Integrate Ground Data and Remote Sensing to Monitor So2 and No2 Pollution over Northern Uae / Considering the Lockdown Period of the Covid-19 Pandemic

Sulfur dioxide and Nitrogen dioxide are two of the main air quality pollutants of concern generally in world countries. North of United Arab Emirates (UAE) urbanization and population growth are increasing all the daily activities related to pollution, which poses a threat to humans and the environment. The aim of this study was to investigate the Spatio-temporal distribution of SO2 and NO2 concentrations, resulting from seven ground stations and The Sentinel-5 Precursor multispectral sensor of the TROPOMI for the periods (2019,2020, and 2021). The data explained how the parameters have changed in the presence of the COVID-19 pandemic. SO2 and NO2 pollution monitoring and regulation assist to take proper steps to control the atmospheric concentration of SO2 and NO2 within the fair levels.

Impact of the COVID-19 Pandemic on Breast Cancer Patient Care: A Retrospective Study in a Tertiary Care Center in Lebanon

INTRODUCTION: The COVID-19 pandemic poses challenges to the healthcare systems including cancer treatment. We aim to evaluate the impact of lockdown during COVID-19 on breast cancer (BC) care in terms of BC stage at presentation, treatment compliance and delays, and follow-up in a tertiary care center in Lebanon. METHOD(S): This is a retrospective observational study comparing patients with BC who presented to a tertiary care center in Lebanon in the pre-COVID period (Sep 2019-Dec 2019) and during COVID (Sep 2020-Dec 2020). After receiving the IRB approval, we retrieved the charts of BC patients who had their initial presentation, were under treatment or were on follow-up during our period of interest. We extracted data from electronic medical records of patients related to demographic parameters, cause of visit, tumor description, and type of treatment received. Descriptive analysis, as well as multivariate analysis, were done using SPSS. RESULT(S): Out of the 497 patients included, 274 visited the hospital in the pre-COVID period (median age 52.5 years) and 223 patients during COVID (median age 54.7 years). More than half of patients presented for BC screening in the pre-COVID (52%), while 52% came symptomatic during COVID. Almost 54% had advanced BC at presentation in the COVID period compared to 48% pre-COVID but with no statistical significance (p=0.36). During the COVID period, almost 39% of patients had surgery, 79.7% received chemotherapy, and 21.2% received radiotherapy, but with no significant difference between the two periods. Also, no difference was found in the type of surgery done between the two periods. The mean time between the onset of symptoms and biopsy was significantly longer in the COVID period (4.8 +/- 3.5 months) than that in the pre-COVID (3.2 +/- 5.1 months). The mean time between the biopsy and first treatment was not significantly different between the two periods (1.5 +/- 2.2 months versus 2.1+/-3.8 months). For patients who received neoadjuvant chemotherapy, the mean time between the last chemotherapy and surgery was longer in the COVID period (1.9 +/- 1.4 months) than in the pre-COVID period (1.2 +/- 1.1 months). Multivariate analysis showed that age at diagnosis (p=0.014) and time to diagnosis (p=0.01) were significantly associated with the advanced stage of BC. CONCLUSION(S): This study showed that COVID pandemic has resulted in a delay in the initial presentation of patients resulting in more advanced stages at presentation. However, the management of breast cancer was not substantially impacted by the COVID-19 lockdown.

Recovering in the post-pandemic era: the role of employee voice, knowledge sharing, employee innovation, and service recovery performance in the hotel industry

Purpose: Covid-19 pandemic is perceived as one of the great disasters in history. It forced countries to impose travel restrictions and lockdowns, and it negatively influenced hotels' performance. Therefore, this article aims to provide explanations of how hotels can survive, recover and succeed in the post-pandemic period. This article focuses on the role of employee voice, knowledge sharing, and employee innovation in promoting service recovery performance. Design/methodology/approach: This is a conceptual paper that focuses on discussing the relationships between employee voice, knowledge sharing, employee innovation, and service recovery performance. Findings: The study suggests that employee voice is a vital element that can enhance knowledge sharing at hotels. Furthermore, knowledge sharing is proposed to encourage employees to engage in innovative behavior, which, in turn, can promote service recovery performance. Originality/value: The study provides a framework that explains a mechanism of how hotels can accelerate recovery efforts from Covid-19 repercussions by shedding light on the important role of employee voice, knowledge sharing, and employee innovation. © 2022, Emerald Publishing Limited.

