Evidence of reduced academic performance among schoolchildren with helminth infection.

BACKGROUND: Soil-transmitted helminths (STHs) pose a formidable health risk to school-age children in resource-limited settings. Unfortunately, mass deworming campaigns have been derailed since the onset of the coronavirus disease 2019 pandemic. The present study assessed the cross-sectional associations between STHs, nutritional status and academic performance of schoolchildren in the Banda District of Ghana. METHODS: Schoolchildren (5-16 y of age; n=275) were recruited through both school and household visits by community health workers using a multistage cluster sampling technique. In addition to school microscopy, anthropometric records were also taken. RESULTS: The prevalence of geohelminthiasis was 40.4% (95% confidence interval 34.6 to 46.2). STHs targeted for elimination by the World Health Organization and national programmes were detected among schoolchildren. Children with intestinal parasite infection (53.7 [standard deviation {SD} 11.5]) had lower mean academic scores compared with uninfected children (59.6 [SD 16.9]) (p=0.034). In multiple regression analysis, intestinal parasite infection status and z-scores for weight-for-age showed a collective significant effect on the academic score (F1117=8.169, p<0.001, R2=0.125). CONCLUSIONS: Schoolchildren with STHs had poorer academic performance compared with uninfected children, despite their nutritional status. In addition to school feeding programmes, school-based mass drug administration campaigns may be critical for improving learning outcomes in young schoolchildren.

Association of macrophage inflammatory protein-1beta with the recovery process in COVID-19

Background: Recovery from coronavirus disease 19 (COVID-19) is a gradual process that depends on the disease severity. Immunologic changes that precede and relate clinical symptoms may predict the course of COVID-19 and final outcome. Our goal was to determine prognostic markers of COVID-19 improvement. Method(s): The study included hospitalized patients from the ages 31-72 with moderate to severe COVID-19. All biomarkers were assessed at three checkpoints starting from the first day of hospitalization (day 0), continuing on day 8, and between 40-50 day. Luminex xMAP technology and the Bio-Plex Pro Human Cytokine 17-plex assay was used for quantitative evaluation cytokines and chemokines in peripheral blood of COVID-19 patients. The comparative study was done in combination with clinical data. Univariate and multivariate analyses of data were delivered. Finally, a fuzzy logic model for decision support was proposed and validated for explored data. Result(s): Macrophage inflammatory protein-1beta (MIP1b) was inversely related to COVID-19 evolution. MIP1b significantly higher on day 8 compared to day 0 (p < 0.0001) correlated with clinical improvement and predicted a successful course of the disease. It was also associated with the significant increase in TNF-alpha (p = 0.03), and decrease in IL-10 (p < 0.0001), and IL-6 (p = 0.01). The increase in MIP1b on day 8 correlated positively with eosinophil and lymphocytes counts and negatively with inflammatory mediators (ferritin, procalcitonin, fibrinogen, CRP). Moderately positive correlation between MIP-1b and TNF-alpha was noted, in parallel. Tested the statistical and machine learning predictors exhibited sensitivity to MIP1b input, improving the ROC curve compared to the classification models trained without MIP1b. Conclusion(s): This finding next to already known indicators such as IL-6, eosinophil and lymphocytes counts, highlight a role of MIP1b as a marker of good prognosis in COVID-19 and provide a novel insight into this as a potential diagnostic and therapeutic target.

Evaluation of Hybrid Learning and Teaching Practices: The Perspective of Academics

This paper presents a study on the evaluation of hybrid learning and teaching practices by academics. A mixed research method involving a questionnaire survey and a focus group interview was employed to gather academics' feedback on their experience in delivering hybrid instruction in a synchronous manner in which on-site and remote students attended classes simultaneously, their students' hybrid learning effectiveness, and their suggestions for improvement. The questionnaire was administered to 76 academics from a university in Hong Kong where hybrid learning and teaching were implemented, and the focus group interview involved 10 academics. The findings reveal that the participating academics perceived themselves as having an overall high degree of readiness to handle technical issues. They expressed that the students from their hybrid classes had lower levels of interaction, engagement, and motivation than those from traditional face-to-face classes. The participants also reported their challenges regarding hybrid learning and teaching, including heavy workload for lesson preparation and face-to-face and online classroom management, unfamiliarity with interactive teaching design suitable for hybrid classes, and difficulties in monitoring students' learning process. They provided suggestions for the improvement of hybrid classes, ranging from the provision of technological support to professional development for enhancing students' online interaction and engagement. These findings contribute to revealing academics' experience in practising hybrid learning and teaching and identifying ways to address their challenges.

