Peak Of Pandemic Research Articles

Accelerated Development of a COVID-19 Lateral Flow Test in an Academic Setting: Lessons Learned.

The COVID-19 pandemic further demonstrated the need for usable, reliable, and cost-effective point-of-care diagnostics that can be broadly deployed, ideally for self-testing at home. Antigen tests using more-detectable reporter labels (usually at the cost of reader complexity) achieve better diagnostic sensitivity, supporting the value of higher-analytical-sensitivity reporter technologies in lateral flow.We developed a new approach to simple, inexpensive lateral flow assays (LFAs) of great sensitivity, based on the glow stick peroxyoxalate chemistry widely used in emergency settings and in children's toys. At the peak of the COVID-19 pandemic, we had the opportunity to participate in the pandemic-driven NIH Rapid Acceleration of Diagnostics (RADx) initiative aiming to develop a deployable lateral flow diagnostic for SARS-CoV-2 nucleoprotein based on our novel glow stick-inspired light-emitting reporter technology. During this project, we screened more than 250 antibody pairs for analytical sensitivity and specificity directly in LFA format, using recombinant nucleoprotein and then gamma-irradiated virions spiked into negative nasal swab extracts. Membranes and other LFA materials and swabs and extraction reagent components also were screened and selected. Optimization of conjugate preparation and spraying as well as pretreatment/conditioning of the sample pad led to the final optimized LFA strip. Technology development also included optimization of excitation liquid enclosed in disposable droppers, design of a custom cartridge and smartphone-based reader, and app development, even a prototype reader usable with any mobile phone. Excellent preclinical performance was first demonstrated with contrived samples and then with leftover clinical samples. Moving beyond traditional academic focus areas, we were able to establish a quality management system (QMS), produce large numbers of customized LFA cassettes by contract injection molding, build in-house facilities to assemble and store thousands of complete tests for verification and validation and usability studies, and source kitting/packaging services and quality standard reagents and build partnerships for clinical translation, regulatory guidance, scale up, and market deployment. We were not able to bring this early stage technology to the point of commercialization within the limited time and resources available, but we did achieve strong proof-of-concept and advance translational aspects of the platform including initial high-performance LFAs, reading by the iPhone app using only a $2 plastic dark box with no lens, and convenient, usable excitation liquid packaging in droppers manufacturable in very large numbers.In this Account, we aim to provide a concise overview of our 18-month sprint toward the practical development of a deployable antigen lateral flow assay under pandemic conditions and the challenges and successes experienced by our team. We highlight what it takes to coach a technically savvy but commercially inexperienced academic team through the accelerated translation of an early stage technology into a useful product. Finally, we provide a guided tutorial and workflow to empower others interested in the rapid development of translatable LFAs.

Unraveling the Spatial Dimensions of Disease Outbreaks: Implications for the Future of Third Places—A Scoping Review

Third places are vital social spaces, outside the typical workplace and living environment, that facilitate meaningful interactions and contribute to an individual’s sense of community and well-being. Nevertheless, during the peak of the COVID-19 pandemic, safety requirements led to the closure of many third places, disrupting socialization, and limiting the positive impact these spaces typically have on people’s lives. This recent global experience highlighted the need for interior design approaches to create more adaptable third places. Through this review, we aimed to explore the evolving influence of different disease outbreaks on the design of interior spaces, focusing on third places and similar communal environments. Emphasis was on exploring interior design approaches employed to reduce transmission risks, ultimately enhancing the resilience and sustainability of these spaces. A scoping review of the literature was conducted, adhering to the framework established by Arksey and O’Malley. Using content identifiers and a detailed flowchart, we found five themes: (a) flexibility through scalability and reconfiguration; (b) fluid circulation and optimized wayfinding; (c) natural ventilation and indoor–outdoor connection; (d) infection control by material selection and design; and (e) integration of technology. By highlighting these approaches, strategies for creating sustainable, resilient, and unobstructed third places are reviewed post-pandemic to ensure social and overall well-being continuity.

