Characteristics, Treatment, Outcomes, and Cause of Death of Invasively Ventilated Patients with COVID-19 ARDS in Asir Central Hospital: A Retrospective Single Center Experience (preprint)

Introduction: COVID-19's emergence caused devastating consequences worldwide, with high morbidity and mortality rates. Critically ill patients face challenges like acute respiratory failure requiring intensive measures, including mechanical ventilation. Mortality rates in ARDS are influenced by various factors. This paper focuses on describing characteristics, management, and survival factors of mechanically ventilated ICU patients in Saudi Arabia. Methods: a retrospective, noninterventional approach, we reviewed charts and data of all COVID-19-infected patients who were admitted to the ICU, particularly those requiring ventilation support at Aseer Central Hospital (ACH) in the southern region of Saudi Arabia. Results: The study enrolled 594 COVID patients, mean age 60.5 ± 17.3 years, with 67% males. Approximately half had O negative blood group. Common chronic health issues: diabetes mellitus (35.5%). Positive culture findings in almost 340 (57.2%), with Klebsiella pneumoniae being the most isolated microorganism (45.5%). Significant correlations found with mortality: age, blood culture, Rh positive group (P<0.05). Conclusion: this study provides critical insights into the clinical and epidemiological aspects of COVID-19 patients admitted to the ICU in a Saudi Arabian hospital. The research underscores the impact of age, comorbidities, laboratory markers, and treatment interventions on patient out-comes, emphasizing the significance of tailored management strategies in this context.

Real-Time Measurement of Psychological Impact Due to E- Learning, among the Undergraduate Dental Students during Covid-19

Objectives: To assess the psychological factors in undergraduate dental students towards e-learning in clinical skills education compared to traditional teaching methods and their relationship with performance during the COVID-19 pandemic. Method(s): In this study, survey conductedamong 494undergraduate dentalstudents of all four sessions from different dental universities within the Pakistan. Total 494 undergraduate dental students responded to a 28-question online survey to identify e- learning is more convenient and practicalthan traditional learning and to measure it 5- pointLikertScaleused. To measure level of psychological impact, Hamilton Anxiety Scale used due to e-learning among undergraduate dental students. Result(s): The majority of undergraduate dental student's responded e-learning is not convenient and practical than traditional learning system. The majority of undergraduate dentalstudents reportedveryseverelevelof psychologicalimpactdueto e-learning and closing of institutions during COVID-19 pandemic. Results are statistically significant and analyzed on IBM SPSS version 23. There are 82% students responded having problem with e-learning system and among them 58 % have very severe anxiety and 24% have severe anxiety. So the results shows increased percentage of anxiety due e-learning. Conclusion(s): Dental students expressed a higher level of comfort and effective learning in a recognizable, conventional classroom circumstance. Teaching with traditional system improvesstudent'scriticalthinkingskillsandformulatesopinionsorargumentsbyengaging in live discussions. This study reveals that students face challenges in using the e-learning resources because of incompetency in the IT skills, lack of motivation and access to proper internet. The most important issue identified by this study is maintaining an effective interaction with dental students in e-learning system of teaching to fill the gap between the teacher and students. There should be further flexibility workload and learning time to students to reduce the level of anxiety among the dental students.Copyright © 2020 Ubiquity Press. All rights reserved.

Willingness of Healthcare Workers to Recommend or Receive a Third COVID-19 Vaccine Dose: A Cross-Sectional Study from Jordan.