A Novel Exercise Intervention, Home-Based and Video-Supervised, Improved Cardiorespiratory Fitness and Physical Performance in CKD

Background: Sarcopenia is a prevalent complication in chronic kidney disease (CKD) and a central component of the frailty phenotype associated with adverse clinical outcomes. In the era of COVID, there is a critical need for practical, safe, interactive, and personalized home-based exercise targeting improvements in physical function in vulnerable patients living with CKD. Method(s): The ESTEEM-VIDA CKD pilot randomized clinical trial tests the efficacy of a home-based, video-supervised, and personalized exercise program on cardiorespiratory fitness (CRF) and physical performance in patients with moderatesevere CKD. Exercise (EX, n=12) consisted of 30-40min exercise sessions, thrice a week for 12 weeks: high-intensity interval training, strength training, and moderate intensity walking. One week of video-supervised exercise alternates with one week of self-directed exercise. Each one-week video-supervised session was conducted by exercise trainers using a videoconference tool, while self-directed exercise weeks used pre-recorded exercise videos. Controls (CTL, n=5) received diet and exercise counseling at baseline. Pre- and post-intervention CRF (VO2peak) and total work were measured using a graded cycle ergometer test and physical performance was assessed by the 6-minutes walking distance (6MWT) test. The effect of exercise on change in CRF and 6MWT using linear mixed effects models was tested. Result(s): Mean age was 62 +/-10y with 47% females and 53% with diabetes. Mean eGFR was 34.4+/-11.8 ml/min per 1.73m2. Mean total work and 6MWT at baseline were 31.7 +/-17kJ and 494 +/-51m, respectively. EX was associated with a 6.9kJ increase in total work (95% CI 2, 12;p=0.008) compared to CTL independent of change in VO2peak, suggesting improved muscular efficiency following training. EX was associated with a 43m increase in 6MWT (95% CI 11, 75;p=0.008) compared to CTL. VO2peak did not differ between groups (p=0.99). Conclusion(s): Preliminary findings suggest a home-based, video supervised, personalized exercise program is feasible and efficacious in improving muscular and physical performance in CKD. It provides a tool for studying metabolic and molecular health and may shed new light on the pathophysiology of sarcopenia in CKD.

Depression, Anxiety, and Stress among Sudanese Medical Students during the COVID-19 Lockdown Period

BACKGROUND: The novel coronavirus disease-2019 (COVID-19) pandemic has imposed a compulsory lockdown that has led to the emergence of various types of psychological distress among medical students. AIM: This study aimed to identify the determinants and the levels of depression, anxiety, and stress among Sudanese medical students during the COVID-19 lockdown period. METHODS: A web-based cross-sectional study was conducted using an online questionnaire that contained the depression, anxiety, and stress scale (DASS-21). RESULTS: A total of 1058 students responded and completed the questionnaire. The study sample consisted of 604 (57.1%) females, and the rest were male. The prevalence rates of depression, anxiety, and stress were 75%, 55.3%, and 51.8%, respectively. Binary logistic regression analysis revealed that depression, anxiety, and stress were significantly associated with the female gender (adjusted odds ratio [AOR] = 1.63, 95% confidence interval [CI] = 1.22‒2.16) (AOR = 1.73, 95% CI = 1.35‒2.22) (AOR = 1.36, 95% CI = 1.07‒1.74) respectively. Depression and stress were significantly associated with students at the pre-clinical phase (AOR = 1.65, 95% CI = 1.24‒2.20) (AOR = 1.43, 95% CI = 1.12‒1.83), respectively. Anxiety was significantly associated with studying at a private university (AOR = 1.36, 95% CI = 1.05‒1.76). CONCLUSIONS: Female students in the pre-clinical phase had an increased risk of depression and stress. Female students attending a private university had an increased risk of anxiety. Depression, anxiety, and stress were highly prevalent among Sudanese medical students.

Sleep quality and insomnia during the COVID-19 lockdown among the Saudi public: A cross-sectional study.

