one during the second wave(T4 or T5)were analysed.Since CovishieldTM elicits only spike protein antibodies,subclinical infection was diagnosed if asymptomatic unvaccinated and CovishieldTM vaccinated individuals tested positive for nucleocapsid antibody.RESULTS Overall,by T5,clinical infection rate was similar in the HR(120/366,32.8%)and LR(22/82,26.8%)groups(P=0.17).However,before vaccination(T3),more HCWs in the HR group developed COVID-19 infection(21.9%vs 8.8%,P=0.046).In the sero-study group,clinical infection occurred in 31.5%(45/143)and 23.7%(14/59)in the HR and LR groups respectively(P=0.23).Spike antibody was detected in 140/143(97.9%)and 56/59(94.9%)and nucleocapsid antibody was positive in 95/143(66.4%)and 35/59(59.3%)in the HR and LR groups respectively(P=0.34).Subclinical infection rate(HR 34.9%,LR 35.6%,P=0.37)and hospitalization rate were similar.There was no mortality.CONCLUSION Before vaccination,HCWs in HR areas had a higher risk of infection.Seroprevalence studies suggest that subclinical infection was not uncommon.展开更多
Coronavirus disease 2019 is caused by severe acute respiratory syndrome coronavirus 2 and emerged in Wuhan,China.It affects millions of people all over the world and has caused the deaths of thousands of people.Mortal...Coronavirus disease 2019 is caused by severe acute respiratory syndrome coronavirus 2 and emerged in Wuhan,China.It affects millions of people all over the world and has caused the deaths of thousands of people.Mortality rates were higher in transplant recipients and patients awaiting transplantation due to social and psychological issues.It also affected candidates who would be transplant providers and caused the transplant chain to be broken worldwide.The coronavirus disease 2019 pandemic has significantly affected solid organ transplantation procedures and led to various changes in protocols and practices to ensure patient safety and increase transplant success.These include challenges in screening protocols,prioritization of cases,telemedicine and virtual consultations,modified surgical procedures,immunosuppression management,updated research and guidelines,post-transplantation process and difficulties to control side effects,difficulties in organ procurement,and patient education/support.It requires a multidisciplinary approach,close collaboration between transplant teams,and adherence to strict infection control measures to ensure the safety of both transplant recipients and healthcare providers.In this article,we compiled the most important points in an overview of this process.展开更多
Objective Despite the global decrease in influenza infections during the coronavirus disease 2019(COVID-19)pandemic,seasonal influenza remains a significant health issue.South Korea,known for its robust pandemic respo...Objective Despite the global decrease in influenza infections during the coronavirus disease 2019(COVID-19)pandemic,seasonal influenza remains a significant health issue.South Korea,known for its robust pandemic response and high influenza vaccination rates,offers a unique context for examining changes in vaccination trends during the pandemic.Using nationally representative data,we aimed to understand the impact of the pandemic on influenza vaccination behavior over a 12-year period and to identify vulnerable groups.Methods We analyzed influenza vaccination rates in South Korea between 2011-2022,focusing on pandemic-related impacts.The data of 2,426,139 adults(≥19 years)from the Korea Community Health Survey were used to assess demographic and sociological factors influencing vaccination behaviors.Results We observed an increase in influenza vaccination rates during the pre-COVID-19 period from 2011-2013(weighted prevalence:46.68%[95%confidence interval(CI):46.55-46.82])to 2017-2019(weighted prevalence:52.50%[95%CI:52.38-52.63]).However,a significant decline was observed in 2022,the late-COVID-19 pandemic period(weighted prevalence:55.78%[95%CI:55.56-56.01]),compared with the mid-pandemic period in 2021(weighted prevalence:59.12%[95%CI:58.91-59.32]),particularly among populations traditionally prioritized for influenza vaccination,including older adults(≥65 years)and patients with chronic diseases and low educational and income levels.Conclusion The influenza vaccination rate in South Korea was significantly affected by the COVID-19 pandemic,showing a notable decrease among vulnerable demographic groups.This suggests the need for targeted public health strategies to address vaccine hesitancy and improve vaccination rates,particularly among high-risk populations.展开更多
The diagnosis and treatment processes for long COVID have been relatively slow to develop for several reasons,such as a lack of consensus about its definition among medical professionals and researchers,and restricted...The diagnosis and treatment processes for long COVID have been relatively slow to develop for several reasons,such as a lack of consensus about its definition among medical professionals and researchers,and restricted access to knowledge from the relevant pandemics of the past.Legacies of viral pandemics unfortunately do not include sufficient research on how the acute symptoms of infection evolved into chronic health conditions.More so,the idea of surviving a viral pandemic with long-lasting symptoms is not new,yet it is curiously disjointed as a medical concept throughout documented histories on the subject.Individuals with long-term conditions that are rooted in acute viral infections,such as COVID-19,require a coordinated system of care that includes comprehensive rehabilitation.This commentary will discuss the philosophical underpinnings of the historical scarcity of documented incidences of individuals with chronic virus symptoms and the need for a shift in post-viral infection treatment approaches.展开更多