BACKGROUND: The availability of COVID-19 vaccines worldwide necessitates measuring healthcare workers' (HCWs') willingness to recommend or receive these vaccines. Therefore, we conducted a local study in Jordan to assess HCWs' willingness to recommend or receive a third dose of a COVID-19 vaccine and the predictors of such a decision. A cross-sectional study investigated Jordanian HCWs' willingness regarding a third dose of a COVID-19 vaccine using a self-administered online questionnaire through WhatsApp, a mobile phone application. A total of 300 HCWs participated in the current study. Of these HCWs, 65.3% were physicians, 25.3% were nurses, and 9.3% were pharmacists. HCWs' overall willingness regarding a third vaccine dose was 68.4% (49.4% certainly and 19.0% probably), whereas the overall willingness of HCWs to recommend a third dose to their patients was 73.3% (49.0% certainly and 24.3% probably). Males had significantly higher willingness than females (82.1% vs. 60.1%, p < 0.05). Physicians reported more willingness than nurses and pharmacists. HCWs' willingness was not significantly affected by direct contact with a patient infected with COVID-19 or by a personal history of COVID-19 infection. Only 31% of HCWs were certainly willing to recommend the vaccine to their patients with chronic diseases, and only 28% of the participants were certainly willing to recommend it to people aged 65 or older. HCWs' willingness to receive a third dose of a COVID-19 vaccine is limited in Jordan. This has affected their certainty in recommending this vaccine to their patients or people older than 60. Decision-makers and health-promotion programs in Jordan should focus on addressing this public health problem.

The Psychological Impact of COVID-19 Pandemic on Persons with Multiple Sclerosis in Saudi Arabia.

OBJECTIVES: To evaluate, in a Saudi Arabian context, how the COVID-19 pandemic psychologically impacted persons with multiple sclerosis (PwMS). METHODS: A cross-sectional study was undertaken during the period from October 2021 to March 2022. 738 participants resident in the Kingdom of Saudi Arabia (KSA) completed a self-administered online questionnaire. The research focused on persons diagnosed with MS. RESULTS: Participant ages spanned from 18 to over 55. The mean was 36.1±12.9 years old. Four hundred eighty-nine (66.3%) of the 738 participants were female. Two hundred sixty-four (35.8%) were single. Four hundred twelve (55.8%) were married. Six hundred eighty-five (92.8%) had received a COVID-19 vaccine. Regarding MS duration, 117 (15.9%) had been diagnosed for less than 2 years, 171 (23.2%) for 2-5 years, while 251 (34%) had the condition for 10 or more years. Regarding psychological health, 11.2% of participants complained of minimal/no depression, 33.3% of mild depression, 28.3% of moderate depression, and 27.1% of moderately severe to severe depression symptoms. Concerning anxiety, 17.2% of participants reported minimal anxiety, 36.9% mild, 23.3% moderate, while 22.6% suffered from severe anxiety symptoms. CONCLUSION: A high prevalence of depression and anxiety was found, along with high prevalence of co-occurrence of these disorders among PwMS.

Prognostic markers in patients with COVID-19 requiring intensive critical support

Objectives Several hematological and immunological markers, particularly neutrophil count, predict the severity of COVID-19. This study aimed at assessing hematological and coagulation parameters at different time points, to predict the complications or outcomes of patients with COVID-19 admitted to the intensive care unit (ICU). Methods We conducted a prospective observational multicenter study in ICU departments. A total of 118 patients with COVID-19 admitted to the ICU were included. Clinical data and blood samples from routine hematology and coagulation tests were collected at admission, and on days 3, 7, and 14. The main outcome measures were high-flow-O2 requirement, thrombosis, and 30-day mortality. Results The mean length of ICU stay for our cohort was 15.70 ± 19 days, and the median was 9 days. The length of stay was significantly prolonged in recovered patients (28.20 ± 29.90 days;chi-square P = 0.0022) and patients with thrombosis (34.40 ± 39.60 days;P = 0.024). A total of 113 (95.70%) patients received prophylactic anticoagulation after admission with different regimens;thrombosis was observed in four (3.90%) patients (P = 0.430), but none died. The venous thromboembolism score increased from a mean of 5.10 ± 2 on day 0 to 6.40 ± 2.80 on day 14 (P = 0.0002). The disseminated intravascular coagulation (DIC) score significantly correlated with thrombosis (P = 0.031). A total of 41.20% of patients in the ICU had a DIC score ≥4, and 11.40% had a score <4. Mortality was negatively associated with patients on high-flow O2, 9 patients (10.80%) (P = 0.040), and positively associated with patients receiving ventilation, 16 patients (27.50%) (P < 0.001). An increase in white blood cell count (subdistribution hazard ratio (SHR): 0.91;95% CI: 0.80–1) and neutrophil count (SHR: 1;95% CI: 1.01–1.05) was associated with greater disease severity and D-dimer level (SHR: 1.60;95% CI: 1.10–2.5). Conclusion The venous thromboembolism score was significantly higher for patients who died than those who recovered. Furthermore, mechanical ventilation was associated with high mortality, whereas the risk of thrombosis and ICU admission correlated with high D-dimer values and DIC scores. Therefore, D-dimer levels and DIC scores are prognostic markers that may predict disease severity in patients with COVID-19.

