Understanding COVID-19 risk perception may help inform public health messaging aimed at encouraging preventive measures and improving countermeasures against the pandemic. We conducted an online survey of 29,708 Japanese adults in February 2021 and estimated the associations between COVID-19 risk perception and a broad array of individual factors. Two logistic regressions were constructed to estimate factors associated with the risk perception of COVID-19 (defined as responding that one might become infected within the next 6 months), and of severe illness among those who responded that they might become infected (defined as responding that one would become severely ill). After adjusting for covariates, those with a higher perceived risk of the COVID-19 vaccine had higher odds of risk perception for both infection and severe illness. Interestingly, those with higher odds of risk perception of being infected were more likely to report obtaining their information from healthcare workers whereas those with lower odds were more likely to report obtaining their information from the Internet or the government; those with lower odds of risk perception of being severely ill were more likely to report obtaining their information from the Internet. The higher the trust level in the government as a COVID-19 information source, the lower the odds of both risk perception of being infected and becoming severely ill. The higher the trust levels in social networking services as a COVID-19 information source, the higher the odds of risk perception of becoming severely ill. Public health messaging should address the factors identified in our study.

Amphibians worldwide continue to battle an emerging infectious disease, chytridiomycosis, caused by Batrachochytrium dendrobatidis (Bd). Southern leopard frogs, Rana sphenocephala, are known to become infected with this pathogen, yet they are considered 'of least concern' for declines due to chytridiomycosis. Previous studies have shown that R. sphenocephala secretes four antimicrobial peptides (AMPs) onto their skin which may play an important role in limiting susceptibility to chytridiomycosis. Here, we examined (1) the effects of temperature and AMP depletion on infections with Bd and (2) the effects of temperature and Bd infection on the capacity to secrete AMPs in juvenile leopard frogs. Pathogen burden and mortality were greater in frogs exposed to Bd at low temperature but did not increase following monthly AMP depletion. Both low temperature and Bd exposure reduced the capacity of juvenile frogs to restore peptides after monthly depletions. Frogs held at 14°C were poorly able to restore peptides in comparison with those at 26°C. Frogs held at 26°C were better able to restore their peptides, but when exposed to Bd, this capacity was significantly reduced. These results strongly support the hypothesis that both colder temperatures and Bd infection impair the capacity of juvenile frogs to produce and secrete AMPs, an important component of their innate defense against chytrid fungi and other pathogens. Thus, in the face of unpredictable climate changes and enzootic pathogens, assessments of disease risk should consider the potential for effects of environmental variation and pathogen exposure on the quality of host defenses.

AbstractIt can be shown that over 94% of COVID-19 superspreading events occurred in limited ventilation areas suggesting aerosolized transmission is a strong contributor to COVID-19 infections.This study helps answer “How long may a person safely remain within various environments?” And “What exposure levels could result in immunity without becoming ill via asymptomatic graduated inoculation?”COVID-19 infection likelihood, symptom severity, and immune response dependencies include viral load exposure amount. A better understanding of these relationships could help determine what Non-Pharmaceutical Interventions (NPI) would help reduce severe case counts and improve at-large epidemiologic responses in specific scenarios.This study references peer reviewed and published studies and uses them as data sources for an estimation model that calculates infection likelihood given exposure within several example scenarios. Information from ASHRAE office ventilation standards, typical home ventilation characteristics, and an outdoor air setting are used to establish several specific examples of indoor and outdoor scenarios.The model establishes a reference scenario using objectively measured air sample viral load concentration levels found within a carefully documented hospital environment containing 2 sick patients. The model extrapolates the reference scenario into several example scenarios that have varied exposure time duration, ventilation amount, with/without surgical mask use, activity/respiration levels, and infected subject shedding levels. It uses the reference data and scenario extrapolations to calculate an estimate of total viral load exposure dose for each scenario.The study then interprets the various scenario total exposure dose estimates using an National Institute of Health human challenge study where volunteers were exposed to multiple specific viral quantities and observed in a clinical environment to objectively determine likelihood of infection, severity level, and immune response given each specific exposure dose. To simplify pragmatic use of the results, each example scenario presents the estimated total exposure dose alongside an intuitive severity category of Not Ill, Minor Illness, Clinical Mild Illness, and Possible Severe Illness which are based on a defined interpretation of the NIH study results. Immune response data related to these categories is also provided along with discussion related to asymptomatic infection, graduated inoculation, and immunity.When appropriately interpreted for individualized applications, the estimates herein could contribute to guidance for those at low-risk for a severe case that have no obvious COVID-19 co-morbidities, with the understanding that those at higher risk should seek to avoid all exposure risk. The estimates herein may help efforts to strike a balance in developing holistic epidemiologic interventions that consider the effects of these interventions on economic, civic, social, and mental health, which have pathologies within their own realms.

