Major Public Health Crisis Research Articles

Effect of Collagen Dressing in the Treatment of Superficial Partial Thickness Burn in Children

Introduction: Burn is the most devastating of all injuries and a major global public health crisis. Biological dressings with collagen create the most physiological interface between the wound surface and environment and are impermeable to bacteria. Collagen dressing is easily applicable, non-immunogenic, non-pyrogenic, hypo allergic and pain free. Collagen is an endogenous substance which forms an important structural component in connective tissue. By applying it over the wound, exposed dermis and free nerve endings get covered leading to reduction in pain and infection. Objective: To assess the efficacy of collagen dressing in burn wound management. Methods: Prospective interventional study was carried out at the Department of Burn and Reconstructive Surgery, faculty of Paediatric Surgery, Bangladesh Shishu Hospital & Institute. A total 20 patients were included in this study after fulfillment of all selection criteria during the study period. Result: The mean pain relief time, wound healing and hospital stay were 2.7±0.6 days, 7.3±1.0 days and 4.5±0.6 days respectively. Conclusion: Collagen dressing is safe and effective in the treatment of superficial partial thickness burn in children.

An Assessment of the Level of Compliance to Guidelines for Prevention of Covid-19 in Public Places in Iganga district, Uganda

The global ongoing COVID-19 pandemic remains a major public health crisis of our time. In an effort to mitigate the outbreak of the deadly COVID-19 pandemic, WHO rolled out the COVID-19 SOPs to ensure the virus is controlled. The effectiveness of these COVID-19 SOPs mitigation measures is highly dependent on cooperation and compliance of all members of society [1]. Globally, a study which was conducted in the United Kingdom, found out that most but not all citizens had complied with COVID-19 SOPs guidelines; the Majority (80%) of UK citizens reported avoiding public places and 77% indicated that they improved their personal hygiene e.g., washing hands [2]. In the Sub-Saharan Africa, a study conducted in Nigeria by (Nnama-Okechukwu CU, 2020) findings indicated that a majority of the respondents believed that COVID-19 pandemic is more of a hoax than reality, of which poor knowledge negatively affected their compliance with preventive measures to curb the spread of COVID-19 [3]. This isn’t any different in the context of East Africa as reported by COVID-19 Pandemic Rapid Evidence Synthesis Group (COVPRES), hence suggested that poor knowledge negatively affect the level of compliance to COVID-19 SOPs.

Adoption of Telemedicine during the COVID-19 pandemic in Ibero-America: A Systematic Literature Review

The outbreak of COVID-19 caused a major international public health crisis and led to the imposition of social distancing measures to contain the spread of the virus. In this context, the use of telehealth skyrocketed as the only way to deliver healthcare to patients during a lockdown was remotely. The countries of Latin America and the Iberian Peninsula were severely hit by the pandemic and the prospects and challenges associated with widespread adoption of telehealth are unique. The goal of this systematic literature review is to explore how telehealth has been used during the pandemic to prevent, diagnose, treat and control diseases in Ibero-America. Thus, we sought to identify the main keywords, themes, theoretical frameworks and methodologies used by researchers in this area. We used several tools for bibliographic management like Rayyan, VOSViewer and NVIVO and followed the PRISMA protocol. Our analysis of themes showed the existence of 3 nodes within the literature: students, teachers and education. After searching in 6 databases, 1826 articles were found. After excluding the duplicates (231 articles), we screened and read the titles and abstracts of 1595 articles. Only 119 articles met the inclusion criteria. Finally, after a full-text analysis, a final sample of 106 articles was selected for analysis. Spain and Brazil are the countries who have produced the greatest volume of research in the region. The public sector is the largest funder of research on this topic by far especially at national level.  Our findings show that the research output in the region of Ibero-America (Latin America and Iberia) on this topic is still relatively small when compared to regions like North America.