Assessment of Quality of the Electronic Education System in the Corona Crisis Period: Applied Study on Al al-Bayt University

In response to the coronavirus crisis, higher education institutions have partially or fully transformed into electronic education systems (EESs). This paper presents the results of a student survey conducted at AL al-Bayt University to assess the quality of the electronic educational system (EES) during the coronavirus pandemic. The study variables addressed by the questionnaire were tangible physical features (TPFs), flexibility (FEES), examination construction and management (ECM);admission, storage, and registration management (ASRM), security and privacy (S&P), learning site content (LSC);and students' level of satisfaction (LoS). The exploratory study methodology was applied to 324 students at AABU, where the research data were collected using a Google Docs questionnaire and distributed to students. The results highlighted that students were satisfied with the quality of EES implemented by AABU during the lockdown period in terms of tangible physical features (TPF) and learning site content (LSC) and there was a statistically significant relationship between TPF and LSC. However, some undesirable features were reported, such as a lack of adequate infrastructure for students, which enabled them to interact effectively with their teachers to gain the target of applying EES. Consequently, AABU needs to implement effective measures to improve and increase the quality and level of satisfaction with EES. Finally, electronic education is a more adapted, smooth, and affordable alternative than traditional face-to-face education. © 2023, International Journal of Interactive Mobile Technologies. All Rights Reserved.

Prognostic markers in patients with COVID-19 requiring intensive care support.

Objectives: Several hematological and immunological markers, particularly neutrophil count, predict the severity of COVID-19. This study aimed at assessing hematological and coagulation parameters at different time points, to predict the complications or outcomes of patients with COVID-19 admitted to the intensive care unit (ICU). Methods: We conducted a prospective observational multicenter study in ICU departments. A total of 118 patients with COVID-19 admitted to the ICU were included. Clinical data and blood samples from routine hematology and coagulation tests were collected at admission, and on days 3, 7, and 14. The main outcome measures were high-flow-O2 requirement, thrombosis, and 30-day mortality. Results: The venous thromboembolism score increased from a mean of 5.10 ± 2 on day 0 to 6.40 ± 2.80 on day 14 (P = 0.0002). The disseminated intravascular coagulation (DIC) score significantly correlated with thrombosis (P = 0.031). A total of 41.20% of patients in the ICU had a DIC score ≥4, and 11.40% had a score <4. Mortality was negatively associated with patients on high-flow O2, 9 patients (10.80%) (P = 0.040), and positively associated with patients receiving ventilation, 16 patients (27.50%) (P < 0.001). An increase in white blood cell count (subdistribution hazard ratio (SHR): 0.91; 95% CI: 0.80-1) and neutrophil count (SHR: 1; 95% CI: 1.01-1.05) was associated with greater disease severity and D-dimer level (SHR: 1.60; 95% CI: 1.10-2.5). Conclusion: The venous thromboembolism score was significantly higher for patients who died than those who recovered. Furthermore, mechanical ventilation was associated with high mortality, whereas the risk of thrombosis and ICU admission correlated with high D-dimer values and DIC scores. Therefore, D-dimer levels and DIC scores are prognostic markers that may predict disease severity in patients with COVID-19.