OBJECTIVES: To measure the Saudi population's sleep quality during the lockdown of COVID-19. METHODS: An internet-based questionnaire that was performed during the lockdown of the COVID-19 pandemic among the Saudi population over 2 weeks from April 1 to April 15, 2020. We used the instant messaging application WhatsApp and Twitter to reach the targeted population. Saudi citizens and non-Saudi residents who can read and understand the questionnaire were recruited. Data were analyzed using Stata and SPSS. RESULTS: A total of 790 responses were included. The majority of participants were the Saudi population 735 (92.9%). The prevalence of insomnia and poor sleep quality were 54.4% and 55.5%, respectively. Saudi citizenship was associated with longer sleep duration (p=0.031). Female gender and being married were associated with worse global PSQI, sleep quality, sleep distribution, sleep latency, and daytime dysfunction. CONCLUSION: Our findings showed that during the COVID-19 pandemic, the Saudi population had a high prevalence of insomnia and poor sleep quality. Routine monitoring of the psychological impact of life-threatening outbreaks and the adoption of effective early mental health actions should be considered.

Understanding prescription behavior across healthcare professionals in treating knee osteoarthritis before and during the 2020 COVID-19 pandemic

Background: Knee Osteoarthritis (OA) treatment aims to provide symptom relief, easing joint pain and enabling mobility. The COVID-19 pandemic affected healthcare systems globally, including ways OA patients were treated. Objectives: This study is to understand how treatment management of knee OA patients and prescribing behavior across US healthcare professionals (HCPs) was affected when COVID-19 impacted healthcare systems and regimes globally Methods: A multi-center online medical chart review study of patients with OA was conducted between May -July 2019 & 2020 among US rheumatologists (rheums), orthopedic surgeons (orthos), primary care physicians with a focus in sports medicine (SM PCPs), and pain specialists, practicing across hospital and private practices. Recruited from a large access panel, physicians were screened for duration of practice in their specialty (3-50 years) and caseload (35 or more knee OA patients personally managed, at least 10 of which must be classified as moderate-severe). Patient charts were recorded for the next 5 eligible patients seen during the screening period. Respondents abstracted patient demographics and treatment regimes used. Descriptive statistics were used to analyse the data Results: 275 physicians were recruited and collectively reported 1375 patients between May-Jul 2019;260 physicians were recruited and collectively reported 1300 patients between May-Jul 2020. Looking at treatments patients were receiving at time of reporting, oral medications, particularly NSAIDs, were widely used, regardless of the physician specialty. A directional increase of 6% in the proportion of reported patients deriving from sampled primary care SM PCPs from pre-COVID (Q219) to during COVID (Q220), whilst the same is not true for rheums, orthos, and pain specialists. Figure 1. Medication usage in reported knee OA patients across all sampled specialties -Q2 2019 vs Q2 2020 With regards to the usage of injectable therapy, the opposite pattern is seen -higher proportions of reported patients deriving from sampled rheums, orthos & pain specialists receiving injectables vs those deriving from sampled SM PCPs. While focusing on orthos, the proportion of reported patients deriving from them who receive injectables grew by 5% in Q220 (during COVID) vs Q219 (pre-COVID) -directionally more so than other specialties. This is possibly due to limited elective surgeries during the pandemic. Looking deeper into injectable usage amongst reported patients deriving from sampled rheums and orthos, the proportion of the total reported patient set receiving this treatment type is relatively similar across both specialties, prior to, and during the COVID-19 pandemic. However, among reported patients who received surgery, a directionally higher proportion of this reported patient cohort deriving from orthos are noted to receive injectables vs those from rheums -this is true both pre-and during the pandemic. Conclusion: From the sample surveyed, it appears that primary care SM PCPs adopted their treatment adjustment during COVID-19 pandemic differently, by prescribing more orals, while other secondary care physicians (rheums, orthos, pain specialists) focused on injection treatment for longer pain relief. Considering movement restrictions and limited elective surgeries during the pandemic, the lack of targeted treatment options for knee OA has been made more apparent. With a burgeoning pipeline, many of which are targeted therapies, it is hopeful that knee OA treaters will be less reliant on symptom remedies and can readily offer patients' longer-acting pain relief or disease modifying options to combat joint deterioration.