The unsanitary other and racism during the pandemic: analysis of purity discourses on social media in India, France and United States of America during the COVID-19 pandemic

The global rise of populism and concomitant polarizations across disenfranchised and marginalized groups has been magnified by so-called echo chambers, and a major public health crisis like the COVID-19 pandemic has only served to fuel these intergroup tensions. Media institutions disseminating information on ways to prevent the propagation of the virus have reactivated a specific discursive phenomenon previously observed in many epidemics: the construction of a defiled ‘Other’. With anthropological lenses, discourse on defilement is an interesting path to understand the continuous emergence of pseudo-scientific forms of racism. In this paper, the authors focus on ‘borderline racism’, that is the use of an institutionally ‘impartial’ discourse to reaffirm the inferiority of another race. The authors employed inductive thematic analysis of 1200 social media comments reacting to articles and videos published by six media in three different countries (France, United States and India). Results delineate four major themes structuring defilement discourses: food (and the relationship to animals), religion, nationalism and gender. Media articles and videos portrayed Western and Eastern countries through contrasting images and elicited a range of reaction in readers and viewers. The discussion reflects on how borderline racism can be an appropriate concept to understand the appearance of hygienic othering of specific subgroups on social media. Theoretical implications and recommendations on a more culturally sensitive approach of media coverage of epidemics and pandemics are discussed.

Experience of School Nurses During Public Health Crises: From 2009 H1N1 Influenza to the COVID-19 Pandemic

ABSTRACT Purpose To elucidate the experiences of school nurses when responding to public health crises in Korea. Design Phenomenological research. Methods One-on-one online in-depth interviews were conducted (N = 10). Findings Major public health crises considerably affected schools, school nurses, and the revision of the School Health Act. Conclusions The experiences of school nurses in responding to periodic public health crises over the few decades have contributed to the advancement of an infectious disease response system in schools. Clinical Evidence The activities of school nurses during public health crises could serve as a foundation to improve the system.

S-55-1: PRIMARY ALDOSTERONISM – WHERE TO FROM HER E?

Over the past decade there have been remarkable advances in the pathophysiology of primary aldosteronism (PA); in contrast, there has been little if any change in the clinical management of PA for over 20 years. A patient suspected of PA is referred to an expert center, and their medications withdrawn for 4–6 weeks, with CCBs/alpha blockers used if needed to control blood pressure (BP).They undergo a single blood draw for plasma aldosterone concentration (PAC) and plasma renin activity or concentration (PRA/PRC), to establish the aldosterone to renin ratio (ARR). If the ARR 'suggests’ PA, the patient then undergoes confirmatory testing by one of at least five different procedures – to ensure no patient who does not have PA ever slips through the net. There are multiple reasons for change. First, in no country are more than 1% of hypertensives ever screened for PA. Secondly, a single blood draw for PAC is a very imperfect index of a patient’s actual aldosterone status; among those referred many are excluded on the basis of their PAC who in fact have PA. Third, the current work up – in addition to being exclusionary - is demanding and clunky. Fourth, the prevailing attitude among those treating hypertension is that if the BP is controlled all will be well, when in fact patients with PA have a three-fold higher risk profile than matched essential hypertensives with the same BP. What we are thus facing is a major public health crisis. There is finally increasing recognition that the current estimate of PA prevalence (5% - 10% of hypertensives) is far too low, and the actual prevalence in hypertensives is of the order of at least 30% (and of 10% in normotensives). The current protocols are useless facing figures such as these; what is needed are much simpler and inclusive measures to diagnose probable PA – rather than excluding all but the most obvious cases. This will require input not only from endocrinologists, but also from hypertension specialists, internists, primary care and public health physicians. It is important to distinguish newly presenting and established hypertension. When a patient is newly diagnosed with an elevated BP eschew immediate antihypertensive(s) and order a PRA/PRC assay. If renin is not suppressed, onto antihypertensives. If the renin is suppressed coach the patient to provide a 24 h urine collection for Na, K, and urinary excretion of aldosterone (UEA). If the UEA is < 6 mcg/24 h the patient does not have PA; if the UEA is 6–12, the patient may have PA; if the UEA is > 12 the patient has PA. For these two latter categories order 25 mg/d spironolactone and review at four weeks. If BP falls by < 10mmHg onto antihypertensives; if BP falls by > 10 mmHg continue spironolactone. Established hypertension is rather simpler. Add spironolactone 25 mg/d to current medication and review at 4 weeks. If BP falls < 10mmHg, discontinue; if BP falls > 10mmHg order a UEA. If UEA and BP are moderately elevated continue spironolactone, as such patients very probably have bilateral hyperaldosteonism; if UEA and BP are high, refer to an expert center. What this is calling for is a radical reassessment of how physicians should address hypertensive patients. The rationale is to save them from the double jeopardy of hypertension and PA, and the attendant increased morbidity and premature mortality. The time is now.

