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
Background:This study aimed to assess the occupational risks encountered by Healthcare Workers(HCWs)in Saudi Arabia during the COVID-19 pandemic.Methods:A cross-sectional survey was carried out from May to October 202...Background:This study aimed to assess the occupational risks encountered by Healthcare Workers(HCWs)in Saudi Arabia during the COVID-19 pandemic.Methods:A cross-sectional survey was carried out from May to October 2021.Using a multi-stage stratified random sampling technique,an online questionnaire was sent to the recruited HCWs,across Saudi Arabia.Results:Of the 768 HCWs recruited,702 participated in the survey.A significant majority(over 80%)reported working beyond 8 hours daily.COVID-19 infection,confirmed via PCR,was identified in 25%of the participants.Notably,infection was significantly correlated with direct or close contact(p=0.0007).Psychological distress was reported by 81%,with anxiety being the most prevalent(33%),followed by stress(19%),depression(17%),and insomnia(12%).Around 20%experienced headaches post-PPE use,while 14%reported adverse skin reactions,predominantly allergy and dermatitis.A concerning one-third of respondents reported exposure to violence.Conclusion:High infection rate,physical and psychological risks among HCWs especially those in direct contact with patients,reflect the need for enhancing the entirety of outbreak preparedness and response,specifically training.Active surveillance system,is crucial to adequately monitor and support HCWs during pandemic scenarios.展开更多
Objective: To compare the effects of extracorporeal membrane oxygenation (ECMO) and routine mechanical ventilation on mortality and the risk of associated adverse events in patients with severe viral pneumonia. Method...Objective: To compare the effects of extracorporeal membrane oxygenation (ECMO) and routine mechanical ventilation on mortality and the risk of associated adverse events in patients with severe viral pneumonia. Methods: PubMed, the Cochrane Library, Embase, Web of Science, and other databases were searched to collect case-control or cohort studies on prognoses associated with ECMO treatment for viral pneumonia. Search terms included extracorporeal membrane oxygenation, ECMO, viral pneumonia, COVID-19, influenza, MERS, and others. According to the PICOS principle, two evaluators independently screened the literature, extracted the data, cross-checked the data, and extracted the data again. Two researchers evaluated the risk of bias in the included studies according to the Newcastle-Ottawa Scale (NOS) and cross-checked the results. Meta-analysis was performed using RevMan 5.3 software. Results: Nine studies were included for analysis, encompassing a total of 4,330 patients, which were categorized into ECMO and CMV groups. There were no significant differences between the two groups in most baseline data;however, the ECMO group had a lower oxygenation index, and some studies reported higher SOFA scores in the ECMO group compared to the CMV group. There was no significant difference in in-hospital mortality between the two groups. The length of ICU stay, total hospital stay, and total mechanical ventilation time were longer in the ECMO group than in the CMV group. In terms of adverse events, there was no significant difference in the occurrence of kidney injury between the two groups. Bleeding events were reported in two studies, with more bleeding events occurring in the ECMO group. According to the subgroup analysis of different virus types, there were no statistical differences in the above aspects among patients with swine flu, novel coronavirus, and MERS. Conclusion: ECMO has a certain degree of positive significance in the treatment of severe viral pneumonia, but there is no significant difference in the treatment outcome of ECMO across different epidemic periods. The timing of ECMO treatment, patient management, and withdrawal evaluation still need further research.展开更多
Lean manufacturing has been used for the last few decades as a process and performance improvement tool.Initially known as Toyota production system(TPS),lean is now used in almost all service and manufacturing sectors...Lean manufacturing has been used for the last few decades as a process and performance improvement tool.Initially known as Toyota production system(TPS),lean is now used in almost all service and manufacturing sectors to deliver favorable results such as decreased operational cost,increased customer satisfaction,decreased cycle time,and enhanced profits.During the coronavirus disease(COVID 19)pandemic,the manufacturing sector struggled immensely and could not function well even after lockdown was eased in many countries.Many companies found out there are not ready to conform with new regulations made by authorities in many countries.This paper proposes the use of simulation and multi response optimization in addition to other typical lean tools in order to arrive at optimum performance at the end of each project through an established optimization framework.The framework is used in a real case study performed at an aluminum extrusion factory.Lean manufacturing helps organizations to operate with smaller number of resources.It standardizes all processes so that most of the jobs can be done by most of the workers,but this is not enough to create a healthy,sanitized work place.Our framework utilizes the strengths of lean tools and adds pandemic readiness factor to them to ensure improvement in performance and health pandemic readiness.Implementation of the framework in the case company resulted in 50%reduction in labor,$730000 in expected annual cost savings,reduction in inventory levels,improved employee morale and the achievement of pandemic ready status.展开更多
This project paper is to give a prediction for the future of other viral pandemics and to provide recommendations for preparing therapies that could help in the success of effective treatments and benefits for patient...This project paper is to give a prediction for the future of other viral pandemics and to provide recommendations for preparing therapies that could help in the success of effective treatments and benefits for patients in life-threatening situations. The theory of prediction was proposed by Huu S. TIEU on March 25, 2019, and he hypothesized that any malfunctioning cell in the body could have a damaging effect. This paper discusses the prediction that Localized Oxygen Deprivation could be a contributing factor for a future epidemic or other viral pandemics that could affect body function. This paper is based on opinion and does not have sufficient evidence to support the claims made. Therefore, further in-depth study is needed to prove the findings. The author cites Hypoxia to support his idea, but he is not claiming that Hypoxia-Inducible Factor (HIF) has worked on his predictions. The author also tested a theory using cow blood curd for body function, but this test was not a structured test and the findings were not supported by other evidence. To further prove the idea or theory, further study into the subject should be conducted.展开更多
