Worldwide Emergency Research Articles

Broadly Accessible 3D In Vitro Skin Model as a Comprehensive Platform for Antibacterial Therapy Screening.

Skin infections are currently a worldwide emergency as antibiotic-resistant bacteria are spreading, leading to the ineffectiveness of most antibiotics and antibacterial strategies. Consequently, there is an urgency of developing and testing innovative antibacterial therapies. As traditional 2D cell culture and planktonic bacteria culture can be obsolete due to their incapability of resembling the complex infection environment, 3D in vitro skin models can be a powerful tool to test and validate therapies. In this article, a 3D in vitro epidermis-dermis skin model has been developed and biofabricated to be broadly available, reaching a balance between the simplicity and reproducibility of the model and its complexity in terms of wound, infection, and treatment response. The results are really promising, as the skin model developed a comprehensive physical barrier. To further investigate the skin model, controlled wounding, infection, and antibiotic treatments were performed. The results were remarkable: Not only was the unwounded epidermal barrier able to partially stop the bacterial proliferation, but the entire system reacted to both wound and infection in a complex and complete way. Extracellular matrix deposition and remodeling, inflammatory response, antimicrobial peptide production, and change in cellular behaviors, from epithelial to mesenchymal and from fibroblasts to myofibroblasts, were witnessed, with different extents depending on the bacterial strain. In addition, the inflammatory response to the antibiotic administration was opposite for the two bacterial infections, probably revealing the release of inflammatory endotoxins during Escherichia coli death. In conclusion, the presented 3D in vitro skin model has all the characteristics to be a future landmark as a platform for antibacterial strategy therapy testing.

Mission Design and Validation of a Fixed-Wing Unmanned Aerial Vehicle for Environmental Monitoring

Climate change is becoming a worldwide emergency. In order to prevent catastrophic levels of climate change, three broad categories of action are ongoing: cutting emissions, adapting to climate impacts, and financing required adjustments. Cutting emissions requires stopping the use of fossil fuels in favor of renewable energy sources. Adapting to climate change and financing required adjustments need instruments for the understanding of the source causes and how effective the potential measures are. In this context, the use of Unmanned Aerial Vehicles for environmental monitoring is continuously increasing thanks to their ability to collect a wide range of environmental data, from the quality of air to the health status of vegetation, waters, and lands. This paper describes the research activities that are being performed for the design and development of a 100 kg Max Take Off Mass prototype zero-emission Unmanned Aerial Vehicle, named Daphne, destined for environmental monitoring, surveillance, and inspection missions. The developed prototype will drive the next industrialization of the vehicle. A particular focus is given to the design of the power system, based on the use of Proton Exchange Membrane fuel cells fueled with green hydrogen, the integration of the sensors allowing for multipurpose observations and measurements, and the design and validation of the relative multi-purpose missions via an innovative approach based on Model-Based System Engineering.

Environmental impact of pressurised metered dose inhalers versus dry powder and soft mist inhalers at a tertiary Melbourne hospital.

The carbon footprint of devices to deliver inhaled respiratory medications has come into focus as climate change has been identified as a worldwide emergency. Metered dose inhalers (MDIs) contain hydrofluorocarbons that have significant global warming potential compared to dry powder inhalers (DPIs) and soft mist inhalers (SMIs), which do not use a propellant gas. A 12-month pharmacy inpatient dispensing audit demonstrated that inpatient MDI use significantly outweighed that of DPIs and SMIs and accounted for approximately 99% of inhaler-related greenhouse gas emissions at our hospital.