Review on COVID-19 Vaccines

Coronavirus disease 2019 (COVID-19) outbreak started in Wuhan, China when people started with the symptoms of respiratory disorder. The onset of this disease have symptoms like fever, dry cough, fatigue, and difficulty in breathing. The nature of SARS-CoV-2 seems highly contagious as it also can be spread with asymptomatically infected individuals. It has been more than a year which this outbreak have been announced as a pandemic by World Health Organization (WHO) due to major public health crisis and uncontrollable around the globe. Some countries have taken initiatives in inventing vaccines and step up in the clinical trial process since a vaccine is an all-powerful tool which it always been a saviour in fighting infectious disease. In searching for the vaccine, researchers had studied the previously published article of SARS-CoV or MERS as in the beginning, in light, there will be a suitable vaccine to fight this pandemic situation. Recent research on the vaccine has been tested to seek the right vaccine for COVID-19. This study is to focus on the current vaccine development against COVID-19 and to explore the potential vaccines’ characteristics that have been studied by the previous proven research findings. This review was done based on the research articles and reviews published until the end of April 2021 through established scientific search engines and related scientific platforms based on the inclusion criteria with its related keywords like coronavirus, SARS-CoV-2, COVID-19 Vaccine, clinical trials, and COVID-19 vaccine development. This review summarized a few vaccine candidates that have entered clinical trials and some supported evidence from Phase I until Phase III clinical trial studies that have been published and reported. In this review, 12 vaccine candidates have the potential to against SARS-CoV-2. Thus, their vaccine platform, characteristic as well as its efficacy studies have been discussed.

Three-dose vaccination-induced immune responses protect against SARS-CoV-2 Omicron BA.2: a population-based study in Hong Kong

The ongoing outbreak of SARS-CoV-2 Omicron BA.2 infections in Hong Kong, the model city of universal masking of the world, has resulted in a major public health crisis. Although the third vaccination resulted in strong boosting of neutralization antibody, vaccine efficacy and correlate of immune protection against the major circulating Omicron BA.2 remain to be investigated. We investigated the vaccine efficacy against the Omicron BA.2 breakthrough infection among 470 public servants who had received different SARS-CoV-2 vaccine regimens including two-dose BNT162b2 (2×BNT, n=169), three-dose BNT162b2 (3×BNT, n=168), two-dose CoronaVac (2×CorV, n=34), three-dose CoronaVac (3×CorV, n=67) and third-dose BNT162b2 following 2×CorV (2×CorV+1BNT, n=32). Humoral and cellular immune responses after three-dose vaccination were further characterized and correlated with clinical characteristics of BA.2 infection. During the BA.2 outbreak, 27.7% vaccinees were infected. The timely third-dose vaccination provided significant protection with lower incidence rates of breakthrough infections (2×BNT 46.2% vs 3×BNT 13.1%, p<0.0001; 2×CorV 44.1% vs 3×CorV 19.4%, p=0.003). Investigation of immune responses on blood samples derived from 90 subjects in three-dose vaccination cohorts collected before the BA.2 outbreak revealed that the third-dose vaccination activated spike (S)-specific memory B cells and Omicron cross-reactive T cell responses, which correlated with reduced frequencies of breakthrough infections and disease severity rather than with types of vaccines. Moreover, the frequency of S-specific activated memory B cells was significantly lower in infected vaccinees than uninfected vaccinees before vaccine-breakthrough infection whereas IFN-γ+ CD4 T cells were negatively associated with age and viral clearance time. Critically, BA.2 breakthrough infection boosted cross-reactive memory B cells with enhanced cross-neutralizing antibodies to Omicron sublineages, including BA.2.12.1 and BA.4/5, in all vaccinees tested. Our results imply that the timely third vaccination and immune responses are likely required for vaccine-mediated protection against Omicron BA.2 pandemic. Although BA.2 conferred the highest neutralization resistance compared with variants of concern tested before the emergence of BA.2.12.1 and BA.4/5, the third dose vaccination-activated S-specific memory B cells and Omicron cross-reactive T cell responses contributed to reduced frequencies of breakthrough infection and disease severity. Neutralizing antibody potency enhanced by BA.2 breakthrough infection in vaccinees with prior 3 doses of CoronaVac or BNT162b2 may reduce the risk of infection against ongoing BA.2.12.1 and BA.4/5. Hong Kong Research Grants Council Collaborative Research Fund, Health and Medical Research Fund, Wellcome Trust, Shenzhen Science and Technology Program, the Health@InnoHK, Innovation and Technology Commission of Hong Kong, China, National Program on Key Research Project, Emergency Key Program of Guangzhou Laboratory, donations from the Friends of Hope Education Fund and the Hong Kong Theme-Based Research Scheme.