The Coronavirus pandemics,or the COVID-19,came as an unwelcomed vip that did not want to leave,where people until today do not know for sure all the ways it affects people’s health and overall being.The year of 202...The Coronavirus pandemics,or the COVID-19,came as an unwelcomed vip that did not want to leave,where people until today do not know for sure all the ways it affects people’s health and overall being.The year of 2020 will be remembered as the one in which life almost stopped.A year full of losses that continue,from losing people dear to us,to losing jobs,opportunities,and freedom in almost every sense.This paper covers the consequences of the COVID-19 outbreak that it had on people,focusing on the job loss and unemployment,the healthcare opportunities and availabilities,the gender discrimination in the process of losing jobs,and the most importantly the psychological consequences people suffered from,due to isolation,inability to work and to provide.展开更多
BACKGROUND Burnout syndrome and anxiety are two mental health symptoms experienced by healthcare workers(HCWs)that can be exacerbated during pandemics due to increased job demands and the global health workforce crisi...BACKGROUND Burnout syndrome and anxiety are two mental health symptoms experienced by healthcare workers(HCWs)that can be exacerbated during pandemics due to increased job demands and the global health workforce crisis.AIM To provide a comprehensive review and summary of evidence on burnout and anxiety in HCWs during previous global pandemics.METHODS A systematic search on electronic databases such as PubMed Central and MEDLINE was conducted to identify high-quality systematic review studies that reported on the prevalence of burnout and/or anxiety in HCWs during any previous global pandemic.RESULTS Twenty-four high quality systematic review articles were found to be suitable for inclusion.Twenty articles focused merely on Coronavirus disease 2019,while four articles examined multiple pandemics.Burnout was examined in nine articles,while anxiety was examined in the remaining 21 articles.Female HCWs and nurses were identified to be at a higher risk of developing burnout and anxiety during pandemic.We also observed a variation in the prevalence of burnouts and anxiety across different studies due to different mental health instruments were used in different studies.CONCLUSION Nurses and females HCWs had a high prevalence of burnout syndrome and anxiety during pandemic.More emphasis and attention should be paid to safeguarding the psychological well-being of these at-risk populations in the future pandemics.展开更多
Lung ultrasound(US)has been shown that it is able to detect interstitial lung disease,subpleural consolidations and acute respiratory distress syndrome in clinical and physical studies that assess its role in upper re...Lung ultrasound(US)has been shown that it is able to detect interstitial lung disease,subpleural consolidations and acute respiratory distress syndrome in clinical and physical studies that assess its role in upper respiratory infections.It is used worldwide in the coronavirus disease 2019(COVID-19)outbreak and the effectiveness has been assessed in several studies.Fast diagnosis of COVID-19 is essential in deciding for patient isolation,clinical care and reducing transmission.Imaging the lung and pleura by ultrasound is efficient,cost-effective,and safe and it is recognized as rapid,repeatable,and reliable.Obstetricians are already using the US and are quite proficient in doing so.During the pandemic,performing lung US(LUS)right after the fetal assessment until reverse transcription polymerase chain reaction results are obtained,particularly in settings that have a centralized testing center,was found feasible for the prediction of the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.The use of LUS is efficient in the triage and monitoring of pregnant women.Clinicians dealing with pregnant women should consider LUS as the first-line diagnostic tool in pregnant women during the SARS-CoV-2 pandemic.展开更多
Social distancing and self-isolation management are crucial preventive measures that can save millions of lives during challenging pandemics of diseases such as the Spanish u,swine u,and coronavirus disease 2019(COVID...Social distancing and self-isolation management are crucial preventive measures that can save millions of lives during challenging pandemics of diseases such as the Spanish u,swine u,and coronavirus disease 2019(COVID-19).This study describes the comprehensive and effective implementation of the Industrial Internet of Things and machine-to-machine technologies for social distancing and smart self-isolation management.These technologies can help prevent outbreaks of any disease that can disperse widely and develop into a pandemic.Initially,a smart wristband is proposed that incorporates Bluetooth beacon technology to facilitate the tracing and tracking of Bluetooth Low Energy beacon packets for smart contact tracing.Second,the connectivity of the device with Android or iOS applications using long-term evolution technology is realized to achieve mobility.Finally,mathematical formulations are proposed to measure the distance between coordinates in order to detect geo-fencing violations.These formulations are specically designed for the virtual circular and polygonal boundaries used to restrict suspected or infected persons from trespassing in predetermined areas,e.g.,at home,in a hospital,or in an isolation ward.The proposed framework outperforms existing solutions,since it is implemented on a wider scale,provides a range of functionalities,and is cost-effective.展开更多
The present moment is not the first time that America has found itself at war with a pathogen during a time of international conflict. Between crowded barracks at home and trenches abroad, wartime conditions helped en...The present moment is not the first time that America has found itself at war with a pathogen during a time of international conflict. Between crowded barracks at home and trenches abroad, wartime conditions helped enable the spread of influenza in the fall of 1918 during World War I such that an estimated 20%–40% of U.S. military members were infected. While the coronavirus disease 2019(COVID-19) pandemic is unparalleled for most of today's population, it is essential to not view it as unprecedented lest the lessons of past pandemics and their effect on the American military be forgotten. This article provides a historical perspective on the effect of the most notable antecedent pandemic, the Spanish Influenza epidemic, on American forces with the goal of understanding the interrelationship of global pandemics and the military, highlighting the unique challenges of the current pandemic, and examining how the American military has fought back against pandemics both at home and abroad, both 100 years ago and today.展开更多