The Fear of COVID-19 Pandemic Effects on Couples' Relationship and Sexual Quality of Life Female: A Study from Iran

Background: The enduring COVID-19 pandemic has implications for the sexual wellbeing of diverse populations, notably women. This worldwide emergency persists in affecting daily routines of individuals, as research indicates that alterations in lifestyle and imposed limitations are linked to mental health challenges. Aim: The objective of this research is to examine the interpersonal dynamics of couples and the sexual well-being of women in the aftermath of the COVID-19 pandemic. Methods: This cross-sectional research involved 395 female participants who utilized Google Forms to complete online questionnaires in Iran from November 2022 to December 2022. The data collection instruments comprised the Sexual Quality of Life-Female (SQOL-F) questionnaire, Depression Anxiety Stress Scale (DASS), Relationship Rating Scale (RAS), and Fear of COVID-19 Scale. Statistical analyses employed in the study included independent t-test, one-way ANOVA, Tukey post hoc test, and Univariate and Multiple linear regression. Results: The average age of female participants in the study was 31.97 years, with a standard deviation of 9.04. The mean scores for sexual quality of life among women were 64.82 with a standard deviation of 11.93, 18.28 with a standard deviation of 4.48 for DASS, 22.48 with a standard deviation of 4.30 for RAS, and 12.88 with a standard deviation of 3.93 for fear of COVID-19 scale. Univariate linear regression analysis indicated a significant association between the quality of sexual life and fear of COVID-19 (P = 0.001), DASS (P = 0.001), and RAS (P = 0.007). The study found a noteworthy and negative impact of fear related to COVID-19 and DASS on the sexual quality of life of women (P < 0.05). Conclusion: The anxiety stemming from the COVID-19 outbreak seems to have repercussions on the dynamics of romantic partnerships and the sexual well-being of women. Furthermore, the pandemic is associated with heightened levels of anxiety, stress, and depression. It is recommended that further research be undertaken to explore the mental health of women and its implications on their sexual experiences in the aftermath of the COVID-19 crisis.

Psychological Anxiety of COVID-19 Pandemic and its Effect on Academic Performance of University Students

The problem and the aim of the study. The COVID-19 pandemic has caused a worldwide emergency, with consequences for more than just physical health, including mental health and educational outcomes. University students are particularly vulnerable since they are dealing with a number of challenges at once, such as the health effects of the pandemic both directly and indirectly, the sudden shift to online schooling, and doubts about their future employment opportunities. Critical to understanding the far-reaching effects of the pandemic on student lives, learning processes, and mental health is research into COVID-19-related psychological anxiety and its impact on academic performance in higher education. This research subject seeks to investigate the extent to which college students are anxious about the COVID-19 pandemic and how this unusual stressor affects their participation in class, grades, and general satisfaction with their education. By looking at it from this perspective, we may identify the many ways in which the epidemic has affected the future generation of researchers and professionals, and then develop strategies to help them cope with the difficulties they will face. Research methods. The study employed a correlational descriptive approach to investigate the psychological distress caused by the COVID-19 epidemic and its influence on the academic performance of university students in Jordan. The sample consisted of 300 undergraduates (male and female) from the College of Educational and Psychological Sciences at Amman Arab University in the 2021–2022 school year, with the entire student body serving as the population. The survey tool was distributed online via social media, leading to 379 respondents, and a chance sample was used because it was feasible to reach a large number of participants—especially during the pandemic. Results. The study results show a detailed range of stress and worry, with average scores varying from 2.8 to 4.1 among 25 items. Major concerns involve social isolation, indicated by an average score of 4.1 for feeling alienated because of social distancing measures, and academic disruptions, with an average score of 4.0 for experiencing a lack of control over academic life owing to the pandemic. There is a significant gender gap between the reported levels of anxiety and its effect on academic performance; 40% of female students and 30% of male students express high levels of anxiety, and the average academic impact score for female students is 3.0 while the average score for male students is 2.5. The data also shows that anxiety levels and the detrimental effect they have on academic performance are getting worse over the years, with fourth-year students having the worst levels of anxiety (45%) and the greatest academic impact score (3.5). The findings highlight the importance of providing students with personalized support to help them cope with the psychological effects of the pandemic. Scientific novelty: Novelty resides in the study's exhaustive examination of COVID-19's psychological effects on Jordanian university students, with a particular emphasis on anxiety levels and how they relate to academic achievement. By looking at the effects of the pandemic across genders and academic years, it shows how anxiety levels rise over time and how there are clear differences between the sexes. The study offers important insights into the many ways in which the pandemic affected students' academic performance and mental health by using a large sample size, a correlational descriptive approach, and social media to reach a wide audience during the epidemic.

