The Austrian State and the COVID-19 Crisis: Achievements and Failures of a Small European Country During the Pandemic Since 2020

The financial crisis from 2008 onwards had already led to a "return of the state” in many countries. This tendency intensified in the face of the COVID-19 pandemic from the beginning of 2020—as well as in Austria. This chapter asks several research questions on the Austrian state's handling of the pandemic in comparison with the other members of the European Union (EU). The most important are: What were the consequences of the pandemic in the areas of public health, the economy and the labour market;and what successes and failures were achieved in combating the pandemic? It is clear, however, that only an interim assessment can be made;a "definitive” comparative survey of the state performance of the EU members will be possible only in the years to come. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022, corrected publication 2022.

From undistracted to instant reading and back: Prototyping a new digital library service

New technologies and digital services influence the current forms of reading, and public libraries respond to these possibilities by offering new services based mainly on ebooks. The constraints resulting from the recent waves of the COVID-19 pandemic have reinforced this trend. This work introduces the development process of new library services based on open web books experimentally developed at Masaryk University and the Municipal Library of Prague. Our initial research focused on people's behavior when reading a book in a browser, on elements of user interface interactions, and the overall context of reading on different types of devices, especially mobile. Through a Research through Design approach, qualitative inquiry, and prototyping, we have identified patterns in reading behavior and library users' needs, to which we have responded by designing a new service. We converted the new service concept into interactive prototypes in the Figma tool, which we further tested and iterated. The research supports reading in the digital world and brings new information about reading behavior in the age of instant digital services.

Public Awareness of Nanotechnology and Its Implications for Health in Jordan

Nanotechnology is often described as an emerging technology, holding promise for a diverse range of fields. Public awareness may have a strong impact on public acceptance of nano-technology and its various implications. In Jordan, nano-education has only been introduced recently into universities and it is offered to students of pharmacy, engineering, biomedical sciences, and agriculture. However, there is no data available on nanotechnology awareness among the public in Jordan. Therefore, we conducted this study to evaluate Jordanian public awareness and concern about nanotechnology, nanomaterials, and nanoproducts and its implications for health related applications of nanotechnology. An online survey was developed consisting of 15 questions and separated into three domains. The study findings show that more than half of the respondents have a very low awareness with regards to nanotechnology and its various implications. Additionally, respondents show interest to learn more about nanotechnology and its implications, preferring several sources of information such as media, universities and research institutions.

Physician's Perception about the Use of PPE, COVID-19 Prevention and Management in Bangladesh

This study aims to explore physician's perceptions about the use of Personal Protective Equipment (PPE), COVID prevention, and management during the COVID pandemic since knowledge on these might explain the reason behind infection and death of physicians in Bangladesh at an unexpected rate. This cross-sectional study was conducted based on an online questionnaire on 346 physicians (n=346) by the Department of Gastroenterology of Mymensingh Medical College Hospital, Bangladesh from 15th July 2020 to 14th September 2020. Physicians of different health care facilities across Bangladesh were invited to take part. Knowledge on specific points of the questionnaire was evaluated, scored, and compared between different groups by Independent sample t-test. Mean knowledge score between the respondents working up to 8 hours and beyond 8 hours per day was 17.28+/-1.28, 16.90+/-1.40 respectively (p=0.03). Mean knowledge score observed between graduate and post-graduate physicians and work experience of 5 years and beyond 5 years were 17.26+/-1.36 vs. 17.16+/-1.27;(p=0.40), 16.87+/-1.75 vs. 17.27+/-1.21;(p=0.11) respectively. Physician's safety should be first concern that is highlighted through proper use of PPE and prevention of COVID. Patient management skills would be better if physicians are trained well on infection prevention and control which in turn will reduce infection and death of physicians.

Infection COVID-19 et enjeux éthiques

Introduction La particulière vulnérabilité des patients infectés par le Covid-19, dans le cadre d’une crise sanitaire mondiale qui limite les ressources, suscite une vigilance éthique renforcée. Une analyse qui se réfère au vécu du personnel médical face à la Pandémie du Covid-19 semble primordiale. Le but de cette étude est de soulever les enjeux éthiques et identifier les initiatives à mettre en œuvre pour y remédier. Méthodes Étude transversale (juillet–septembre 2021) mené par un questionnaire pré-établi au près des médecins exerçant à l’hôpital A. Mami pendant cette période. Résultats Pendant la période d’étude, 164 médecins exerçaient à l’hôpital A. Mami, seuls 120 médecins ont répondu au questionnaire (73,3 % des cas). Soixante-huit des médecins interrogés étaient âgés entre 25 et 35 ans. Quatre-vingt médecins (67 %) ont jugé que le nombre d’heures passées en contact direct avec des patients Covid les a exposés à un risque de contamination. Dans 70 % des cas, les médecins avaient peur d’être contaminé et de transmettre l’infection à un proche et parmi eux, 73 % considèrent que cette crainte a affecté leur prise en charge des malades. De plus, 60 % des médecins ont déclarés avoir examiné des malades sans équipement de protection dans un contexte d’urgence. Soixante-seize médecins ont rapporté avoir inclus des patients dans un essai clinique avec respect de l’anonymat (80 %) et signature du consentement (80 %). Pour l’administration de médicaments hors AMM, 67 % des médecins étaient d’accord. A défaut de lits disponibles, 84 % des médecins ont été amené à choisir entre deux patients pour hospitalisation se basant l’âge jeune (50 %) et le moins de comorbidités (30 %). La majorité des médecins (81 %) pensent que le recul logistique et scientifique acquis depuis le début de la pandémie, a permis une prise en charge plus éthique des malades. Enfin, 70 % des médecins considèrent avoir bien à très bien accomplit leurs devoir en tant que médecin. Conclusion S’interroger sur les enjeux éthiques révélés au cours de la pandémie du Covid peut être intéressant pour prévoir des pistes de renforcements de notre système de santé.

