Real-time experiences of Hungarian youth in digital education as an example of the impact of pandemia. "I've never had better grades on average: I got straight all the time”

In this paper, we attempted to find an answer to the perceptions and experiences related to online education, with the help of the stories told, which can adequately indicate the epidemic's effects on the 15–29-year-old age group. The global pandemic events of 2020, 2021 and partly 2022, associated with digital education, may have profound and long-lasting effects on young people as a social group. However, we have only a few scientific findings contributing to assessing the COVID-19 pandemic's long-term effects on young people. The social listening analysis used during the research, precisely the so-called social listening method, the experiences and opinions of 15–29-year-olds related to online education were explored, and the perceived differences in competence in terms of infrastructural, educational organisation, and tool use. Young people's assessment of digital education is two-fold: positive attitudes are primarily related to the measurement/evaluation of student performance, negative ones to the effectiveness of the learning process, which has increased the value of face-to-face education, as well as the eroding effect of online school on social relations, and the difficulties related to the epidemiological regulations (mask-wearing, vaccination) or non-compliance (keeping a distance) were also reflected on. © 2023 Elsevier Ltd

The Design and Utilisation of PanSim, a Portable Pandemic Simulator

The COVID-19 pandemic has presented a clear and present need for urgent decision making. Set in an environment of uncertain and unreliable data, and a diverse range of possible interventions, there is an obvious need for integrating HPC into workflows that include model calibration, and the exploration of the decision space. In this paper, we present the design of PanSim, a portable, performant, and productive agent-based simulator, which has been extensively used to model and forecast the pandemic in Hungary. We show its performance and scalability on CPUs and GPUs, then we discuss the workflows PanSim integrates into. We describe the heterogeneous, resource-constrained HPC environment available to us, and formulate a scheduling optimisation problem, as well as heuristics to solve them, to either minimise the execution time of a given number of simulations or to maximise the number of simulations executed in a given time frame. © 2022 IEEE.

Serological response following second and third SARSCoV-2 vaccines in lung transplant recipients

Introduction: Lung transplant recipients (LuTX) represent a vulnerable patient population for the new SARS-CoV-2 infection (severe acute respiratory syndrome coronavirus 2). Even though many vaccines are already developed, there is a few knowledge with non-mRNA vaccines in LuTX patients. Method(s): Stable LuTX recipients at least one year after transplantation were enrolled. Patients who had new coronavirus infection were excluded. Currently available (BNT162b2-mRNA, mRNA-1273, ChAdOx1 and BBIBPCorV) vaccines were given randomly, third doses were mRNA-based vaccines. SARS-CoV-2 Spike1 IgG antibody titer was evaluated before vaccination and 2 weeks after the second and third doses. Result(s): Forty-one LuTX recipients (49% men, 48.4+/-13.8 years) received minimum 2 doses of vaccines, 19 from them vaccinated with non-mRNA vaccines. 24 patients also had third dose. Positive serology was found in 37% of the patients after the second dose and 52% from all became positive after the third vaccine. The average level of Spike1 antibody among the patients with positive serology was 1894 U/ml [range 3.29-5797 U/ml] after the third dose. Six patients vaccinated with two mRNA-based vaccine developed moderate disease in average of 178 days and 3 of them died in ICU. No serious adverse events were observed. Conclusion(s): Immunosuppression therapy may induce weaker SARS-CoV-2 response in LuTX recipients. Our data confirm that non-mRNA vaccines could be safe and effective, however immunity decreases over time, therefore third dose vaccine is a priority in transplanted patients. Further data are needed to evaluate cellular responses after all type of SARS-CoV-2 vaccinations.