The novel coronavirus disease 2019(COVID-19)is an emerging disease,caused by severe acute respiratory syndrome coronavirus-2.It bears unique biological characteristics,clinical symptoms and imaging manifestations,ther...The novel coronavirus disease 2019(COVID-19)is an emerging disease,caused by severe acute respiratory syndrome coronavirus-2.It bears unique biological characteristics,clinical symptoms and imaging manifestations,therefore presenting an important and urgent threat to global health.As a result,a new public health crisis arose,threatening the world with the spread of the 2019 novel coronavirus.Despite the maximal worldwide public health responses aimed at containing the disease and delaying its spread,many countries have been confronted with a critical care crisis,and even more,countries will almost certainly follow.In Slovenia,the COVID-19 has struck the health system immensely and among all the specialities,neurosurgery has also been experiencing difficulties in the service,not only in regular,elective surgeries but especially during emergencies.The management of these neurosurgical patients has become more difficult than ever.We describe our protocol in the management of neurosurgical patients in the University Medical Centre Ljubljana,Slovenia and how neurosurgical pathology was tackled during the pandemics.展开更多
The pandemic of severe acute respiratory syndrome coronavirus 2 has spread very quickly all over the world and has become an unparalleled public health crisis.This unforeseen and exceptional situation has instigated a...The pandemic of severe acute respiratory syndrome coronavirus 2 has spread very quickly all over the world and has become an unparalleled public health crisis.This unforeseen and exceptional situation has instigated a wave of research to investigate the virus,track its spread,and study the disease it causes.Current methods of diagnosis and monitoring largely rely on polymerase chain reactions and enzyme-linked immunesorbent assay methods.In this hour of crisis,researchers are looking for new technologies to monitor and control such disease outbreaks.Artificial intelligence(AI)is one such technology.Being an evidence-based tool,this technology has the potential to upgrade our disease management strategies and help us to restrict the spread of such diseases.AI can play an effective role in tracking the spread of diseases,screening of the population,identifying patients and developing treatments of diseases.Through this review,we aim to analyze the role of AI in the diagnosis,monitoring and treatment of diseases like coronavirus disease 2019,with most recent updates and assess the prospects of this technology in the management of such diseases.展开更多
The global pandemic caused by the coronavirus disease 2019 not only exposed the fragility of global preparedness and response to public health emergence,but also illustrated the fragmentation and gaps of research and ...The global pandemic caused by the coronavirus disease 2019 not only exposed the fragility of global preparedness and response to public health emergence,but also illustrated the fragmentation and gaps of research and development ecosystem.This emphasizes the need for planned actions against the potentiality of new pandemics and requires research to better understand how viruses bridge the animal/human divide making human-to-human transmission of new diseases possible.Major challenges to response to new epidemics under the current health framework reside in the so called 4-CC approach that focuses on Concept,Communication,Coherence,and Continuity.There is a need to also add a One Health perspective with emphasis on governance,surveillance,capacity building and multi-disciplinary research to achieve a holistic and better integrated system.Using a regulatory framework to equip professionals might facilitate the function of a multi-sector approach that recognizes the value of their mandates and a One Health approach in their work.Collaborative,multisectoral actions under the global regulations and guidance would make evidence-based One Health approaches sustainable and accessible to everyone.展开更多
The cohesion of social“emotion–norm–goal”in response to major pandemics means the intention coordination of the involved group attitude,the value regulation of joint participations and the system optimization of p...The cohesion of social“emotion–norm–goal”in response to major pandemics means the intention coordination of the involved group attitude,the value regulation of joint participations and the system optimization of power concentration.Social cohesive mobilization includes the core role and key variables of the government’s initiative and public response,with social rectification functions of centralized leadership,social coordination and public participation as derivatives.The mobilization of national spirit in the process of cohesion emphasizes the formation of guidance,persuasion and influence of internal driving force based on value concept,which are mainly represented in the form of emotional mobilization,normative mobilization and goal mobilization.The“emotional paradigm”of national spirit mobilization that enters the practical level focuses on the“heart-warming”function of emotional strategy rituals;“normative paradigm”shows the function of“heart-winning”in the sense of norms and shapes interpretation scheme as well as social regulations of social cohesion value reproduction;“goal paradigm”reflects the“confidence strengthening”function led by collective actions,and conducts the goal transmission and framework construction of“idea+action”.展开更多
The optimum delivery of safeguarding substances is a major part of supply chain management and a crucial issue in the mitigation against the outbreak of pandemics.A problem arises for a decision maker who wants to opt...The optimum delivery of safeguarding substances is a major part of supply chain management and a crucial issue in the mitigation against the outbreak of pandemics.A problem arises for a decision maker who wants to optimally choose a subset of candidate consumers to maximize the distributed quantities of the needed safeguarding substances within a specic time period.A nonlinear binary mathematical programming model for the problem is formulated.The decision variables are binary ones that represent whether to choose a specic consumer,and design constraints are formulated to keep track of the chosen route.To better illustrate the problem,objective,and problem constraints,a real application case study is presented.The case study involves the optimum delivery of safeguarding substances to several hospitals in the Al-Gharbia Governorate in Egypt.The hospitals are selected to represent the consumers of safeguarding substances,as they are the rst crucial frontline for mitigation against a pandemic outbreak.A distribution truck is used to distribute the substances from the main store to the hospitals in specied required quantities during a given working shift.The objective function is formulated in order to maximize the total amount of delivered quantities during the specied time period.The case study is solved using a novel Discrete Binary Gaining Sharing Knowledge-based Optimization algorithm(DBGSK),which involves two main stages:discrete binary junior and senior gaining and sharing stages.DBGSK has the ability of nding the solutions of the introduced problem,and the obtained results demonstrate robustness and convergence toward the optimal solutions.展开更多
