Future Pandemics Research Articles

From destination choice to departure: analysing French tourists’ behaviours facing health risks from COVID-19

ABSTRACT During a pandemic, individuals react both cognitively and emotionally, leading them to adopt self-protective behaviours. Governments, meanwhile, face a delicate balancing act between safeguarding public health and mitigating the socioeconomic impact. In the tourism industry, this translates to reducing infection risk while minimizing mass cancellations. Past research suggests that providing updated information can help achieve these objectives. This study examines two pre-departure behaviours of French tourists in response to health risks from COVID-19: (1) seeking or not seeking information about COVID-19 indicators and protective measures at the chosen destination; (2) continuing with the planned stay or cancelling it. Seeking information and cancelling trips are voluntary actions driven by various factors, including tourists’ emotional state, particularly their worry about contracting and transmitting COVID-19. We find that worry motivates both behaviours, with worry about contracting exerting the strongest influence. Information-seeking, regardless of whether analysed as ordinal or nominal, tends to promote cancellations. This suggests a potential conflict between public health and tourism objectives. Our findings highlight the critical need for tourism managers to reassure tourists about health safety and tailor communication strategies accordingly. In this vein, we discuss some propositions that could be considered in the event of future pandemics.

Clinical evolution of patients with lower extremity peripheral artery disease during the COVID-19 pandemic (the COVID-PAD study).

Background: The COVID-19 pandemic has led to significant disruptions in chronic disease care and forced people to stay at home. The effects of such issues on outpatients with lower extremity peripheral artery disease (PAD) remain unknown. Patients and methods: Single-centre, retrospective-prospective study conducted in a Swiss University Hospital. Patients with PAD were included between May 1 and July 31, 2020, with a follow-up visit at 12 months. Upon both visits, the Leriche-Fontaine PAD stage was recorded, and study participants underwent ankle-brachial index (ABI) calculation to assess limb perfusion. Functional capacities were assessed through the 6-minute walking and treadmill tests. Major adverse cardiovascular (MACE) and limb events (MALE) were recorded. Data collected during the pandemic were compared with the pre-pandemic period (January 1, 2019-April 30, 2020). Results: Overall, 259 patients were included. Mean age was 69 years and male sex was prevalent (69.1%). Odds of experiencing a degradation in PAD stage were lower during the pandemic than before (odds ratio [OR]: 0.43; 95% confidence interval [CI]: 0.21-0.87; p = 0.018). No significant difference was found between periods in terms of ABI trends. Both pain-free walking time at treadmill test (p = 0.003) and maximal pain intensity at 6-minute walking test (p = 0.001) significantly improved during the pandemic. Compared with the pre-pandemic period, during the pandemic patients were hospitalized less frequently (p = 0.028) and were less likely to undergo elective limb revascularization (p<0.001). No significant difference was found between periods in terms of MALE (p = 0.311), whereas non-fatal strokes were less frequently reported during the pandemic (p = 0.043). Conclusion: In a cohort of outpatients with PAD, we found no evidence of clinical deterioration during the pandemic compared with the pre-pandemic period, though rates of adverse events were nonnegligible in both periods. In case of future pandemics, patients with PAD should be encouraged to maintain an active lifestyle while being closely monitored to avoid clinical worsening.

Resilience during lockdown: a longitudinal study investigating changes in behaviour and attitudes among older females during COVID-19 lockdown in the UK

In order to slow the spread of COVID-19, on March 23, 2020, a strict lockdown was implemented in the UK. This was followed by alternating periods of less restrictive lockdowns until most public health restrictions were lifted in the summer of 2021. While these measures were necessary, they significantly affected people’s daily activities, lifestyles, and mental well-being.This paper presents a longitudinal research study that focused on females aged 55 + in the UK, aiming to understand how COVID-19 and the subsequent 15-month period of lockdowns affected their lifestyles and emotions. The study collected data through online surveys, where respondents reported the frequency and mode of access to activities, and their positive and negative emotional experiences during distinct study phases that encompassed both lockdown and less strict periods.In contrast to previous studies highlighting vulnerabilities for females and the elderly during lockdowns, this research found that the studied group maintained an overall positive outlook throughout the study period and successfully adapted to the lockdowns by increasing their engagement in certain activities, in particular, activities like ‘getting active’. In addition, our findings indicate rapid adaptive behaviour change towards many online activities, such as cultural activities. However, the study also revealed negative emotions and a decrease in some activities during the second lockdown in 2020 and the subsequent lockdowns in 2021, underscoring the challenges inherent in prolonged periods of confinement. In addition, the study found negative affect associated with some activities, including working and studying from home.The findings provide valuable insights into how females aged over 55 coped with stressful circumstances, which can inform the development of resilient and mental health-conscious public health policies and responses in preparation for future pandemics or other hazards.

