Global Consciousness Predicts Behavioral Responses to the COVID-19 Pandemic: Empirical Evidence From 35 Cultures.

COVID-19 has drastically changed human behaviors and posed a threat to globalism by spurring a resurgence of nationalism. Promoting prosocial behavior within and across borders is of paramount importance for global cooperation to combat pandemics. To examine both self-report and actual prosocial behavior, we conducted the first empirical test of global consciousness theory in a multinational study of 35 cultures (N = 18,171 community adults stratified by age, gender, and region of residence). Global consciousness encompassed cosmopolitan orientation, identification with all humanity, and multicultural acquisition, whereas national consciousness reflected ethnic protection. Both global consciousness and national consciousness positively predicted perceived risk of coronavirus and concern about coronavirus, after controlling for interdependent self-construal. While global consciousness positively predicted prosocial behavior in response to COVID-19, national consciousness positively predicted defensive behavior. These findings shed light on overcoming national parochialism and provide a theoretical framework for the study of global unity and cooperation.

Outcomes Following Extracorporeal Membrane Oxygenation for Severe COVID-19 in Pregnancy or Post Partum.

Importance: Existing reports of pregnant patients with COVID-19 disease who require extracorporeal membrane oxygenation (ECMO) are limited, with variable outcomes noted for the maternal-fetal dyad. Objective: To examine maternal and perinatal outcomes associated with ECMO used for COVID-19 with respiratory failure during pregnancy. Design, Setting, and Participants: This retrospective multicenter cohort study examined pregnant and postpartum patients who required ECMO for COVID-19 respiratory failure at 25 hospitals across the US. Eligible patients included individuals who received care at one of the study sites, were diagnosed with SARS-CoV-2 infection during pregnancy or up to 6 weeks post partum by positive nucleic acid or antigen test, and for whom ECMO was initiated for respiratory failure from March 1, 2020, to October 1, 2022. Exposures: ECMO in the setting of COVID-19 respiratory failure. Main outcome and measures: The primary outcome was maternal mortality. Secondary outcomes included serious maternal morbidity, obstetrical outcomes, and neonatal outcomes. Outcomes were compared by timing of infection during pregnancy or post partum, timing of ECMO initiation during pregnancy or post partum, and periods of circulation of SARS-CoV-2 variants. Results: From March 1, 2020, to October 1, 2022, 100 pregnant or postpartum individuals were started on ECMO (29 [29.0%] Hispanic, 25 [25.0%] non-Hispanic Black, 34 [34.0%] non-Hispanic White; mean [SD] age: 31.1 [5.5] years), including 47 (47.0%) during pregnancy, 21 (21.0%) within 24 hours post partum, and 32 (32.0%) between 24 hours and 6 weeks post partum; 79 (79.0%) had obesity, 61 (61.0%) had public or no insurance, and 67 (67.0%) did not have an immunocompromising condition. The median (IQR) ECMO run was 20 (9-49) days. There were 16 maternal deaths (16.0%; 95% CI, 8.2%-23.8%) in the study cohort, and 76 patients (76.0%; 95% CI, 58.9%-93.1%) had 1 or more serious maternal morbidity events. The largest serious maternal morbidity was venous thromboembolism and occurred in 39 patients (39.0%), which was similar across ECMO timing (40.4% pregnant [19 of 47] vs 38.1% [8 of 21] immediately postpartum vs 37.5% postpartum [12 of 32]; P > .99). Conclusions and Relevance: In this multicenter US cohort study of pregnant and postpartum patients who required ECMO for COVID-19-associated respiratory failure, most survived but experienced a high frequency of serious maternal morbidity.

Implicit intertemporal trajectories in cognitive representations of the self and nation.