Do stock market fear and economic policy uncertainty co-move with COVID-19 fear? Evidence from the US and UK

Purpose: The purpose of the paper is to investigate co-movement of major implied volatility indices and economic policy uncertainty (EPU) indices with both the health-based fear index and market-based fear index of COVID-19 for the USA and the UK to help investors and portfolio managers in their informed investment decisions during times of infectious disease spread. Design/methodology/approach: This study uses wavelet coherence approach because it allows to observe lead–lag nonlinear relationship between two time-series variables and captures the heterogeneous perceptions of investors across time and frequency. The daily data used in this study about the USA and the UK covers major implied volatility indices, EPU, health-based fear index and market-based fear index of COVID-19 for both the first and second waves of COVID-19 pandemic over the period from March 3, 2020 to February 12, 2021. Findings: The results document a strong positive co-movement between implied volatility indices and two proxies of the COVID-19 fear. However, in all the cases, the infectious disease equity market volatility index (IDEMVI), the COVID-19 proxy, is more representative of the stock market and exhibits a stronger positive co-movement with volatility indices than the COVID-19 fear index (C19FI). This study also finds that the UK's implied volatility index weakly co-moves with the C19FI compared to the USA. The results show that EPU indices of both the USA and the UK exhibit a weak or no correlation with the C19FI. However, this study finds a significant and positive co-movement of EPU indices with IDEMVI over the short horizon and most of the sampling period with the leading effect of IDEMVI. This study's robustness analysis using partial wavelet coherence provides further strengths to the findings. Research limitations/implications: The investment decisions and risk management of investors and portfolio managers in financial markets are affected by the new information on volatility and EPU. The findings provide insights to equity investors and portfolio managers to improve their risk management practices by incorporating how health-related risks such as COVID-19 pandemic can contribute to the market volatility and economic risks. The results are beneficial for long-term equity investors, as their investments are affected by contributing factors to the volatility in US and UK's stock markets. Originality/value: This study adds following promising values to the existing literature. First, the results complement the existing literature (Rubbaniy et al., 2021c) in documenting that type of COVID-19 proxy matters in explaining the volatility (EPU) relationships in financial markets, where market perceived fear of COVID-19 is appeared to be more pronounced than health-based fear of COVID-19. Second, the use of wavelet coherence approach allows us to observe lead–lag relationship between the selected variables, which captures the heterogeneous perceptions of investors across time and frequency and have important insights for the investors and portfolio managers. Finally, this study uses the improved data of COVID-19, stock market volatility and EPU compared to the existing studies (Sharif et al., 2020), which are too early to capture the effects of exponential spread of COVID-19 in the USA and the UK after March 2020. © 2022, Emerald Publishing Limited.

Does Online Learning Impact Accounting Students' Performance? An Empirical Answer from Kuwait

This study aimed to empirically assess and document the impact of online learning on the academic performance of accounting students at a business college in Kuwait. The main value of this study would be its effort to fill some of the gaps in the existing local and regional remote (distance) accounting education literature as e-learning is considered to be a new phenomenon in most developing countries including Kuwait. A linear regression model (OLS), correlation, and t-tests analyses using a sample of 143 accounting students, who were enrolled before and during the COVID-19 pandemic, were used to test the study's hypotheses. The results indicate that there was a statistically significant association between learning systems (class delivery models) and accounting students' performance explaining the superiority of the academic performance of accounting students utilizing online learning over the performance of the same group of students using traditional learning and showing the significant impact of learning systems on accounting students' performance. The study concluded by considering the implications of these findings, which can provide decision-makers with a useful benchmark for improving accounting programs by considering online learning as an alternative system to traditional learning and provide insights for future academic research.

