Kidney Health and Care: Current Status, Challenges, and Developments.

The concept of chronic kidney disease (CKD) originated in the 2000s, and an estimated 850 million patients are currently suffering from health threats from different degrees of CKD. However, it is unclear whether the existing CKD care systems are optimal for improving patient prognosis and outcomes, so this review summarizes the burden, existing care models, effectiveness, challenges, and developments of CKD care. Even under the general care principles, there are still significant gaps in our understanding of the causes of CKD, prevention or care resources, and care burdens between countries worldwide. Receiving care from multidisciplinary teams rather than only a nephrologist shows potential profits in comprehensive and preferable outcomes. In addition, we propose a novel CKD care structure that combines modern technologies, biosensors, longitudinal data visualization, machine learning algorithms, and mobile care. The novel care structure could simultaneously change the care process, significantly reduce human contact, and make the vulnerable population less likely to be exposed to infectious diseases such as COVID-19. The information offered should be beneficial, allowing us to rethink future CKD care models and applications to reach the goals of health equality and sustainability.

Reduction of Viral and Bacterial Activity by Using a Self-Powered Variable-Frequency Electrical Stimulation Device.

Viruses and bacteria, which can rapidly spread through droplets and saliva, can have serious effects on people's health. Viral activity is traditionally inhibited using chemical substances, such as alcohol or bleach, or physical methods, such as thermal energy or ultraviolet-light irradiation. However, such methods cannot be used in many applications because they have certain disadvantages, such as causing eye or skin injuries. Therefore, in the present study, the electrical stimulation method is used to stimulate a virus, namely, coronavirus 229E, and two types of bacteria, namely, Escherichia coli and Staphylococcus aureus, to efficiently reduce their infectivity of healthy cells (such as the Vero E6 cell in a viral activity-inhibition experiment). The infectivity effects of the aforementioned virus and bacteria were examined under varying values of different electrical stimulation parameters, such as the stimulation current, frequency, and total stimulation time. The experimental results indicate that the activity of coronavirus 229E is considerably inhibited through direct-current pulse stimulation with a current of 25 mA and a frequency of 2 or 20 Hz. In addition, E. coli activity was reduced by nearly 80% in 10 s through alternating-current pulse stimulation with a current of 50 mA and a frequency of 25 Hz. Moreover, a self-powered electrical stimulation device was constructed in this study. This device consists of a solar panel and battery to generate small currents with variable frequencies, which has advantages of self-powered and variable frequencies, and the device can be utilized on desks, chairs, or elevator buttons for the inhibition of viral and bacterial activities.

Internet searches for "insomnia" and "suicide" mediated by stay-at-home behaviors in 45 countries during the first 12 months of the COVID-19 pandemic.

BACKGROUND: This study aimed to investigate (1) the mental health impacts (i.e., insomnia and suicide ideas) of the COVID-19 pandemic and (2) the mediation effects of stay-at-home levels on those impacts. METHODS: This study investigated monthly national COVID-19 deaths, stay-at-home levels, and internet searches for words for "insomnia" and "suicide" across 45 countries during the first year of the COVID-19 pandemic (March 1, 2020, to February 28, 2021). We used the changes of internet search volumes for "insomnia" and "suicide" (from the Google Trends database) to represent the mental health impacts, and the time of cell phone activity at the residence (from Google Location History) to estimate the stay-at-home effects. We computed the proportion mediated (PM) caused by stay-at-home levels in the COVID-19 impacts on insomnia and suicide ideas, respectively. RESULTS: Throughout the first year of the COVID-19 pandemic, national COVID-19 deaths significantly correlated to increased internet searches for "insomnia" but decreased searches for "suicide". In addition, the mediation effect was significant in the first six-month of COVID-19-related increases in insomnia (PM = 42.6 %, p = 0.016), but this effect was not significant (PM = 13.1 %, p = 0.270) in the second six-month. By contrast, the mediation effect was not significant in the first six-month of COVID-19-related decrease in suicide ideation (PM = 8.1 %, p = 0.180), but this effect was significant (PM = 39.6 %, p = 0.014) in the second six-month. CONCLUSIONS: Stay-at-home levels significantly mediated both increased insomnia and decreased suicide ideas, but within different time frames.

