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BACKGROUND: Although interest in qualitative olfactory dysfunction (OD), including parosmia and phantosmia, has been increasing since the COVID-19 pandemic, little is known about the clinical characteristics and associated factors of qualitative OD. METHODS: Adult patients with subjective smell disturbance who underwent both the olfactory questionnaire and psychophysical olfactory function test were retrospectively enrolled. Demographic and clinical characteristics were analysed according to the presence or absence of parosmia or phantosmia. RESULTS: Among a total of 753 patients with self-reported OD, 60 (8%) and 167 (22.2%) patients reported parosmia and phantosmia, respectively. Younger age and female sex were related to both parosmia and phantosmia. The frequency of parosmia was significantly higher in patients with post-viral OD (17.9%) than in patients with the sinonasal disease (5.5%), whereas that of phantosmia was not different according to aetiologies of OD. Patients with COVID-19 had significantly younger ages and higher TDI scores than those with other viral infections. Remarkably, patients with parosmia or phantosmia had significantly higher TDI scores than those without but experienced more disruption in daily life. In the multivariate analysis, younger age and higher TDI score were identified as independent factors associated with both parosmia and phantosmia, while the viral infection was associated with parosmia but not with phantosmia. CONCLUSIONS: Patients with OD who have parosmia or phantosmia have higher odour sensitivity than those who do not, but experience more deterioration in the quality of life. Viral infection is a risk factor for parosmia but not for phantosmia.
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Background: Nervous system post-acute sequelae of COVID-19 (NS-PASC) include cognitive and mental health symptoms. To further define these, we applied a Research Domain Criteria (RDoC) approach to examine motor, positive valence (PV) and negative valence (NV) systems, and social processing data in The COVID Mind Study of NS-PASC. Method(s): NS-PASC participants (>3 months after COVID-19) referred from a NeuroCOVID Clinic and non-COVID controls from New Haven, CT and Baltimore, MD completed an RDoC test battery for cognition (language, declarative and working memory, cognitive control, perception), motor, PV, NV, and social processes. To date, 3T MRI with diffusion tensor imaging was performed in 11 NS-PASC to assess white matter integrity (global white matter fractional anisotropy [FA]) as a contributor to alterations identified on the RDoC tests. Analysis of Covariance examined group differences after adjusting for sex, race, ethnicity, age, and years of education. Result(s): 25 NS-PASC participants (age 43.4+/-11.3 yrs, 76% female, 402 days after COVID-19 symptom onset) and 29 controls (age 46.2.6+/-13.1 yrs, 66% female) completed the battery. Controls were more racially diverse and less educated than NS-PASC (43% vs. 12% Black, p=0.005;14.5 vs. 16.1 yrs of education, p< 0.05). Means and statistics for RDoC between NS-PASC and controls are shown in Table. NS-PASC performed worse in language, verbal working and declarative memory, and perception and reported greater cognitive control difficulties (e.g., behavioral inhibition, set shifting) without issues on performance-based metrics (Stroop, Trail Making Test-Part B), and had slower motor function. NS-PASC reported more NV issues including greater symptoms of depression, rumination in response to depressive mood, apathy, childhood trauma, anxiety, and perceived stress. There were no differences in PV and social processing. In a subset of NS-PASC participants who underwent MRI, there was a dynamic range of FA values with a mean of 0.509 (IQR 0.481 - 0.536). Conclusion(s): Our findings extend previous PASC studies characterizing cognitive and mental health alterations, indicating that additional RDoC assessments warrant focus, including alterations in motor and the negative valence system. In future analyses, we will examine white matter integrity as a pathophysiologic contributor to these RDoC systems.