Impact of COVID-19 infection and vaccination in pancreatobiliary IgG4-related disease patients: An international multicenter study.

BACKGROUND AND AIM: Dedicated studies evaluating the impact of COVID-19 on outcomes of pancreatobiliary IgG4 related disease (IgG4-RD) patients are scarce. Whether COVID-19 infection or vaccination would trigger IgG4-RD exacerbation remains unknown. METHODS: Pancreatobiliary IgG4-RD patients ≥ 18 years old with active follow-up since January 2020 from nine referral centers in Asia, Europe, and North America were included in this multicenter retrospective study. Outcome measures include incidence and severity of COVID-19 infection, IgG4-RD disease activity and treatment status, interruption of indicated IgG4-RD treatment. Prospective data on COVID-19 vaccination status and new COVID-19 infection during the Omicron outbreak were also retrieved in the Hong Kong cohort. RESULTS: Of the 124 pancreatobiliary IgG4-RD patients, 25.0% had active IgG4-RD, 71.0% were on immunosuppressive therapies and 80.6% had ≥ 1 risk factor for severe COVID. In 2020 (pre-vaccination period), two patients (1.6%) had COVID-19 infection (one requiring ICU admission), and 7.2% of patients had interruptions in indicated immunosuppressive treatment for IgG4-RD. Despite a high vaccination rate (85.0%), COVID-19 infection rate has increased to 20.0% during Omicron outbreak in the Hong Kong cohort. A trend towards higher COVID-19 infection rate was noted in the non-fully vaccinated/unvaccinated group (17.6% vs 33.3%, P = 0.376). No IgG4-RD exacerbation following COVID-19 vaccination or infection was observed. CONCLUSION: While a low COVID-19 infection rate with no mortality was observed in pancreatobiliary IgG4-RD patients in the pre-vaccination period of COVID-19, infection rate has increased during the Omicron outbreak despite a high vaccination rate. No IgG4-RD exacerbation after COVID-19 infection or vaccination was observed.

Societal disruptions and child mental health: evidence from ADHD diagnosis during the COVID-19 pandemic

We study how the societal disruptions of the COVID-19 pandemic impacted diagnosis of a prevalent childhood mental health condition, Attention Deficit Hyperactivity Disorder (ADHD). Using both nationwide private health insurance claims and a single state's comprehensive electronic health records, we compare children exposed to the pandemic to same aged children prior to the pandemic. We find the pandemic reduced new ADHD diagnoses by 8.6% among boys and 11.0% among girls nationwide through February 2021. We further show that higher levels of in-person schooling in Fall 2020 dampened the decline for girls but had no moderating effect for boys.

Effects of social distancing policy on labor market outcomes

US workers receive unemployment benefits if they lose their job, but not for reduced working hours. In alignment with the benefits incentives, we find that the labor market responded to COVID-19 and related closure-policies mostly on the extensive (12 pp outright job loss) margin. Exploiting timing variation in state closure-policies, difference-in-differences (DiD) estimates show, between March 12 and April 12, 2020, employment rate fell by 1.7 pp for every 10 extra days of state stay-at-home orders (SAH), with little effect on hours worked/earnings among those employed. Forty percentage of the unemployment was due to a nationwide shock, rest due to social-distancing policies, particularly among "non-essential” workers. © 2022 The Authors. Contemporary Economic Policy published by Wiley Periodicals LLC on behalf of Western Economic Association International.