This paper investigates</span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><...This paper investigates</span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">the impact of biohazards and pandemics on construction workers’ health and well-being. A proper selection of control methods for biohazards and pandemics like COVID-19 pandemic will result in improved public health conditions. Occupational risks in the construction industry are also examined, with a focus on biohazards and pandemics, their containment, and the implications for health and safety. A safer work environment in the construction industry is encouraged. In this study, some statistical methods were used to analyse the data obtained from sampled</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">questionnaire. According to the findings, fewer people in poor developing</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">countries get routine check-ups compared to developed countries. The</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">construction industries studied have little or no insurance plans for staff. It also demonstrates that personal protective equipment (PPE) such as nasal masks, helmets, hand gloves, and work aprons can assist in the control of biohazards in the construction sector, such as asthma, cancer, and asbestosis. There should be safety awareness programmes, conferences, and seminars, as well as first-aid kits and HSE and qualified health workers on all building sites. In addition, the government should examine the site for the usage of PPEs and verify that records of family/personal medical history are maintained.展开更多
1.Introduction In reaction to large-scale pandemics like Covid-19,State governments across the world implemented different containment policies in an effort to reduce the spread of infections.In practice,the outcomes ...1.Introduction In reaction to large-scale pandemics like Covid-19,State governments across the world implemented different containment policies in an effort to reduce the spread of infections.In practice,the outcomes of these measures can drift significantly from the stated policies due to enforcement,adherence,and the policy content.These factors suggest a gap between policy“by the letter”and the true impact of its implementation.展开更多
Most human pathogens originate from non-human hosts and certain pathogens persist in animal reservoirs.The transmission of such pathogens to humans may lead to self-sustaining chains of transmission.These pathogens re...Most human pathogens originate from non-human hosts and certain pathogens persist in animal reservoirs.The transmission of such pathogens to humans may lead to self-sustaining chains of transmission.These pathogens represent the highest risk for future pandemics.For their prevention,the transmission over the species barrier—although rare—should,by all means,be avoided.In the current COVID-19 pandemic,surprisingly though,most of the current research concentrates on the control by drugs and vaccines,while comparatively little scientific inquiry focuses on future prevention.Already in 2012,the World Bank recommended to engage in a systemic One Health approach for zoonoses control,considering integrated surveillance-response and control of human and animal diseases for primarily economic reasons.First examples,like integrated West Nile virus surveillance in mosquitos,wild birds,horses and humans in Italy show evidence of financial savings from a closer cooperation of human and animal health sectors.Provided a zoonotic origin can be ascertained for the COVID-19 pandemic,integrated wildlife,domestic animal and humans disease surveillance-response may contribute to prevent future outbreaks.In conclusion,the earlier a zoonotic pathogen can be detected in the environment,in wildlife or in domestic animals;and the better human,animal and environmental surveillance communicate with each other to prevent an outbreak,the lower are the cumulative costs.展开更多
BACKGROUND Antibiotic resistance is a growing global health threat,and understanding local trends in bacterial isolates and their susceptibility patterns is crucial for effective infection control and antimicrobial st...BACKGROUND Antibiotic resistance is a growing global health threat,and understanding local trends in bacterial isolates and their susceptibility patterns is crucial for effective infection control and antimicrobial stewardship.The coronavirus disease 2019(COVID-19)pandemic has introduced additional complexities,potentially influencing these patterns.AIM To analyze trends in bacterial isolates and their antibiotic susceptibility patterns at Salmaniya Medical Complex from 2018 to 2023,with a specific focus on the impact of the COVID-19 pandemic on these trends.METHODS A retrospective analysis of microbiological data was conducted,covering the period from 2018 to 2023.The study included key bacterial pathogens such as Escherichia coli(E.coli),Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa,and Staphylococcus aureus,among others.The antibiotic susceptibility profiles of these isolates were assessed using standard laboratory methods.To contextualize the findings,the findings were compared with similar studies from other regions,including China,India,Romania,Saudi Arabia,the United Arab Emirates,Malaysia,and United States.RESULTS The study revealed fluctuating trends in the prevalence of bacterial isolates,with notable changes during the COVID-19 pandemic.For example,a significant increase in the prevalence of Staphylococcus aureus was observed during the pandemic years,while the prevalence of E.coli showed a more variable pattern.Antibiotic resistance rates varied among the different pathogens,with a concerning rise in resistance to commonly used antibiotics,particularly among Klebsiella pneumoniae and E.coli.Additionally,the study identified an alarming increase in the prevalence of multidrug-resistant(MDR)strains,especially within Klebsiella pneumoniae and E.coli isolates.The impact of the COVID-19 pandemic on these trends was evident,with shifts in the frequency,resistance patterns,and the emergence of MDR bacteria among several key pathogens.CONCLUSION This study highlights the dynamic nature of bacterial isolates and their antibiotic susceptibility patterns at Salmaniya Medical Complex,particularly in the context of the COVID-19 pandemic.The findings underscore the need for continuous monitoring and effective anti-microbial stewardship programs to combat the evolving threat of antibiotic resistance.Further research and policy initiatives are required to address the identified challenges and improve patient outcomes in the face of these ongoing challenges.展开更多
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
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.