SARS-CoV2 vaccination in Hungarian IPF patients

Introduction: SARS-CoV2 infection is associated with significant risk of coronavirus disease (COVID-19) and represents a significant risk factor for functional deterioration in idiopathic pulmonary fibrosis (IPF) patients. Method(s): We retrospectively reviewed all IPF patients treated at our university center for their SARS-CoV2 vaccination status starting from January 2021 in Hungary. Result(s): Total of 68 (out of treated 70 IPF patients) received minimum 2 doses of SARS-CoV2 vaccines (male 52.85%, age: 72.24 +/- 9.65 years), 20 of them were vaccinated with non-mRNA vaccines (BBIBP-CorV-Sinopharm, ChAdOx1-AstraZeneca, Gam-Covid-Vac-Sputnik and Ad26. COV2.S-Janssen), while 48 with mRNA vaccines. Majority (N=57) of patients also took a third dose: most patients received BNT162b2-mRNA-Pfizer/Biontech (58.82%), followed by BBIBP-CorV and mRNA-1273-Moderna (both 11.76 %). There were no hospitalizations for COVID-19 in the vaccinated group, regardless of the type of the vaccine received and no significant adverse event was detected. One of the non-vaccinated patients (2 women, age 70 and 73 years) died in COVID-19 pneumonia. IPF patients were mainly in a good functional state (FVC = 2.52 +/- 1.03 L;78.81 +/- 22.72%) with reduced diffusion capacity (TLCO = 5.28 +/- 2.11 mmol/kPa/min;66.28 +/- 21.58%). Conclusion(s): SARS-CoV2 vaccination is utmost important in IPF patients, and independent of vaccine type used it resulted in significantly decreased risk of COVID-19 hospitalization.

Size distribution and relationship of airborne SARS-CoV-2 RNA to indoor aerosol in hospital ward environments.

Aerosol particles proved to play a key role in airborne transmission of SARS-CoV-2 viruses. Therefore, their size-fractionated collection and analysis is invaluable. However, aerosol sampling in COVID departments is not straightforward, especially in the sub-500-nm size range. In this study, particle number concentrations were measured with high temporal resolution using an optical particle counter, and several 8 h daytime sample sets were collected simultaneously on gelatin filters with cascade impactors in two different hospital wards during both alpha and delta variants of concern periods. Due to the large number (152) of size-fractionated samples, SARS-CoV-2 RNA copies could be statistically analyzed over a wide range of aerosol particle diameters (70-10 µm). Our results revealed that SARS-CoV-2 RNA is most likely to exist in particles with 0.5-4 µm aerodynamic diameter, but also in ultrafine particles. Correlation analysis of particulate matter (PM) and RNA copies highlighted the importance of indoor medical activity. It was found that the daily maximum increment of PM mass concentration correlated the most with the number concentration of SARS-CoV-2 RNA in the corresponding size fractions. Our results suggest that particle resuspension from surrounding surfaces is an important source of SARS-CoV-2 RNA present in the air of hospital rooms.

An application for identification and stratification psychological crisis among pandemic frontline healthcare workers

Introduction: The COVID-MENTA Screening Program was developed to monitor the mental health of frontline healthcare professionals and identify those at high risk for suicide at the Kiskunhalas Mobile Disease Control Hospital. Objective(s): Our post hoc analysis aimed to investigate the association between psychological distress and suicide ideation based on passively collected data during the screening work. Method(s): A sample of 50 healthcare professionals was analyzed from 167 participants in the COVID-MENTA Screening Program between the second and third waves of the COVID-19 pandemic. Data collection was performed during the breaks of healthcare professionals at work. Half of the group (N=25) perceived severe distress (scored > 5/10 on Distress Thermometer). The crisis monitoring application was based on Klonsky and May's 3-step theory (2015) and was built by adapting the questions on the appropriate international scales (Psychache Scale, Beck's Hopelessness Scale, Interpersonal Needs Questionnaire, Suicide Capacity Scale). The tool can stratify the current suicide risk into seven levels. Result(s): Spearman's Rank Correlation was used for statistical analysis. There was a significant positive correlation between the psychological distress and the suicide risk (r (48) = 0,43, p < 0,01). Conclusion(s): Our findings supported the hypothesis of the study that the risk of suicide rises with the increase of the level of distress. The application has been proved effective in ecological conditions, helping in several cases to screen individuals currently at increased risk for suicide, allowing us to intervene in a timely and effective manner.

