Timely PCI Shows Beneficial Long-Term Outcomes in Late Presentation With STEMI: A Systematic Review and Meta-Analysis Between 2012 and 2022

Introduction: Approximately 8-40% of ST-elevation Myocardial Infarction (STEMI) present later than 12 hours after symptom onset. Current ACC/AHA guidelines recommend primary percutaneous coronary intervention (PCI) for STEMI after 12 hours of symptom onset only in the setting of cardiogenic shock or severe acute heart failure, (Class Ia, LOE B) or persistent ischemic symptoms (Class IIa, LOE B). There are limited data comparing long-term outcomes among patients with a late STEMI presentation managed with PCI versus medical therapy (MT). Objective(s): To compare long-term outcomes among patients treated with PCI versus MT who have late presentation of STEMI Methods: We followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to extract data from PubMed/Medline, Cochrane, Embase, and Clinicaltrials.gov databases by using the search terms "late" or "delayed" or ">12 hours" presentation with STEMI from 01/2012 through 12/2022. Included studies reported at least one of the following outcomes: all-cause mortality, reinfarction, heart failure, major adverse cardiac events (MACE), and stroke. Studies reporting delays in PCI due to COVID-19 positive status or COVID-19 enforced protocols were excluded to prevent the impact of pragmatic barriers on treatment. Relative risk (RR) was calculated using random effects model if heterogeneity was >50%, otherwise, fixed effects model was used Results: Seven studies (n=11,576, delayed PCI n=6,248, and medical therapy n=5,319) were included in our analysis. The median follow-up was 12 months (1-60 months). Overall, among patients with STEMI and PCI >12 hour after presentation had lower incidence of MACE (27% vs. 30%, RR 0.85, 95% CI 0.76-0.69, I2=30%, p=0.007) compared to MT alone, which was driven by a significantly reduced all-cause mortality with PCI (4.4% vs. 17%, RR 0.38, 95% CI 0.17-0.85, I2=95%, p=0.01). No significant differences were observed in the incidence of recurrent MI and heart failure hospitalizations. Conclusion(s): Our study suggests favorable outcomes of PCI in STEMI with presentation >12 hours compared with medical therapy. Further prospective studies are needed to validate our findings.

COVID-19 preventive behavior among university students in Southeast Asia: Effects of knowledge, concern, awareness, and perceived risk.

The persistent rise of pandemics across the globe in recent times has led to the prescription of several collaborative preventive strategies to reduce the effect that the pandemic has on public health. Consistent monitoring and surveillance appear to be the only available approach to detecting and classifying the issues of public health threats. Global pandemic threats demand public co-operation to take preventive actions at a personal level so that the risk of infectious diseases can be contained. Said that, this study explored the influence of awareness of precaution measures (APM), concerns about coronavirus disease 2019 (COVID-19) (CAC), knowledge of COVID-19 (KOC), and perceived risk (PRK) on preventive behavior (PRB), as well as the effect of age and gender on the relationships among the studied variables. Quantitative data were collected from 551 university students across Malaysia and Vietnam through field survey and online survey, respectively. The data collection was performed from 13 March to 23 March 2020. Partial least square structural equation modeling (PLS-SEM) was employed for data analysis. The multiple group analysis (MGA) technique was applied to compare the data retrieved from the respondents based on age and gender. The results revealed that APM, CAC, KOC, and PRK on PRB significantly influenced PRB toward COVID-19. In light of the two personal factors, age and gender, significant variances were noted for age and KOC, while PRK on PRB on the PRB toward COVID-19. Based on the study outcomes, APM emerged as the most significant predictor of PRB, followed by PRK on PRB, and CAC. Since a large fraction of the world reside in rural areas and have high-level interaction with animals, the provision of education at all level can harness the attitude to adopt PRB toward COVID-19. As such, policymakers need to work with the young generation so that the latter may serve as change agents to spread the message of taking precautions and adopting effective PRB toward COVID-19.

Designing of building readiness assessment instruments in accordance with the covid-19 protocol

The Covid-19 pandemic has led to the adaptation of new habits to prevent transmission of Covid-19 in the workplace. In Indonesia, two work systems currently apply, namely working from home (WFO) and working from the office (WFO) to minimize the spread of Covid-19. It is necessary to prepare office facilities and infrastructure to comply with the Covid-19 protocol, and it is necessary to develop an instrument for assessing building readiness. In this study, a building readiness assessment instrument was prepared according to the Covid-19 protocol using a questionnaire. The methodology to design the questionnaire uses the literature study method, validation on three experts, and reliability testing on 24 Covid-19 unit task forces. Furthermore, the final questionnaire was used to assess the readiness of 83 buildings in ITS by using the safety culture maturity level scoring. The result shows that 1.2% of buildings are at the reactive level, 12,05% of the buildings are at the bureaucratic level, 44,58% of the buildings are at the proactive level, and 42.17% of the buildings are at the generative level. At the end of the study, can concluded that the building at the proactive and generative level could carry out work activities in the office. Meanwhile, buildings at the bureaucratic and reactive levels need to improve the Covid-19 protocol before being reactivated. © IEOM Society International.