The growing role of designated communicators in the monitoring of patients with left ventricular assist device in the era of the COVID pandemic

Background: Left ventricular assist devices (LVAD) are increasingly implanted in patients with end-stage heart failure. Patients require special care in terms of the safety and effectiveness of therapy, but during pandemic lockdown it is much more difficult to achieve. For many years at our institution, apart from routine personal visits, we have been using the REMEDIZER® internet communicator for remote care in LVAD group of patients. Objective: - evaluation of the safety and effectiveness of remote monitoring in the care of patients with LVAD during the COVID pandemic-evaluation of the safety of remote monitoring with a designated communicator instead of personal visits Methods: During the lockdown period (01/03/2020 - 31/12/2020), 72 patients (3 female) pts mean age 54.7±12,1 years with LVAD were monitored. For epidemiological reasons, the number of personal visits has been reduced in favor of telephone consultations and an increased volume of data entered into the REMEDIZER® internet communicator. The data collected in this period were compared with the data collected on 1 March 2019 - 31 December 2019, when: 53 pts (1 female) mean age 56,2±11,78 years were routinely, personally controlled at the Center for at least every 3 months and had blood, echo and LVAD examinations. Patients entered pump parameters: flow, motor speed, power consumption, pulse and blood pressure, body weight and temperature, at least twice a day (morning and evening) INR and dose of warfarin used were also reported. The number of complications during LVAD support was assessed: death or heart transplantation major complications: stroke, hemorrhage, pump thrombosis also other like arrhythmias requiring ICD intervention, hospitalization. Results: Mean time of monitoring from hospital discharge after LVAD implantation to the end of observation in 2020 cohort was 651±486 days compared to 586±508, days in 2019 cohort In 2019, personal visits were performed significantly more often, 94 v. 17 (p<0.05), while remote visits (by phone or internet) were significantly more frequent in 2020 (2033 v. 1390). In 2019 patients were hospitalized significantly more often (28 vs. 10), but if we considered urgent hospitalizations, the differences were not statistically significant (9 vs. 8). In 2020, 5 patients (6,94%) died compared with 4 (7,55%) in 2019 (NS). In 2020, 9 patients (12,5%) were transplanted v. 3 (5,66%) in 2019. We observed 22 episodes of major complications in the 2020 cohort vs 20 in 2019 (NS);11 ICD interventions vs 13 in 2019 (NS). Conclusions: Replacing routine personal visits with increased patient selfcontrol and constant remote contact with the center allowed a safe organization of patient care during COVID-19 pandemic The use of REMEDIZER® internet communicator dedicated for LVAD patients for remote care control proved to be effective and safe to control LVAD patients.

E-learning in gynecologic oncology: A new approach for medical students during COVID 19 pandemic

Objectives Since the worldwide spread of Covid 19 pandemic, medical education is affected. To ensure the integrity and the continuity of medical education e-learning has been adopted. Methods To evaluate the efficiency of e-learning in gynecologic oncology education in time of Covid 19 pandemic, we do a comparative study including 30 undergraduate medical students. Half of them received traditional learning about four gynecologic cancer (endometrial, ovarian, cervical and breast cancers), the others received an e-learning education for the same chapters. Clinical knowledge was evaluated before and after getting the courses in the two groups. Results There wasn't a significant differences comparing the two groups evaluations. Before getting the endometrial cancer course, 74% of e-learning group students (first group) have less than the average score (5/10), versus 68% in the groupe of traditional learning (the second group). By receiving the course, the rate of good response (more than 5/10) increases respectively to 92 and 94%. Similar rates were reported for the other delivered chapters. Conclusions Based on the non significant differences between results of the two learning methods, e-learning is a efficient tool to provide gynecologic oncology education in time of Covid 19 pandemic. More studies are needed to evaluate the implementation and the student's adherence to this educational process.

Sclerosing Encapsulating Peritonitis Following Recovery From COVID-19 Pneumonia.