Accurate origin–destination(OD)demand prediction is crucial for the efficient operation and management of urban rail transit(URT)systems,particularly during a pandemic.However,this task faces several limitations,incl...Accurate origin–destination(OD)demand prediction is crucial for the efficient operation and management of urban rail transit(URT)systems,particularly during a pandemic.However,this task faces several limitations,including real-time availability,sparsity,and high-dimensionality issues,and the impact of the pandemic.Consequently,this study proposes a unified framework called the physics-guided adaptive graph spatial–temporal attention network(PAG-STAN)for metro OD demand prediction under pandemic conditions.Specifically,PAG-STAN introduces a real-time OD estimation module to estimate real-time complete OD demand matrices.Subsequently,a novel dynamic OD demand matrix compression module is proposed to generate dense real-time OD demand matrices.Thereafter,PAG-STAN leverages various heterogeneous data to learn the evolutionary trend of future OD ridership during the pandemic.Finally,a masked physics-guided loss function(MPG-loss function)incorporates the physical quantity information between the OD demand and inbound flow into the loss function to enhance model interpretability.PAG-STAN demonstrated favorable performance on two real-world metro OD demand datasets under the pandemic and conventional scenarios,highlighting its robustness and sensitivity for metro OD demand prediction.A series of ablation studies were conducted to verify the indispensability of each module in PAG-STAN.展开更多
This editorial article is intended to perform a discussion on the manuscript entitled“Simultaneous portal vein thrombosis and splenic vein thrombosis in a COVID-19 patient:A case report and review of literature”writ...This editorial article is intended to perform a discussion on the manuscript entitled“Simultaneous portal vein thrombosis and splenic vein thrombosis in a COVID-19 patient:A case report and review of literature”written by Abramowitz et al.The article focuses on the diagnostic processes in a 77-year-old-male patient with a simultaneous portal vein and splenic artery thrombosis accompanying coronavirus disease 2019(COVID-19).The authors postulated that splanchnic thrombosis should be on the list of differential diagnoses in a patient presenting with abdominal pain in presence of a COVID-19 infection.The tendency for venous and arterial thrombosis in COVID-19 patients is encountered,largely attributed to hypercoagulopathy.In general,venous thromboembolism mostly manifest as deep vein thrombosis(DVT),pulmonary embolism(PE)or catheterrelated thromboembolic events.Acute PE,DVT,cerebrovascular events and myocardial infarction are seen as the most common thromboembolic complications in COVID-19 patients.COVID-19-associated hemostatic abnormalities include mild thrombocytopenia and increased D-dimer level.Similar to other coagulopathies,the treatment of the underlying condition is the mainstay.Addition of antiplatelet agents can be considered in critically ill patients at low bleeding risk,not on therapeutic anticoagulation,and receiving gastric acid suppression Early administration of antithrombotic drugs will have a beneficial effect in both the prevention and treatment of thrombotic events,especially in non-ambulatory patients.Low molecular weight heparin(LMWH)should be started if there is no contraindication,including in non-critical patients who are at risk of hospitalization LMWH(enoxaparin)is preferred to standard heparin.展开更多
Background: The coronavirus disease (COVID-19) pandemic has impacted perinatal women’s mental health. However, protective factors associated with depression among pregnant Japanese women during the pandemic have not ...Background: The coronavirus disease (COVID-19) pandemic has impacted perinatal women’s mental health. However, protective factors associated with depression among pregnant Japanese women during the pandemic have not been reported. Purpose: The present study investigated the risk and protective factors associated with depression and anxiety among pregnant women during the COVID-19 pandemic. Methods: An online questionnaire was administered to 157 pregnant women between October 2022 and May 2023 at two general hospitals in Japan. The Japanese versions of the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to assess symptoms of depression and anxiety. The χ<sup>2</sup> test or Fisher’s exact test and multivariate logistic regression model were used to examine factors associated with depression and anxiety among pregnant women. Results: Overall, 47.1% and 35.7% of the pregnant women reported depressive and anxiety symptoms, respectively. A “history of mental illness” was a risk factor for depression and anxiety among pregnant women during the COVID-19 pandemic. Additionally, unmarried status was a risk factor for anxiety among pregnant women, whereas outdoor and indoor exercises were protective factors against depression and anxiety, respectively. Conclusions: Exercise may have protected pregnant women from depression and anxiety during the COVID-19 pandemic. Encouraging exercise may help maintain the mental health of pregnant women who do not have exercise restrictions.展开更多
Introduction: At the beginning of the COVID-19 pandemic, a drop in the number of patients treated for cardiac emergencies raised concern about cardiovascular mortality in that period. An increase in care delay for pat...Introduction: At the beginning of the COVID-19 pandemic, a drop in the number of patients treated for cardiac emergencies raised concern about cardiovascular mortality in that period. An increase in care delay for patients with ST-segment elevation myocardial infarction (STEMI) may have affected clinical outcomes. Objectives: To analyze delay times and clinical outcomes of patients with STEMI undergoing primary percutaneous coronary intervention (PPCI), before and during the COVID-19 pandemic. Methods: Retrospective observational study that included patients with STEMI undergoing PPCI from December 2018 to July 2021. The COVID-19 pandemic cases were divided into two groups: pandemic I—from March to August 2020;and pandemic II—from September 2020 to July 2021. Patients were compared according to the period of hospitalization. Primary outcomes were delay times in assistance and clinical outcomes (acute kidney injury [AKI], post-procedural vascular complications and in-hospital mortality). Results: 108 patients were included, 39 (36.1%) in the pre-pandemic period, 13 (12.1%) in pandemic I and 56 (51.8%) in pandemic II. Time from onset of symptoms to arrival at the service and door-to-balloon time did not differ significantly among groups. Vascular complications were more frequent during the pandemic (I and II) than in the pre-pandemic period (2.5% pre-pandemic vs 15.4% pandemic vs 12.5% pandemic II;p = 0.03). AKI incidence was similar in all three periods. There was a non-significant increase in in-hospital mortality during the COVID-19 pandemic. Conclusion: In patients with STEMI, there was an increase in vascular complications and a trend toward increased mortality during the COVID-19 pandemic. Delay times to admission and reperfusion did not differ significantly between before and during the pandemic.展开更多