Students' perception of emergency remote teaching in the Sultanate of Oman

During the coronavirus disease 2019 (COVID-19) pandemic, educational institutions adopted emergency remote teaching (ERT) practices. In ERT, courses are taught online by teachers who have experience with face-to-face classroom instruction. Students and teaching staff were concerned about the sudden change to ERT and learning practices. Higher education institutions (HEIs) need to understand students' perceptions of ERT in order to prepare appropriate strategies for online teaching and learning. This study is intended: i) to analyze the students' perception of ERT and ii) to explore the factors that determine the effectiveness of ERT during pandemic periods. The researchers used an online survey method to collect the primary data by employing a structured questionnaire. They employed the purposive sampling technique for this study. The results of the study highlight the fact that students prefer to take advantage of the available learning opportunities during the pandemic period. This is because they can earn their academic qualifications on time. It is also evident that the sudden transition to online teaching did compromise the efficacy of academic delivery to a certain extent. The study also found that motivation and assessment were crucial factors in determining the effectiveness of ERT during the pandemic period. © 2023, Institute of Advanced Engineering and Science. All rights reserved.

Perspectives on cyberlearning: A case study by students, about students.

This paper reports on a study conducted by college students at a private university in Saudi Arabia. The research examines the online learning experiences of their peers during the first wave of the coronavirus covid-19 pandemic. Many assumptions exist about online learning and its impact in higher education, but these are mainly based on the views of instructors and leaders of institutions. Hitherto, the perspectives of those meant to be beneficiaries of digital technologies have been given little consideration even though students use cyberspace for academic work and beyond. To address this silence, a group of student-researchers conducted a case study to examine students' views of cyberlearning. The research used a qualitative analysis approach to address the following questions: (1) What were the cyberlearning experiences of students at our university during the first two semesters of lockdown? (2) What are students' understandings of cyberlearning? (3) What are their aspirations for cyberlearning? Data were collected through an online survey administered to the entire student body at the university. Responses were received from 3574 students. The data were analysed using thematic analysis. The research participants perceive cyberlearning to be the same as online learning and see it as a viable educational option. They reported that the dominant mode of instruction in online classrooms is instructors delivering information. Respondents also highlighted the need for improved online teaching pedagogies and curbing academic dishonesty in online classrooms. Students' aspirations for cyberlearning were clearly articulated. Respondents suggested that increasing online learning opportunities would have a positive impact on their academic progress. Through this research students demonstrate a sense of agency and provide opportunities for equity strategies at their university. The results show that serious attempts should be made to include cyberlearning as part of everyday educational activity in an attempt to increase student engagement.

Digital information channels during the COVID-19 global health emergency through a situational awareness lens: a study of Pakistani citizens

PurposeThe main aim of this study was to know the role of digital information and communication channels in developing citizens' understanding regarding COVID-19 with reference to situation awareness. Furthermore, the impact of gender, age, qualification and area of respondents on citizens' perception and comprehension of COVID-19 was also investigated. Design/methodology/approachThis quantitative study used an online survey and received 377 usable responses. The instrument was developed with the help of literature, and it was based on two constructs (perception of the element and comprehension of the current situation) of the situational awareness (SA) model. Data were collected from Pakistani citizens through a convenient sampling technique. FindingsIt was observed that the majority of citizens used electronic media, Facebook and WhatsApp for accessing COVID-19-related information. World Health Organization website played an important role in developing citizens' understanding. Alert messages through mobile phone and apps played role in developing citizen's understanding regarding COVID-19 situation. They perceived that media was effective in providing social distancing techniques. Moreover, they believed that government campaigns were helpful. Findings revealed that there was no significant impact of gender, age, qualification and area on citizens' perceptions and comprehension of COVID-19 through media. Originality/valueThis study is helpful for authorities in decision-making regarding COVID-19 and also filled the literature gap as, to the best of the authors' knowledge, no comprehensive study has been conducted regarding the SA of COVID-19.

Prolonged Versus Standard Prone Position in Covid-19 Ventilated Patients: A Quasi-Experimental Study