Learning health systems on the front lines to strengthen care against future pandemics and climate change: a rapid review

BackgroundAn essential component of future-proofing health systems against future pandemics and climate change is strengthening the front lines of care: principally, emergency departments and primary care settings. To achieve this, these settings can adopt learning health system (LHS) principles, integrating data, evidence, and experience to continuously improve care delivery. This rapid review aimed to understand the ways in which LHS principles have been applied to primary care and emergency departments, the extent to which LHS approaches have been adopted in these key settings, and the factors that affect their adoption.MethodsThree academic databases (Embase, Scopus, and PubMed) were searched for full text articles reporting on LHSs in primary care and/or emergency departments published in the last five years. Articles were included if they had a primary focus on LHSs in primary care settings (general practice, allied health, multidisciplinary primary care, and community-based care) and/or emergency care settings. Data from included articles were catalogued and synthesised according to the modified Institute of Medicine’s five-component framework for LHSs (science and informatics, patient-clinician partnerships, incentives, continuous learning culture, and structure and governance).ResultsThirty-seven articles were included, 32 of which reported LHSs in primary care settings and seven of which reported LHSs in emergency departments. Science and informatics was the most commonly reported LHS component, followed closely by continuous learning culture and structure and governance. Most articles (n = 30) reported on LHSs that had been adopted, and many of the included articles (n = 17) were descriptive reports of LHS approaches.ConclusionsDeveloping LHSs at the front lines of care is essential for future-proofing against current and new threats to health system sustainability, such as pandemic- and climate change-induced events. Limited research has examined the application of LHS concepts to emergency care settings. Implementation science should be utilised to better understand the factors influencing adoption of LHS approaches on the front lines of care, so that all five LHS components can be progressed in these settings.

A ‘forced holiday’ or ‘no escape route’? Contrasting experiences of survivors and perpetrators of domestic abuse during COVID-19

Drawing on a nested qualitative study within REPROVIDE, a randomised controlled trial examining the effectiveness of a group-based domestic abuse perpetrator programme, this article explores accounts of domestic abuse during the COVID-19 pandemic from the perspectives of victims/survivors and perpetrators. Based on interviews with male perpetrators and female survivors, including with partner/ex-partner dyads, our study reveals the gendered effects of the pandemic on abusive perpetrator behaviour. Findings are presented through themes addressing the different experiences of victims/survivors and perpetrators during the pandemic. Through an exploration of victim/survivor attempts to ameliorate intensified abuse through compliance (Theme 1), the way perpetrators put on a masculine ‘front’ (Theme 2), the gendered burden of domestic responsibilities (Theme 3) and highlighting the importance of continued specialist support (Theme 4), this article contributes to an understanding of gender inequalities underpinning pre-pandemic domestic violence and abuse and how perpetrators utilised inequalities during COVID restrictions. Some dyads reported relationships feeling more settled in the first UK lockdown, however, this was associated with increased opportunities for control that lockdown provided perpetrators. Both parties experienced changes in service responses. We articulate implications for safe working with perpetrators and families during future pandemics or social crises.

A trivalent protein-based pan-Betacoronavirus vaccine elicits cross-neutralizing antibodies against a panel of coronavirus pseudoviruses

The development of broad-spectrum coronavirus vaccines is essential to prepare for future respiratory virus pandemics. We demonstrated broad neutralization by a trivalent subunit vaccine, formulating the receptor-binding domains of SARS-CoV, MERS-CoV, and SARS-CoV-2 XBB.1.5 with Alum and CpG55.2. Vaccinated mice produced cross-neutralizing antibodies against all three human Betacoronaviruses and others currently exclusive to bats, indicating the epitope preservation of the individual antigens during co-formulation and the potential for epitope broadening.