Individual selves and the collectives to which people belong can be mentally represented as following intertemporal trajectories-progress, decline, or stasis. These studies examined the relation between intertemporal trajectories for the self and nation in American and British samples collected at the beginning and end of major COVID-19 restrictions. Implicit temporal trajectories can be inferred from asymmetries in the cognitive availability of positive and negative events across different mentally represented temporal periods (e.g., memory for the past and the imagined future). At the beginning of COVID-19 restrictions, both personal and collective temporal thought demonstrated implicit temporal trajectories of decline, in which future thought was less positive than memory. The usually reliable positivity biases in personal temporal thought may be reversable by major public events. This implicit trajectory of decline attenuated in personal temporal thought after the lifting of COVID-19 restrictions. However, collective temporal thought demonstrated a pervasive negativity bias across temporal domains at both data collection points, with the collective future more strongly negative than collective memory. Explicit beliefs concerning collective progress, decline, and hope for the national future corresponded to asymmetries in the cognitive availability of positive and negative events within collective temporal thought.

A randomized controlled trial to evaluate outcomes with Aggrenox in patients with SARS-CoV-2 infection.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is an immunoinflammatory and hypercoagulable state that contributes to respiratory distress, multi-organ dysfunction, and mortality. Dipyridamole, by increasing extracellular adenosine, has been postulated to be protective for COVID-19 patients through its immunosuppressive, anti-inflammatory, anti-coagulant, vasodilatory, and anti-viral actions. Likewise, low-dose aspirin has also demonstrated protective effects for COVID-19 patients. This study evaluated the effect of these two drugs formulated together as Aggrenox in hospitalized COVID-19 patients. METHODS: In an open-label, single site randomized controlled trial (RCT), hospitalized COVID-19 patients were assigned to adjunctive Aggrenox (Dipyridamole ER 200mg/ Aspirin 25mg orally/enterally) with standard of care treatment compared to standard of care treatment alone. Primary endpoint was illness severity according to changes on the eight-point COVID ordinal scale, with levels of 1 to 8 where higher scores represent worse illness. Secondary endpoints included all-cause mortality and respiratory failure. Outcomes were measured through days 14, 28, and/or hospital discharge. RESULTS: From October 1, 2020 to April 30, 2021, a total of 98 patients, who had a median [IQR] age of 57 [47, 62] years and were 53.1% (n = 52) female, were randomized equally between study groups (n = 49 Aggrenox plus standard of care versus n = 49 standard of care alone). No clinically significant differences were found between those who received adjunctive Aggrenox and the control group in terms of illness severity (COVID ordinal scale) at days 14 and 28. The overall mortality through day 28 was 6.1% (3 patients, n = 49) in the Aggrenox group and 10.2% (5 patients, n = 49) in the control group (OR [95% CI]: 0.40 [0.04, 4.01], p = 0.44). Respiratory failure through day 28 occurred in 4 (8.3%, n = 48) patients in the Aggrenox group and 7 (14.6%, n = 48) patients in the standard of care group (OR [95% CI]: 0.21 [0.02, 2.56], p = 0.22). A larger decrease in the platelet count and blood glucose levels, and larger increase in creatinine and sodium levels within the first 7 days of hospital admission were each independent predictors of 28-day mortality (p < 0.05). CONCLUSION: In this study of hospitalized patients with COVID-19, while the outcomes of COVID illness severity, odds of mortality, and chance of respiratory failure were better in the Aggrenox group compared to standard of care alone, the data did not reach statistical significance to support the standard use of adjuvant Aggrenox in such patients.

Immune imprinting, breadth of variant recognition, and germinal center response in human SARS-CoV-2 infection and vaccination.

During the SARS-CoV-2 pandemic, novel and traditional vaccine strategies have been deployed globally. We investigated whether antibodies stimulated by mRNA vaccination (BNT162b2), including third-dose boosting, differ from those generated by infection or adenoviral (ChAdOx1-S and Gam-COVID-Vac) or inactivated viral (BBIBP-CorV) vaccines. We analyzed human lymph nodes after infection or mRNA vaccination for correlates of serological differences. Antibody breadth against viral variants is lower after infection compared with all vaccines evaluated but improves over several months. Viral variant infection elicits variant-specific antibodies, but prior mRNA vaccination imprints serological responses toward Wuhan-Hu-1 rather than variant antigens. In contrast to disrupted germinal centers (GCs) in lymph nodes during infection, mRNA vaccination stimulates robust GCs containing vaccine mRNA and spike antigen up to 8 weeks postvaccination in some cases. SARS-CoV-2 antibody specificity, breadth, and maturation are affected by imprinting from exposure history and distinct histological and antigenic contexts in infection compared with vaccination.