Utilizing Internet Search Volume to Monitor Stages of Change in Vaccine Hesitancy During the COVID-19 Outbreaks

Real-time vaccine hesitancy surveillance is needed to better understand changes in vaccination behaviors. We aim to understand the association between coronavirus disease 2019 (COVID-19) outbreaks and population vaccine hesitancy and to monitor the dynamic changes in vaccination behaviors. We used the autoregressive integrated moving average model to examine the association between daily internet search volume for vaccines and two waves of COVID-19 local outbreaks in Taiwan from 19 March to 25 May, 2021. During the small-scale outbreak, the search volume increased significantly for 7 out of 22 days with an average increase of 17.3% ± 10.7% from the expected search volume. During the large-scale outbreak, the search volume increased significantly for 14 out of 14 days, with an average increase of 58.4% ± 14.7%. There was a high correlation between the search volume and the number of domestic cases (r = 0.71, P < 0.001). Google Trends serves as a timely indicator to monitor the extent of population vaccine willingness.

A comprehensive evaluation of COVID-19 policies and outcomes in 50 countries and territories.

The COVID-19 pandemic struck the world unguarded, some places outperformed others in COVID-19 containment. This longitudinal study considered a comparative evaluation of COVID-19 containment across 50 distinctly governed regions between March 2020 and November 2021. Our analysis distinguishes between a pre-vaccine phase (March-November 2020) and a vaccinating phase (December 2020-November 2021). In the first phase, we develop an indicator, termed lockdown efficiency (LE), to estimate the efficacy of measures against monthly case numbers. Nine other indicators were considered, including vaccine-related indicators in the second phase. Linear mixed models are used to explore the relationship between each government policy & hygiene education (GP&HE) indicator and each vital health & socioeconomic (VH&SE) measure. Our ranking shows that surveyed countries in Oceania and Asian outperformed countries in other regions for pandemic containment prior to vaccine development. Their success appears to be associated with non-pharmaceutical interventions, acting early, and adjusting policies as needed. After vaccines have been distributed, maintaining non-pharmacological intervention is the best way to achieve protection from variant viral strains, breakthrough infections, waning vaccine efficacy, and vaccine hesitancy limiting of herd immunity. The findings of the study provide insights into the effectiveness of emerging infectious disease containment policies worldwide.

Google searches for the keywords of "wash hands" predict the speed of national spread of COVID-19 outbreak among 21 countries.

This study hypothesized that national population health literacy might reflect on their keywords searching. We applied Google searches for "wash hands" and "face mask" during January 19 to February 18 as a surrogate of national population health literacy among 21 countries, and examine whether google searches for "wash hands" and "face masks" would protect from increased numbers of confirmed cases of among 21 countries We found the increased google searches for "wash hands" from January 19 to February 18, 2020, correlated with a lower spreading speed of COVID-19 from February 19 to March 10, 2020 among 21 countries (Pearson's correlation coefficient of -0.70, P < 0.001). The result highlights the importance of public awareness of hand washing in preventing COVID-19 disease spreading.

Efficiency and Quality of Data Collection Among Public Mental Health Surveys Conducted During the COVID-19 Pandemic: Systematic Review.

BACKGROUND: The World Health Organization has recognized the importance of assessing population-level mental health during the COVID-19 pandemic. During a global crisis such as the COVID-19 pandemic, a timely surveillance method is urgently needed to track the impact on public mental health. OBJECTIVE: This brief systematic review focused on the efficiency and quality of data collection of studies conducted during the COVID-19 pandemic. METHODS: We searched the PubMed database using the following search strings: ((COVID-19) OR (SARS-CoV-2)) AND ((Mental health) OR (psychological) OR (psychiatry)). We screened the titles, abstracts, and texts of the published papers to exclude irrelevant studies. We used the Newcastle-Ottawa Scale to evaluate the quality of each research paper. RESULTS: Our search yielded 37 relevant mental health surveys of the general public that were conducted during the COVID-19 pandemic, as of July 10, 2020. All these public mental health surveys were cross-sectional in design, and the journals efficiently made these articles available online in an average of 18.7 (range 1-64) days from the date they were received. The average duration of recruitment periods was 9.2 (range 2-35) days, and the average sample size was 5137 (range 100-56,679). However, 73% (27/37) of the selected studies had Newcastle-Ottawa Scale scores of <3 points, which suggests that these studies are of very low quality for inclusion in a meta-analysis. CONCLUSIONS: The studies examined in this systematic review used an efficient data collection method, but there was a high risk of bias, in general, among the existing public mental health surveys. Therefore, following recommendations to avoid selection bias, or employing novel methodologies considering both a longitudinal design and high temporal resolution, would help provide a strong basis for the formation of national mental health policies.