COVID-19 lockdowns and children's access to justice: An interrupted time series analysis of Moroccan court filings

Morocco's national lockdown was enforced between March 21st and June 10th 2020 in response to the spread of coronavirus. Restriction of civil space was not fully extended to the judiciary which had to transition to virtual sessions. To prepare for future pandemics and disasters, it is crucial to understand how well court systems across jurisdictions especially in low- and middle-income countries managed to function and protect children's access to justice under the constraints of stay-at-home orders. To investigate the effect of the national lockdown on children's access to justice in Morocco, this study employed interrupted time series analysis of publicly available court filings (N = 77,335) pertaining to child protection from January 1st to December 31st 2020 spanning the pre-lockdown, lockdown, and post-lockdown periods. Results showed that lockdown measures hampered children's access to justice and is associated with statistically significant and substantial deceases in the number of cases heard by the courts across all filing types. The interrupted time series model estimates that average cases per week dropped by 199.5 for penal filings, 1180.3 for civil filings, 942.5 for complaint filings, and 358.1 for report fillings during the lockdown relative to the pre-lockdown period. While the percentage of cases with recorded delays mostly increased, the average case length decreased except for civil filings which saw a significant increase. The substantial susceptibility of civil cases to lockdowns might be precipitated by the need of individuals to petition the court for a hearing. Evidence suggests that the courts adjudicating child protection cases struggled to maintain operations during the national lockdown, and indicates the need for stronger disaster preparedness and an integrated child protection system to increase the judiciaries' resilience and children's access to justice in future emergency and disaster events.

Primary care team reorganisation after the SARS-COV-2 pandemic. Differences between Catalonia and Spain in the PRICOV study.

Spanish primary care services are managed differently by each region's authorities. Catalonia started its services provision and design nearly two decades before other Spanish regions and developed nurses' roles and task shifting in primary care. This work identifies differences in the Europe PRICOV-19 study answers between Catalonia and those submitted from the rest of Spain regarding how primary care teams (PCT) were organised during the SARS-CoV-2-2019 pandemic, how tasks and roles changed, and the pandemic's impact on the care providers. Initially, we computed bivariate relationships and tested using contingency association and unpaired Wilcoxon. Still, we estimated multiple linear regressions controlling with a list of individual and GP practice characteristics and clustering standard errors at the kind of location. Main statistically significant differences were found in the adaptation to the new tasks, the ability to solve most health problems, and specific accessibilities to primary care. In Catalonia, satisfaction with the adaptation to the new tasks was higher (41.9% satisfied and 30.2% neutral) than in the rest of Spain (50.9% dissatisfaction). Also, GPs in Catalonia reported to a greater extent than the rest of Spain that chronic patients were listed for extensive follow-up. These differences may be related to Catalonia's strategy for empowering primary care professionals other than family doctors. Considering future pandemics, demographic ageing, and professional shortages, we point out the potential benefits of these changes in PCT organisations and the need to review the centres's design.

Experiences of Irish Advanced Nurse Practitioners Delivering Nursing Care During the COVID-19 Pandemic

Objective: The objective of this research was to explore ANP's experience in the delivery of advanced nursing care to patients and how the Covid-19 pandemic has affected the day-to-day work of ANPs as well as gaining an understanding of ANPs’ perceptions of how the pandemic has influenced the delivery of care to patients and the personal impact of working as an ANP during the Covid-19 pandemic. Background: The COVID-19 pandemic has affects healthcare staff and patients worldwide. Many studies have looked at the experiences of nursing staff during the pandemic but very few have examined the experiences of ANPs. Study design and methods: A qualitative descriptive study was conducted examining the experiences of Irish ANPs during the COVID-19 pandemic. Semi-structured interviews were conducted with 15 ANP participants. Thematic analysis of interview transcripts was performed using a Castleberry and Nolan’s (2008) five-step thematic analysis. Results: Three themes and four sub-themes were found through thematic interview analysis. These themes were, 1. Adapting to COVID with subthemes fear and anxiety of covid, feeling supported, the advent of telehealth, 2. Impact of redeployment with subtheme not prepared for redeployment, 3. Primary Care and General Practitioners. Conclusion: The identified themes provided insight into the experiences of Irish advanced nurse practitioners caring for patients during the COVID-19 pandemic. Each theme shed a personal light on the impact the COVID-19 pandemic had on the professional working lives of nurses working at an advanced level within Ireland. The finding of this study adds to a growing body of literature on the impact COVID-19 had on nursing. Advanced nurse practitioners are a cohort of nurses who had to adapt to the challenges of COVID-19 which impacted their professional and their personal lives. Implications for research, policy, and practice: Understanding how ANPs experienced the COVID-19 pandemic as a group of healthcare professionals allows for better planning for future pandemics or crises using the skills of these professionals to better serve their patient populations as well as planning healthcare workforce more effectively. What is already known about the topic? • COVID-19 has had a great impact on nursing in both positive and negative ways. • Nurses have had to adapt to challenges posed by the COVID-19 pandemic. What this paper adds • An insight into how COVID-19 impacted advanced nurse practitioners within Ireland. Keywords: Nurse practitioner; Nurse; COVID-19; Qualitative Research; Ireland Objective