文摘Background:This study aimed to assess the occupational risks encountered by Healthcare Workers(HCWs)in Saudi Arabia during the COVID-19 pandemic.Methods:A cross-sectional survey was carried out from May to October 2021.Using a multi-stage stratified random sampling technique,an online questionnaire was sent to the recruited HCWs,across Saudi Arabia.Results:Of the 768 HCWs recruited,702 participated in the survey.A significant majority(over 80%)reported working beyond 8 hours daily.COVID-19 infection,confirmed via PCR,was identified in 25%of the participants.Notably,infection was significantly correlated with direct or close contact(p=0.0007).Psychological distress was reported by 81%,with anxiety being the most prevalent(33%),followed by stress(19%),depression(17%),and insomnia(12%).Around 20%experienced headaches post-PPE use,while 14%reported adverse skin reactions,predominantly allergy and dermatitis.A concerning one-third of respondents reported exposure to violence.Conclusion:High infection rate,physical and psychological risks among HCWs especially those in direct contact with patients,reflect the need for enhancing the entirety of outbreak preparedness and response,specifically training.Active surveillance system,is crucial to adequately monitor and support HCWs during pandemic scenarios.
文摘Objective: To compare the effects of extracorporeal membrane oxygenation (ECMO) and routine mechanical ventilation on mortality and the risk of associated adverse events in patients with severe viral pneumonia. Methods: PubMed, the Cochrane Library, Embase, Web of Science, and other databases were searched to collect case-control or cohort studies on prognoses associated with ECMO treatment for viral pneumonia. Search terms included extracorporeal membrane oxygenation, ECMO, viral pneumonia, COVID-19, influenza, MERS, and others. According to the PICOS principle, two evaluators independently screened the literature, extracted the data, cross-checked the data, and extracted the data again. Two researchers evaluated the risk of bias in the included studies according to the Newcastle-Ottawa Scale (NOS) and cross-checked the results. Meta-analysis was performed using RevMan 5.3 software. Results: Nine studies were included for analysis, encompassing a total of 4,330 patients, which were categorized into ECMO and CMV groups. There were no significant differences between the two groups in most baseline data;however, the ECMO group had a lower oxygenation index, and some studies reported higher SOFA scores in the ECMO group compared to the CMV group. There was no significant difference in in-hospital mortality between the two groups. The length of ICU stay, total hospital stay, and total mechanical ventilation time were longer in the ECMO group than in the CMV group. In terms of adverse events, there was no significant difference in the occurrence of kidney injury between the two groups. Bleeding events were reported in two studies, with more bleeding events occurring in the ECMO group. According to the subgroup analysis of different virus types, there were no statistical differences in the above aspects among patients with swine flu, novel coronavirus, and MERS. Conclusion: ECMO has a certain degree of positive significance in the treatment of severe viral pneumonia, but there is no significant difference in the treatment outcome of ECMO across different epidemic periods. The timing of ECMO treatment, patient management, and withdrawal evaluation still need further research.
文摘Lean manufacturing has been used for the last few decades as a process and performance improvement tool.Initially known as Toyota production system(TPS),lean is now used in almost all service and manufacturing sectors to deliver favorable results such as decreased operational cost,increased customer satisfaction,decreased cycle time,and enhanced profits.During the coronavirus disease(COVID 19)pandemic,the manufacturing sector struggled immensely and could not function well even after lockdown was eased in many countries.Many companies found out there are not ready to conform with new regulations made by authorities in many countries.This paper proposes the use of simulation and multi response optimization in addition to other typical lean tools in order to arrive at optimum performance at the end of each project through an established optimization framework.The framework is used in a real case study performed at an aluminum extrusion factory.Lean manufacturing helps organizations to operate with smaller number of resources.It standardizes all processes so that most of the jobs can be done by most of the workers,but this is not enough to create a healthy,sanitized work place.Our framework utilizes the strengths of lean tools and adds pandemic readiness factor to them to ensure improvement in performance and health pandemic readiness.Implementation of the framework in the case company resulted in 50%reduction in labor,$730000 in expected annual cost savings,reduction in inventory levels,improved employee morale and the achievement of pandemic ready status.