The Active Role of the Internet and Social Media Use in Nonpharmaceutical and Pharmaceutical Preventive Measures against COVID-19.

During the COVID-19 pandemic, does more internet and social media use lead to taking more- or less-effective preventive measures against the disease? A two-wave longitudinal survey with the general population in mainland China in mid-2020 found that during the COVID-19 pandemic, internet and social media use intensity promoted the adoption of nonpharmaceutical and pharmaceutical antipandemic measures. The first wave of data (n = 1014) showed that the more intensively people used the internet/social media, the more they perceived the threat of the pandemic, and took more nonpharmaceutical preventive measures (e.g., wearing masks, maintaining social distance, and washing hands) as a result. The second wave (n = 220) showed firstly the predicted relationship between internet/social media use intensity and the perceived threat of the pandemic and the adoption of nonpharmaceutical preventive measures by cross-lagged analysis; secondly, the predictive effect of internet/social media use on the adoption of pharmacological measures (i.e., willingness to vaccinate against COVID-19) and the mediating role of perceived pandemic threat were verified. The article concludes with a discussion of the role of the internet and social media use in the fight against COVID-19 in specific macrosocial contexts.

The Impact of Telemedicine on Sexual Medicine at a Major Academic Center During the COVID-19 Pandemic.

INTRODUCTION: Telemedicine has the potential to improve access to care; however, its utility in the field of sexual medicine remains in question. AIM: To examine the importance of video visits for the treatment of male sexual medicine at our academic center during the period of peak telemedicine use in April 2020. METHODS: We collected and compared deidentified data from all nonprocedure, adult outpatient encounters conducted as either office visits in April 2019 (n = 1,949) or video visits in April 2020 (n = 608). The primary International Classification of Diseases codes (ICD-10) labeled as diagnoses from all encounters were collected, with most encounters linked to several disease codes (n = 4,584). Demographic data were also collected. We performed comparative analyses on Stata (College Station, TX, USA) with significance set at α = .05. MAIN OUTCOME MEASURES: Disease codes were categorized based on their use and classification in urological care and the proportion that each category made up within the outpatient practice was calculated. RESULTS: In comparison to the office visits, which took place in April 2019, male sexual medicine visits in April 2020, during the peak of telemedicine use, made up a significantly larger overall share of our practice (P = .012), defined by relative rises in encounters pertaining to male hypogonadism, infertility, penile abnormalities, and testicular abnormalities. Outpatients seen over video visits were also younger than outpatients seen during the previous year over office visits (58.9 vs 60.8, P = .008). Further, race and ethnicity characteristics in the outpatient population were unaffected during the period of telemedicine use. CONCLUSIONS: During the period of historically high telemedicine use following the SARS-CoV-2 outbreak, encounters associated with male sexual medicine made up a significantly larger portion of our outpatient practice. Although the full influence of the COVID-19 pandemic cannot be delineated, our findings suggest telemedicine use is compatible with the field of sexual medicine. Rabinowitz MJ, Kohn TP, Ellimoottil C, et al. The Impact of Telemedicine on Sexual Medicine at a Major Academic Center During the COVID-19 Pandemic. Sex Med 2021;9:100366.

Direct comparison of antibody responses to four SARS-CoV-2 vaccines in Mongolia.