The effect of tocilizumab administration on inflammatory markers in COVID-19 patients

BackgroundThe COVID-19 outbreak was declared a worldwide emergency as a result of its rapid spread. The number of people infected with COVID-19 is increasing rapidly around the world, and pneumonia can develop in COVID-19 cases. The monoclonal antibody tocilizumab blocks the interleukin-6 receptor, which in turn reduces inflammation.Aimof the workThe study aims to determine how tocilizumab affects inflammatory markers, laboratory indices, and oxygen therapy.Subjects and methodsThis retrospective observational study aimed to assess the effect of tocilizumab on inflammatory markers, laboratory parameters, and short-term outcomes in COVID-19 cases. Data was collected from 55 patients with COVID-19 who tested positive for SARS-CoV-2 using PCR. These patients were admitted to Ain Shams University Specialized Hospital—Obour between June 1, 2021, and May 31, 2022.ResultsAfter tocilizumab administration, C-reactive protein levels decreased significantly, but there was no statistically significant change in hemoglobin, serum ferritin, or D-dimer levels. Following tocilizumab administration, the leukocyte counts, and platelet count increased significantly. There was a significant correlation between the presence of comorbidities in the studied patients (e.g., heart failure, post-renal transplantation, and hepatitis C virus) and the risk of mortality. The study's final result showed a significant decrease in platelet count in dead patients compared to discharged patients after receiving tocilizumab. Regarding oxygen therapy following tocilizumab administration, the use of face masks and non-rebreather facemasks was high in dead patients, while nasal prong usage was high in discharged patients. After receiving tocilizumab, there was an increase in the mean liters of oxygen required in dead patients compared to discharged patients.ConclusionAfter administration of tocilizumab in COVID-19 hospitalized patients who have progressing disease, there was highly and significantly decrease in CRP level with no statistically significant alteration in the levels of hemoglobin, serum ferritin, and D-dimer and an increase in TLC and platelets was observed. Following tocilizumab administration, there was a decrease in oxygen demands, an improvement in oxygen therapy and oxygen saturation. Tocilizumab is a recommended therapy option.

Safety and Efficacy of Tocilizumab in critically ill patients with COVID-19: An Observational study