文摘This project paper is to give a prediction for the future of other viral pandemics and to provide recommendations for preparing therapies that could help in the success of effective treatments and benefits for patients in life-threatening situations. The theory of prediction was proposed by Huu S. TIEU on March 25, 2019, and he hypothesized that any malfunctioning cell in the body could have a damaging effect. This paper discusses the prediction that Localized Oxygen Deprivation could be a contributing factor for a future epidemic or other viral pandemics that could affect body function. This paper is based on opinion and does not have sufficient evidence to support the claims made. Therefore, further in-depth study is needed to prove the findings. The author cites Hypoxia to support his idea, but he is not claiming that Hypoxia-Inducible Factor (HIF) has worked on his predictions. The author also tested a theory using cow blood curd for body function, but this test was not a structured test and the findings were not supported by other evidence. To further prove the idea or theory, further study into the subject should be conducted.
文摘The Coronavirus pandemics,or the COVID-19,came as an unwelcomed vip that did not want to leave,where people until today do not know for sure all the ways it affects people’s health and overall being.The year of 2020 will be remembered as the one in which life almost stopped.A year full of losses that continue,from losing people dear to us,to losing jobs,opportunities,and freedom in almost every sense.This paper covers the consequences of the COVID-19 outbreak that it had on people,focusing on the job loss and unemployment,the healthcare opportunities and availabilities,the gender discrimination in the process of losing jobs,and the most importantly the psychological consequences people suffered from,due to isolation,inability to work and to provide.
文摘BACKGROUND Burnout syndrome and anxiety are two mental health symptoms experienced by healthcare workers(HCWs)that can be exacerbated during pandemics due to increased job demands and the global health workforce crisis.AIM To provide a comprehensive review and summary of evidence on burnout and anxiety in HCWs during previous global pandemics.METHODS A systematic search on electronic databases such as PubMed Central and MEDLINE was conducted to identify high-quality systematic review studies that reported on the prevalence of burnout and/or anxiety in HCWs during any previous global pandemic.RESULTS Twenty-four high quality systematic review articles were found to be suitable for inclusion.Twenty articles focused merely on Coronavirus disease 2019,while four articles examined multiple pandemics.Burnout was examined in nine articles,while anxiety was examined in the remaining 21 articles.Female HCWs and nurses were identified to be at a higher risk of developing burnout and anxiety during pandemic.We also observed a variation in the prevalence of burnouts and anxiety across different studies due to different mental health instruments were used in different studies.CONCLUSION Nurses and females HCWs had a high prevalence of burnout syndrome and anxiety during pandemic.More emphasis and attention should be paid to safeguarding the psychological well-being of these at-risk populations in the future pandemics.
文摘Lung ultrasound(US)has been shown that it is able to detect interstitial lung disease,subpleural consolidations and acute respiratory distress syndrome in clinical and physical studies that assess its role in upper respiratory infections.It is used worldwide in the coronavirus disease 2019(COVID-19)outbreak and the effectiveness has been assessed in several studies.Fast diagnosis of COVID-19 is essential in deciding for patient isolation,clinical care and reducing transmission.Imaging the lung and pleura by ultrasound is efficient,cost-effective,and safe and it is recognized as rapid,repeatable,and reliable.Obstetricians are already using the US and are quite proficient in doing so.During the pandemic,performing lung US(LUS)right after the fetal assessment until reverse transcription polymerase chain reaction results are obtained,particularly in settings that have a centralized testing center,was found feasible for the prediction of the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.The use of LUS is efficient in the triage and monitoring of pregnant women.Clinicians dealing with pregnant women should consider LUS as the first-line diagnostic tool in pregnant women during the SARS-CoV-2 pandemic.
基金supported by Data and Articial Intelligence Scientic Chair at Umm Al-Qura University,Makkah City,Saudi Arabia。
文摘Social distancing and self-isolation management are crucial preventive measures that can save millions of lives during challenging pandemics of diseases such as the Spanish u,swine u,and coronavirus disease 2019(COVID-19).This study describes the comprehensive and effective implementation of the Industrial Internet of Things and machine-to-machine technologies for social distancing and smart self-isolation management.These technologies can help prevent outbreaks of any disease that can disperse widely and develop into a pandemic.Initially,a smart wristband is proposed that incorporates Bluetooth beacon technology to facilitate the tracing and tracking of Bluetooth Low Energy beacon packets for smart contact tracing.Second,the connectivity of the device with Android or iOS applications using long-term evolution technology is realized to achieve mobility.Finally,mathematical formulations are proposed to measure the distance between coordinates in order to detect geo-fencing violations.These formulations are specically designed for the virtual circular and polygonal boundaries used to restrict suspected or infected persons from trespassing in predetermined areas,e.g.,at home,in a hospital,or in an isolation ward.The proposed framework outperforms existing solutions,since it is implemented on a wider scale,provides a range of functionalities,and is cost-effective.