Different SARS-CoV-2 vaccines are approved in various countries, but few direct comparisons of the antibody responses they stimulate have been reported. We collected plasma specimens in July 2021 from 196 Mongolian participants fully vaccinated with one of four COVID-19 vaccines: Pfizer/BioNTech, AstraZeneca, Sputnik V, and Sinopharm. Functional antibody testing with a panel of nine SARS-CoV-2 viral variant receptor binding domain (RBD) proteins revealed marked differences in vaccine responses, with low antibody levels and RBD-ACE2 blocking activity stimulated by the Sinopharm and Sputnik V vaccines in comparison to the AstraZeneca or Pfizer/BioNTech vaccines. The Alpha variant caused 97% of infections in Mongolia in June and early July 2021. Individuals who recover from SARS-CoV-2 infection after vaccination achieve high antibody titers in most cases. These data suggest that public health interventions such as vaccine boosting, potentially with more potent vaccine types, may be needed to control COVID-19 in Mongolia and worldwide.

Loop Drainage Is Noninferior to Traditional Incision and Drainage of Cutaneous Abscesses in the Emergency Department.

BACKGROUND: There is limited research on loop drainage (LD) compared to incision and drainage (I&D) for treatment of cutaneous abscesses. We investigated whether LD was noninferior to I&D for abscess resolution and whether there was any difference in repeat ED visits or complication rates between these techniques. METHODS: We performed a prospective randomized controlled trial, using a convenience sample at an urban academic emergency department (ED). Subjects over 18 years who presented for first-time management of an abscess were eligible. Patients requiring specialist drainage or hospital admission or had previous treatment for the abscess were excluded. Enrolled subjects were seen 2 weeks after treatment for blinded reevaluation of abscess resolution, and the electronic medical record was reviewed for return ED visits/abscess complications. RESULTS: Of 2,889 patients screened, 238 subjects consented and were randomized to LD or I&D. Abscess resolution was achieved in 53/65 (81.5%) of patients in the I&D arm, compared to 66/75 (88%) in the LD arm. Fewer patients in the LD group compared to the I&D group returned to the ED for abscess-related management during the following 14 days (37.3% vs 67.1%, p = 0.002). Among returning subjects, there was a significant difference in mean visits per subject between LD and I&D groups (0.5 vs. 1.2, p = 0.001). There were fewer complications among LD than I&D subjects (9.3% vs. 24.6%, p = 0.01). CONCLUSION: Our study provides evidence that LD is noninferior to I&D in achieving complete abscess resolution at 14 days and is associated with fewer return ED visits and fewer complications. This makes it an attractive alternative treatment option for abscesses.

The Political Psychology of COVID-19.

The COVID-19 pandemic has given rise to unprecedented and extraordinary conditions. It represents a profound threat to health and political and economic stability globally. It is the pressing issue of the current historical moment and is likely to have far-reaching social and political implications over the next decade. Political psychology can inform our preparedness for the next phase of the pandemic as well as our planning for a post COVID-19 world. We hope that this special issue will play its part in helping us to think how we manage and live with COVID-19 over the coming decade. In this editorial, we review the key themes arising from the contributions to our special issue and, alongside existing knowledge highlight the relevance of political psychology to finding solutions during this time of crisis. The contributions to this special issue and the pandemic raise many classic topics of central interest to political psychology: leadership, solidarity and division, nationalism, equality, racism, and international and intergroup relations. In our editorial, we offer an analysis that highlights three key themes. First, the importance of sociopolitical factors in shaping behavior during this pandemic. Second, the relevance of political leadership and rhetoric to collective efforts to tackle SARS-COV-2. And third, how sociopolitical cohesion and division has become increasingly relevant during this time of threat and crisis.

Dual impacts of coronavirus anxiety on mental health in 35 societies.