Examination of Physical Activity and Subjective Well-Being before and during the First Wave of the Covid-19 Pandemic Amongst the Hungarian Sportsmen and Professionals in the Sports Sector

Background. The aim of the research was to analyze the changing exercising frequency, the well-being, the mental health, and the social relationships before and during the curfew of the COVID-19 first wave. Material and methods. The data collection was May-June in 2020 via an online questionnaire survey amongst the sportsmen and professionals in the sports sector. The descriptive and inferential statistical methods were used with the SPSS 27.0 software (Chi-square test, Wilcoxon, Mann-Whitney U and Kruskal-Wallis tests). Results. The respondents were 44.17% female and 55.83% male. The average age was 36.36 +/- 16.52 years. The sample was classified into four sectors: elite sportsmen (20.60%), recreational sportsmen (34.29%), sports professionals (28.21%) and multiple roles (16.90%). There was a significant difference at the exercising frequency before and during the curfew between the sectors (p<0.001). The well-being, the mental health and the social relations did not show any significant differences. Regarding physical activity, there were decreases in every category:-268.36 minutes weekly average in the elite sportsmen,-194.90 minutes weekly average in the recreational sportsmen and-250.33 minutes weekly average in the multiple roles' category (p<0.001). Conclusions. The curfew of the COVID-19 pandemic had a major impact on the exercising frequency and physical activity amongst the sportsmen and professionals in the sports sector.

Perceived usefulness of open educational resources: Impact of switching to online learning for face-to-face and distance learners.

This paper reports a study on the perceived usefulness of university students on open educational resources (OER) in relation to the switch of learning mode to online learning during the COVID-19 pandemic. The participants involved two groups of students, one studying in a face-to-face mode and the other in a distance learning mode. They took part in a survey which was conducted in 2019 before the pandemic (with a total of 912 responses) and 2021 during the pandemic (with a total of 1,018 responses). The results show that both groups of students generally perceived OER to be more useful during the pandemic. The specific types of OER which were perceived as relatively more useful include open online courses and open access textbooks. Face-to-face students showed a higher level of perceived usefulness of OER for preparing tests and examinations, while distance learning students perceived OER as more useful for supplementing course materials. They both concerned about the limitations of OER, especially on accuracy and comprehensiveness. The findings suggest the importance of recognizing the diverse needs of the two groups of students and offering appropriate OER support for them.

Perceived usefulness of open educational resources: Impact of switching to online learning for face-to-face and distance learners

This paper reports a study on the perceived usefulness of university students on open educational resources (OER) in relation to the switch of learning mode to online learning during the COVID-19 pandemic. The participants involved two groups of students, one studying in a face-to-face mode and the other in a distance learning mode. They took part in a survey which was conducted in 2019 before the pandemic (with a total of 912 responses) and 2021 during the pandemic (with a total of 1,018 responses). The results show that both groups of students generally perceived OER to be more useful during the pandemic. The specific types of OER which were perceived as relatively more useful include open online courses and open access textbooks. Face-to-face students showed a higher level of perceived usefulness of OER for preparing tests and examinations, while distance learning students perceived OER as more useful for supplementing course materials. They both concerned about the limitations of OER, especially on accuracy and comprehensiveness. The findings suggest the importance of recognizing the diverse needs of the two groups of students and offering appropriate OER support for them.

If you build it, will they vaccinate? The impact of COVID-19 vaccine sites on vaccination rates and outcomes

Safe and effective vaccines have vastly reduced the lethality of the COVID-19 pandemic worldwide, but disparities exist in vaccine take-up. Although the out-of-pocket price is set to zero in the U.S., time (information gathering, signing up, transportation and waiting) and misinformation costs still apply. To understand the extent to which geographic access impacts COVID-19 vaccination take-up rates and COVID-19 health outcomes, we leverage exogenous, pre-existing variation in locations of retail pharmacies participating the U.S. federal government's vaccine distribution program through which over 40% of US vaccine doses were administered. We use unique data on nearly all COVID-19 vaccine administrations in 2021. We find that the presence of a participating retail pharmacy vaccination site in a county leads to an approximately 26% increase in the per-capita number of doses administered, possibly indicating that proximity and familiarity play a substantial role in vaccine take-up decisions. Increases in county-level per capita participating retail pharmacies lead to an increase in COVID-19 vaccination rates and a decline in the number of new COVID-19 cases, hospitalizations, and deaths, with substantial heterogeneity based on county rurality, political leanings, income, and race composition. The relationship we estimate suggests that averting one COVID-19 case, hospitalization, and death requires approximately 25, 200, and 1,500 county-level vaccine total doses, respectively. These results imply a 9,500% to 22,500% economic return on the full costs of COVID-19 vaccination. Overall, our findings add to understanding vaccine take-up decisions for the design of COVID era and other public health interventions.