Introduction: The initial global response to the SARS-CoV-2 pandemic focused on adults as adolescents mainly had subclinical infections. Adolescents, however, could transmit the virus and hence be a risk to the elderl...Introduction: The initial global response to the SARS-CoV-2 pandemic focused on adults as adolescents mainly had subclinical infections. Adolescents, however, could transmit the virus and hence be a risk to the elderly, young children and immunocompromised. Adolescents are also at risk of long-term complications. This study sought to determine the prevalence of antibodies to SARS-CoV-2 among adolescents in Southern Nigeria, and to determine the association between SARS-CoV-2 seropositivity and age, gender, socioeconomic class, school type and nutritional status. Methods: This descriptive cross-sectional study was carried out in Edo state of southern Nigeria. We recruited 270 in-school adolescents aged 10 - 19 years. A WHO-adapted, pre-tested questionnaire was used to obtain data on participant history and risk factors. The questionnaire was interviewer-administered. Adolescents whose parents gave consent were recruited through a multi-stage randomized sampling method. Capillary blood for the assay was collected and analysed using a lateral-flow immunoassay device. The primary outcome was serostatus of the study. The positive predictors of serostatus were finally determined using a multiple logistics regression model. Statistical significance was set at p Results: The seroprevalence of SARS-CoV-2 was 45.9%. IgM antibodies were found in 5.6% of participants. Older adolescents had higher seropositivity rates than younger adolescents (2 = 8.101, p = 0.017). There was no association between gender and seropositivity. Adolescents in public schools were more likely to be seropositive than those in private schools (2 = 25.242, p = 0.001). A higher seroprevalence was noticed among study participants in the lower socioeconomic class (x2 = 6.928, p = 0.031), and those in overcrowded classes. (2 = 79.303, p = 0.001). Conclusion: This study showed a high seroprevalence of SARS-CoV-2 among in-school adolescents. Behavioural change communication on SARS-CoV-2, vaccination of adolescents, and standardization of classrooms are recommended.展开更多
Routine pediatric vaccination is one of the most effective public health inter-ventions for the control of a number of fatal diseases.However,during the coronavirus disease 2019 pandemic,routine pediatric vaccination ...Routine pediatric vaccination is one of the most effective public health inter-ventions for the control of a number of fatal diseases.However,during the coronavirus disease 2019 pandemic,routine pediatric vaccination rates were severely affected by disruptions of health services and vaccine confidence issues.Governments and the United Nations have taken measures to re-establish routine pediatric vaccination,while additional efforts are needed to catch up and develop plans to ensure routine vaccination services for the future pandemics.展开更多
BACKGROUND The advent of coronavirus disease 2019(COVID-19)unveiled the worst national blood crisis that the United States had witnessed in over a decade.With the pandemic influencing the different stages of the acqui...BACKGROUND The advent of coronavirus disease 2019(COVID-19)unveiled the worst national blood crisis that the United States had witnessed in over a decade.With the pandemic influencing the different stages of the acquisition of blood products outside the hospital setting,we aimed to explore the possible barriers contributing to the shortage of blood products within the medical community.the COVID era and pre-COVID era.METHODS We conducted a retrospective cross-sectional study on hospitalized patients distinguishing the pattern of blood transfusion during the COVID and pre-COVID era in a community hospital.Data was tabulated to include the number of red blood cell(RBC)transfusions and if transfusions met restrictive blood transfusion criteria as per institutional guidelines.Chi-square was applied to test the statistical association between qualitative variables.Unpaired t test and Mann Whitney U test were applied respectively to test the mean difference of quantitative variables.RESULTS A total of 208 patients were included in the study,of which 108 were during COVID era and 100 were during pre-COVID era.The leading reason for admission in both the COVID era and pre-COVID era transfused patients was shortness of breath(53.7%and 36%P=0.001),followed by gastrointestinal bleeding(25.9%and 21%P=0.001).There was a higher percentage of RBC transfusions in the intensive care unit in the COVID-era group than in the pre-COVID era group(38.9%vs 22%,P=0.008).The restrictive transfusion criteria were met in 62%vs 79%in the COVID and pre-COVID eras,respectively(P=0.008).CONCLUSION The COVID-era group received RBC transfusions with less stringent adherence to restrictive blood transfusion practices in comparison to pre-COVID era group.展开更多
Florida has the highest number of motorcycle fatalities in the United States and contains the second largest population of registered motorcycles. The COVID-19 pandemic influenced the roads, traffic, and driving behav...Florida has the highest number of motorcycle fatalities in the United States and contains the second largest population of registered motorcycles. The COVID-19 pandemic influenced the roads, traffic, and driving behavior in the continental United States. Motorcycle crashes decreased during the COVID-19 years (2020 and 2021) while the fatality rates increased. The purpose of this study is to 1) investigate motorcycle crashes before and during the Pandemic period to understand the impacts on motorcycle safety and contributing factors to the crash severity levels;2) develop the crash predictive model for different degrees of severity in motorcycle crashes in Florida. Florida statewide crash data were collected. T tests have been conducted to compare the contributing factors between two periods. The injury severities are significantly different among all five levels between those during normal period and the Pandemic period. A crash predictive model has been developed to determine the facts to injury severity levels for motorcycle crashes. A total of eight variables are found to significantly increase the injury severity levels for motorcycle crashes during the Pandemic period.展开更多