Exploring adolescent mental health during the COVID-19 crisis - strengths and difficulties.

The SARS-CoV-2 pandemic has significantly impacted children and adolescents, leading to mental health challenges. Knowledge on their resources and difficulties is crucial and there is a need for valid instruments to assess their psychosocial condition especially in this exceptional situation. We assessed psychopathological symptoms using the SDQ during the pandemic, comparing to pre-pandemic data. Our study aims to understand adolescents' strengths and difficulties amidst COVID-19, evaluating the SDQ's utility in crisis settings. Within the German school-based surveillance study ("B-Fast"), we assessed behavioral strengths and difficulties in 664 adolescents aged 11-17 years during the peak of the German COVID-19 pandemic using the validated Strengths and Difficulties Questionnaire (SDQ) for both external and self-assessed data collection. Data were collected between November 2020 and April 2021. We compared self-assessed SDQ-scores to pre-pandemic data from a comparable sample and examined adolescent classification as "normal" or "borderline/abnormal" based on both external and self-assessed SDQ subscale scores using established cut-off values. Additionally, we conducted sex and rater-based score comparisons. In our study, we observed a significant worsening of "Emotional Symptoms" compared to pre-pandemic levels, while "Conduct Problems" and "Prosocial Behavior" showed improvement. Variations in classification to "normal" and "abnormal" emerged when applying German versus British cut-off values. Females scored higher on "Emotional Symptoms" while males scored higher on "Hyperactivity Symptoms." Correlations between external and self-assessed SDQ ratings ranged from 0.43 (p < 0.001) for "Prosocial Behavior" among girls to 0.62 (p < 0.001) for "Peer Problems" among boys, indicating moderate to high consistency. Our study contributes to understanding the psychosocial impact of the COVID-19 pandemic on German adolescents. Compared to other symptoms, we observed a particular worsening in "Emotional Symptoms" based on our data. Despite the moderate correlation between parental and self-reported evaluations, there appears to be a certain discrepancy in the perception of adolescent quality of life. Therefore, it seems prudent to assess both the external and self-reported evaluations and amalgamate the results from both parties to obtain a comprehensive problem profile of the individual. These findings underscore the importance of using country-specific cutoff values and reaffirm the utility of the SDQ as a valuable assessment tool, even within the unique circumstances posed by a pandemic.

Implementation of HCSR04Ultrasonic Sensor based Internet of Things Hospital Drip Bag Monitoring and Alert System

In our current healthcare system, keeping an eye on patients daily in a hospital is a demanding duty. Due to the steady stream of new patients, healthcare personnel were overworked during the peak of the Covid-19 pandemic. In times like these, frontline staff members are unable to personally oversee and tend to every patient. This resulted in multiple problems. In contemporary hospitals, one example of this type of practice is injecting saline or intravenous (IV) fluid into patient veins. Nurses administer nutrients, medications, and fluids directly into a patient's vein during an intravenous treatment. Because IV therapy is often utilized to rehydrate and deliver nutrients, it is crucial to help a patient heal more quickly. However, IV drips still need to be regularly inspected and changed. Measurements must also be made of the fluid flow, contingent on the patient's state. Problems such as blood loss, fluid leakage, and other problems might arise from inadequate drip system monitoring. This IoT intravenous liquid checking framework utilizes an ultrasonic sensor to quantify the IV imbuement jug's liquid level and send the data through the Web. This has eased the burden and fixed a major problem in the intravenous drip monitoring system area.