Public Health and Prisons: Priorities in the Age of Mass Incarceration.

Mass incarceration is a sociostructural driver of profound health inequalities in the United States. The political and economic forces underpinning mass incarceration are deeply rooted in centuries of the enslavement of people of African descent and the genocide and displacement of Indigenous people and is inextricably connected to labor exploitation, racial discrimination, the criminalization of immigration, and behavioral health problems such as mental illness and substance use disorders. This article focuses on major public health crises and advances in state and federal prisons and discusses a range of practical strategies for health scholars, practitioners, and activists to promote the health and dignity of incarcerated people. It begins by summarizing the historical and sociostructural factors that have led to mass incarceration in the United States. It then describes the ways in which prison conditions create or worsen chronic, communicable, and behavioral health conditions, while highlighting priority areas for public health research and intervention to improve the health of incarcerated people, including decarceral solutions that can profoundly minimize-and perhaps one day help abolish-the use of prisons.

1109. Rise and Fall of COVID-19 Therapies Throughout Different Waves of the Pandemic: Results of a Nationwide Survey

Abstract Background The COVID-19 pandemic has caused a major public health crisis and is now a leading cause of death. At the start of the COVID-19 pandemic, treatment was limited to supportive care and off-label use of a variety of agents as we awaited the results of randomized controlled trials (RCTs). Our understanding of the disease has evolved and multiple evidence-based (EBM) treatment strategies supported by RCTs are now approved for use. Interpreting emerging data while responding to the pandemic can been challenging. We seek to understand the use of common medications during the COVID-19 pandemic. Methods A survey was developed and disseminated through Infectious Diseases Society of America (IDSA) IDea network, IDSA Antimicrobial Stewardship Centers for Excellence and the Society for Healthcare Epidemiology messaging boards. Data collected included city, therapeutic options including convalescent plasma (CP), hydroxychloroquine (HCQ), baricitinib and tocilizumab during each COVID-19 wave. Results A total of 78 responses were collected, representing wide geographic reach in the US (Figure 1). Use of HCQ declined by 96% and use of CP declined by 85% (Figure 2). The decline in CP was gradual each wave despite RCTs showing lack of benefit. Tocilizumab was used in 71% and 76% of hospitals during the first wave, prior to RCT data supporting its use. Baricitinib was used in 42% of hospitals prior to RCT data supporting its use. There was a 90% increase in baricitinib use after RCT data emerged. Figure 1Geographic distribution of hospitals represented in the survey Figure 2 Use of Hydroxychloroquine, Convalescent Plasma, Tocilizumab and Baricitinib Throughout Different COVID-19 Waves Conclusion The use of therapies before proven benefit was common through the pandemic. Similarly, the use of therapies after benefit was in question continued. Hydroxychloroquine was widely used in the first wave and then halted by the majority of hospitals in subsequent COVID-19 surges. IL-6 and JAK-2 inhibitors were commonly used prior to evidence of benefit and were more widely adopted once evidence emerged. Convalescent plasma use was common despite lack of evidence and its use continued despite multiple negative RCTs. Overall, our survey shows a gap between evidence and practice. Communicating evidence-based treatment strategies is a vital priority for major professional societies. Translating evidence into practice remains challenging during public health emergencies like the COVID-19 pandemic. Disclosures All Authors: No reported disclosures.