Long-term functioning status of COVID-19 survivors: a prospective observational evaluation of a cohort of patients surviving hospitalisation.

OBJECTIVES: The study investigated the long-term functional status of hospitalised COVID-19 survivors to explore and document their functional situation. DESIGN: This prospective observational study assessed 801 COVID-19 survivors at 3-11 months after hospital discharge. It analyses participants' sociodemographic background, COVID-19 clinical manifestations, and clinical and functional evaluations. SETTING: Tertiary-level university hospital in São Paulo, Brazil. PARTICIPANTS: Study participants are COVID-19 survivors admitted to hospital care for at least 24 hours to treat acute SARS-CoV-2 infection. OUTCOME MEASURES: Epworth Sleepiness Scale, EuroQoL-5 Dimensions-5 Levels, Functional Assessment of Chronic Illness Therapy-Fatigue, Functional Independence Measure, Functional Oral Intake Scale, Handgrip Strength, Insomnia Severity Index, Medical Research Council (MRC) Dyspnea Scale, MRC sum score, Modified Borg Dyspnea Scale, pain Visual Analogue Scale, Post-COVID-19 Functional Status, Timed Up and Go, WHO Disability Assessment Schedule 2.0, 1-Minute Sit to Stand Test. RESULTS: Many participants required invasive mechanical ventilation (41.57%, 333 of 801). Mean age was 55.35±14.58 years. With a mean of 6.56 (SD: 1.58; 95% CI: 6.45 to 6.67) months after hospital discharge, 70.86% (567 of 800) reported limited daily activities, which were severe in 5.62% (45 of 800). They also reported pain and discomfort (64.50%, 516 of 800), breathlessness (64.66%, 514 of 795), and anxiety and depression (57.27%, 457 of 798). Daytime sleepiness and insomnia evaluations showed subthreshold results. Most (92.85%, 727 of 783) participants reported unrestricted oral intake. Data indicated no generalised fatigue (mean score: 39.18, SD: 9.77; 95% CI: 38.50 to 39.86). Assessments showed poor handgrip strength (52.20%, 379 of 726) and abnormal Timed Up and Go results (mean 13.07 s, SD: 6.49). The invasive mechanical ventilation group seemed to have a better handgrip strength however. We found no clear trends of change in their functional status during months passed since hospital discharge. CONCLUSIONS: Muscle weakness, pain, anxiety, depression, breathlessness, reduced mobility, insomnia and daytime sleepiness were the most prevalent long-term conditions identified among previously hospitalised COVID-19 survivors.

The great unequalizer: initial health effects of COVID-19 in the United States

We measure inequities from the COVID-19 pandemic on mortality and hospitalizations in the United States during the early months of the outbreak. We discuss challenges in measuring health outcomes and health inequality, some of which are specific to COVID-19 and others that complicate attribution during most large health shocks. As in past epidemics, pre-existing biological and social vulnerabilities profoundly influenced the distribution of disease. In addition to the elderly, Hispanic, Black and Native American communities were disproportionately affected by the virus, particularly when assessed using the years of potential life lost metric. For example, Hispanic and Black Americans in 2020 saw 39.5 and 25 percent increases in excess mortality relative to trend, compared to a less than 15 percent increase for Whites;we find losses in potential years of life three to four times larger among Hispanic and Black compared to White Americans. Individual-level data from a commercially insured population show that otherwise similar Black and Hispanic enrollees were hospitalized due to COVID-19 at a higher rate than White enrollees. We provide a conceptual framework and initial empirical analysis which seek to shed light on contributors to pandemic-related health inequality, and suggest areas for future research.

Patient and clinician use characteristics and perceptions of pulse oximeter use: A scoping review.