Orthopedic Surgery Volume Trends During the COVID-19 Pandemic and Postvaccination Era: Implications for Healthcare Planning

BackgroundThe Coronavirus Disease 2019 (COVID-19) pandemic decreased surgical volumes, but prior studies have not investigated recovery through 2022, or analyzed specific procedures or cases of urgency within orthopedic surgery. The aims of this study were to (1) quantify the declines in orthopedic surgery volume during and after the pandemic peak, (2) characterize surgical volume recovery during the postvaccination period, and (3) characterize recovery in the 1-year postvaccine release period. MethodsWe conducted a retrospective cohort study of 27,476 orthopedic surgeries from January 2019 to December 2022 at one urban academic quaternary referral center. We reported trends over the following periods: baseline pre–COVID-19 period (1/6/2019 to 1/4/2020), COVID-19 peak (3/15/2020 to 5/16/2020), post–COVID-19 peak (5/17/2020 to 1/2/2021), postvaccine release (1/3/2021 to 1/1/2022), and 1-year postvaccine release (1/2/2022 to 12/30/2022). Comparisons were performed with 2 sample t-tests. ResultsPre–COVID-19 surgical volume fell by 72% at the COVID-19 peak, especially impacting elective procedures (P < .001) and both hip and knee joint arthroplasty (P < .001) procedures. Nonurgent (P = .024) and urgent or emergency (P = .002) cases also significantly decreased. Postpeak recovery before the vaccine saw volumes rise to 92% of baseline, which further rose to 96% and 94% in 2021 and 2022, respectively. While elective procedures surpassed the baseline in 2022, nonurgent and urgent or emergency surgeries remained low. ConclusionsThe COVID-19 pandemic substantially reduced orthopedic surgical volumes, which have still not fully recovered through 2022, particularly nonelective procedures. The differential recovery within an orthopedic surgery program may result in increased morbidity and can serve to inform department-level operational recovery.

The perinatal health secondary to pandemic: association between women's delivery concerns and infant's behavioral problems.

COVID-19 pandemic characterised a unique and vulnerable social, emotional, and health environment for pregnancy, with potential long-lasting risks to maternal and child health outcomes. In women who were pregnant at the peak of COVID-19 pandemic, we investigated the association between pandemic-related concerns about pregnancy and delivery and both the parent's (i.e. maternal parenting stress) and the infant's (i.e. emotional-behavioral problems) outcomes 12 months after birth. A sample of 352 Italian pregnant women completed a web-based survey from 8 April to 4 May 2020 and a follow-up at 12 months after delivery. Maternal assessment in pregnancy covered prenatal measures for: pandemic-related concerns about pregnancy and childbirth, COVID-19 stressful events exposure, pandemic psychological stress, and mental-health symptoms (i.e. depression, anxiety). The 12 months' assessment covered post-partum measures of social support, parenting stress and maternal reports of infants' behavioral problems. The results of the Quasi-Poisson regression models on the association between COVID-19 related influencing factors and parenting stress and infant's behavioral problems showed that the presence of higher pandemic-related concerns about pregnancy and childbirth scores was associated with greater total and internalising behavioral problems but not with parenting stress levels. Perinatal mother-infant health has been sensitively threatened by pandemic consequences with maternal concerns about childbirth in pregnancy being associated with 12 months' children's behavioral outcomes. There is a need to invest in psychological support for perinatal women throughout the transition to parenthood to protect risk conditions before they get chronic or severe and influence offspring development.

Technology as a predictor of students’ virtual learning experiences in post- covid era: Empirical analysis from a Ghanaian higher education institution

The devastating effect of the Covid pandemic negatively affect most economies while conspicuously changing the mode of interactions in the educational sector from the traditional face-to-face to a full online deployment or a blend of virtual and in-person interactions during the post covid. The aim of this study is to determine the impact of technology on students’ virtual learning experiences after the peak of the covid pandemic. Three hundred and seventy-nine ( N = 379) undergraduate students participated in the study. Findings showed that the use of technology significantly predicted student online teaching and learning and also, influenced student virtual learning experiences positively. These findings will help managers of higher education institutions to invest into training and technology driven interactions to enhance students’ engagement.