INTRODUCTION: Acute respiratory distress syndrome (ARDS) related to COVID-19 increased the number of patients requiring prone position ventilation (PPV). The ProSEVA PPV strategy of daily reproning is resource intensive because each complete PPV cycle takes half an hour of work from 4 experienced operators. Therefore the Standard PPV was extended until 24 to 48 hours. In 2021 Douglas et al. propose the Prolonged PPV strategy for COVID-19 ARDS, returning to the supine position only when the patient has stable gas exchange (Fio2< 60% with PEEP< 10cmH2O). This strategy was secure, but they did not compare the clinical outcomes of the Prolonged against the Standard PPV. In this study, we compare the number of PPV cycles and pressure wounds (PWs) in COVID-19 patients with Standard PPV vs. Prolonged PPV. METHOD(S): Quasi-experimental before-and-after study. We included ventilated patients with PPV indication (criteria from the ProSEVA Trial). Between October 1, 2020, to April 30, 2021, patients with indication of PPV received the standard PPV (24 to 48 hs), and patients hospitalized between May 1, 2021, to October 1, 2021, were treated with the Prolonged PPV. For the primary outcome (number of PPV cycles), we compare the proportion of patients with more than 2 PPV cycles in each group. As a sensitivity analysis, we performed a Fine and Gray regression adjusting by confounders, considering death as a competing event, two PPV cycles as the event, and censoring patients with one PPV cycle at ICU discharge. RESULT(S): We included 64 patients in the Standard PPV group and 16 in the Prolonged PPV group. No differences were observed in the number of PPV cycles between groups (patients with more than one cycle: 42.2% [n=27] vs. 62.5% [n=10];p=0.18). These observations were robust to the sensitivity analysis (the adjusted sHR to have two PPV cycles for the Prolonged PPV group was 1.31 [CI95% 0.63-2.71;p=0.46]). Patients in Prolonged PPV had 2.96 (IQR1.98-3.42) days in PPV vs. 1.98 (IQR1.38-2.94) in the Standard PPV (p=0.03). Chest and abdominal PWs were more frequently in the Prolonged PPV group (chest wounds: 5 patients [31.5%] vs 5 [7.8%];p=0.024 - abdominal: 3 [18.8%] vs 2 [3.12%];p=0.02). CONCLUSION(S): The Prolonged PPV increases the time in PPV and the PPV-associated PWs but does not reduce the total PPV cycles.

Discrimination and Calibration of Predictive Scores of Mortality in Ecmo for Patients with Covid-19

INTRODUCTION: The criteria for the COVID-19 patients' selection that benefit most from ECMO therapy are yet to be defined. In this study, we evaluate the predictive performance of the ECMO mortality predictive models in patients with COVID-19. METHOD(S): A retrospective study was performed in two high-complexity hospitals between March 18, 2020, and December 31, 2021. We included patients over 18 years old with COVID-19 infection confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) who received V-V ECMO due to COVID-19-related ARDS. We evaluated the predictive performance (discrimination, calibration, and accuracy) of death prediction of the following predictive models: i) Prediction of Death due to Severe ARDS in V-V ECMO score (PRESERVE);ii) The Respiratory Extracorporeal Membrane Oxygenation Survival Score (RESP) score;iii) Prediction of Survival on ECMO Therapy- Score (PRESET) score, to predict death. Also, we perform a cost-benefit analysis using the health-related quality of life reported by the CESAR TRIAL and the US life expectancy. Besides, we add the mortality predicted probability calculated with the best predictive model to the cost-benefit analysis. Therefore, the cost/QALY formula was: cost/QALY = cost / age-specific life expectancy*health utilitiesz.ast;survival probability. RESULT(S): We included 38 adult patients who received ECMO due to COVID-19. The PRESET score had the highest discrimination (AUROCs 0.81 [CI95% 0.67-0.94]) and the best calibration (Hosmer-Lemeshow test, p=0.6). The optimal threshold for this score was 7 (sensitivity 67%, specificity 89%, accuracy 78%). The cost per QALY in the USA, adjusted to life expectancy, was higher than UDS 100,000 in patients older than 45 years with a PRESET>10. CONCLUSION(S): The PRESET score had the highest predictive performance and could help in the patient's selection that benefits most from this resource-demanding and highly invasive therapy. Also, the addition of the costbenefit analysis output can help decide which patient to place on ECMO therapy, especially in low-resource settings.