文摘The present moment is not the first time that America has found itself at war with a pathogen during a time of international conflict. Between crowded barracks at home and trenches abroad, wartime conditions helped enable the spread of influenza in the fall of 1918 during World War I such that an estimated 20%–40% of U.S. military members were infected. While the coronavirus disease 2019(COVID-19) pandemic is unparalleled for most of today's population, it is essential to not view it as unprecedented lest the lessons of past pandemics and their effect on the American military be forgotten. This article provides a historical perspective on the effect of the most notable antecedent pandemic, the Spanish Influenza epidemic, on American forces with the goal of understanding the interrelationship of global pandemics and the military, highlighting the unique challenges of the current pandemic, and examining how the American military has fought back against pandemics both at home and abroad, both 100 years ago and today.
文摘The novel coronavirus disease 2019(COVID-19)is an emerging disease,caused by severe acute respiratory syndrome coronavirus-2.It bears unique biological characteristics,clinical symptoms and imaging manifestations,therefore presenting an important and urgent threat to global health.As a result,a new public health crisis arose,threatening the world with the spread of the 2019 novel coronavirus.Despite the maximal worldwide public health responses aimed at containing the disease and delaying its spread,many countries have been confronted with a critical care crisis,and even more,countries will almost certainly follow.In Slovenia,the COVID-19 has struck the health system immensely and among all the specialities,neurosurgery has also been experiencing difficulties in the service,not only in regular,elective surgeries but especially during emergencies.The management of these neurosurgical patients has become more difficult than ever.We describe our protocol in the management of neurosurgical patients in the University Medical Centre Ljubljana,Slovenia and how neurosurgical pathology was tackled during the pandemics.
文摘The pandemic of severe acute respiratory syndrome coronavirus 2 has spread very quickly all over the world and has become an unparalleled public health crisis.This unforeseen and exceptional situation has instigated a wave of research to investigate the virus,track its spread,and study the disease it causes.Current methods of diagnosis and monitoring largely rely on polymerase chain reactions and enzyme-linked immunesorbent assay methods.In this hour of crisis,researchers are looking for new technologies to monitor and control such disease outbreaks.Artificial intelligence(AI)is one such technology.Being an evidence-based tool,this technology has the potential to upgrade our disease management strategies and help us to restrict the spread of such diseases.AI can play an effective role in tracking the spread of diseases,screening of the population,identifying patients and developing treatments of diseases.Through this review,we aim to analyze the role of AI in the diagnosis,monitoring and treatment of diseases like coronavirus disease 2019,with most recent updates and assess the prospects of this technology in the management of such diseases.
基金supported by the Excellence Action Plan for Science and Technology Journals in China(C-084)。
文摘The global pandemic caused by the coronavirus disease 2019 not only exposed the fragility of global preparedness and response to public health emergence,but also illustrated the fragmentation and gaps of research and development ecosystem.This emphasizes the need for planned actions against the potentiality of new pandemics and requires research to better understand how viruses bridge the animal/human divide making human-to-human transmission of new diseases possible.Major challenges to response to new epidemics under the current health framework reside in the so called 4-CC approach that focuses on Concept,Communication,Coherence,and Continuity.There is a need to also add a One Health perspective with emphasis on governance,surveillance,capacity building and multi-disciplinary research to achieve a holistic and better integrated system.Using a regulatory framework to equip professionals might facilitate the function of a multi-sector approach that recognizes the value of their mandates and a One Health approach in their work.Collaborative,multisectoral actions under the global regulations and guidance would make evidence-based One Health approaches sustainable and accessible to everyone.
基金This paper is a staged achievement of project“Research on Cultivating and Solidifying the Consciousness of Chinese National Community in the New Era”(No.18VSJ090)sponsored by The National Social Science Fund of China.
文摘The cohesion of social“emotion–norm–goal”in response to major pandemics means the intention coordination of the involved group attitude,the value regulation of joint participations and the system optimization of power concentration.Social cohesive mobilization includes the core role and key variables of the government’s initiative and public response,with social rectification functions of centralized leadership,social coordination and public participation as derivatives.The mobilization of national spirit in the process of cohesion emphasizes the formation of guidance,persuasion and influence of internal driving force based on value concept,which are mainly represented in the form of emotional mobilization,normative mobilization and goal mobilization.The“emotional paradigm”of national spirit mobilization that enters the practical level focuses on the“heart-warming”function of emotional strategy rituals;“normative paradigm”shows the function of“heart-winning”in the sense of norms and shapes interpretation scheme as well as social regulations of social cohesion value reproduction;“goal paradigm”reflects the“confidence strengthening”function led by collective actions,and conducts the goal transmission and framework construction of“idea+action”.
基金funded by Deanship of Scientic Research,King Saud University through the Vice Deanship of Scientic Research.
文摘The optimum delivery of safeguarding substances is a major part of supply chain management and a crucial issue in the mitigation against the outbreak of pandemics.A problem arises for a decision maker who wants to optimally choose a subset of candidate consumers to maximize the distributed quantities of the needed safeguarding substances within a specic time period.A nonlinear binary mathematical programming model for the problem is formulated.The decision variables are binary ones that represent whether to choose a specic consumer,and design constraints are formulated to keep track of the chosen route.To better illustrate the problem,objective,and problem constraints,a real application case study is presented.The case study involves the optimum delivery of safeguarding substances to several hospitals in the Al-Gharbia Governorate in Egypt.The hospitals are selected to represent the consumers of safeguarding substances,as they are the rst crucial frontline for mitigation against a pandemic outbreak.A distribution truck is used to distribute the substances from the main store to the hospitals in specied required quantities during a given working shift.The objective function is formulated in order to maximize the total amount of delivered quantities during the specied time period.The case study is solved using a novel Discrete Binary Gaining Sharing Knowledge-based Optimization algorithm(DBGSK),which involves two main stages:discrete binary junior and senior gaining and sharing stages.DBGSK has the ability of nding the solutions of the introduced problem,and the obtained results demonstrate robustness and convergence toward the optimal solutions.