The spread of coronavirus disease 2019 (COVID-19) has affected both physical health and mental well-being around the world. Stress-related reactions, if prolonged, may result in mental health problems. We examined the consequences of the COVID-19 pandemic on mental health in a multinational study and explored the effects of government responses to the outbreak. We sampled 18,171 community adults from 35 countries/societies, stratified by age, gender, and region of residence. Across the 35 societies, 26.6% of participants reported moderate to extremely severe depression symptoms, 28.2% moderate to extremely severe anxiety symptoms, and 18.3% moderate to extremely severe stress symptoms. Coronavirus anxiety comprises two factors, namely Perceived Vulnerability and Threat Response. After controlling for age, gender, and education level, perceived vulnerability predicted higher levels of negative emotional symptoms and psychological distress, whereas threat response predicted higher levels of self-rated health and subjective well-being. People in societies with more stringent control policies had more threat response and reported better subjective health. Coronavirus anxiety exerts detrimental effects on subjective health and well-being, but also has the adaptive function in mobilizing safety behaviors, providing support for an evolutionary perspective on psychological adaptation.

Majority world successes and European and American failure to contain COVID-19: Cultural collectivism and global leadership.

United Nations and World Health Organization data show a positive correlation, r = .53, p < .0001, N = 189, between COVID-19 infection rates and the human development index (HDI). Less wealthy, less educated countries with lower life spans were also more successful in maintaining lower fatality rates, r = .46, p < .0001, N = 189 whereas 9 of the top-10 countries in the world in per capita fatalities due to COVID-19 were Western societies high in HDI. Similar positive correlations were found between COVID-19 infection and fatality rates and a smaller sample of 76 countries measured on Schwartz intellectual autonomy (or individualism), and negative correlations of similar magnitude were found for embeddedness (or collectivism). East Asia was a global leader in preventing the spread of COVID-19 because of a vigilant public concerned for public safety and compliant with public safety measures. African Union leaders coordinated their responses, and bought into a continent-wide African Medical Supplies Platform that prevented panicked competition for scare supplies. Western global media and scholars have not paid attention to the successes of East Asia, Africa, and the South Pacific in fighting the pandemic. It is worth asking why this should be the case; understand the weaknesses of extreme individualism in fighting a pandemic requiring coordinated and unified public response, and consider the lessons for global scholars from the pandemic for doing research in the future.

Effects of containment and closure policies on controlling the COVID-19 pandemic in East Asia.

Growing efforts have been made to pool coronavirus data and control measures from countries and regions to compare the effectiveness of government policies. We examine whether these strategies can explain East Asia's effective control of the COVID-19 pandemic based on time-series data with cross-correlations between the Stringency Index and number of confirmed cases during the early period of outbreaks. We suggest that multidisciplinary empirical research in healthcare and social sciences, personality, and social psychology is needed for a clear understanding of how cultural values, social norms, and individual predispositions interact with policy to affect life-saving behavioural changes in different societies.

Nasoseptal Flap Necrosis After Endoscopic Skull Base Surgery in the Setting of COVID-19 Pandemic.

BACKGROUND: A novel viral strain known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created a worldwide pandemic known as coronavirus 2019 (COVID-19). Early reports from China have highlighted the risks associated with performing endoscopic endonasal skull base surgery in patients with SARS-CoV-2. We present a rare complication of nasoseptal flap (NSF) necrosis associated with COVID-19, further emphasizing the challenges of performing these procedures in this era. CASE DESCRIPTION: A 78-year-old man underwent an extended endoscopic endonasal transplanum resection of a pituitary macroadenoma for decompression of the optic chiasm. The resulting skull base defect was repaired using a pedicled NSF. The patient developed meningitis and cerebrospinal fluid (CSF) leak on postoperative day 13, requiring revision repair of the defect. Twelve days later, he developed persistent fever and rhinorrhea. The patient was reexplored endoscopically, and the NSF was noted to be necrotic and devitalized with evident CSF leakage. At that time, the patient tested positive for SARS-CoV-2. Postoperatively, he developed acute respiratory distress syndrome complicated by hypoxic respiratory failure and death. CONCLUSIONS: To our knowledge, this is the first reported case of NSF necrosis in a patient with COVID-19. We postulate that the thrombotic complications of COVID-19 may have contributed to vascular pedicle thrombosis and NSF necrosis. Although the pathophysiology of SARS-CoV-2 and its effect on the nasal tissues is still being elucidated, this case highlights some challenges of performing endoscopic skull base surgery in the era of COVID-19.