Background: The healthy bond that develops prenatally between the mother and her infant is important for the neuropsychological development and development of the child. In stressful situations and mental disorders, t...Background: The healthy bond that develops prenatally between the mother and her infant is important for the neuropsychological development and development of the child. In stressful situations and mental disorders, the development of this bond is inhibited. With this study, an attempt is made to investigate whether the COVID-19 pandemic affected the development of the mother-infant bond. Methods: We have searched in the databases, PubMed, Google Scholar, PsycINFO, from July to October 2023 and we have found 18 related articles. Results: Most studies supported a lower mother-infant attachment during the pandemic period. We also found increased rates of depressive symptoms, anxiety and post-traumatic stress during the pandemic. Conclusions: The period of the pandemic and the psychological factors were the right conditions for the reduced development of the mother-infant bond. In epidemiological outbreaks, the mental health of the mother and her relationship with the infant should be a priority for perinatal care professionals.展开更多
文摘BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making.One analytical technique that can be helpful in uncertain situations is clinical judgment.Clinicians must deal with contradictory information,lack of time to make decisions,and long-term factors when emergencies occur.AIM To examine the ethical issues healthcare professionals faced during the coronavirus disease 2019(COVID-19)pandemic and the factors affecting clinical decision-making.METHODS This pilot study,which means it was a preliminary investigation to gather information and test the feasibility of a larger investigation was conducted over 6 months and we invited responses from clinicians worldwide who managed patients with COVID-19.The survey focused on topics related to their professional roles and personal relationships.We examined five core areas influencing critical care decision-making:Patients'personal factors,family-related factors,informed consent,communication and media,and hospital administrative policies on clinical decision-making.The collected data were analyzed using the χ^(2) test for categorical variables.RESULTS A total of 102 clinicians from 23 specialties and 17 countries responded to the survey.Age was a significant factor in treatment planning(n=88)and ventilator access(n=78).Sex had no bearing on how decisions were made.Most doctors reported maintaining patient confidentiality regarding privacy and informed consent.Approximately 50%of clinicians reported a moderate influence of clinical work,with many citing it as one of the most important factors affecting their health and relationships.Clinicians from developing countries had a significantly higher score for considering a patient's financial status when creating a treatment plan than their counterparts from developed countries.Regarding personal experiences,some respondents noted that treatment plans and preferences changed from wave to wave,and that there was a rapid turnover of studies and evidence.Hospital and government policies also played a role in critical decision-making.Rather than assessing the appropriateness of treatment,some doctors observed that hospital policies regarding medications were driven by patient demand.CONCLUSION Factors other than medical considerations frequently affect management choices.The disparity in treatment choices,became more apparent during the pandemic.We highlight the difficulties and contradictions between moral standards and the realities physicians encountered during this medical emergency.False information,large patient populations,and limited resources caused problems for clinicians.These factors impacted decision-making,which,in turn,affected patient care and healthcare staff well-being.
文摘BACKGROUND The coronavirus disease 2019(COVID-19)pandemic had a profound societal impact in the United States which was associated with a decrease in overall life expectancy and an increase in substance abuse and firearm injury.Our under-standing of changes in mortality trends during the pandemic and its effect on organ availability for transplantation is limited.AIM To examine the trends of substance abuse and firearm injury fatalities during COVID-19 and a potential correlation with organ transplantation.METHODS Crude rates of population-based deaths among adults(18-75 years)from firearm injury and substance abuse from the period of 2014-2021 were obtained from centers of disease control wide-ranging online data for epidemiologic research database.Crude rates of causes of donor(18-75 years)deaths from 2014-2021 were obtained from the united network for organ sharing database.RESULTS Average annual percentage change(AAPC)deaths among the United States population were 16.4%from substance abuse and 3.4%from firearm injury.AAPC in cause of death among organ donors was 10.9%from drug intoxication and 2.1%from firearm injury.There was a significant(P<0.001)and progressive increase in mortality from both causes during the pandemic(2020-2021)and significant correlation(P<0.001)between population and donor causes of death.COVID-19 exacerbated trends in substance abuse and firearm mortality with a consequent increase in organ donation from donors who died from these two causes.CONCLUSION Identifying the socioeconomic and regional disparities associated with increase in deaths from substance abuse and firearms can help guide post-pandemic healthcare policies and mitigate their impact on organ transplantation.
文摘The coronavirus disease(COVID-19)pandemic introduced significant psychosocial stressors for morticians in South Africa,yet their coping mechanisms remain underexplored.This study investigated how South African morticians(N=10,Black males)coped with these stressors during the pandemic through semi-structured interviews.Interpretative phenomenological analysis(IPA)informed thematic analysis identifiedfive themes:(i)death overload distress associated with trauma and fear of exposure;(ii)insomnia due to worry,workload,and fear of infection;(iii)stigmatisation from community avoidance and negative perceptions;(iv)social isolation and anxiety related to emotional disconnection,personal protective equipment(PPE)shortages,and workload demands;and(v)adaptive coping mechanisms such as acceptance,resilience,external support,and religious faith,alongside less beneficial maladaptive strategies.Findings highlight the importance of targeted mental health services,psychoeducation,and social inclusion programmes to support morticians managing psychosocial stress during community health crises.