COVID-MENTA: an integrated mental health protection system for pandemic frontline healthcare workers

Introduction: At Kiskunhalas Semmelweis Hospital, a special mobile container hospital was set up to care for patients infected with SARS-CoV-2 during the first wave of the pandemic. Objective(s): We aimed to create a proactive integrated mental health protection system for the frontline healthcare workers that provides an opportunity for psychophysiological monitoring of stress and crisis during shifts, as well as providing staff with more lasting methods of coping with difficulties. Method(s): From the ascending branch of the second wave, every two weeks on the workers'rest day, mental helpers initiated a phone call to each employee participating in the program. If it was necessary, we provided psychological counseling, crisis intervention, brief psychotherapy, and psychopharmacotherapy. In addition, selfoperated psychophysiological screening devices were used at the frontline work site, which provided an opportunity for continuous telemedicine monitoring. Result(s): In our department, three psychologists and three psychiatrists kept in touch with an average of 150 frontline workers per month. Interventions were needed for a total of over 24% in December and January, over 17% in February and March, almost 9% in April, and only 4% in May. Helpers rated an average of twothirds of these cases as moderate. They faced severe stress 2-3 times a month in sum, and for 2-3 workers needed medication. Conclusion(s): Without a mental support system, self-report-based data suggest that nearly half of responders working at the frontline reached the threshold of clinically significant mental syndromes (Greenberg et al, 2021). Using our mental health support system, one-fifth of the workers needed intervention.

Sustainable Catching-Up Requires a Complete Turn in Competitiveness

Further strengthening of competitiveness is essential for Hungary's sustainable growth and catching up. According to the Magyar Nemzeti Bank's approach, an economy is competitive if it utilises its available resources optimally to attain the highest possible, but at the same time sustainable, level of welfare. In the past decade, the macroeconomic conditions necessary for a turn in competitiveness have developed in Hungary, which also provided a stable basis for managing the economic impact of the coronavirus pandemic. Hungary was ranked 18th in the MNB's competitiveness ranking among the 27 countries of the European Union in 2021. The result shows that further strengthening competitiveness and the effective release of growth reserves, in particular in the areas of high-quality human capital and the digital and green transition of the economy, arc essential to achieve sustainable catching-up and avoid the middle-income trap.

A CASE OF BOTHERED PERICARDIUM

Background: Post-cardiac injury syndrome or Dressler syndrome, described as pericarditis with or without effusion, is often associated with myocardial infarction or a procedure in which the pericardium is disturbed. However, it may be provoked by a minor intervention, including radiofrequency ablation. Case: A 41 year-old male with paroxysmal atrial fibrillation (AF) and obstructive sleep apnea on CPAP presented with chest pain, palpitations, and dyspnea. He underwent cryoablation 1 month prior to presentation. He was febrile, tachycardic, and hypotensive. ECGs showed atrial flutter (Figure A) and AF with rapid ventricular response. Cardioversion was unsuccessful. Decision-making: Work-up included a negative COVID PCR. C-Reactive Protein was 311 mg/L (normal <10.0 mg/L). A CT chest showed bilateral pleural effusions and a pericardial effusion. Thoracentesis removed 850 mL of serous yellow fluid (exudative effusion). Transthoracic echo (TTE) revealed normal left ventricular function with a small pericardial effusion. Within 24 hours, the patient demonstrated tamponade physiology. Pericardiocentesis removed 400 cc of serosanguinous fluid.Cardiac MRI was concerning for myopericarditis (Figure B).Rate control for AF was difficult to achieve in the face of an inflammatory state. After several days of high-dose ibuprofen and colchicine, the patient started sotalol with conversion to normal sinus rhythm. Conclusion: Although rare, Dressler syndrome can be associated with minimally-invasive cardiac procedures, including cryoablation. [Formula presented]

Dynamics of vaccination against Covid-19

After a late and difficult start, Covid-19 vaccination is making rapid progress in Brazil. However, the distribution of those vaccinated is far from homogeneous, and changes over time. Based on SUS data we show progress in vaccination coverage. While in April 2021 rates were high in peripheral regions in July they had increased in the Sao Paulo-Mato Grosso do Sul axis, and even more so in October: by this date the entire state of Sao Paulo stands out for the dense and homogeneous coverage of its entire territory.

The COVID problem reflected by economics - A bibliometric analysis

COVID-19 has been the "hottest" topic in many fields of research during 2020-2021. Our analysis focuses on the publications related to the pandemic in the business and economics area. Using the Web of Science database, the main international research patterns in this field have been analysed. Our research covers less than two years (2020 and part of 2021), but the number of publications is large (more than 1,000) in this limited time span. The publication patterns of the CEE countries have also been examined. Bibliometric and social network analysis was used to assess which countries and institutions published the most during this period. For analysing the main trends in the given field, keyword analysis was performed.