Mental illness is the most common diagnosis resulting in long-term sick leave in Sweden today, especially stress-related syndromes and mood disorders. The aim of this article is to analyse the relational and emotional processes in the workplace that may contribute to the understanding of long-term sick leave for mental-health reasons. We conducted interviews with twenty-six people who were on sick-leave because of diagnoses of mental ill-health. The empirical material was analysed using Classic Grounded Theory. We suggest that the risk of being afflicted with mental illness, and forced into long-term sick leave, increases when there are conflicts at work that remain unresolved and which lead to malignant shaming processes that jeopardize personal dignity. In their struggle to maintain self-esteem, the afflicted escalate their work efforts by increasing work intensity, putting in overtime, and working when ill. Eventually, this behaviour affects their health and results in sick-listing. The strengths and weaknesses of the study are discussed along with the need for further research.

Skin decontamination in cold weather temperatures might be challenging due to the aggravating circumstances. However, no information is available on the efficacy of commonly used procedures in winter conditions. Therefore, the efficacy of the reactive skin decontamination lotion (RSDL) and soapy water decontamination following skin exposure to the nerve agent VX was evaluated at three ambient air temperatures (-5°C, -15°C and room temperature). Experiments were performed in vitro using human dermatomed skin. The ability of RSDL to degrade VX at the three different air temperatures was separately evaluated. The ambient air temperature in experiments without decontamination did not influence the penetration rate of VX through skin. RSDL decontamination was highly efficient in removing VX from skin when performed in all three ambient temperatures, despite the slower agent degradation rate of VX at the lower temperatures. Decontamination with soapy water at RT resulted in an increased skin penetration of VX compared with the control without decontamination; however, in colder temperatures the VX skin penetration was similar to the corresponding control without decontamination. At RT, dry removal prior to washing with soapy water did not improve decontamination of VX compared with washing solely with soapy water. This study demonstrated high efficacy of RSDL decontamination following skin exposure to VX also at cold temperatures. The previously reported 'wash-in' effect of soapy water on VX skin penetration was reduced at cold temperatures. Altogether, this study found a scientific basis to establish guidelines for skin decontamination of chemical casualties at cold weather temperatures.

INTRODUCTION: Sick euthyroid syndrome is also known as low triiodothyronine (T3) syndrome or non-thyroidal illness syndrome which is characterized by alterations in the levels of thyroid hormones in the absence of any disorder related to thyroid gland or hypothalamic-hypophysial axis. Abnormal findings on thyroid functions tests which occur in the setting of a non thyroidal illness (NTI) without preexisting hypothalamic-pituitary and thyroid gland dysfunction. In the 1970s initially described low T3 (triiodothyronine) syndrome, known as the euthyroid sick syndrome or the nonthyroidal illness syndrome (NTIS). This can be representing especially in in critically ill patients, particularly those admitted to intensive care units. Although by definition these abnormalities are not related to intrinsic diseases of hypothalamus-pituitary-thyroid axis though rather represent imbalances in thyroid hormone production, metabolism, and action. As there is progress in illness gradual development of a more complex syndrome associated with low levels of T3 and thyroxine (T4). AIM: The main objective of this study is to study clinical profile sick euthyroid syndrome in Non-thyroidal Illness. MATERIAL AND METHODS: Total 60 patients were included in this study with the diagnosis of euthyroid syndrome with suggestive of Non-thyroidal Illness. From all the patients detail history were recorded as data as well as all the necessary lab investigations were recorded as hemogram, renal function test, liver function test, ECG, Chest roentgenogram, and thyroid function status and serum cholrine esterase. RESULT: Total 60 patients were including in this study within the period of study with different age group. Patients with age group 20-30 years age group shows majority followed by age group 30-40 years age group as 33.3% and 30% respectively. Among the 60 patients only 15 patients were observed as sick Euthyroid. Out of 15 patients with sick Euthyroid 60% showed Low T3 alone and 40% shows changes in T3, T4 & TSH Levels. CONCLUSION: Non-thyroidal illness syndrome is common among male in comparisons to female with the middle ages. Since the mechanism of sick euthyroid syndrome is similar to sick euthyroid syndrome in other critical care illnesses. Therefore more and more studies should be done for the better evaluation of the prognostic value of NTIS in critically ill. Thyroid functions should be assessed routinely in patients for prevent of Non-thyroidal illness syndrome. 
 KEYWORDS: sick euthyroid syndrome, Non-thyroidal Illness, Thyroid