Impacts of reduced deposition of atmospheric nitrogen on coastal marine eco-system during substantial shift in human activities in the twenty-first century

The novel infectious disease (COVID-19) took only a few weeks from its official inception in December 2019 to become a global pandemic in early 2020. Countries across the world went to lockdown, and various strict measures were implemented to reduce the further spread of the infection. Although, the strict lockdown measures were aimed at stopping the spread of COVID-19, however, Its positive implications were also observed for the environmental conditions across the global regions. The present study attempted to explore the eco-restoration of coastal marine system in response to reduced deposition of atmospheric nitrogen (NO2) emission during the substantial shift in human activities across the global metropolitan cities. Remotely data of NO2 emission were taken from Ozone Monitoring Instrument and the coastal water quality along the marine system was estimated from MODIS-Aqua Level-3 using Semi-Analytic Sediment Model (SASM). The changes in tropospheric NO2 in 2020s were also compared with the long-term average changes over the baseline period 2015 - 2019. A significant reduction in anthropogenic mobility (85 - 90%) has been observed in almost all countries over different places, especially grocery, parks, workplaces, and transit stations. A massive reduction in tropospheric NO2 was detected in Wuhan (53%), Berlin (42%), London (41%), Karachi (40%), Paris (38%), Santiago (35%), and Chennai (34%) during the strict lockdown period of the early 2020 as compared to the last five years. However, after the partial lockdown was lifted, tropospheric NO2 values bounced back and slightly increased over Karachi (6%) and Bremen (12%). For water turbidity, the rate of reduction was found to be the highest along the different coastal regions of the Mediterranean Sea and Black Sea (51%), West Atlantic Ocean (32%), East Atlantic Ocean (29%), and Indian Ocean (21%) from Apr to Jun 2020. The monthly comparison of overland-runoff in 2020 compared to 2019 across the different costal watersheds indicates that the observed decline in turbidity might have been due to the reduced deposition of atmospheric nitrogen. The findings of this study suggest that the recent decline in tropospheric NO2 and water turbidity might be associated with reduced emissions from fossil fuels and road transports followed by COVID-19 forced restrictions in the twenty-first century. The inferences made here highlight the hope of improving the global environmental quality by reducing greenhouse gas emissions using innovative periodic confinement measures on heavy transport and industries while securing public health and socioeconomics.

General awareness on hantavirus infection: A brief review

Hantavirus is a negative, stranded RNA virus, largely known to be transmitted to humans, especially working in forestry from the rodents. The human-to-human transmission of this virus is still in obscure;however, upon transmission of this virus from the rodent fluids, its fatality is noticed mainly through the hyperinflammatory syndrome and the cardiopulmonary syndrome. Several reports revealed an alternation of the immune response including the natural killer cells, CD8+T cells, neutrophils, and several cytokines during the viral pathogenesis. Unlike the other emerging viruses including the currently ongoing novel coronavirus (COVID-19) pandemic, the global mortality rate due to hantavirus infection is so far very low, which, in turn, made the general people all around the world know a very little about this virus. Besides, no effective antiviral therapy including vaccines has yet been developed to combat the viral infection. Lots of comprehensive reports elaborately discussed this virus pointing toward its dreadfulness. The current review discussed the fatal effects of the hantavirus infection in a relatively simplistic way, which can be easily understood by the general community who are still unaware of the risks posed by this relatively uncommon virus. © 2021 Royal Society of Chemistry. All rights reserved.

A comparative study between the severe acute respiratory syndrome-Coronavirus-2, severe acute respiratory syndrome coronavirus, and the middle east respiratory syndrome coronavirus

The ongoing COVID-19 pandemic caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is of public health emergency of international concern. Within the last two decades, the prevalence of the epidemics by the acute respiratory syndrome coronavirus (SARS-CoV) and by the Middle East respiratory syndrome coronavirus has also been observed. Therefore, regarding these three coronaviruses, certain critical issues have been focused in the current review concerning their evolution and transmission, genomic influence on the corresponding virulence, immunopathogenesis, and the preventive measures including the vaccination strategies and the antiviral therapies. © 2020 Medknow.