Assessing the dynamics and impact of COVID-19 vaccination on disease spread: A data-driven approach

The COVID-19 pandemic has significantly impacted global health, social, and economic situations since its emergence in December 2019. The primary focus of this study is to propose a distinct vaccination policy and assess its impact on controlling COVID-19 transmission in Malaysia using a Bayesian data-driven approach, concentrating on the year 2021. We employ a compartmental Susceptible-Exposed-Infected-Recovered-Vaccinated (SEIRV) model, incorporating a time-varying transmission rate and a data-driven method for its estimation through an Exploratory Data Analysis (EDA) approach. While no vaccine guarantees total immunity against the disease, and vaccine immunity wanes over time, it is critical to include and accurately estimate vaccine efficacy, as well as a constant vaccine immunity decay or wane factor, to better simulate the dynamics of vaccine-induced protection over time. Based on the distribution and effectiveness of vaccines, we integrated a data-driven estimation of vaccine efficacy, calculated at 75% for Malaysia, underscoring the model's realism and relevance to the specific context of the country. The Bayesian inference framework is used to assimilate various data sources and account for underlying uncertainties in model parameters. The model is fitted to real-world data from Malaysia to analyze disease spread trends and evaluate the effectiveness of our proposed vaccination policy. Our findings reveal that this distinct vaccination policy, which emphasizes an accelerated vaccination rate during the initial stages of the program, is highly effective in mitigating the spread of COVID-19 and substantially reducing the pandemic peak and new infections. The study found that vaccinating 57–66% of the population (as opposed to 76% in the real data) with a better vaccination policy such as proposed here is able to significantly reduce the number of new infections and ultimately reduce the costs associated with new infections. The study contributes to the development of a robust and informative representation of COVID-19 transmission and vaccination, offering valuable insights for policymakers on the potential benefits and limitations of different vaccination policies, particularly highlighting the importance of a well-planned and efficient vaccination rollout strategy. While the methodology used in this study is specifically applied to national data from Malaysia, its successful application to local regions within Malaysia, such as Selangor and Johor, indicates its adaptability and potential for broader application. This demonstrates the model's adaptability for policy assessment and improvement across various demographic and epidemiological landscapes, implying its usefulness for similar datasets from various geographical regions.

Epidemiologic trends, risk factors and outcomes for pediatric myocarditis in the COVID era

BackgroundDuring the peak of the COVID pandemic, there was a high degree of awareness around myocarditis as a potential manifestation. However, it is not very clear if hospitalizations related to myocarditis increased pre- and during the COVID era and if there was an impact on outcomes of the same. ObjectivesThe objective of this study was to assess the epidemiology of hospitalizations for pediatric myocarditis between 2019 and 2022 (COVID era) compared to the prior era. An additional objective was to assess the outcomes for COVID and non-COVID myocarditis for hospitalized patients. MethodsPHIS database was utilized to identify patients diagnosed with myocarditis from 2006 to 2022 using appropriate diagnostic codes. To assess and compare the outcomes, such as in-hospital mortality, ICU hospitalization, and length of stay (LOS), mixed model multivariable logistic regression analysis was performed. ResultsA total of 5084 patients were diagnosed with myocarditis from 2006 to 2022. The incidence of myocarditis patients increased significantly from 4.23 % in 2006 to 15.2 % in 2021 (p < 0.001). Specifically, during the post-COVID era from 2020 to 2022, the incidence of myocarditis (n = 1298, 28.7 %) increased significantly. Out of which, one-third (n = 366, 28.1 %) of the patients were also diagnosed with COVID-19. Patients having COVID-19 along with myocarditis had two times (OR: 2.13 (95 % CI: 1.55–2.92), and patients utilizing mechanical ventilation had 13 times higher odds of ICU hospitalization. In contrast, patients visiting ED had 35 % lower odds of ICU hospitalization. Although patients diagnosed with COVID and myocarditis are twice as likely to be hospitalized in the ICU, there were comparable rates of discharge mortality between COVID era and non-COVID era among pediatric myocarditis cases. ConclusionDespite the increase in the incidences of myocarditis patients and increased hospitalizations during post-COVID era, rates of mortality among these patients were comparable.