Abstract Background The current coronavirus disease 2019 (COVID-19) outbreak is a worldwide emergency, as its rapid spread and high mortality rate has caused severe disruptions. The number of people infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2), the causative agent of COVID-19, is rapidly increasing worldwide. Patients with COVID- 19 can develop pneumonia. Severe symptoms of acute respiratory distress syndrome (ARDS), and multiple organ failure. Aim of the Work to compare Compare between clinical symptoms (MMRC Dyspnea score), oxygen therapy, TlC & Lymphocytic count and inflammatory markers (CRP, serum ferritin, D.dimer) before and after the administration of 2 doses of tocilizumab noting that the second dose is given within 24-48 hours from first dose on 50 patients admitted to Ain-Shams isolation university hospital at Al-Obour, Ain-shams Geriatrics isolation hospital and Ain- shams isolation field hospital from 1st of May 2020 to 1st of January 2022. Patients and Methods Baseline cbc with differential, liver function tests, kidney functions tests, D dimer, serum ferritin and CRP. 2 doses of tocilizumab given on two days, first dose is 8mg/kg diltuted in 100 cc saline 0.9% given along 1 hour while the second dose (4mg/kg diltuted in 100 cc saline 0.9%) is given after 24 hours. Follow up inflammatory markers (cbc with differential, crp, d dimer, serum ferritin) were withdrawn after 3 days from second dose of tocilizumab. Assestment of clinical symptoms after 48 hours of second dose of tocilizumab. Assestment of oxygen thearpy on day 2 and day 30 after administration of tocilizumab. Results the administration of tocilizumab highly significantly improves some clinical symptoms (bony aches, fatigue, fever) while worsens expectoration, but highly significantly improves oxygen therapy and po2/fio2 ratio, with no significant effect on inflammatory marker other than CRP which showed marked increase. Tocilizumab shows neither effect on patients’ fate and mortality nor on hospital stay although mean age of 63 was statistically highly significant on increased patients’ mortality and renal impairment significantly affected length of hospital stay. the effect of timing of tocilizumab administration on patients’ fate and mortality showed non statistically significant improvement when given from day 6 to day 10 since onset of symptoms Conclusion The administration of tocilizumab highly significantly improves clinical symptoms, oxygen therapy and po2/fio2 ratio, with no siginifcant effect on inflammatory marker other than CRP which showed marked increase, which may be attributed to early withdrawal of inflammatory markers. Tocilizumab shows neither effect on patients’ fate and mortality nor on hospital stay although mean age of 63 was statistically highly significant on increased patients’ mortality and renal impairment significantly affected length of hospital stay. We studied the effect of timing of tocilizumab administration on patients’ fate and mortality which showed non statistically significant improvement when given from day 6 to day 10 since onset of symptoms which may be due to small sample size.

Interrogating the lack of diversity of thought in the pandemic response that led to mistakes - holistic evidence-based approach to deal with future pandemics.

The COVID-19 pandemic, triggered by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), rapidly became a worldwide emergency. How it was managed garnered both commendation and vehement censure. This crisis profoundly affected healthcare, the economy, education, and public confidence in scientific endeavors. Our primary aim was to scrutinize the shortcomings in the pandemic management and to articulate a more effective strategy for handling prospective pandemics. We delved into the errors encountered in the COVID-19 response and posited a holistic, evidence-grounded approach for future pandemic mitigation.

Herpes Zoster and COVID-19 Vaccination: A Narrative Review.

COVID-19 was a worldwide emergency, leading to a global health crisis, which completely revolutionized every aspect of human life. Several strategies were adopted to limit the spreading of the infection such as testing and contact tracing, quarantine and isolation, use of face mask, social distancing, lockdowns, travel restrictions, etc. Of these, vaccines were the most important measures to reduce the transmission of the virus and the severity of the infection, in order to overcome the pandemic. Fortunately, vaccination campaign was a success, showing to be efficient in controlling and preventing the COVID-19, reducing the risk of disease progression, hospitalization, and mortality. Monitoring and addressing vaccine-related adverse events have been essential for maintaining public confidence. Indeed, with the increasing number of vaccines administered, various cutaneous reactions have been reported, making dermatologists key players in their recognition and treatment. Particularly, several cutaneous diseases and cutaneous findings have been reported. Of note, also viral reactivations have been described following COVID-19 vaccination. Among these, varicella zoster virus (VZV) reactivation has been collected. Globally, an early diagnosis and an accurate treatment of herpes zoster (HZ) is mandatory to reduce possible complications. In this context, we conducted a review of the current literature investigating cases HZ following COVID-19 vaccination with the aim of understanding the possible causal correlation and underlying pathogenetic mechanisms to offer clinicians a wide perspective on VZV reactivation and COVID-19 vaccines.