文摘The popularity of traditional healing practices on social media during the COVID-19 pandemic challenged the discourse diffused by the Ministry of Health in Morocco.This created a struggle in the public sphere between a scientific discourse on health care constructed by the Ministry of Health and a culturally conservative discourse propagated by practitioners of traditional healing.This paper explores how both discourses were competing to shape public opinion about the best health-care practices to end the COVID-19 pandemic in Morocco.The data was collected from Facebook and You Tube based on criteria of social-media functionalities.The data was analysed using multimodal critical discourse analysis followed by a process of coding and category development.The results of the study reveal that shaping public opinion about ways to deal with the COVID-19 pandemic in Morocco was characterized by the success of traditional health-care discourse in a counter-hegemonic struggle with the discourse of the Ministry of Health.This discourse was conservative,as it cherished an online Muslim identity of social-media users by relying on ideologically constructed argumentation and discursive strategies in representing prophetic medicine as the best health-care practice to end the pandemic.
基金supported by the Ministry of Education,Culture and Sport(Predoctoral Contract University Faculty Training Program:FPU15/04335)later by the Spanish Public Administration“Ministerio de Universidades”and the European Union through the“NextGeneration EU”(Postdoctoral contract Margarita Salas).
文摘Background:Prosocial behavior plays a crucial role in improving interpersonal relationships and social well-being,especially in times of crisis.The COVID-19 pandemic caused a severe humanitarian crisis,prompting governments to implement measures such as social confinement.The main objective of the study was to analyze the psychological and sociodemographic variables that may predict prosocial behavior during quarantine.Methods:The sample consisted of 172 participants from Spain,divided into two groups based on whether they reported an increase in prosocial behaviors during quarantine.An online survey was administered to analyze the psychological and sociodemographic variables.Results:Overall,results demonstrate that emotional regulation,morality and age may predict prosocial behavior.Conclusions:Understanding the predictors of prosocial behavior during social crises is crucial for devising effective policies aimed at fostering community resilience and support networks,with particular attention to factors such as the capacity to regulate emotions,morality,and age.
基金supported by the Natural Science Basic Research Program of Shaanxi(No.2023-JC-QN-0141)the Qinchuanyuan introducing high-level innovation and entrepreneurship talent program(No.QCYRCXM-2022-363)the“Young Talent Support Plan”of Xi'an Jiaotong University(No.ND6J027).
文摘This study investigated the variations in summer and winter PM_(2.5)concentrations and chemical composition in urban Xi'an before and during the COVID-19 pandemic restrictions.During the pandemic restrictions,summer daytime PM_(2.5)concentrations remained comparable to pre-pandemic levels,while a reduction was noted at nighttime.Conversely,winter experienced a significant increase in both daytime and nighttime PM_(2.5)concentrations.Chemical composition analysis revealed reductions in secondary inorganic ion concentrations but notable increases in crustal matter concentrations during the pandemic restrictions,particularly evident in winter.The reductions in secondary inorganic ion concentrations were likely due to decreased emissions of corresponding anthropogenic precursors in summer,while linked to reductions in transformation efficiencies in winter.The heightened crustal matter concentrations were likely attributed to increased contributions of long-range air mass transport from dusty regions,especially prevalent in winter.Source apportionment using positive matrix factorization analysis provided quantitative insights into the distinct source profiles contributing to PM_(2.5)before and during the pandemic restrictions,with secondary inorganic-rich sources decreasing and dust-related sources increasing during the pandemic restrictions.Additionally,combustion sources,primarily from coal and biomass burning,showed higher contributions during winter.In conclusion,this study underscores the complex interplay between anthropogenic and natural factors influencing PM_(2.5)levels in Xi'an.Efforts to mitigate PM_(2.5)pollution should prioritize reducing anthropogenic emissions and implementing measures to control dust emissions,particularly when dust-related sources significantly contribute to elevated PM_(2.5)concentrations.These findings provide valuable insights into developing effective strategies for addressing the PM_(2.5)pollution problem in Xi'an.
基金supported by the National Natural Science Foundation of China(T2241028)STI2030-Major Projects[2021ZD0203000(2021ZD0203003)].
文摘Mental health disorders have emerged as a critical global health challenge,profoundly impacting individuals,communities,and societies worldwide.The prevalence of mental health problems has been steadily increasing,with~1 in 8 people,equivalent to 970 million individuals suffering from a mental disorder in 2019(https://vizhub.healthdata.org/gbd-results).Anxiety and depressive disorders are predominant,contributing significantly to the burden of mental health issues,according to the World Health Organization.The COVID-19 pandemic has further exacerbated this situation.It led to a notable upsurge in anxiety and major depressive disorders in 2020.Estimates indicate a 26%rise in anxiety and a 28%increase in depression within that year(https://www.who.int/publications/i/item/WHO-2019-nCoVSci_Brief-Mental_health-2022.1)[1].
基金Supported by Internal Institutional Research Fund.