The Impact of COVID-19 on Rates of Pressure Injuries Among Hospitalized Patients across the US.

To determine the impact of the COVID-19 pandemic on hospital-acquired pressure injury (HAPI) rates and composition of HAPI stages among hospitalized patients across the US. Using encounter-level data from a nationwide healthcare insurance claims database, the authors conducted a retrospective cohort study and an interrupted time-series analysis to determine HAPI rates among hospitalized patients within 90 days of admission before (January 2018 to February 2020) and after (March 2020 to December 2020) the onset of the COVID-19 pandemic. Of 3,418,438 adult patients assessed for inclusion in the study, 1,750,494 met the inclusion criteria. Outcomes measured included the presence of a HAPI within 90 days of admission and HAPI stage based on the International Classification of Diseases, 10th Revision diagnosis codes. The authors identified HAPIs in 59,175 episodes of care, representing 59,019 unique patients and corresponding to an overall HAPI rate of 2.65%. Baseline characteristics did not vary significantly across the two time periods. Further, HAPI rates were consistent across the time periods analyzed with no significant differences in rates following the onset of the pandemic (P = .303). Composition of HAPI stages remained consistent across the pandemic (unspecified, stages 1-4, Ps = .62, .80, .22, .23, and .52, respectively) except for a significant decrease in unstageable/deep tissue pressure injuries (-0.088%, P = .0134). Although hospital resources were strained at the peak of the COVID-19 pandemic, no differences were identified in HAPI rates among the study's cohort of privately insured patients.

Social support and mental health: the mediating role of perceived stress.

Social support has been associated with improved mental health; however, the mechanisms underlying this relationship remain unclear. This study aimed to explore whether perceived stress mediate the relationship between social support and positive affect, anxiety, and depression. Drawing from Lazarus and Folkman's stress and coping theory, the study emphasized the influential role of social support in appraising stressful events. A cross-sectional survey was conducted online among 426 Filipino adults during the peak of the COVID-19 pandemic. Participants completed measures including the Multidimensional Scale of Perceived Social Support (MSPSS), the Perceived Stress Scale-10 (PSS-10), the Positive Affect subscale of PANAS, and the Depression and Anxiety subscales of DASS-21. The hypotheses of the study were tested using mediation analysis. Consistent with the hypotheses, perceived stress significantly mediated the relationship between family and significant other support with positive affect, anxiety, and depression. Family and significant other support decreased perceived stress, increasing positive affect, and decreasing anxiety and depression. On the other hand, perceived stress did not mediate the relationship between friend support and positive affect, anxiety, and depression. Implications and future research directions are discussed.

Arab American well-being and impacts of the COVID-19 pandemic.

Like other racial and ethnic minority groups in the United States, discrimination has contributed to health disparities for Arab Americans and placed them at increased risk for health concerns that have only persisted with the COVID-19 pandemic. The purpose of the present study was to identify how the wellbeing of Arab Americans was impacted during the peak of the COVID-19 pandemic in the United States. Using a qualitative approach, we gathered responses from 604 Arab Americans to open-ended questions. Relying on coders and thematic analysis, common patterns were identified in the data. Themes and subthemes that focused on the impact of COVID-19 were identified in the data set. The themes of negative outcomes included depression, interpersonal loss, and anxiety. The theme of positive outcomes included time with family, heightened reflection, and strengthened faith. The theme of challenging adjustments included disrupted routine and change in plans. As Arab Americans in this study reported numerous mental health outcomes due to the COVID-19 pandemic, the conclusion that this group warrants attention in the health disparities discourse was further reinforced. The themes discovered in this study can be used to develop culturally relevant health interventions for Arab Americans as a means of beginning to make health care more accessible for this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Benefit and hidden cost of organizational support for telework amid the COVID‐19 pandemic on public employees' job satisfaction and retention intention