Laser surface texturing and numerical simulation of heat flux on Cr2AlC MAX phase heat exchangers

The energetic worldwide emergency demands a significant drop in fossil energy to renewable energies as part of the sustainable solutions for global energy consumption. MAX phase materials, such as Cr2AlC, are potential candidates for heat exchanger applications due to their excellent oxidation and corrosion resistance, good thermal shock response and relatively high thermal conductivity. This study uses laser surface texturing (LST) technology to design plate heat exchanger patterns on the Cr2AlC MAX phase. Furthermore, performing numerical simulations on textured plate models under molten salt conduction and convection conditions, accessing temperature gradient and heat transfer behaviour were conducted on Cr2AlC, as well as on 316 L stainless steel and alumina for comparison. As a result, combined microtextures with a corrugated surface and spaced V-shape channels were obtained using LST in a single step. The parametric study indicated that the optimal channels (groves) were found for 25 W in air and 20 s laser conditions, with approximately 145 µm width and 340 µm depth. Furthermore, the numerical simulation showed that ceramics materials present better heat transfer conditions than 316 L stainless steel, where Cr2AlC and alumina only differ in 1.9% heat flux. In addition, the corrugated surface plate with 2.6% width of the total thickness increases heat transfer by 9.8%.

Systemic inflammatory indexes (NLR, DNLR, PLR and SII) role in predicting COVID-19 progression

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has caused a worldwide emergency. The disease is characterized primarily by symptoms of the respiratory system, but also by systemic inflammation. Since the onset of the disease, there has been a need for biomarkers to predict the severity of the clinical picture and the outcome of the disease. The aim of this study is to evaluate systemic inflammatory markers for predicting severity of COVID-19. Methods: The study was conducted at the Sarajevo Canton Health Center on a total of 170 adults suffering from COVID-19. 70 subjects had mild clinical picture, while the control group consisted of 100 subjects with moderate clinical picture. The results of complete and differential blood counts, C-reactive protein (CRP), and systemic inflammatory indexes (SII) (neutrophil/lymphocyte ratio [NLR], derived NLR [dNLR], platelet/lymphocyte ratio [PLR], and SII) were used to compare the groups. IBM SPSS Ver. 23 was used for statistical analysis and data processing. Results: The proportion of male patients in the group with a milder clinical picture was higher than the proportion of male patients with a moderate clinical picture, p = 0.016. The values of leukocytes and neutrophils were higher in patients with a moderate clinical picture (p = 0.006 and p < 0.001, respectively). The values of all inflammatory indexes (NLR, dNLR, PLR and SII) were higher in patients with a moderate clinical picture of COVID-19 than in patients with a mild clinical picture (p < 0.001 for NLR, dNLR, and SII; p = 0.023 for PLR). In the research, patient age showed no correlation and CRP showed no correlation with SII. Conclusion: SII show higher values in patients with a moderate compared with a mild clinical picture of COVID-19. These parameters can be cost-effective and useful indicators in patient classification, diagnosis, and probably in monitoring patients with COVID-19.

EpiMob: Interactive Visual Analytics of Citywide Human Mobility Restrictions for Epidemic Control.

The outbreak of coronavirus disease (COVID-19) has swept across more than 180 countries and territories since late January 2020. As a worldwide emergency response, governments have implemented various measures and policies, such as self-quarantine, travel restrictions, work from home, and regional lockdown, to control the spread of the epidemic. These countermeasures seek to restrict human mobility because COVID-19 is a highly contagious disease that is spread by human-to-human transmission. Medical experts and policymakers have expressed the urgency to effectively evaluate the outcome of human restriction policies with the aid of big data and information technology. Thus, based on big human mobility data and city POI data, an interactive visual analytics system called Epidemic Mobility (EpiMob) was designed in this study. The system interactively simulates the changes in human mobility and infection status in response to the implementation of a certain restriction policy or a combination of policies (e.g., regional lockdown, telecommuting, screening). Users can conveniently designate the spatial and temporal ranges for different mobility restriction policies. Then, the results reflecting the infection situation under different policies are dynamically displayed and can be flexibly compared and analyzed in depth. Multiple case studies consisting of interviews with domain experts were conducted in the largest metropolitan area of Japan (i.e., Greater Tokyo Area) to demonstrate that the system can provide insight into the effects of different human mobility restriction policies for epidemic control, through measurements and comparisons.