A practical real-time control strategy for high-performance building HVAC operation concerning potential pandemic outbreaks in post-pandemic era

The lessons learned from the COVID-19 pandemic emphasize the need for building HVAC systems to be adaptable and prepared to adjust their operation for infection risk mitigation for future pandemics. Most guidelines suggest increasing outdoor air fraction in HVAC systems during pandemics. However, this approach is not energy-efficient due to the conditioning of additional outdoor air, and many practical systems face limitations in introducing more outdoor air than normal due to capacity or design constraints. Therefore, there is an urgent need for an alternative solution for HVAC system operation during pandemics that is energy-efficient, can effectively mitigate infection risks and does not require extensive retrofits to existing systems. To meet this need, this study proposes a practical real-time control strategy for high-performance HVAC operation in response to potential pandemic outbreaks. First, a supply air temperature (SAT) reset scheme for infection risk mitigation is proposed based on Mamdani fuzzy inference theory. Then, a coordinated control scheme is proposed to coordinate SAT reset with chilled water temperature adjustment for energy-efficiency enhancement. This strategy does not require system equipment retrofits but only changes in control logic to transition to pandemic operation. The effectiveness of the proposed strategy is validated in a high-fidelity Modelica-based simulation environment under various weather conditions. Results show that, compared to normal operation, the proposed strategy can significantly reduce new infection cases by 32∼46 % without increasing energy use, and may even achieve slight energy savings of 9∼13 %, while maintaining expected occupant comfort.

Innovation through Artificial Intelligence in Triage Systems for Resource Optimization in Future Pandemics.

In this study, we propose the use of a machine learning system in emergency department triage during pandemics to detect patients at the highest risk of death and infection using the COVID-19 era as an example, where rapid decision making and comprehensive support have becoming increasingly crucial. All patients who consecutively presented to the emergency department were included, and more than 89 variables were automatically analyzed using the extreme gradient boosting (XGB) algorithm. The XGB system demonstrated the highest balanced accuracy at 91.61%. Additionally, it obtained results more quickly than traditional triage systems. The variables that most influenced mortality prediction were procalcitonin level, age, and oxygen saturation, followed by lactate dehydrogenase (LDH) level, C-reactive protein, the presence of interstitial infiltrates on chest X-ray, and D-dimer. Our system also identified the importance of oxygen therapy in these patients. These results highlight that XGB is a useful and novel tool in triage systems for guiding the care pathway in future pandemics, thus following the example set by the well-known COVID-19 pandemic.

Disgust proneness influences the effects of political orientation on xenophobia during the COVID-19 pandemic.

Although political conservatism has been associated with xenophobia, the processes that may explain this link during the COVID-19 pandemic are unclear. Xenophobia does increase during infectious disease outbreaks, suggesting an adaptation for those concerned about disease threats. Given that disgust facilitates disease avoidance, the present study examined the extent to which disgust proneness (DP) moderated the association between political conservatism and xenophobia during the pandemic. Community participants (n = 277) reporting their political orientation and levels of DP on May 27, 2020 completed measures of COVID-19 xenophobia and COVID-19 anxiety every 2 weeks for a total of 15 timepoints over 30 weeks. Multilevel models revealed that xenophobia was elevated among those high in DP but decreased throughout the pandemic. Xenophobia was also elevated among conservatives but also decreased during the pandemic. Consistent with predictions, DP moderated the effect of political orientation on xenophobia such that at high (but not low) levels of DP, the link between political orientation and xenophobia was significant, with higher levels of conservativism predicting higher xenophobia even when controlling for COVID-19 anxiety. The implications of the present findings for conceptualizing the various processes that explain how political attitudes may fuel xenophobia during future pandemics are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

“It’s what we perceive as different”: an interpretative phenomenological analysis of Nigerian women’s characterization of their health during the COVID-19 pandemic