Increased Internet Searches for Insomnia as an Indicator of Global Mental Health During the COVID-19 Pandemic: Multinational Longitudinal Study.

BACKGROUND: Real-time global mental health surveillance is urgently needed for tracking the long-term impact of the COVID-19 pandemic. OBJECTIVE: This study aimed to use Google Trends data to investigate the impact of the pandemic on global mental health by analyzing three keywords indicative of mental distress: "insomnia," "depression," and "suicide." METHODS: We examined increases in search queries for 19 countries. Significant increases were defined as the actual daily search value (from March 20 to April 19, 2020) being higher than the 95% CIs of the forecast from the 3-month baseline via ARIMA (autoregressive integrated moving average) modeling. We examined the correlation between increases in COVID-19-related deaths and the number of days with significant increases in search volumes for insomnia, depression, and suicide across multiple nations. RESULTS: The countries with the greatest increases in searches for insomnia were Iran, Spain, the United States, and Italy; these countries exhibited a significant increase in insomnia searches on more than 10 of the 31 days observed. The number of COVID-19-related deaths was positively correlated to the number of days with an increase in searches for insomnia in the 19 countries (ρ=0.64, P=.003). By contrast, there was no significant correlation between the number of deaths and increases in searches for depression (ρ=-0.12, P=.63) or suicide (ρ=-0.07, P=.79). CONCLUSIONS: Our analysis suggests that insomnia could be a part of routine mental health screening during the COVID-19 pandemic.

Border Quarantine Measures and Achievement of COVID-19 Control in Taiwan

Since December 21, 2019, on-board inspection had been implemented on direct flights from Wuhan, China, marking the beginning of boarder quarantine challenges in respond to COVID-19 pandemic. In line with the development of the international epidemic, the Central Epidemic Command Center gradually expanded entry restrictions and post-entry quarantine requirements. Since March 19, 2020, all foreign nationals had been prohibited from entering Taiwan. Passengers eligible for entry were required to undergo home quarantine for 14 days. Upon arrival, passengers were required to declare their symptoms and travel history, and to receive fever screening and health assessment. Throat swab specimens were collected from those who presented symptoms at the airport or in the hospital, and then these passengers stayed in a centralized quarantine facility to wait for testing results. In addition, aiming at reducing risks originated from crowds and frequent movement, only aircrafts from five airports in China were allowed to enter Taiwan. Also, all connecting flights were suspended, and cruises and cross-strait passenger liners were banned from calling at ports of Taiwan. For front-line officers at ports of entry, health monitoring and protection guidelines were developed to protect their safety. In order to ensure safety and security of air and sea transport, the competent authorities in charge of transportation have established an epidemic prevention and management mechanism for air and sea transport respectively. Over 184,000 home quarantine notices had been issued by border quarantine authorities. More than 80% of the inbound travelers completed the declaration via Entry Quarantine System, greatly improving timeliness and accuracy of information required for further epidemic prevention and control in community. With on-board quarantine and health surveillance system for entry, not only the first confirmed case in Taiwan, but also more than one-third of imported cases were detected through border quarantine, sparing more capacity for domestic response and preparedness for medical resources and medical systems and therefore alleviating pressure on epidemic prevention and control in the community. Despite continuous and serious epidemic and significant challenges ahead, Taiwan keeps on implementing various quarantine measures in accordance with the principle of ＂strict risk control at border ＂ to comprehensively protect border security.

Quarantine measures for coronavirus disease 2019 on a cruise ship, Taiwan, February 2020.

To early detect coronavirus disease 2019 on an international cruise ship and prevent its spread, Taiwan's Central Epidemic Command Center implemented on-board quarantine measures on a cruise ship docked at the Port of Keelung, Taiwan, on February 8, 2020. Quarantine officers, medical professionals, and administrative staff from competent authorities conducted fever screening and investigated the present illness and travel history of 1738 passengers and 776 crew members on the ship. Throat swabs were collected from 128 (5.1%) passengers and crew members with fever or respiratory symptoms during the past 14 days or travel history to China, Hong Kong, or Macao within 30 days. All swabs tested negative for severe acute respiratory syndrome coronavirus 2 at the national reference laboratory. The whole process, from on-board preparation to the completion of testing, took 9 h. All passengers and crew were permitted to disembark and were required to take 14-day self-health management measures. No cases were reported by the end of the self-health management period.