COVID-19: Variants, Immunity, and Therapeutics for Non-Hospitalized Patients.

The continuing transmission of coronavirus disease 2019 (COVID-19) remains a world-wide 21st-century public health emergency of concern. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused greater than 600 million cases of COVID-19 and over 6 million deaths globally. COVID-19 continues to be a highly transmissible disease despite efforts by public health officials and healthcare providers to manage and control the disease. Variants identified in selected worldwide epicenters add to the complexity of vaccine efficacy, overage, and antibody titer maintenance and bioactivity. The identification of the SARS-CoV-2 variants is described with respect to evading protective efficacy of COVID-19 vaccines and breakthrough infections. Vaccines and other therapeutics have prevented millions of SARS-CoV-2 infections and thousands of deaths in the United States. We explore aspects of the immune response in a condensed discussion to understand B and T cell lymphocyte regulatory mechanisms and antibody effectiveness and senescence. Finally, COVID-19 therapies including Paxlovid, Remdisivir, Molnupiravir and convalescent plasma in non-hospitalized patients are presented with limitations for identification, collection, and distribution to infected patients.

Repurposing Anti-Dengue Compounds against Monkeypox Virus Targeting Core Cysteine Protease.

The monkeypox virus (MPXV) is an enveloped, double-stranded DNA virus belonging to the genus Orthopox viruses. In recent years, the virus has spread to countries where it was previously unknown, turning it into a worldwide emergency for public health. This study employs a structural-based drug design approach to identify potential inhibitors for the core cysteine proteinase of MPXV. During the simulations, the study identified two potential inhibitors, compound CHEMBL32926 and compound CHEMBL4861364, demonstrating strong binding affinities and drug-like properties. Their docking scores with the target protein were -10.7 and -10.9 kcal/mol, respectively. This study used ensemble-based protein-ligand docking to account for the binding site conformation variability. By examining how the identified inhibitors interact with the protein, this research sheds light on the workings of the inhibitors' mechanisms of action. Molecular dynamic simulations of protein-ligand complexes showed fluctuations from the initial docked pose, but they confirmed their binding throughout the simulation. The MMGBSA binding free energy calculations for CHEMBL32926 showed a binding free energy range of (-9.25 to -9.65) kcal/mol, while CHEMBL4861364 exhibited a range of (-41.66 to -31.47) kcal/mol. Later, analogues were searched for these compounds with 70% similarity criteria, and their IC50 was predicted using pre-trained machine learning models. This resulted in identifying two similar compounds for each hit with comparable binding affinity for cysteine proteinase. This study's structure-based drug design approach provides a promising strategy for identifying new drugs for treating MPXV infections.

Public procurement for innovation: Lessons and challenges of a COVID-19 vaccine contract

During the COVID-19 pandemic, which triggered a worldwide emergency call to pursue new drugs and devices to treat and cure the disease, vaccines began to be developed mid-2020, as a promising weapon and shield. Fiocruz, a Brazilian government science and technology institute, signed a public procurement for innovation contract with the foreign pharmaceutical company AstraZeneca to purchase, at that time, vaccines still under development. It was the first public procurement for innovation contract in the Brazilian public health system (SUS). This paper analyzes how the Brazilian public procurement contracts for the COVID-19 vaccine dealt with technology and institutional risks and uncertainties. It also aims to describe how such agreements (and the legal apparatus behind them) relate to the Brazilian system of innovation and to the theoretical approach of contracting for innovation. A key question is: how does the public procurement for innovation vaccine contract signed by Fiocruz deal with the intrinsic nature of uncertainty that characterizes innovation, and what lessons and challenges can be drawn?

Transcription Factor Driven Gene Regulation in COVID-19 Patients.