文摘BACKGROUND In the initial stages of the coronavirus disease 2019(COVID-19)pandemic,healthcare workers(HCWs)who were immunologically naive to COVID-19,were exposed to a highly transmissible virus.AIM To compare infection risk among HCWs in high-risk(HR)and low-risk(LR)areas.METHODS Data on reverse transcriptase-polymerase chain reaction confirmed clinical infection and samples for nucleocapsid,and spike protein antibodies were collected at five time-points(T1 to T5)from HCWs in the emergency department and intensive care unit(HR group)and pre-clinical and para-clinical areas(LR).For the sero-study,only participants who provided at least one baseline sample and one during the second wave(T4 or T5)were analysed.Since CovishieldTM elicits only spike protein antibodies,subclinical infection was diagnosed if asymptomatic unvaccinated and CovishieldTM vaccinated individuals tested positive for nucleocapsid antibody.RESULTS Overall,by T5,clinical infection rate was similar in the HR(120/366,32.8%)and LR(22/82,26.8%)groups(P=0.17).However,before vaccination(T3),more HCWs in the HR group developed COVID-19 infection(21.9%vs 8.8%,P=0.046).In the sero-study group,clinical infection occurred in 31.5%(45/143)and 23.7%(14/59)in the HR and LR groups respectively(P=0.23).Spike antibody was detected in 140/143(97.9%)and 56/59(94.9%)and nucleocapsid antibody was positive in 95/143(66.4%)and 35/59(59.3%)in the HR and LR groups respectively(P=0.34).Subclinical infection rate(HR 34.9%,LR 35.6%,P=0.37)and hospitalization rate were similar.There was no mortality.CONCLUSION Before vaccination,HCWs in HR areas had a higher risk of infection.Seroprevalence studies suggest that subclinical infection was not uncommon.
文摘Coronavirus disease 2019 is caused by severe acute respiratory syndrome coronavirus 2 and emerged in Wuhan,China.It affects millions of people all over the world and has caused the deaths of thousands of people.Mortality rates were higher in transplant recipients and patients awaiting transplantation due to social and psychological issues.It also affected candidates who would be transplant providers and caused the transplant chain to be broken worldwide.The coronavirus disease 2019 pandemic has significantly affected solid organ transplantation procedures and led to various changes in protocols and practices to ensure patient safety and increase transplant success.These include challenges in screening protocols,prioritization of cases,telemedicine and virtual consultations,modified surgical procedures,immunosuppression management,updated research and guidelines,post-transplantation process and difficulties to control side effects,difficulties in organ procurement,and patient education/support.It requires a multidisciplinary approach,close collaboration between transplant teams,and adherence to strict infection control measures to ensure the safety of both transplant recipients and healthcare providers.In this article,we compiled the most important points in an overview of this process.
基金supported by the Basic Science Research Program through the National Research Foundation of Korea,funded by the Ministry of Education(RS-2024-00460379).
文摘Objective Despite the global decrease in influenza infections during the coronavirus disease 2019(COVID-19)pandemic,seasonal influenza remains a significant health issue.South Korea,known for its robust pandemic response and high influenza vaccination rates,offers a unique context for examining changes in vaccination trends during the pandemic.Using nationally representative data,we aimed to understand the impact of the pandemic on influenza vaccination behavior over a 12-year period and to identify vulnerable groups.Methods We analyzed influenza vaccination rates in South Korea between 2011-2022,focusing on pandemic-related impacts.The data of 2,426,139 adults(≥19 years)from the Korea Community Health Survey were used to assess demographic and sociological factors influencing vaccination behaviors.Results We observed an increase in influenza vaccination rates during the pre-COVID-19 period from 2011-2013(weighted prevalence:46.68%[95%confidence interval(CI):46.55-46.82])to 2017-2019(weighted prevalence:52.50%[95%CI:52.38-52.63]).However,a significant decline was observed in 2022,the late-COVID-19 pandemic period(weighted prevalence:55.78%[95%CI:55.56-56.01]),compared with the mid-pandemic period in 2021(weighted prevalence:59.12%[95%CI:58.91-59.32]),particularly among populations traditionally prioritized for influenza vaccination,including older adults(≥65 years)and patients with chronic diseases and low educational and income levels.Conclusion The influenza vaccination rate in South Korea was significantly affected by the COVID-19 pandemic,showing a notable decrease among vulnerable demographic groups.This suggests the need for targeted public health strategies to address vaccine hesitancy and improve vaccination rates,particularly among high-risk populations.
文摘The diagnosis and treatment processes for long COVID have been relatively slow to develop for several reasons,such as a lack of consensus about its definition among medical professionals and researchers,and restricted access to knowledge from the relevant pandemics of the past.Legacies of viral pandemics unfortunately do not include sufficient research on how the acute symptoms of infection evolved into chronic health conditions.More so,the idea of surviving a viral pandemic with long-lasting symptoms is not new,yet it is curiously disjointed as a medical concept throughout documented histories on the subject.Individuals with long-term conditions that are rooted in acute viral infections,such as COVID-19,require a coordinated system of care that includes comprehensive rehabilitation.This commentary will discuss the philosophical underpinnings of the historical scarcity of documented incidences of individuals with chronic virus symptoms and the need for a shift in post-viral infection treatment approaches.
基金supported by the National Natural Science Foundation of China(72288101,72201029,and 72322022).