BACKGROUND AND OBJECTIVES: The need to monitor patients outside of a formal clinical setting, such as a hospital or ambulatory care facility, has become increasingly important since COVID-19. It introduces significant challenges to ensure accurate and timely measurements, maintain strong patient engagement, and operationalise data for clinical decision-making. Remote Patient Monitoring (RPM) devices like the pulse oximeter help mitigate these difficulties, however, practical approaches to successfully integrate this technology into existing patient-clinician interactions that ensure the delivery of safe and effective care are vital. The objective of this scoping review was to synthesise existing literature to provide an overview of the variety of user perceptions associated with pulse oximeter devices, which may impact patients' and clinicians' acceptance of the devices in a RPM context. METHODS: A search over three databases was conducted between April 2021 - June 2021 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review (PRISMA-ScR) guidelines. A total of 16 articles were included in this scoping review. RESULTS: Results indicate there has been an increase in use of pulse oximeters across hospital and community settings for continuous vital signs monitoring and remote monitoring of patients over time. Research in this area is shifting towards increasing accessibility of care through the development and implementation of telehealth systems and phone oximeters. Aspects of pulse oximeter UX most frequently investigated are usability and acceptability, however, these terms are often undefined, or definitions vary across studies. Perceived effectiveness, opportunity costs, and attitude towards use remain unexplored areas of UX. Overall, patients and clinicians view the pulse oximeter positively and find it user-friendly. A high level of learnability was found for the device and additional benefits included increasing patient self-efficacy and clinician motivation to work. However, issues getting an accurate reading due to device usability are still experienced by some patients and clinicians. CONCLUSION: This scoping review is the first to summarise user perceptions of the pulse oximeter in a healthcare context. It showed that both patients and clinicians hold positive perceptions of the pulse oximeter and important factors to consider in designing user-focused services include ease-of-use and wearability of devices; context of use including user's prior health and IT knowledge; attitude towards use and perceived effectiveness; impact on user motivation and self-efficacy; and finally, potential user costs like inconvenience or increased anxiety. With the rapid increase in research studies examining pulse oximeter use for RPM since COVID-19, a systematic review is warranted as the next step to consolidate evidence and investigate the impact of these factors on pulse oximeter acceptance and effectiveness.

Safety and Immunogenicity of INO-4800, a COVID-19 DNA Vaccine as a Primary Series and Booster

Background. DNA vaccines are safe, tolerable, elicit humoral and cellular responses, allow for repeated dosing over time, are thermostable at room temperature, and are easy to manufacture. We present a compilation of Phase 1 and Phase 2 data of Inovio's US COVID-19 DNA Vaccine (INO-4800) targeting the full-length Spike antigen of SARS-CoV-2. A South Korean Phase 2 study is ongoing. Methods. Participants in the open-label Phase 1 trial received 0.5 mg, 1.0 mg or 2.0 mg intradermally (ID) followed by electroporation (EP) at Days 0 and 28. An optional booster dose was administered >6 months post-dose 2. The Phase 2 further compared the 1.0 mg and 2.0 mg doses against placebo in a total of 401 participants randomized at a 3:3:1:1 ratio. ClinicalTrials.gov identifiers: NCT04336410 and NCT04642638 Results. The majority of adverse events (AEs) related to INO-4800 across both trials were mild in severity and did not increase in frequency with age and subsequent doses. In Phase 1, 78% (14/18) and 84% (16/19) of subjects generated neutralizing antibody responses with geometric mean titers (GMTs) of 17.4 (95%CI 8.3, 36.5) and 62.3 (95% CI 36.4, 106.7) in the 1.0 and 2.0 groups, respectively (Figure 1). By week 8, 74% (14/19) and 100% (19/19) subjects generated T cell responses by Th1- associated IFNγ ELISPOT assay . Following a booster dose, neutralizing GMTs rose to 82.2 (95% CI 38.2, 176.9) and 124.7 (95% CI 62.8, 247.7) in the 1.0 mg and 2.0 mg groups, respectively, demonstrating the ability of INO-4800 to boost (Figure 2). In Phase 2, neutralizing antibody responses demonstrated GMTs of 93.6 (95%CI 77.3, 113.4) in the 1.0 mg dose group and 150.6 (95%CI 123.8, 183.1) in the 2.0 mg dose group (Figure 3). Conclusion. INO-4800 appears safe and tolerable as a primary series and as a booster with the induction of both humoral and cellular immune responses. In addition to eliciting neutralizing antibodies, INO-4800 also induced T cell immune responses as demonstrated by IFNγ ELISpot. Finally, as a homologous booster, INO-4800, when administered 6-10.5 months following the primary series, resulted in an increased immune response without increase in reactogenicity. The 2.0 mg dose was selected for Phase 3 evaluation.