Covid-19 Vaccine Protection against Mortality in Patients with Oxygen: A Multicontinental Study

INTRODUCTION: The COVID-19 vaccines have effectiveness above 90% for avoiding hospitalization. However, 5% of vaccinated patients require hospitalization with a mortality ratio between 15% to 24%, similar to the one reported for unvaccinated hospitalized patients. These vaccinated patients belong to the most sensitive groups with a high comorbidity burden. The similarity in the mortality ratio between vaccinated and unvaccinated patients has been used to make claims against the vaccine's efficacy. A thoughtful analysis, taking into account the comorbidities of each group, on how vaccination protects patients with moderate or severe illness, is missing. METHOD(S): We perform a multi-continental retrospective cohort study in 111 hospitals in Spain and 37 in Argentina. We included hospitalized patients who received oxygen therapy older than 18 years with COVID-19. To assess the relation between COVID-19 vaccine status and death, we performed a logistic regression adjusting by confounders. Also, as a sensitivity analysis, we perform a propensityscore matching. Additionally, we studied the Population Attributable Risk (PAR). RESULT(S): Between January 2020 and May 2022, we included 21,479 patients, 717 (3 3%) were vaccinated. Hospitalized vaccinated patients with oxygen therapy had a higher proportion of comorbidities. The overall mortality in vaccinated patients was 20 9%, and 19 5% in unvaccinated patients. The crude Odds Ratio was 1 07 (IC95% 0 89-1 29;p=0 41), while the adjusted was 0 73 (IC95% 0 56-0 95;p=0 02) in the complete case analysis (6,352 patients) and 0 77 (CI 95% 0 54-0 97;p=0 02) in the complete dataset after multiple imputations. These observations were robust to the sensitivity analysis. The adjusted PAR reduction was 4 3% (95%CI 1%-5%). Therefore, as the death proportion in unvaccinated patients was 19 6% (95%CI 19%-20 1%), if they were vaccinated the expected death proportion would have been 15 3% (95%CI 12 9%-18%;p< 0 01). CONCLUSION(S): Even with the high protection of the COVID-19 vaccine, patients with a high burden of comorbidities will be hospitalized in future pandemic waves. In this study, we observed that the COVID-19 vaccines significantly reduce the probability of death even when lung inflammation has already been initiated, with moderate or severe COVID-19 disease.

A Global Survey of Impact of Violence against Healthcare Workers in Critical Care Settings: Vishwas

INTRODUCTION: A rise in the incidents of violence against Health Care Workers (HCWs) in recent years calls for improvement in modes of spreading awareness and educating the public. We aimed to conduct a large global cross-sectional survey called ViSHWaS- Violence Study of Healthcare Workers and Systems in the departments of Anesthesiology, Critical Care Medicine, and Emergency medicine. METHOD(S): A global survey after tool validation, was created using REDCap forms and distributed from June 5th to July 24th, 2022. Communication tools including emails, phone calls, SMS, and social media applications like WhatsApp, Twitter, and LinkedIn were used in securing responses. This study was deemed eligible for category-2 Institutional Review Board exempt status. RESULT(S): Total of 598 responses from 69 countries, out of these 445 (74%) were complete. The maximum responses were from India (N=49), followed by the USA (N=44) and while those from the other 67 countries ranged from N=1-30. Out of these, 221 (50%) were female, the majority (56%) were in the 26-35 years category, followed by (19%) in 36-45 years. The participants encompassed 156 (35%) consultants, 97 (22%) nurses and the rest were residents/fellows in training, auxiliary/ staff, advanced registered nurse practitioners (ARNP), physician assistants (PA), researcher and others. The vast majority (73%) reported facing violence within the past year;Verbal (63%) and physical (39%) were the most commonly reported. Total 126 (28.3%) reported that patient and/or family member as the type of aggressor they/ their colleague encountered most frequently. A majority (75%) reported that the incidence of violence has either stayed the same (39%) or increased (36%) during COVID-19 pandemic. Because of violent episodes, 48% felt less motivated/ had decreased job satisfaction;an additional 25% were willing to quit. While half of respondents were familiar with Occupational Safety and Health standards, only 20% felt prepared to handle aggressive situation. CONCLUSION(S): In this global cross-sectional survey, a majority of HCWs reported to have faced violence. They felt that it either increased or stayed the same during the COVID-19 pandemic. It has led to decreased job satisfaction. Majority of those, who responded, felt unprepared to handle the violence.