文摘Accurate origin–destination(OD)demand prediction is crucial for the efficient operation and management of urban rail transit(URT)systems,particularly during a pandemic.However,this task faces several limitations,including real-time availability,sparsity,and high-dimensionality issues,and the impact of the pandemic.Consequently,this study proposes a unified framework called the physics-guided adaptive graph spatial–temporal attention network(PAG-STAN)for metro OD demand prediction under pandemic conditions.Specifically,PAG-STAN introduces a real-time OD estimation module to estimate real-time complete OD demand matrices.Subsequently,a novel dynamic OD demand matrix compression module is proposed to generate dense real-time OD demand matrices.Thereafter,PAG-STAN leverages various heterogeneous data to learn the evolutionary trend of future OD ridership during the pandemic.Finally,a masked physics-guided loss function(MPG-loss function)incorporates the physical quantity information between the OD demand and inbound flow into the loss function to enhance model interpretability.PAG-STAN demonstrated favorable performance on two real-world metro OD demand datasets under the pandemic and conventional scenarios,highlighting its robustness and sensitivity for metro OD demand prediction.A series of ablation studies were conducted to verify the indispensability of each module in PAG-STAN.
文摘This editorial article is intended to perform a discussion on the manuscript entitled“Simultaneous portal vein thrombosis and splenic vein thrombosis in a COVID-19 patient:A case report and review of literature”written by Abramowitz et al.The article focuses on the diagnostic processes in a 77-year-old-male patient with a simultaneous portal vein and splenic artery thrombosis accompanying coronavirus disease 2019(COVID-19).The authors postulated that splanchnic thrombosis should be on the list of differential diagnoses in a patient presenting with abdominal pain in presence of a COVID-19 infection.The tendency for venous and arterial thrombosis in COVID-19 patients is encountered,largely attributed to hypercoagulopathy.In general,venous thromboembolism mostly manifest as deep vein thrombosis(DVT),pulmonary embolism(PE)or catheterrelated thromboembolic events.Acute PE,DVT,cerebrovascular events and myocardial infarction are seen as the most common thromboembolic complications in COVID-19 patients.COVID-19-associated hemostatic abnormalities include mild thrombocytopenia and increased D-dimer level.Similar to other coagulopathies,the treatment of the underlying condition is the mainstay.Addition of antiplatelet agents can be considered in critically ill patients at low bleeding risk,not on therapeutic anticoagulation,and receiving gastric acid suppression Early administration of antithrombotic drugs will have a beneficial effect in both the prevention and treatment of thrombotic events,especially in non-ambulatory patients.Low molecular weight heparin(LMWH)should be started if there is no contraindication,including in non-critical patients who are at risk of hospitalization LMWH(enoxaparin)is preferred to standard heparin.
文摘Background: The coronavirus disease (COVID-19) pandemic has impacted perinatal women’s mental health. However, protective factors associated with depression among pregnant Japanese women during the pandemic have not been reported. Purpose: The present study investigated the risk and protective factors associated with depression and anxiety among pregnant women during the COVID-19 pandemic. Methods: An online questionnaire was administered to 157 pregnant women between October 2022 and May 2023 at two general hospitals in Japan. The Japanese versions of the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to assess symptoms of depression and anxiety. The χ<sup>2</sup> test or Fisher’s exact test and multivariate logistic regression model were used to examine factors associated with depression and anxiety among pregnant women. Results: Overall, 47.1% and 35.7% of the pregnant women reported depressive and anxiety symptoms, respectively. A “history of mental illness” was a risk factor for depression and anxiety among pregnant women during the COVID-19 pandemic. Additionally, unmarried status was a risk factor for anxiety among pregnant women, whereas outdoor and indoor exercises were protective factors against depression and anxiety, respectively. Conclusions: Exercise may have protected pregnant women from depression and anxiety during the COVID-19 pandemic. Encouraging exercise may help maintain the mental health of pregnant women who do not have exercise restrictions.
文摘Introduction: At the beginning of the COVID-19 pandemic, a drop in the number of patients treated for cardiac emergencies raised concern about cardiovascular mortality in that period. An increase in care delay for patients with ST-segment elevation myocardial infarction (STEMI) may have affected clinical outcomes. Objectives: To analyze delay times and clinical outcomes of patients with STEMI undergoing primary percutaneous coronary intervention (PPCI), before and during the COVID-19 pandemic. Methods: Retrospective observational study that included patients with STEMI undergoing PPCI from December 2018 to July 2021. The COVID-19 pandemic cases were divided into two groups: pandemic I—from March to August 2020;and pandemic II—from September 2020 to July 2021. Patients were compared according to the period of hospitalization. Primary outcomes were delay times in assistance and clinical outcomes (acute kidney injury [AKI], post-procedural vascular complications and in-hospital mortality). Results: 108 patients were included, 39 (36.1%) in the pre-pandemic period, 13 (12.1%) in pandemic I and 56 (51.8%) in pandemic II. Time from onset of symptoms to arrival at the service and door-to-balloon time did not differ significantly among groups. Vascular complications were more frequent during the pandemic (I and II) than in the pre-pandemic period (2.5% pre-pandemic vs 15.4% pandemic vs 12.5% pandemic II;p = 0.03). AKI incidence was similar in all three periods. There was a non-significant increase in in-hospital mortality during the COVID-19 pandemic. Conclusion: In patients with STEMI, there was an increase in vascular complications and a trend toward increased mortality during the COVID-19 pandemic. Delay times to admission and reperfusion did not differ significantly between before and during the pandemic.