Sources of Supply and Demand in Cuba's Informal Foreign Exchange Market

Cuba's informal currency market has undergone a considerable growth in recent years, reaching a greater complexity in its organization and operation. The goal of this article is to contribute to a better understanding of the behavior of this kind of market, by describing its sources of supply and demand. Although these sources have undergone some changes depending on the situation, they have remained relatively stable, with the portfolio motive and informal imports being the main sources of demand, and informal remittances and tourism the fundamental sources of supply. In the last two years, the expansion of dollarization, the notable reduction of the good supply in pesos, the intensification of the blockade, the effects of COVID-19 and the fall in tourism, have led to transformations in this market and in the incentives, acquiring the portfolio motive and informal remittances a major role.

Tracki ng publi c and pri vate responses to the covi d-19 epi demi c evidence from state and local government actions

This paper examines the determinants of social distancing during the shutdown phase of the COVID-19 epidemic. We classify state and local government actions, and we study multiple proxies for social distancing based on data from smart devices. Mobility fell substantially in all states, even ones that did not adopt major distancing mandates. Most of the fall in mobility occurred prior to the most stringent sanctions against movement, such as stay-at-home laws. However, we find evidence suggesting that state and local policies did have an independent effect on mobility even after the large initial reductions occurred. Event studies show that early and information-focused actions such as first case announcements, emergency declarations, and school closures reduced mobility by 1–5 percent after five days. Between March 1 and April 14, average time spent at home grew from 9.1 hours to 13.9 hours. We find, for example, that without state emergency declarations, hours at home would have been 11.3 hours in April, suggesting that 55 percent of the growth is associated with policy and 45 percent is associated with (non-policy) trends. State and local government actions induced changes in mobility on top of a large and private response across all states to the prevailing knowledge of public health risks. © 2021 American Society of Health Economists.

Mandated and voluntary social distancing during the COVID-19 epidemic: a review

For much of 2020, the COVID-19 epidemic upended social and economic life globally. In an effort to reduce COVID-19 risks in the U.S., state and local governments issued many recommendations and regulations to induce social distancing, adding to voluntary reductions in interpersonal contact. The responses to the epidemic helped contain spread, but also lead to high unintended societal costs. In the summer months, states took steps to revive the economy and lift social distancing regulations. However, as many epidemiologists expected, the scale of the epidemic has expanded very rapidly in the fall. In the week of October 14, the US generated around 57,000 new COVID-19 cases and 700 deaths each day. By November 15, the country was generating about 151,000 new cases and 1,200 deaths per day. These rapid increases in cases and deaths raise concerns about the capacity of local healthcare systems around the country. State governments are once again facing difficult choices about whether and how to use policies to address the spread of the virus. The incoming Biden-Harris administration faces an important challenge in trying to manage the epidemic as well as a large scale vaccination campaign. Although the epidemic is less than a year old, it has generated a huge volume of research by economists, epidemiologists, and others. This body of work may help inform policy decisions facing society in the coming months.

Paid sick-leave and physical mobility: evidence from the United States during a pandemic

We study the effects of a massive temporary U.S. paid sick leave (PSL) mandate that became effective April 1st, 2020 on self-quarantining, proxied by physical mobility behaviors gleaned from cellular devices. Such behaviors are critical for containment of infectious diseases. The national PSL policy was implemented in response to the COVID-19 global pandemic and mandated two weeks of fully compensated paid leave. We study the impact of this policy using difference-in-differences methods, leveraging pre-policy county-level differences in the share of 'nonessential' workers likely eligible for paid sick leave benefits. We find robust evidence that the policy increased the average number of hours at home and reduced the share of the individuals likely at work. Comparing the county with the lowest to highest policy exposure, we find that the average hours per day not at home, and at work decreased by 8.9% and 6.9% post- policy.