Understanding prescription behavior across healthcare professionals in treating knee osteoarthritis before and during the 2020 COVID-19 pandemic

Purpose: The main goal in treating knee osteoarthritis (OA) is providing symptom relief, with a continued focus on easing joint pain and enabling mobility, in order for patients to go about daily activity. With the COVID-19 pandemic having impacted healthcare systems and regimes globally, the aim of this study is to understand how treatment management of knee OA patients and prescribing behavior across US healthcare professionals (HCPs) was affected, and how they adapt towards a potential ‘new norm’ in treating this condition. Methods: A cross-sectional chart review survey was conducted in both Q2 2019 and Q2 2020 among US board-certified rheumatologists (rheums), orthopedic surgeons (orthos), primary care physicians with a focus in sports medicine (SM PCPs), and pain specialists, all practicing across hospital and private practices. Recruited from a large access panel, physicians were screened for duration of practice in their specialty (3-50 years) and caseload (35 or more knee OA patients personally managed, at least 10 of which must be classified as moderate-severe). Participants were asked to complete a 3-part online survey: (1) a doctor demographic questionnaire, (2) a perceptual questionnaire, assessing perception of available and upcoming OA therapies, and (3) patient record charts for the next 5 knee OA patients seen following receipt of the survey, capturing demographics and treatment history. Data were analyzed using descriptive statistics. Results: The total number of sampled physicians recruited in this survey with their reported patient totals are stated in Table 1. [Formula presented] When focusing on the current prescription medication reported patients are receiving, oral medications, particularly NSAIDs, are widely used, regardless of the physician specialty. Here we see a directional increase in the proportion of reported patients deriving from sampled primary care SM PCPs from pre-COVID (Q219) to during COVID (Q220) (not statistically significantly different), whilst the same is not true for the other three secondary care sampled specialties, namely rheums, orthos and pain specialists (not statistically significantly different) - see Fig. 1. [Formula presented] [Formula presented] [Formula presented] Conclusions: From the sample surveyed, it appears that primary care SM PCPs adopted their treatment adjustment during COVID-19 pandemic differently, by prescribing more orals while other secondary care physicians (rheums, orthos, pain specialists) focused on injection treatment for longer pain relief. Considering movement restrictions and limited elective surgeries during the pandemic, the lack of targeted treatment options for knee OA has been made more apparent. With a burgeoning pipeline, many of which are targeted therapies, it is hopeful that knee OA treaters will be less reliant on symptom remedies and can readily offer patients’ longer-acting pain relief or disease modifying options to combat joint deterioration.

The Effects of the COVID-19 Lockdown on Severe Asthma in Patients Taking Biologic Therapy and Air Pollution in Riyadh (preprint)

Background:The curfews and lockdowns imposed during the COVID 19 pandemic may decreased volume of traffic and reduced air pollution. In addition, social distancing measures may contribute to reduce infection and asthma exacerbation.Objective:To assess asthma control and asthma medication use among sever asthmatics on biologics before and after COVID-19 pandemicMethod:This is a cross-sectional survey study of patients with severe asthma receiving biologic therapy at King Abdulaziz Medical City-Riyadh (KAMC-R), Saudi Arabia. We looked at the effects of the COVID19 lockdown on this cohort of sever asthmatics on biologic therapy from March till June 2020 over a period of 12 weeks. We investigated changes in patients symptoms and asthma control using the asthma control test (ACT) score and other parameters including, emergency department (ED) visits, hospitalizations, use of oral prednisolone, changes in inhaler therapy, frequency of bronchodilators use and patient perception of their symptoms before and after the lockdown period. Results:A total of 56, Female 39;(69%0; mean age ± SD 47.4 ± 13.8 years. The duration of bronchial asthma since diagnosis range from 4-30 years. Most patients had been treated with Omalizumab (47; 84%); the rest received Mepolizumab (7; 12.5%) and Dupilumab (2; 3.6%). All these patients had been on biologic therapy for 5 months, range from 5 to 120 months. Most of the patients (45; 80.4%) agreed that their symptoms of asthma had improved with biologic therapy. Most of the patients felt overall asthma symptoms is better after curfew and lockdown 28 (50%).   Less use of bronchodilators post curfew reported in 38% of the patients. Asthma control (≥20) using ACT score was significantly higher among patients in post curfew and lockdown period compared to pre curfew period 34(61.7%) and 23 (41%), (p.0.001) respectively.Conclusion: Asthma control was better post curfew and lockdown. Decrease in air pollution and social distances may be contribute factor.