文摘Introduction: The initial global response to the SARS-CoV-2 pandemic focused on adults as adolescents mainly had subclinical infections. Adolescents, however, could transmit the virus and hence be a risk to the elderly, young children and immunocompromised. Adolescents are also at risk of long-term complications. This study sought to determine the prevalence of antibodies to SARS-CoV-2 among adolescents in Southern Nigeria, and to determine the association between SARS-CoV-2 seropositivity and age, gender, socioeconomic class, school type and nutritional status. Methods: This descriptive cross-sectional study was carried out in Edo state of southern Nigeria. We recruited 270 in-school adolescents aged 10 - 19 years. A WHO-adapted, pre-tested questionnaire was used to obtain data on participant history and risk factors. The questionnaire was interviewer-administered. Adolescents whose parents gave consent were recruited through a multi-stage randomized sampling method. Capillary blood for the assay was collected and analysed using a lateral-flow immunoassay device. The primary outcome was serostatus of the study. The positive predictors of serostatus were finally determined using a multiple logistics regression model. Statistical significance was set at p Results: The seroprevalence of SARS-CoV-2 was 45.9%. IgM antibodies were found in 5.6% of participants. Older adolescents had higher seropositivity rates than younger adolescents (2 = 8.101, p = 0.017). There was no association between gender and seropositivity. Adolescents in public schools were more likely to be seropositive than those in private schools (2 = 25.242, p = 0.001). A higher seroprevalence was noticed among study participants in the lower socioeconomic class (x2 = 6.928, p = 0.031), and those in overcrowded classes. (2 = 79.303, p = 0.001). Conclusion: This study showed a high seroprevalence of SARS-CoV-2 among in-school adolescents. Behavioural change communication on SARS-CoV-2, vaccination of adolescents, and standardization of classrooms are recommended.
基金Supported by Scientific Research Foundation of Shanghai Municipal Health Commission of Changning District,No.20234Y038.
文摘Routine pediatric vaccination is one of the most effective public health inter-ventions for the control of a number of fatal diseases.However,during the coronavirus disease 2019 pandemic,routine pediatric vaccination rates were severely affected by disruptions of health services and vaccine confidence issues.Governments and the United Nations have taken measures to re-establish routine pediatric vaccination,while additional efforts are needed to catch up and develop plans to ensure routine vaccination services for the future pandemics.
文摘BACKGROUND The advent of coronavirus disease 2019(COVID-19)unveiled the worst national blood crisis that the United States had witnessed in over a decade.With the pandemic influencing the different stages of the acquisition of blood products outside the hospital setting,we aimed to explore the possible barriers contributing to the shortage of blood products within the medical community.the COVID era and pre-COVID era.METHODS We conducted a retrospective cross-sectional study on hospitalized patients distinguishing the pattern of blood transfusion during the COVID and pre-COVID era in a community hospital.Data was tabulated to include the number of red blood cell(RBC)transfusions and if transfusions met restrictive blood transfusion criteria as per institutional guidelines.Chi-square was applied to test the statistical association between qualitative variables.Unpaired t test and Mann Whitney U test were applied respectively to test the mean difference of quantitative variables.RESULTS A total of 208 patients were included in the study,of which 108 were during COVID era and 100 were during pre-COVID era.The leading reason for admission in both the COVID era and pre-COVID era transfused patients was shortness of breath(53.7%and 36%P=0.001),followed by gastrointestinal bleeding(25.9%and 21%P=0.001).There was a higher percentage of RBC transfusions in the intensive care unit in the COVID-era group than in the pre-COVID era group(38.9%vs 22%,P=0.008).The restrictive transfusion criteria were met in 62%vs 79%in the COVID and pre-COVID eras,respectively(P=0.008).CONCLUSION The COVID-era group received RBC transfusions with less stringent adherence to restrictive blood transfusion practices in comparison to pre-COVID era group.
文摘Florida has the highest number of motorcycle fatalities in the United States and contains the second largest population of registered motorcycles. The COVID-19 pandemic influenced the roads, traffic, and driving behavior in the continental United States. Motorcycle crashes decreased during the COVID-19 years (2020 and 2021) while the fatality rates increased. The purpose of this study is to 1) investigate motorcycle crashes before and during the Pandemic period to understand the impacts on motorcycle safety and contributing factors to the crash severity levels;2) develop the crash predictive model for different degrees of severity in motorcycle crashes in Florida. Florida statewide crash data were collected. T tests have been conducted to compare the contributing factors between two periods. The injury severities are significantly different among all five levels between those during normal period and the Pandemic period. A crash predictive model has been developed to determine the facts to injury severity levels for motorcycle crashes. A total of eight variables are found to significantly increase the injury severity levels for motorcycle crashes during the Pandemic period.
文摘Background: The healthy bond that develops prenatally between the mother and her infant is important for the neuropsychological development and development of the child. In stressful situations and mental disorders, the development of this bond is inhibited. With this study, an attempt is made to investigate whether the COVID-19 pandemic affected the development of the mother-infant bond. Methods: We have searched in the databases, PubMed, Google Scholar, PsycINFO, from July to October 2023 and we have found 18 related articles. Results: Most studies supported a lower mother-infant attachment during the pandemic period. We also found increased rates of depressive symptoms, anxiety and post-traumatic stress during the pandemic. Conclusions: The period of the pandemic and the psychological factors were the right conditions for the reduced development of the mother-infant bond. In epidemiological outbreaks, the mental health of the mother and her relationship with the infant should be a priority for perinatal care professionals.