Coronavirus disease 2019 (COVID-19) is primarily a respiratory illness and pulmonary manifestations are the typical presentations of the disease. However, it became evident that the COVID-19 is not limited to the respiratory system. Specifically, gastrointestinal involvement in patients with COVID-19 is very common, particularly in patients with a critical illness. We present a case of a 52-year-old man who was diagnosed as having severe COVID-19 pneumonia and underwent endotracheal intubation and mechanical ventilation. The patient remained in the intensive care unit for seven days. Following his recovery, he started to experience generalized abdominal pain. The pain did not resolve with conservative measures. A computed tomography scan of the abdomen demonstrated small bowel loops clustered with a surrounding thin membrane. Such findings conferred the diagnosis of sclerosing encapsulating peritonitis. The patient was prepared for laparoscopic surgery. Resection of the membrane was performed without any injury to the encapsulated bowel. Analysis of peritoneal fluid by reverse transcription-polymerase chain reaction (RT-PCR) was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The patient had an uneventful recovery. Sclerosing encapsulating peritonitis is a very rare condition associated with COVID-19 pneumonia. The present case is the first reported case to document the presence of the SARS-CoV-2 virus in the peritoneal fluid in a patient with sclerosing encapsulating peritonitis.

Evaluation of hysteroscopy practice in time of COVID 19 pandemic: a multicenter experience

ObjectivesThe aims of our study were to assess different indications of office hysteroscopy and to evaluate the efficiency of this examination to diagnose uterine abnormalities in time of Covid 19 pandemic.MethodsThis is a prospective and descriptive study from March 2020 to November 2020. 54 patients were enrolled in our study. They presented an abnormal uterine bleeding. The indication of hysteroscopy was discussed to know if deferring the procedure could have an impact on patient’s condition and outcome. If hysteroscopy was indicated, preference was given to in-office procedure. In case of failure, patients underwent a hysteroscopy in an operating theatre under general or regional anesthesia. All hysteroscopies were performed under specific safety protocol.Results54 patients were enrolled in our study. office hysteroscopy was performed in all cases. The indication was related to a recurrent abnormal uterine bleeding complicated with anemia or associated to a thick endmetrium in post menopausal women. In four cases, office hysteroscopy was performed in infertile women. The failure rate of in-office hysteroscopy was 7.4%. In 16 cases an operative hysteroscopy was performed in an operating room under anesthesia.Two cases of complex endometrial hyperplasia and one case of endometrial carcinoma were diagnosed. No cases of Covid 19 infection have been reported.Conclusions office hysteroscopy is an efficient and safe examination to manage abnormal uterine bleeding in time of Covid 19 pandemic.

The impact of withholding Entonox in labor during the COVID-19 pandemic on maternal and neonatal outcomes

Background: Entonox (Nitrous oxide in 50% oxygen) is commonly used for labor analgesia in obstetric units. During the pandemic uncertainties around the risk of aerosol generation and virus transmission led to withholding Entonox for women in labor for a 3-week period at our institution. We aimed to determine if withdrawing Entonox for labor analgesia impacted primarily on epidural rates, opioid analgesia use and several other secondary outcomes. Methods: The audit population included all women laboring during March 9-28 (the Entonox group), and March 29-April 16, 2020 (the COVID group). Women who delivered prior to, or within 30 mins of arriving on the birthing unit;as well as women with an intrauterine foetal death and those with incomplete clinical records were excluded. Binary outcomes were analysed using logistic regression and skewed continuous outcomes were logtransformed and analysed by linear regression. Models were adjusted for maternal and clinical risk factors, such as primiparity and induction of labor. Results: There were 122 and 121 women in the Entonox and COVID groups, respectively. Maternal demographics were similar between the groups (Table 1). Epidural requests were similar. Opioid use was significantly higher when Entonox was not available, but there were no significant differences in any maternal and neonatal outcomes (Table 2). Conclusion: Results from our study suggest that withholding Entonox in labor did not result in higher epidural rates. Opioid analgesia requirements were significantly increased. Withholding Entonox appeared safe and did not impact on any maternal and neonatal outcomes. (Figure Presented).

Disinfection methods and survival of SARS-CoV-2 in the environment and contaminated materials: a bibliometric analysis

The presence of SARS-CoV-2 in sewage and water resources has been used as an indication for the possible occurrence of the virus among communities and for its potential of transmission among humans through the surrounding environment or water resources. In order to reduce the transmission of SARS-CoV-2, contaminated surfaces should be disinfected frequently by using an effective disinfectant. The present review discusses a bibliometric analysis of the global SARS-CoV-2 research and focuses mainly on reviewing the efficiency of the most traditional disinfection technologies. The disinfection methods reviewed include those for hospitals' or medical facilities' wastewater, contaminated surfaces, and contaminated masks. The elimination of the virus based on the concept of sterility assurance level (SAL) is also discussed. In addition, the chemical disinfectants that are currently used, as well as their temporary efficiency, are also reviewed. The different technologies that are globally used for disinfection processes during the COVID-19 pandemic are shown. However, more advanced technologies, such as nanotechnology, might have more potential for higher inactivation effectiveness against SARS-CoV-2.