文摘This paper investigates</span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">the impact of biohazards and pandemics on construction workers’ health and well-being. A proper selection of control methods for biohazards and pandemics like COVID-19 pandemic will result in improved public health conditions. Occupational risks in the construction industry are also examined, with a focus on biohazards and pandemics, their containment, and the implications for health and safety. A safer work environment in the construction industry is encouraged. In this study, some statistical methods were used to analyse the data obtained from sampled</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">questionnaire. According to the findings, fewer people in poor developing</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">countries get routine check-ups compared to developed countries. The</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">construction industries studied have little or no insurance plans for staff. It also demonstrates that personal protective equipment (PPE) such as nasal masks, helmets, hand gloves, and work aprons can assist in the control of biohazards in the construction sector, such as asthma, cancer, and asbestosis. There should be safety awareness programmes, conferences, and seminars, as well as first-aid kits and HSE and qualified health workers on all building sites. In addition, the government should examine the site for the usage of PPEs and verify that records of family/personal medical history are maintained.
文摘1.Introduction In reaction to large-scale pandemics like Covid-19,State governments across the world implemented different containment policies in an effort to reduce the spread of infections.In practice,the outcomes of these measures can drift significantly from the stated policies due to enforcement,adherence,and the policy content.These factors suggest a gap between policy“by the letter”and the true impact of its implementation.
基金This work was supported by the National Key Research and Development Programme of China(grant No.2016YFC1202000)the National Natural Science Foundation of China(grant No.81973108).
文摘Most human pathogens originate from non-human hosts and certain pathogens persist in animal reservoirs.The transmission of such pathogens to humans may lead to self-sustaining chains of transmission.These pathogens represent the highest risk for future pandemics.For their prevention,the transmission over the species barrier—although rare—should,by all means,be avoided.In the current COVID-19 pandemic,surprisingly though,most of the current research concentrates on the control by drugs and vaccines,while comparatively little scientific inquiry focuses on future prevention.Already in 2012,the World Bank recommended to engage in a systemic One Health approach for zoonoses control,considering integrated surveillance-response and control of human and animal diseases for primarily economic reasons.First examples,like integrated West Nile virus surveillance in mosquitos,wild birds,horses and humans in Italy show evidence of financial savings from a closer cooperation of human and animal health sectors.Provided a zoonotic origin can be ascertained for the COVID-19 pandemic,integrated wildlife,domestic animal and humans disease surveillance-response may contribute to prevent future outbreaks.In conclusion,the earlier a zoonotic pathogen can be detected in the environment,in wildlife or in domestic animals;and the better human,animal and environmental surveillance communicate with each other to prevent an outbreak,the lower are the cumulative costs.
文摘BACKGROUND Antibiotic resistance is a growing global health threat,and understanding local trends in bacterial isolates and their susceptibility patterns is crucial for effective infection control and antimicrobial stewardship.The coronavirus disease 2019(COVID-19)pandemic has introduced additional complexities,potentially influencing these patterns.AIM To analyze trends in bacterial isolates and their antibiotic susceptibility patterns at Salmaniya Medical Complex from 2018 to 2023,with a specific focus on the impact of the COVID-19 pandemic on these trends.METHODS A retrospective analysis of microbiological data was conducted,covering the period from 2018 to 2023.The study included key bacterial pathogens such as Escherichia coli(E.coli),Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa,and Staphylococcus aureus,among others.The antibiotic susceptibility profiles of these isolates were assessed using standard laboratory methods.To contextualize the findings,the findings were compared with similar studies from other regions,including China,India,Romania,Saudi Arabia,the United Arab Emirates,Malaysia,and United States.RESULTS The study revealed fluctuating trends in the prevalence of bacterial isolates,with notable changes during the COVID-19 pandemic.For example,a significant increase in the prevalence of Staphylococcus aureus was observed during the pandemic years,while the prevalence of E.coli showed a more variable pattern.Antibiotic resistance rates varied among the different pathogens,with a concerning rise in resistance to commonly used antibiotics,particularly among Klebsiella pneumoniae and E.coli.Additionally,the study identified an alarming increase in the prevalence of multidrug-resistant(MDR)strains,especially within Klebsiella pneumoniae and E.coli isolates.The impact of the COVID-19 pandemic on these trends was evident,with shifts in the frequency,resistance patterns,and the emergence of MDR bacteria among several key pathogens.CONCLUSION This study highlights the dynamic nature of bacterial isolates and their antibiotic susceptibility patterns at Salmaniya Medical Complex,particularly in the context of the COVID-19 pandemic.The findings underscore the need for continuous monitoring and effective anti-microbial stewardship programs to combat the evolving threat of antibiotic resistance.Further research and policy initiatives are required to address the identified challenges and improve patient outcomes in the face of these ongoing challenges.
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.