Real-life measurement of size-fractionated aerosol concentration in a plethysmography box during the COVID-19 pandemic and estimation of the associated viral load.

INTRODUCTION: There are concerns about pulmonary function tests (PFTs) being associated with aerosol generation and enhanced virus transmission. As a consequence, the number of PFTs was reduced significantly during the coronavirus disease 2019 pandemic. However, there are no robust data supporting this fear. OBJECTIVES: To perform real-life measurement of aerosol concentrations in a PFT laboratory to monitor the concentration of particles near the patient, and to model the associated potential viral load. METHODS: Two optical particle counters were used to sample the background concentration and the concentration of particles near the patient's mouth in a whole-body plethysmography box. Statistical evaluation of the measured particle concentration time series was completed. The particle exhalation rate was assessed based on the measured particle concentration data by applying the near-field/far-field theory. The number of exhaled viruses by an infected patient during the test was compared with the emission of viruses during quiet breathing and speaking. RESULTS: Twenty-five patients were included in the study. Eighteen patients showed a significant increase in aerosol concentration [mean 1910 (standard deviation 593) particles/L]. Submicron particles dominated the number size distribution of the generated particles, but large particles represented a higher volume fraction in the generated particles compared with background. An average gene exhalation rate of 0.2/min was estimated from this data. This is one order of magnitude higher than the release rate for the same infected person during quiet breathing, and of the same order of magnitude as the release rate during normal speaking. CONCLUSIONS: This study demonstrated that PFTs are aerosol-generating procedures. Based on these results, the moderate increase in viral load does not underpin stopping such examinations.

Report of a remote participatory design process to renew a schoolyard during covid-19

The aim of this paper is to share the experiences of an ongoing remote co-design process. With an inductive research approach, analysing the experiences of an ongoing case study, the research presents the challenges of remote collaboration such as the changed spatial understanding, transformed rules in communication and online community experiences. Pandemic circumstances allowed us to discover how remote settings can bring new rules and dynamics to participatory design processes. The research offers guidelines and solutions on how digital tools and online platforms can add value to community design processes. © 2021, VDE VERLAG GMBH. All rights reserved.

A retrospective cohort study of treatment patterns and clinical outcomes in patients with COVID-19

Background: The SARS-CoV-2 pandemic has caused over 400,000 deaths worldwide thus far, and poses therapeutic challenges for millions of patients. There is currently no treatment for SARS-CoV-2 infection approved by the United States Food and Drug Administration. Multiple agents have been used off-label to treat SARS-CoV-2 infection based on small observational cohorts and in vitro data. Here we present the experience of a large academic medical center in treating SARSCoV- 2 infection. Methods: We performed a retrospective cohort study of patients admitted for greater than 24 hours with a nasopharyngeal, oropharyngeal, and/or bronchoalveolar lavage sample positive for SARS-CoV-2 by polymerase chain reaction (PCR). Demographic data, comorbidities, clinical data, and treatment data were collected from the electronic medical record. Off-label therapies were used at the discretion of the treating providers guided by regularly updated treatment guidelines assembled by infectious diseases physicians and antimicrobial stewardship pharmacists. The primary outcome assessed was in-hospital mortality. Secondary outcomes included admission to the intensive care unit (ICU), endotracheal intubation, initiation of vasopressors, and drug-related adverse events. Results: Data collection was completed for 448 patients admitted between March 18, 2020 and May 8, 2020. All-cause in-hospital mortality was 13.4% (60/448) during this time. Mortality rates increased with age, up to 45% for patients over 80 years old. Male sex, hypertension, chronic pulmonary disease, end-stage renal disease, chronic liver disease were also risk factors for increased mortality. QTc interval prolongation occurred significantly more frequently in patients who received hydroxychloroquine (HCQ) with or without azithromycin(AZM) than those who did not (HCQ 6%, HCQ+AZM 7.8% vs all other patients, 0%, p< .0001). Review of treatment trends showed close adherence to the treatment recommendations at that time (Figure 1). Conclusion: SARS-CoV-2 infection is associated with significant inpatient mortality, and use of off-label treatments was associated with significant drug-related adverse events. Treatment regimens changed rapidly, and providers adhered closely to institutional guidelines as they evolved. (Table Presented).