AbstractThis study examines the impact of crisis‐induced telework during the COVID‐19 pandemic 2020 on public sector employees' job satisfaction (JS) and retention intention (RI). Analyses of the 2020 Federal Employee Viewpoint Survey data reveal a negative association between the amount of COVID‐induced telework and the federal employees' JS and RI. However, this negative effect is mitigated by offering adequate organizational telework support for mandatory telework during the COVID peak and subsequently decreasing the amount of telework after the peak. Nevertheless, the findings also indicate that solid organizational support for teleworkers during the pandemic's peak can ironically discourage them from returning to the regular work setting even when it is safe, potentially compromising organizational performance—a hidden cost of the organizational support. Still, this hidden cost does not appear to be significant enough to warrant revisions in the level of crisis‐specific organizational support.

Women's experiences of receiving antenatal and intrapartum care during COVID-19 at public hospitals in the Sidama region, Ethiopia: A qualitative study using the combination of three delay and social-ecological framework (hybrid framework).

The COVID-19 pandemic, drought and internal conflict have worsened Ethiopia's already weak healthcare system. Antenatal and intrapartum care are especially prone to interruption under these circumstances. To explore women's experiences receiving antenatal and intrapartum care during the pandemic. A descriptive qualitative approach was utilised. We conducted in-depth interviews with 17 women and held 4 focus group discussions with women who gave birth at 4 public hospitals during the pandemic. A study was conducted at four public hospitals in the Sidama region of Ethiopia, during which data were collected from 14 February to 10 May 2022. Thematic analysis was performed to generate themes. The peak of the COVID-19 pandemic in Ethiopia presented several barriers to access and uptake of antenatal and intrapartum care at public hospitals. Four themes and 10 subthemes emerged from the thematic analysis. The themes were 'Barriers to maternity care uptake during COVID-19', 'Shortage of resources during COVID-19', 'Delays in maternity care uptake during COVID-19' and 'Mistreatment of women during maternity care during COVID-19'. The subthemes included 'Fear of contracting COVID-19', 'People in the hospital neglecting COVID-19 prevention', 'Women losing their job during COVID-19', 'Shortage of beds in the labour ward', 'Shortage of medical supplies', 'Delays in seeking care', 'Delays in receiving care', 'Complications during childbirth', 'disrespectful' and 'suboptimal care'. The findings of this study underscore the impact of COVID-19 on antenatal and intrapartum care, leading to delays in seeking and receiving care due to reduced rapport, resource shortages, companion restrictions, disrespectful care and suboptimal care. These factors contribute to increased obstetric complications during COVID-19. It is imperative for policymakers to prioritise essential resources for antenatal and intrapartum care in the present and future pandemics. Moreover, healthcare providers should maintain respectful and optimal care even amid challenges.

Moral Distress and Intention to Leave During COVID: A Cross-sectional Study on the Current Nursing Workforce to Guide Nurse Leaders for the Future.

The aim of this study was to investigate how the experience of caring for COVID-19 patients, nurses' moral distress, and the current practice environment impact nurses' intention to leave. Caring for COVID-19 patients has been associated with an increase in nurses' moral distress and an increase in nurses' turnover. To date, research has focused on nurses' moral distress, the practice environment, and intentions to leave during the pandemic's peak. The current workplace climate, including those who stayed in their positions, has not been adequately assessed. This cross-sectional correlational study was conducted in a Magnet® hospital. Moral distress related to team/system (B = 0.64, t = 3.86, P < 0.001), nurses' participation in hospital affairs (B = -2.21, t = -3.52, P < 0.001), and staffing (B = -1.91, t = -5.48, P < 0.001) are strongest predictors for nurses' intention to leave postpandemic. Nurses in practice still report experiencing COVID-related moral distress; however; issues related to resources and staffing have the most substantial impact on intention to leave among the current nursing workforce.

Phalangeal microgeodic syndrome: a paediatric case series.