Role of Efflux Pumps on Antimicrobial Resistance in Pseudomonas aeruginosa

Antimicrobial resistance is an old and silent pandemic. Resistant organisms emerge in parallel with new antibiotics, leading to a major global public health crisis over time. Antibiotic resistance may be due to different mechanisms and against different classes of drugs. These mechanisms are usually found in the same organism, giving rise to multidrug-resistant (MDR) and extensively drug-resistant (XDR) bacteria. One resistance mechanism that is closely associated with the emergence of MDR and XDR bacteria is the efflux of drugs since the same pump can transport different classes of drugs. In Gram-negative bacteria, efflux pumps are present in two configurations: a transmembrane protein anchored in the inner membrane and a complex formed by three proteins. The tripartite complex has a transmembrane protein present in the inner membrane, a periplasmic protein, and a porin associated with the outer membrane. In Pseudomonas aeruginosa, one of the main pathogens associated with respiratory tract infections, four main sets of efflux pumps have been associated with antibiotic resistance: MexAB-OprM, MexXY, MexCD-OprJ, and MexEF-OprN. In this review, the function, structure, and regulation of these efflux pumps in P. aeruginosa and their actions as resistance mechanisms are discussed. Finally, a brief discussion on the potential of efflux pumps in P. aeruginosa as a target for new drugs is presented.

Fighting Myopia with Intermittent Nearwork Breaks: 20 Seconds Every 20 Minutes Might Not Be Enough Time.

Practitioners commonly prescribe the 20/20/20 rule with hopes that, if patients follow it, they will reduce their myopic progression. This clinical perspective provides evidence that 20-second break from nearwork every 20 minutes are not enough time to impact ocular growth.The ongoing myopia epidemic is a major public health crisis. Although the correlation between nearwork tasks such as reading, computers, and smartphones and myopia development is controversial, multiple lines of research suggest that sustained nearwork contributes to myopia development. Clinicians have proposed that children should take short breaks from nearwork with a 20-second break every 20 minutes being a common suggestion. Animal model data do strongly support the idea that multiple short breaks across time can cancel out the effects of longer periods of myopia-promoting activities. However, the animal model data also suggest that repeated episodes of 20 seconds are ineffective at reducing myopia development and instead indicate that sustained breaks of 5 minutes or more every hour are needed to negate myopiagenic effects.

Hesitancy towards the COVID-19 vaccine among health care practitioners in the Kingdom of Saudi Arabia: a cross-sectional study

Background: The coronavirus disease 2019 (COVID-19) pandemic is a major public health crisis worldwide. In less than 12 months since the World Health Organization declared the outbreak, several different COVID-19 vaccines have been approved and deployed mostly in developed countries since January 2021. However, hesitancy to accept the newly developed vaccines is a well-known public health challenge that needs to be addressed. The aim of this study was to measure willingness and hesitancy toward COVID-19 vaccines among health care practitioners' (HCPs) in Saudi Arabia. Methods: A cross-sectional study using an online self-reported survey was conducted among HCPs in Saudi Arabia between April 4th to April 25th 2021 using snowball sampling. Multivariate logistic regression was employed to identify the possible factors affecting HCPs’ willingness and hesitancy to receive COVID-19 vaccines. Results: Out of 776 participants who started the survey, 505 (65%) completed it and were included in the results. Among all HCPs, 47 (9.3%) either said “no” to receive the vaccine [20 (4%)] or were hesitant to receive it [27 (5.3%)]. Of the total number of the HCPs, 376 (74.5%) already received the COVID-19 vaccine, and 48 (9.50%) were registered to receive it. The main reason of agreement to receive the COVID-19 vaccine was “wanting to protect self and others from getting the infection” (24%). Conclusion: Our findings have shown that hesitancy toward receiving COVID-19 vaccines among HCPs in Saudi Arabia is limited and therefore may not be a serious issue. The outcomes of this study may help to understand factors that lead to vaccine hesitancy in Saudi Arabia and help public health authorities to design targeted health education interventions aiming to increase uptake of these vaccines.