BackgroundHealth has historically been adversely affected by social, economic, and political pandemics. In parallel with the spread of diseases, so do the risks of comorbidity and death associated with their consequences. As a result of the current pandemic, shifting resources and services in resource-poor settings without adequate preparation has intensified negative consequences, which global service interruptions have exacerbated. Pregnant women are especially vulnerable during infectious disease outbreaks, and the current pandemic has significantly impacted them.MethodsThis study used an interpretive phenomenological analysis study with a feminist lens to investigate how women obtained healthcare in Ebonyi, Ogun, and Sokoto states Nigeria during the COVID-19 pandemic. We specifically investigated whether the epidemic influenced women’s decisions to seek or avoid healthcare and whether their experiences differed from those outside of it.ResultsWe identified three superordinate themes: (1) the adoption of new personal health behaviour in response to the pandemic; (2) the pandemic as a temporal equalizer for marginalized individuals; (3) the impacts of the COVID-19 pandemic on maternal health care. In Nigeria, pregnant women were affected in a variety of ways by the COVID-19 epidemic. Women, particularly those socially identified as disabled, had to cross norms of disadvantage and discrimination to seek healthcare because of the pandemic’s impact on prescribed healthcare practices, the healthcare system, and the everyday landscapes defined by norms of disadvantage and discrimination.ConclusionIt is clear from the current pandemic that stakeholders must begin to strategize and develop plans to limit the effects of future pandemics on maternal healthcare, particularly for low-income women.

A Ten-Year Review of Neonatal Tetanus Seen in a Tertiary Health Facility in Sokoto North-Western Nigeria: Before and During the Covid-19 Pandemic

Background: Neonatal tetanus (NNT) remains among the leading cause of preventable morbidity and mortality among neonates in Nigeria. Nigeria remains among the countries carrying the global NNT burden. At the onset of the COVID-19 pandemic, reports have predicted that the pandemic will significantly impact on the health system globally, and low-resource countries where vaccination programs fared even worse are likely to see a surge in vaccine-preventable diseases during and after COVID-19 pandemic. Aims: To determine the prevalence, yearly trend, risk factors, and outcome of NNT cases seen in the Special Care Baby Unit (SCBU) of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria over a ten year period: before and during COVID-19 pandemic. Methods: This was a retrospective study. Data was retrieved from all the case notes of neonates admitted with a clinical diagnosis of NNT into the SCBU of the UDUTH, Sokoto from 1st January, 2013 to 31st December, 2022. The data obtained was analyzed using SPSS version 21. Results: During the 10 years period of the study, NNT accounted for 0.4% of admissions. The majority 15(57.0%) of the mothers of the neonates with NNT were from rural areas, 15(56.0%) had no antenatal care (ANC), and only 10(37.0%) of the mothers received vaccination against tetanus. All the mothers were from lower socio-economic classes. Most 17(63.0%) of the neonates were delivered at home by traditional birth attendants. The umbilical cord was the portal of entry in 26(96.0%) of cases, while 1(4.0%) followed traditional uvulectomy. Cord care was done using hot water fermentation in more than half of the neonates 17(63.0%), while only 1(4.0%) of the mothers used chlorhexidine gel for cord care. The case- fatality rate was 6(22.0%). the yearly trend showed an increased incidence of NNT admissions in 2022. Conclusion: The study showed that NNT is still a public health problem, with an increased scourge during the COVID-19 pandemic, which can be tackled through health education of mothers via mass media, improving the quality and access to ANC services, tetanus toxoid vaccination, hospital delivery and avoidance of traditional uvulectomy particularly in rural areas by the Sokoto state government. Antenatal and vaccination services should be given priority in response to future pandemics to sustain gains of the SDG 3.

The Use of COVID-19 Mobile Apps in Connecting Patients with Primary Healthcare in 30 Countries: Eurodata Study.