We present the clinical and radiological characteristics of phalangeal microgeodic syndrome in a cluster of five children during the second peak of COVID-19 pandemic in the UK. Each child presented with phalangeal swelling and erythema, prompting a comprehensive multi-disciplinary team review to analyse the clinical presentation, blood test results and imaging. The cohort's average age was 14.1years, ranging from 10.4 to 16.6years, with two girls and three boys. Four children experienced phalangeal involvement in the hands, whilst one was affected solely in the feet. A rheumatological work-up was performed for all. Hand X-rays performed on three children revealed distinct radiographic features like microgeodes, subperiosteal bone resorption and rarefaction in two cases. However, further MRI showed extensive changes closely correlated with the clinical signs of cutaneous vasculopathic rashes. The MRI abnormalities were notable, encompassing marrow oedema primarily affecting metaphyses and epiphyses, displaying broad transition zones. Soft tissue swelling and cortical erosions were also observed. These MRI features proved more pathognomonic in the acute clinical context. The study concluded that phalangeal microgeodic syndrome, characterised by digital swelling and erythema, might not be adequately assessed by plain X-rays. The more comprehensive MRI features, including marrow oedema and soft tissue abnormalities, appeared to be more indicative in diagnosing the condition. Considering the rarity of this syndrome and its temporal association with the COVID-19 pandemic, the study hypothesised that COVID-related thrombophilia and immune-mediated vasculopathy might act as crucial triggers for the active bony manifestations seen in this syndrome. KEY POINTS: • PMS is a rare, predominantly paediatric condition, of unknown aetiology which affects the digits. • Laboratory investigations are generally negative; however, in the appropriate clinical context, the X-ray findings of microgeodes and pattern of bone marrow oedema seen on MRI are pathognomonic. • Considering the rarity of PMS and temporal association with the COVID-19 pandemic, COVID vasculopathy may represent a previously unrecognised aetiology for PMS.

Uncovering heterogeneous inequities induced by COVID-19 interventions: Evidence from three states in the U.S.

The debate surrounding the efficacy of the interventions stipulated at the peak of the COVID-19 pandemic is still raging. Specifically, there are mixed reactions to the success of the interventions. Even when the response strategies were deemed satisfactory, there were still lingering perceptions of inherent systemic failures due to the inequity of the seeming success. The objective of this paper is to reconcile these tensions by examining the heterogeneous impacts of stipulated interventions in the U.S. The examination employs the widely regarded simulation platform, COVASIM, to examine the equity implications of the prescribed interventions. A tailored Gini coefficient is used to evaluate the impact of the interventions with respect to the equitable distribution of healthcare resources that underscore the interventions. The findings indicate that there were inequities in the delivery of the interventions. Furthermore, the examination shows that the efficacy of the interventions has a different distribution across different subgroups and also by location such that the inequities were more profound across minority-populated locations. The disparities in the interventions across age, gender, and racial subgroups translated into the disproportionate count of cases and mortality. These findings provide guidance for future pandemic policies, highlighting that a one-size-fits-all approach is suboptimal. Tailored interventions for different population categories are necessary to achieve equitable success and minimize cases and fatalities.

"We Never Stop Singing": The Dynamics of the Mental and Physical Health of Czech Religious Pastors duringthe COVID-19 Pandemic.

This study explores the dynamics of coping strategies of Czech religious leaders during a peak of the COVID-19 pandemic. An interpretative phenomenological analysis reveals that mental health among pastors is closely linked to a need to maintain community and social contact, while physical health is related to limitations upon ritual elements. In all narratives, the lived experience of mental health in the form of prosocial behavior is significantly prioritized despite the possibility of spreading infection. The analysis also shows that maintaining the community is closely linked to risky behaviors, which positively affected group and individual well-being.

Coronary inflammation on chest computed tomography and COVID-19 mortality.