Transcriptional differences between coronavirus disease 2019 and bacterial sepsis

BackgroundCoronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, has led to major public health crises worldwide. Several studies have reported the comprehensive mRNA expression analysis of immune-related genes in patients with COVID-19, using blood samples, to understand its pathogenesis; however, the characteristics of RNA expression in COVID-19 and bacterial sepsis have not been compared. The current study aimed to address this gap.MethodsRNA-sequencing and bioinformatics analyses were used to compare the transcriptome expression of whole blood samples from patients with COVID-19 and patients with sepsis who were admitted to the intensive care unit of Osaka University Graduate School of Medicine.ResultsThe COVID-19 and sepsis cohorts showed upregulation of mitochondrial- and neutrophil-related transcripts, respectively. Compared with that in the control cohort, neutrophil-related transcripts were upregulated in both the COVID-19 and sepsis cohorts. In contrast, mitochondrial-related transcripts were upregulated in the COVID-19 cohort and downregulated in the sepsis cohort, compared to those in the control cohort. Moreover, transcript levels of the pro-apoptotic genes BAK1, CYCS, BBC3, CASP7, and CASP8 were upregulated in the COVID-19 cohort, whereas those of anti-apoptotic genes, such as BCL2L11 and BCL2L1, were upregulated in the sepsis cohort.ConclusionsThis study clarified the differential expression of transcripts related to neutrophils and mitochondria in sepsis and COVID-19 conditions. Mitochondrial-related transcripts were downregulated in sepsis than in COVID-19 conditions, and our results indicated suboptimal intrinsic apoptotic features in sepsis samples compared with that in COVID-19 samples. This study is expected to contribute to the development of specific treatments for COVID-19.

Impact of COVID-19 pandemic in safe abortion and safe motherhood services in provincial hospital of rural Nepal: comparison of 3 waves of COVID-19

Introduction: The COVID-19 pandemic has challenged the whole world with a major public health crisis, both directly due to the disease and indirectly in all dimensions of the health care system. This included safe abortion services and safe motherhood services but data quantifying this in a lower resource setting is lacking. This study analyzed the trends of safe abortion services, post abortion contraception opted during pandemic and safe motherhood services at a provincial hospital in rural Nepal during 25 months of COVID-19 pandemic, comparing data of three major waves.&#x0D; Method: This is a retrospective observational study conducted at Pashupati Chaulagain Memorial Hospital. The data were collected from records of abortion and safe motherhood service registers. We compared the overall trends of safe abortion, family planning and safe motherhood services during first, second and third waves of COVID-19 pandemic and analyzed the sociodemographic profile of patients. Data analysis was done using SPSS 25 version.&#x0D; Result: During the study period from February 2020 to February 2022, a total of 634 and 2054 clients received safe abortion services and safe motherhood services respectively. There was reductions in clients visiting for safe abortion services during lockdown periods of first and second waves, but no differences noted during the third wave. More numbers of women opted for condoms as a family planning method during lockdown period of first and second waves with less intake of Long Acting Reversible Contraceptives and permanent methods compared to non-lockdown period.&#x0D; Conclusion: Utilization of safe abortion services was seriously affected in the first two waves due to COVID-19 pandemic presumably due to lockdowns, travel restrictions, home isolation, patient fear of going to hospitals, and health facilities prioritizing only COVID-19 and other emergencies. However, there was no impact in third wave for reproductive and safe motherhood services.