The COVID-19 pandemic has necessitated changes in European healthcare systems, with a significant proportion of COVID-19 cases being managed on an outpatient basis in primary healthcare (PHC). To alleviate the burden on healthcare facilities, many European countries developed contact-tracing apps and symptom checkers to identify potential cases. As the pandemic evolved, the European Union introduced the Digital COVID-19 Certificate for travel, which relies on vaccination, recent recovery, or negative test results. However, the integration between these apps and PHC has not been thoroughly explored in Europe. To describe if governmental COVID-19 apps allowed COVID-19 patients to connect with PHC through their apps in Europe and to examine how the Digital COVID-19 Certificate was obtained. Design and setting: Retrospective descriptive study in PHC in 30 European countries. An ad hoc, semi-structured questionnaire was developed to collect country-specific data on primary healthcare activity during the COVID-19 pandemic and the use of information technology tools to support medical care from 15 March 2020 to 31 August 2021. Key informants belong to the WONCA Europe network (World Organization of Family Doctors). The data were collected from relevant and reliable official sources, such as governmental websites and guidelines. Patient's first contact with health system, governmental COVID-19 app (name and function), Digital COVID-19 Certification, COVID-19 app connection with PHC. Primary care was the first point of care for suspected COVID-19 patients in 28 countries, and 24 countries developed apps to complement classical medical care. The most frequently developed app was for tracing COVID-19 cases (24 countries), followed by the Digital COVID-19 Certificate app (17 countries). Bulgaria, Italy, Serbia, North Macedonia, and Romania had interoperability between PHC and COVID-19 apps, and Poland and Romania's apps considered social needs. COVID-19 apps were widely created during the first pandemic year. Contact tracing was the most frequent function found in the registered apps. Connection with PHC was scarcely developed. In future pandemics, connections between health system levels should be guaranteed to develop and implement effective strategies for managing diseases.

Development and validation of a model to predict ceiling of care in COVID-19 hospitalized patients

BackgroundTherapeutic ceiling of care is the maximum level of care deemed appropiate to offer to a patient based on their clinical profile and therefore their potential to derive benefit, within the context of the availability of resources. To our knowledge, there are no models to predict ceiling of care decisions in COVID-19 patients or other acute illnesses. We aimed to develop and validate a clinical prediction model to predict ceiling of care decisions using information readily available at the point of hospital admission.MethodsWe studied a cohort of adult COVID-19 patients who were hospitalized in 5 centres of Catalonia between 2020 and 2021. All patients had microbiologically proven SARS-CoV-2 infection at the time of hospitalization. Their therapeutic ceiling of care was assessed at hospital admission. Comorbidities collected at hospital admission, age and sex were considered as potential factors for predicting ceiling of care. A logistic regression model was used to predict the ceiling of care. The final model was validated internally and externally using a cohort obtained from the Leeds Teaching Hospitals NHS Trust. The TRIPOD Checklist for Prediction Model Development and Validation from the EQUATOR Network has been followed to report the model.ResultsA total of 5813 patients were included in the development cohort, of whom 31.5% were assigned a ceiling of care at the point of hospital admission. A model including age, COVID-19 wave, chronic kidney disease, dementia, dyslipidaemia, heart failure, metastasis, peripheral vascular disease, chronic obstructive pulmonary disease, and stroke or transient ischaemic attack had excellent discrimination and calibration. Subgroup analysis by sex, age group, and relevant comorbidities showed excellent figures for calibration and discrimination. External validation on the Leeds Teaching Hospitals cohort also showed good performance.ConclusionsCeiling of care can be predicted with great accuracy from a patient’s clinical information available at the point of hospital admission. Cohorts without information on ceiling of care could use our model to estimate the probability of ceiling of care. In future pandemics, during emergency situations or when dealing with frail patients, where time-sensitive decisions about the use of life-prolonging treatments are required, this model, combined with clinical expertise, could be valuable. However, future work is needed to evaluate the use of this prediction tool outside COVID-19.

Adaptive evolution of traits for parasitism and pathogen transmission potential in bat flies

Abstract Deciphering the mechanisms underlying the transmission and spillover of zoonoses from reservoir hosts is essential in preventing future global pandemics. Bat flies, obligate blood-feeding ectoparasites of bats, are known carriers of diverse viruses. Here, we conducted a de novo assembly of a chromosome-level genome for the bat fly species Phthiridium sp. Comparative genomic analysis unveiled genes associated with specialized traits, such as the loss of eyes and wings, as well as elongated legs, which have adapted to parasitism on the dense fur of bats. Utilizing small RNA (sRNA) sequencing, we identified a spectrum of known and previously unclassified viruses in bat flies. Notably, experimental evidence indicated that bat flies can also feed on mammalian hosts other than bats, suggesting the potential for the spillover of bat-borne viruses. Furthermore, we demonstrated the role of the bat fly's RNA interference pathway in influencing the diversity and evolution of viruses. In summary, this study not only presents a new genome catalog to unveil the evolutionary mechanisms underpinning bat fly parasitism, but also provides a novel research system that can be used to investigate the mechanisms of cross-species transmission of bat-borne viruses and the co-evolution of bats and viruses.