The main factors associated with coronavirus disease-19 (COVID-19) mortality are age, comorbidities, pattern of inflammatory response, and SARS-CoV-2 lineage involved in infection. However, the clinical course of the disease is extremely heterogeneous, and reliable biomarkers predicting adverse prognosis are lacking. Our aim was to elucidate the prognostic role of a novel marker of coronary artery disease inflammation, peri-coronary adipose tissue attenuation (PCAT), available from high-resolution chest computed tomography (HRCT) in COVID-19 patients with severe disease requiring hospitalization. Two distinct groups of patients were admitted to Parma University Hospital in Italy with COVID-19 in March 2020 and March 2021 (first- and third-wave peaks of the COVID-19 pandemic in Italy, with the prevalence of wild-type and B.1.1.7 SARS-CoV-2 lineage, respectively) were retrospectively enrolled. The primary endpoint was in-hospital mortality. Demographic, clinical, laboratory, HRCT data, and coronary artery HRCT features (coronary calcium score and PCAT attenuation) were collected to show which variables were associated with mortality. Among the 769 patients enrolled, 555 (72%) were discharged alive, and 214 (28%) died. In multivariable logistic regression analysis age (p< 0.001), number of chronic illnesses (p< 0.001), smoking habit (p= 0.006), P/F ratio (p= 0.001), platelet count (p= 0.002), blood creatinine (p< 0.001), non-invasive mechanical ventilation (p< 0.001), HRCT visual score (p< 0.001), and PCAT (p <0.001), but not the calcium score, were independently associated with in-hospital mortality. Coronary inflammation, measured with PCAT on non-triggered HRCT, appeared to be independently associated with higher mortality in patients with severe COVID-19, while the pre-existent coronary atherosclerotic burden was not associated with adverse outcomes after adjustment for covariates. The current study demonstrates that a relatively simple measurement, peri-coronary adipose tissue attenuation (PCAT), available ex-post from standard high-resolution computed tomography, is strongly and independently associated with in-hospital mortality. • Coronary inflammation can be measured by the attenuation of peri-coronary adipose tissue (PCAT) on high-resolution CT (HRCT) without contrast media. • PCAT is strongly and independently associated with in-hospital mortality in SARS-CoV-2 patients. • PCAT might be considered an independent prognostic marker in COVID-19 patients if confirmed in other studies.

Trends in the Utilization of Surgical Modalities for the Treatment of Drug-Resistant Epilepsy: A Comprehensive 10-Year Analysis Using the National Inpatient Sample.

Epilepsy is considered one of the most prevalent and severe chronic neurological disorders worldwide. Our study aims to analyze the national trends in different treatment modalities for individuals with drug-resistant epilepsy and investigate the outcomes associated with these procedural trends in the United States. Using the National Inpatient Sample database from 2010 to 2020, patients with drug-resistant focal epilepsy who underwent laser interstitial thermal therapy (LITT), open surgical resection, vagus nerve stimulation (VNS), or responsive neurostimulation (RNS) were identified. Trend analysis was performed using piecewise joinpoint regression. Propensity score matching was used to compare outcomes between 10 years prepandemic before 2020 and the first peak of the COVID-19 pandemic. This study analyzed a total of 33 969 patients with a diagnosis of drug-resistant epilepsy, with 3343 patients receiving surgical resection (78%), VNS (8.21%), RNS (8%), and LITT (6%). Between 2010 and 2020, there was an increase in the use of invasive electroencephalography monitoring for seizure zone localization (P = .003). There was an increase in the use of LITT and RNS (P < .001), while the use of surgical resection and VNS decreased over time (P < .001). Most of these patients (89%) were treated during the pre-COVID pandemic era (2010-2019), while a minority (11%) underwent treatment during the COVID pandemic (2020). After propensity score matching, the rate of pulmonary complications, postprocedural hematoma formation, and mortality were slightly higher during the pandemic compared with the prepandemic period (P = .045, P = .033, and P = .026, respectively). This study indicates a relative decrease in the use of surgical resections, as a treatment for drug-resistant focal epilepsy. By contrast, newer, minimally invasive surgical approaches including LITT and RNS showed gradual increases in usage.