SARS-CoV-2 and its many variants have caused a worldwide emergency. Host cells colonised by SARS-CoV-2 present a significantly different gene expression landscape. As expected, this is particularly true for genes that directly interact with virus proteins. Thus, understanding the role that transcription factors can play in driving differential regulation in patients affected by COVID-19 is a focal point to unveil virus infection. In this regard, we have identified 19 transcription factors which are predicted to target human proteins interacting with Spike glycoprotein of SARS-CoV-2. Transcriptomics RNA-Seq data derived from 13 human organs are used to analyse expression correlation between identified transcription factors and related target genes in both COVID-19 patients and healthy individuals. This resulted in the identification of transcription factors showing the most relevant impact in terms of most evident differential correlation between COVID-19 patients and healthy individuals. This analysis has also identified five organs such as the blood, heart, lung, nasopharynx and respiratory tract in which a major effect of differential regulation mediated by transcription factors is observed. These organs are also known to be affected by COVID-19, thereby providing consistency to our analysis. Furthermore, 31 key human genes differentially regulated by the transcription factors in the five organs are identified and the corresponding KEGG pathways and GO enrichment are also reported. Finally, the drugs targeting those 31 genes are also put forth. This in silico study explores the effects of transcription factors on human genes interacting with Spike glycoprotein of SARS-CoV-2 and intends to provide new insights to inhibit the virus infection.

Edukasi Tuberkulosis dan Etika Batuk kepada Masyarakat Somagede, Banyumas, Jawa Tengah

Introduction: Since 1992, the WHO has labeled tuberculosis a worldwide emergency. Delays in tuberculosis diagnosis, detection of new cases, and treatment are brought on by the COVID-19 epidemic. In Somagede Village, 20 (90,9%) of 24 TB cases were successfully treated, and there were 1 (4,5%) deaths as a result of TB therapy.
 Objective: This public service was carrying out these activities as a kind of health promotion in order to increase public awareness of health education regarding TB prevention and prevent the spread of the disease in Somagede.
 Method: This public service was implemented in three steps, including the permission granted, media disclosure, and the second stage, which is currently based on approval from the government of the Somagede and the letter of duty number UHB/KET/035/1121. At the end of the session, participants' public service actions are evaluated. On June 26, 2022, this health education promotion will take place. The household is the focus. With the aid of a leaflet, PowerPoint slides, notebook, LCDs, projectors, pointers, and speakers, health education methods can be presented through lectures, discussions, demonstrations, and redemonstrations.
 Result: The number of participants was 30. The execution time is approximately 1 hour, with the group members organized as moderator, presenter, notuensis, observer, documentarian, and facilitator. During the implementation of the public examination, participants actively followed the entire range of activities, properly demonstrated how to wash hands, and discussed the ethics of coughing.
 Conclusion: Activities are running well, and there is extensive public knowledge about TB disease.

Combining remote work and training: the experience of participating in the first Virtual EPA Gaining Experience Programme

AbstractEach year the European Psychiatric Association offers early career psychiatrists the opportunity to take part in the Gaining Experience programme, a scholarship that funds short observership placements (between 2 and 8 weeks) overseas in different psychiatric institutions across Europe to ECPs who have completed their psychiatric training. However, since COVID-19 was declared by the WHO as a worldwide emergency on 11th March 2020, it was no longer possible to provide offline overseas observerships. Therefore, the Gaining Experience programme changed its format in 2020-2021 and became virtual. It was in this context, that an Ukranian early career psychiatrist was going to participate in the virtual Gaining Experience programme at the Institute of Psychiatry, Psychology & Neuroscience, King’s College London (United Kingdom) from December 2021. The observership placement had a particular academic focus, the essence of which was investigating psychotherapy training among ECPs in Ukraine, and to examine how it is included in psychiatry training. The sharing of this example of virtual observership shows that it is possible and feasible high-quality and affordable distance learning for ECPs. This training format can be useful not only during quarantine restrictions, but also in conditions of limited travel opportunities.Disclosure of InterestNone Declared

The Effect of the COVID-19 Lockdown on the Frequency of Acute Poisoning Presentation to Adult and Pediatric Emergency Departments.