Gender Differences in Connecting Veterans to Care Through the Veterans Crisis Line: A Mixed Methods Evaluation of Referrals to Suicide Prevention Coordinators.

Suicide is a major public health crisis within the US military veteran community, with distinct gender differences in suicide risk and behavior. The Veterans Crisis Line (VCL) is a component of the Veterans Health Administration (VHA) suicide prevention program; through VCL, veterans may be referred to a VHA Suicide Prevention Coordinator (SPC) to arrange follow-up care. Research shows that engagement with an SPC is a strong protective factor in reducing veteran suicide risk. We evaluated SPC referral acceptance and assessed correlates of SPC referral decline using VCL administrative data for contacts: (1) made between January 1, 2018, through December 31, 2019; (2) by veterans contacting VCL on their own behalf; (3) with gender identified; and (4) current thoughts of suicide. Then, among a subsample of 200 veterans, evenly distributed by gender, we examined data from call synopsis notes to identify reasons given for veterans declining an SPC referral. We found it was generally callers rated as lower risk by responders, and callers with loneliness as a reason for contacting VCL, who more frequently declined the SPC referral. An analysis of reasons given for declining SPC referral found that concerns with/about Veterans Affairs care were a key concern, particularly among women veterans articulating specific negative care experiences. Other reasons for referral decline included managing the veteran's needs directly on the call or via alternative resources. The VCL as an intervention provides an important opportunity to re-engage vulnerable veterans into care, one that may be more challenging for women veterans.

Replacement of KPC-producing pandemic lineages and dissemination of plasmids associated with antimicrobial resistance determinants during inpatient’s hospitalization

The emergence of blaKPC-2 within nosocomial settings has become a major public health crisis worldwide. Our aim was to perform whole-genome sequencing (WGS) of three KPC-producing Gram-negative bacilli (KPC-GNB) strains isolated from a hospitalized patient to identify acquired antimicrobial resistance genes (ARGs). WGS was performed using Illumina MiSeq-I, and de novo assembly was achieved using SPAdes. Bioinformatics analysis was done using Resfinder, AMRFinder, ISFinder, plasmidSPAdes, PlasmidFinder, MOB-suite, PLSDB database, and IntegronFinder. Conjugation assays were performed to assess the ability of blaKPC-2 to transfer via a plasmid-related mobilization mechanism. High-risk clone KPC-producing Klebsiella pneumoniae sequence type (ST) 258 (HA3) was colonizing an inpatient who later was infected by KPC-producing Escherichia coli ST730 (HA4) and subsequently by KPC-producing K. pneumoniae ST11 (HA15) during hospitalization. Although belonging to different species, both strains causing infections harbored the same gene configuration for dissemination of blaKPC-2 in related IncM1 plasmids recently found in other KPC-GNB isolated from Hospital Alemán at Ciudad Autónoma de Buenos Aires. Conjugation assays revealed that only pDCVEA4-KPC from E. coli HA4 was successfully transferred with a conjugation frequency of 3.66×101. Interchange of multidrug-resistant K. pneumoniae lineages ST258 replaced by ST11 in the framework of colonization and infection by KPC-GNB of an inpatient from our institution was found. In addition, the transfer of the gene configuration of blaKPC-2 between infecting strains may have occurred in the nosocomial environment, but we cannot rule out that the event took place in vivo, within the patient, during hospitalization.

Frontline Nurses' Experiences of Patient Care in the COVID-19 Pandemic: A Phenomenological Study.

Introduction: The COVID-19 pandemic is now a major public health crisis in the world. Nurses as key members of professional are exposed the most challenges caused by COVID19. Knowledgeable nurses' experiences can provide appropriate solutions to increase the quality of care and improve the health of the society. This study aimed to explore the lived experiences of nurses' caring for patients with COVID-19. Methods: 12 nurses participated in this phenomenological study. We performed purposeful sampling and in-depth face-to-face and semi-structured individual interviews for collecting data. Qualitative data, was analyzed by the 6-step Van Manen hermeneutic phenomenology. Results: After data analysis, the mean (SD) age of study participants was 32.25 (5.62) years and their mean work experience was 9.75 (5.39) years. From the analysis of data obtained from interviews with nurses working in COVID-19 wards, 1050 primary codes, 17 subthemes and 5 themes were extracted. Main themes include: sincere service, patient oppression, emotional instability, suspension and relaxation. Conclusion: Analysis of data in this study suggested that the nurses who care patients in COVID-19 pandemic, faced many professional and psychological challenges. Healthcare managers should plan for psychological support services for the nurses.