Unmasking the coronavirus pandemic impact on students' academic performance (University of Cape Coast-Ghana).

The coronavirus (COVID-19) pandemic has impacted various institutions significantly, including education. Although several studies have explored the transmission of the COVID-19 virus among humans health, few have investigated its impact on tertiary education in Ghana. This study, therefore, aimed to unmask the effects of COVID-19 on the academic performance of tertiary students in Ghana, specifically at the University of Cape Coast (UCC). Stratified and convenience sampling techniques were employed to select respondents from the College of Health and Allied Sciences at UCC for this study. Based on Krejcie and Morgan's table for determining sample sizes for a large population in a study, a sample size of 531 was studied. Questionnaires were created and distributed to respondents from various departments to solicit their views. COVID-19 has significantly affected the academic performance of students at the University of Cape Coast, Ghana. A strong positive correlation was found between the positive impact of COVID-19 and academic performance (β = 3.385, p < 0.001). The study identified the absence of group discussions, poor internet networks, and other factors hurting students' academic performance (β = -2.308, p < 0.001). Resources such as libraries, conducive environments in halls and hostels, and other factors also significantly influenced students' academic performance (β = 2.941, p < 0.005). The study's findings suggest that virtual learning platforms, adequate learning infrastructures, and internet packages should be available to students to facilitate teaching and learning as the University prepares for future pandemics.

Navigating the Pandemic: Shifts in Breast Reconstruction Trends and Surgical Decision-Making in the United States.

Background: This study aimed to investigate the impact of the COVID-19 pandemic on breast reconstruction trends in the United States, focusing on implant-based and autologous techniques, as well as the timing of reconstruction (immediate vs. delayed). Methods: A retrospective analysis of data from 2015 to 2022 from the American Society of Plastic Surgeons' National Plastic Surgery Statistics was conducted. Annual trends in breast reconstruction procedures were analyzed, comparing the pre-pandemic (2015-2019) and pandemic (2020-2022) periods. A sensitivity analysis was performed to assess the impact of missing data from 2019 and 2021. Results: The total number of breast reconstructions increased from 106,338 in 2015 to 151,641 in 2022. The proportion of implant-based reconstructions decreased from 81.41% pre-pandemic to 76.51% during the pandemic (p < 0.001), with a notable rise in direct-to-implant procedures from 10.37% to 19.12% (p < 0.001). Autologous reconstructions increased from 18.59% to 23.49% (p < 0.001). Among autologous techniques, DIEP flaps remained the most popular. Immediate reconstruction rates increased from 72.61% pre-pandemic to 75.57% during the pandemic, while delayed reconstruction rates decreased from 27.39% to 24.43% (p < 0.001). The sensitivity analysis confirmed the robustness of these trends. Conclusions: During the COVID-19 pandemic, there was a significant shift towards autologous breast reconstruction techniques, particularly DIEP flaps, and an increase in immediate reconstructions in the United States. Within implant-based reconstructions, the proportion of DTI procedures increased while the proportion of tissue expander procedures decreased. These changes likely reflect adaptations in surgical practice and decision-making processes in response to the unique challenges posed by the pandemic, rather than alterations in surgical techniques themselves. The insights gained from this study can help guide plastic surgeons and healthcare providers in preparing for future pandemics or similar disruptions.

Novel immunomodulatory properties of adenosine analogs promote their antiviral activity against SARS-CoV-2

The COVID-19 pandemic reminded us of the urgent need for new antivirals to control emerging infectious diseases and potential future pandemics. Immunotherapy has revolutionized oncology and could complement the use of antivirals, but its application to infectious diseases remains largely unexplored. Nucleoside analogs are a class of agents widely used as antiviral and anti-neoplastic drugs. Their antiviral activity is generally based on interference with viral nucleic acid replication or transcription. Based on our previous work and computer modeling, we hypothesize that antiviral adenosine analogs, like remdesivir, have previously unrecognized immunomodulatory properties which contribute to their therapeutic activity. In the case of remdesivir, we here show that these properties are due to its metabolite, GS-441524, acting as an Adenosine A2A Receptor antagonist. Our findings support a new rationale for the design of next-generation antiviral agents with dual - immunomodulatory and intrinsic - antiviral properties. These compounds could represent game-changing therapies to control emerging viral diseases and future pandemics.