Background The coronavirus type 2 that causes severe acute respiratory syndrome (SARS-CoV-2) was detected in December 2019 in Wuhan, China. A worldwide emergency response has been initiated because of the fast rise in the number of cases and fatalities during the early stages of the pandemic when vaccinations and efficient medical care were unavailable.Misinformation spread quickly in the early phases of the pandemic, leading to the inappropriate use of medications, chemicals, and traditional remedies for their claimed preventive or therapeutic purposes. Thus, our aim is to identify the impact of the coronavirus disease 2019 (COVID-19) lockdown on the patterns of intoxicated patients presenting to King Abdulaziz Medical City's adult and pediatric emergency departments. Methods A retrospective cohort study was conductedin the adult emergency department at King Abdulaziz Medical City and the pediatric emergency department at King Abdullah Specialized Children's Hospital in Riyadh, Saudi Arabia.All patients presented with poisoning as a chief complaint between March 23 to June 21 in 2019 (pre-lockdown), 2020 (the lockdown), and 2021 (post-lockdown) were included. Cases of registered poisoning complaints were reviewed and assessed with respect to patient demographics, the causative agent/substance responsible for the poisoning, management of poisoning, and particular outcomes on the approved data collection form by the research team.The data were entered and analyzed by using SPSS v26 (IBM Corp, Armonk, NY). The descriptive statistics are presented as frequency and percentage for the categorical data variables and mean and standard deviation for the numerical data. The data were further analyzed by using cross-tabulation (chi-square test), for the data that are both the predictor and the outcome was categorical. A p-value of < 0.05 was considered significant for allstatistical tests. Results Out of 318 patients identified, 164 were adults and 154 were pediatric patients. The mean age of adult and pediatric patients was 33.3±15.5 years and 4±3.6 years, respectively. The majority of patients (115; 70.1%) were males in the adult group and females (90; 58.4%) in the pediatric.The majority of self-harm cases were accidental among both adults and pediatrics, 109 (66.5%) and 144 (93.5%), respectively. The dispositionfrom the emergency department was discharged for 113 (68.7%) adult patients and134 (87.0%) pediatric patients.The number of cases presented to ER with poisoning cases during the lockdown decreased. This was further tested inferentially, but no significant association was seen among study variables, i.e., p > 0.05. Conclusion The lockdown and pandemic had a significant impact on the rate and patterns of ED visits. The establishment and operation of Drug and Poison Information Centers (DPIC) across the Kingdom, in addition to increasing awareness through campaigns addressing drug and substance safety, is recommended.

COVID-19: Has the Liver Been Spared?

The liver is a secondary and often collateral target of COVID-19 disease but can lead to important consequences. COVID-19 might directly cause a high number of complications in patients with pre-existing chronic liver disease, increasing their risk of hepatic decompensation. Moreover, it also determines indirect consequences in the management of patients with liver disease, especially in those suffering from decompensated cirrhosis and HCC, as well as in the execution of their follow-up and the availability of all therapeutic possibilities. Liver imaging in COVID-19 patients proved to be highly nonspecific, but it can still be useful for identifying the complications that derive from the infection. Moreover, the recent implementation of telemedicine constitutes a possible solution to both the physical distancing and the re-organizational difficulties arising from the pandemic. The present review aims to encompass the currently hypothesized pathophysiological mechanisms of liver injury in patients with COVID-19 mediated by both the direct invasion of the virus and its indirect effects and analyze the consequence of the pandemic in patients with chronic liver disease and liver tumors, with particular regard to the management strategies that have been implemented to face this worldwide emergency and that can be further improved.