Hypothalamic-pituitary-thyroid (HPT) axis dysfunction is associated with morbidity and mortality in critically ill people. To date, investigations of HPT axis in critically ill foals are limited. To document the occurrence of low thyroid hormone concentrations (presumptive nonthyroidal illness syndrome; NTIS) in critically ill newborn foals and investigate whether NTIS is associated with severity of disease and outcome. NTIS occurs frequently in foals with sepsis and is associated with sepsis score and outcome. Reverse T3 (rT3) concentrations will be increased in septic foals and highest in nonsurvivors. Thyroid hormones (total and free thyroxine [TT4 and fT4], total and free tri-iodothyronine [TT3 and fT3], reverse T3 [rT3]) were prospectively measured in healthy, sick nonseptic and septic foals. Clinical and laboratory information was retrieved from the medical records. Hormones were measured by validated radioimmunoassays. Concentrations of all thyroid hormones except rT3 (P = 0.69) were decreased in septic and sick nonseptic foals (P < 0.01). Reductions in hormone concentrations were associated with an increased sepsis score (P < 0.01). Nonsurviving septic foals had lower TT4, fT4, TT3 and fT3 concentrations than surviving septic foals (P < 0.01). rT3 concentrations were higher in nonsurviving septic prematurefoals than surviving septic premature foals (P < 0.05). NTIS (euthyroid sick syndrome) is frequently observed in critically ill and premature foals, and associated with severity of disease and mortality. More research is needed to better understand the mechanism of this finding and determine whether manipulation of the HPT axis or thyroid replacement therapy could be beneficial.

Introduction: The Omicron variant of the novel coronavirus (COVID-19) has been spreading more rapidly and is more infectious, posing a higher risk of death and treatment difficulty for patients undergoing hemodialysis. This study aims to explore the severity rate and risk factors for hemodialysis patients infected with the Omicron variant and to conduct a preliminary analysis of the clinical efficacy of drugs. Methods: Clinical and biochemical indicators of 219 hemodialysis patients infected with the Omicron variant were statistically analyzed. The patients were divided into two groups based on whether they were severely ill or not, and multiple regression analysis was conducted to determine the risk factors for severe illness. The severely ill patients were then grouped based on discharge or death, and the treatment drugs were included as influencing factors for multiple regression analysis to determine the risk factors and protective factors for death of severely ill patients, and drug efficacy analysis was conducted. Results: Analysis showed that diabetes, low oxygen saturation, and high C-reactive protein (CRP) were independent risk factors for severe illness in hemodialysis patients infected with the Omicron variant. A history of diabetes and high C-reactive significantly increased the risk of severe illness in patients (aOR: 1.450; aOR: 1.011), while a high oxygen saturation level can reduce this risk (aOR: 0.871). In addition, respiratory distress was an independent risk factor for death in severely patients, significantly reducing the probability of discharge for patients (aOR: 0.152). The drugs thymalfasin and Tanreqing significantly increased the probability of discharge for patients (aOR: 1.472; aOR: 3.104), with the latter having a higher correlation, but with a relatively longer effective course. Conclusion: Hemodialysis patients infected with the Omicron variant of COVID-19 should pay special attention to their history of diabetes, CRP, and oxygen saturation levels, as well as respiratory distress symptoms, to reduce the risk of severe illness and death. In addition, thymalfasin and Tanreqing may be considered in treatment.

We sought to better understand the frostbite risk during first-aid tourniquet use by reviewing information relevant to an association between tourniquet use and frostbite. However, there is little information concerning this subject, which may be of increasing importance because future conflicts against near-peer competitors may involve extreme cold weather environments. Historically, clinical frostbite cases with tourniquet use occurred in low frequency but in high severity when leading to limb amputation. The physiologic response of vasoconstriction to cold exposure leads to limb cooling and causes a reduction of limb blood flow, but cold-induced vasodilation ensues as periodic fluctuations that increase blood flow to hands and feet. In animal experiments, tourniquet use increased the development of frostbite. Evidence from human experiments also supports an association between tourniquet use and frostbite. Clinical guidance for caregiving to casualties at risk for frostbite with tourniquet use had previously been provided but slowly and progressively dropped out of documents. Conclusions: The cause of frostbite was deduced to be a sufficiently negative heat-transfer trend in local tissues, which tourniquet use may worsen because of decreasing tissue perfusion. An association between tourniquet use and frostbite exists but not as cause and effect. Tourniquet use increased the risk of the cold causing frostbite by allowing faster cooling of a limb because of reduced blood flow and lack of cold-induced vasodilation. Care providers above the level of the lay public are warned that first-aid tourniquet use in low-temperature (<0°C [<32°F]) environmental conditions risks frostbite.

Severe fever with thrombocytopenia syndrome (SFTS) caused by Dabie bandavirus (formerly SFTS virus, SFTSV), which belongs to the Bandavirus genus (formerly Phlebovirus genus) of the Phenuiviridae family (formerly Bunyaviridae family), is a tick-borne novel bunyavirus infection with high rates of mortality. SFTSV infection was diagnosed virologically in a 4-year-old dog with symptoms of lethargy and anorexia in western Japan in June 2017. The dog's owner, a man in his 40s, had taken care of the sick dog and became sick 10 days after disease onset in the dog, showing symptoms, such as fever, arthralgia, headache, nausea, and vomiting. Total blood cell counts revealed leukocytopenia and thrombocytopenia. He was treated as an outpatient. He had no scars suggesting that he had not been bitten by ticks. He was diagnosed as having SFTS via the detection of IgM and neutralizing antibodies to SFTSV. The patient was directly infected with SFTSV from the SFTSV-infected dog. In conclusion, humans can be at a risk of SFTSV infection through direct contact with sick dogs infected with SFTSV.