Tackling a post-COVID-19 cholecystectomy waiting list, are we meeting the challenge?

Background: The COVID-19 pandemic has led to a tremendous backlog in elective surgical activity, with over six million people on waiting lists and only 64% of patients meeting the 18-week elective standard. Our Hospital Trust adopted an innovative approach to dealing with elective waiting times for cholecystectomy during the recovery phase from COVID-19. This study aimed to evaluate trends in overall cholecystectomy activity and the effect on waiting times. Method(s): A prospective observational study was undertaken investigating patients who received a cholecystectomy at large UK hospital Trust, between February 2021 and February 2022. There were multiple phased strategies to tackle a 533 patient waiting list: Private sector, multiple sites including emergency operating, mobile theatre, and seven-day working. An additional 364 patients were added and 145 removed, for multiple reasons, from the list during the study period. Correlation of determination (R2) and Kruskal-Wallis analysis were used to evaluate trends in waiting times across the study period. Result(s): 657 patients underwent a procedure, of which 628 (95.6%) were completed electively. The median age was 49 years, 602 (91.6%) patients had an ASA of 1-2, and 494 (75.2%) were female. Thirty (4.6%) patients were listed post gallstone pancreatitis, 380 (57.8%) for cholelithiasis, and 228 (34.7%) for cholecystitis. The median length of stay was zero days (IQR 0-1), with 30-day complication (C-D >=3, 1.8%), readmission (3.0%) and mortality (0.0%) rates noted. The current waiting list includes 95 patients, with median waiting times reduced from 428 days (IQR 373-508) to 49 (IQR 34-96), R2=0.654, p<0.001. For pancreatitis specifically, waiting times have dropped from a median of 218 days (IQR 139-239) to 28 (IQR 24-40), R2=0.613, p<0.001. Conclusion(s):We have safely and effectively tackled the cholecystectomy waiting list locally utilising a number of phased strategies. Significant progress is being made towards once again meeting the gold-standard target for gallstone pancreatitis patients. The approach utilised here has potential to be adapted to other units, or other operation types in order to reduce elective waiting times.We have safely and effectively tackled the cholecystectomy waiting list locally utilising a number of phased strategies. Significant progress is being made towards once again meeting the gold-standard target for gallstone pancreatitis patients. The approach utilised here has potential to be adapted to other units, or other operation types in order to reduce elective waiting times.

Single-chirality of single-walled carbon nanotubes (SWCNTs) through chromatography and its potential biological applications

The separation of highly pure single-chirality single-walled carbon nanotubes (SWCNTs) is challenging and also in demand due to their intrinsic physical, optical, and electronic properties. The use of single-chirality and their performance characteristics makes them a selective candidate for multifunctional applications and opens a new front in nanotube development. It has previously been reported that SWCNTs can be separated in various ways by employing direct control and post-synthesis approaches. Herein, we review the separation of single-chiralities of SWCNTs on account of simplicity and time/cost effectiveness by using gel chromatography. The most recent progress in the controlled synthesis of SWCNTs is comprehensively reviewed in terms of selective-diameter, single-chirality, and specific geometric shape. The method to achieve the single-chirality of SWCNTs is also highlighted. Besides addressing COVID-19 characteristics, epidemiology, and pathology, we also review the most recent developments in nano-biosensors for the rapid and early detection of COVID-19. Furthermore, the photothermal/bioimaging response of single-chirality is reviewed in order to enhance the cytotoxicity of drugs against cancer cells over simple carbon nanotubes (CNTs). The single-chirality allows for precise imaging (due to efficient absorption and emission) of tumors/blood vessels up to ~10-fold higher by injecting a low dose. We hope this review stimulates further study on single-chirality controlled SWCNTs for practical applications. Copyright © 2023 The Royal Society of Chemistry.