How public confidence was established during the COVID-19 pandemic by Chinese media: A corpus-based discursive news value analysis.

During the COVID-19 pandemic, Chinese media played a significant role in dispelling the public panic, establishing the public confidence and stabilizing the society during the COVID-19 pandemic. This corpus-based discourse study explored the discursive construction of news values by Chinese media to reveal how the COVID-19 pandemic was packaged and sold to the public to establish confidence in the news reporting. Adopting corpus linguistic method and the Discursive news values analysis (DNVA) framework, this study examines news values through key words, news quotations, and images in the Chinese domestic mainstream media (http://www.people.com.cn/) during two different phases of the pandemic. The results show that during the first pandemic phase (2019.12.27-2020.4.28) when there had been no treatment protocol or understanding of the medical ramifications, Chinese media dominantly constructed political Eliteness through multimodal resources to portray a people-oriented government, a transparent notification mechanism and an immediate response capability to crises, and to give the public psychological support and to cultivate positive attitudes toward the government's policy. This news reporting way exposes the universal trust of Chinese society in the political authorities. During the second phase (2020.4.29-2020.8.31) when the cognition about the COVID-19 virus had been greatly improved and more medical treatment and prevention methods had been developed, the political Eliteness was replaced by medical Eliteness which was more vital to people's safety during the health crisis. We propose actionable recommendations for scholars to use this in-depth DNVA framework to examine the social trend of thoughts during major public health crisis.

A comprehensive update on CIDO: the community-based coronavirus infectious disease ontology

BackgroundThe current COVID-19 pandemic and the previous SARS/MERS outbreaks of 2003 and 2012 have resulted in a series of major global public health crises. We argue that in the interest of developing effective and safe vaccines and drugs and to better understand coronaviruses and associated disease mechenisms it is necessary to integrate the large and exponentially growing body of heterogeneous coronavirus data. Ontologies play an important role in standard-based knowledge and data representation, integration, sharing, and analysis. Accordingly, we initiated the development of the community-based Coronavirus Infectious Disease Ontology (CIDO) in early 2020.ResultsAs an Open Biomedical Ontology (OBO) library ontology, CIDO is open source and interoperable with other existing OBO ontologies. CIDO is aligned with the Basic Formal Ontology and Viral Infectious Disease Ontology. CIDO has imported terms from over 30 OBO ontologies. For example, CIDO imports all SARS-CoV-2 protein terms from the Protein Ontology, COVID-19-related phenotype terms from the Human Phenotype Ontology, and over 100 COVID-19 terms for vaccines (both authorized and in clinical trial) from the Vaccine Ontology. CIDO systematically represents variants of SARS-CoV-2 viruses and over 300 amino acid substitutions therein, along with over 300 diagnostic kits and methods. CIDO also describes hundreds of host-coronavirus protein-protein interactions (PPIs) and the drugs that target proteins in these PPIs. CIDO has been used to model COVID-19 related phenomena in areas such as epidemiology. The scope of CIDO was evaluated by visual analysis supported by a summarization network method. CIDO has been used in various applications such as term standardization, inference, natural language processing (NLP) and clinical data integration. We have applied the amino acid variant knowledge present in CIDO to analyze differences between SARS-CoV-2 Delta and Omicron variants. CIDO's integrative host-coronavirus PPIs and drug-target knowledge has also been used to support drug repurposing for COVID-19 treatment.ConclusionCIDO represents entities and relations in the domain of coronavirus diseases with a special focus on COVID-19. It supports shared knowledge representation, data and metadata standardization and integration, and has been used in a range of applications.