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Background: It is unknown whether individuals with neurological post-acute sequelae of COVID-19 (NeuroPASC) display altered levels of neuroimmune activity or neuronal injury. Method(s): Participants with new or worsened neurologic symptoms at least 3 months after laboratory-confirmed COVID-19 were enrolled in The COVID Mind Study at Yale. Never COVID controls (no history of COVID-19;nucleocapsid (N) antibody negative) were pre-pandemic or prospectively enrolled volunteers. CSF and plasma were assessed for neopterin and for IL-1beta, IL-1RA, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p40, IL-12p70, IL-13, MCP-1, TNFalpha by bead-based multiplex assay;and for anti-SARS-CoV-2 N antibodies by Luminex-based multiplex assay in technical replicate, normalized against bovine serum albumin conjugated beads. Plasma concentrations of D-dimer, C-reactive protein, neurofilament light chain (NFL), and glial fibrillary acid protein (GFAP) were measured using high-sensitivity immunoassays. Group comparisons used non-parametric tests. Result(s): NeuroPASC participants (n=38) were studied 329 (median) days (range 81-742) after first positive test for acute COVID-19. Cognitive impairment (84%) and fatigue (82%) were the most frequent post-COVID symptoms. NeuroPASC and controls (n=22) were median 49 vs 52 yrs old (p=0.9), 74% vs 32% female (p< 0.001), 76% vs 23% white race (p< 0.001), and 6% vs 57% smokers (p< 0.001). CSF white blood cells/mL, CSF protein, and serum:CSF albumin ratio were normal in both groups. CSF TNFalpha (0.66 vs 0.55 pg/ul) and plasma IL12p40 were higher (103.3 vs 42.7);and MCP-1 (503 vs 697 pg/ul) and IL-6 (1.32 vs 1.84 pg/ul;p < 0.05 for IL-6) were lower in NeuroPASC vs controls (p< 0.05);but none of these differences were significant after adjusting for multiple comparisons. Plasma GFAP was elevated in NeuroPASC vs controls (54.4 vs 42.3 pg/ml;adjusted p< 0.03). There were no differences in the other biomarkers tested. 10/31 and 7/31 NeuroPASC had anti-N antibodies in CSF and plasma, respectively. Conclusion(s): When comparing NeuroPASC to never COVID controls, we found no evidence of neuroinflammation (normal CSF cell count, inflammatory cytokines) or blood-brain barrier dysfunction (normal albumin ratio), and no support for ongoing neuronal damage (normal plasma NFL). Future studies should include better gender and race matched controls and should explore the significance of a persistent CNS humoral immune response to SARS-CoV-2 and elevated plasma GFAP after COVID-19. (Figure Presented).
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Purpose - The purpose of this study is to analyze the market power of the Korea Container Shipping Market (Intra Asia, Korea-Europe, and Korea-U.S.) to verify the existence of collusion empirically, and to answer whether the joint actions of liner market participants in Korea have formed market dominance for each route. Precisely, it will be verified through the Lerner index as to whether the regional market of Asia is a monopoly, oligopoly, or perfect competition. Design/methodology - This study used a Lerner index adjusted with elasticity presented in the New Imperial Organization (NEIO) studies. NEIO refers to a series of empirical studies that estimate parameters to judge market power from industrial data. This study uses B-L empirical models by Bresnahan (1982) and Lau (1982). In addition, NEIO research data statistically contain self-regression and stability problems as price and time series data. A dynamic model following Steen and Salvanes' Error Correction Model was used to solve this problem. Findings - The empirical results are as follows. First, lambda, representing market power, is nearly zero in all three markets. Second, the Korean shipping market shows low demand elasticity on average. Nevertheless, the markup is low, a characteristic that is difficult to see in other industries. Third, the Korean shipping market generally remains close to perfect competition from 2014 to 2022, but extreme market power appears in a specific period, such as COVID-19. Fourth, there was no market power in the Intra Asia market from 2008 to 2014. Originality/value - Doubts about perfect competition in the liner market continued, but there were few empirical cases. This paper confirmed that the Korea liner market is a perfect competition market. This paper is the first to implement dynamics using ECM and recursive regression to demonstrate market power in the Korean liner market by dividing the shipping market into Deep Sea and Intra Asia separately. It is also the first to prove the most controversial problems in the current shipping industry numerically and academically.
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We investigate the mechanisms of investors' herding behavior using machine learning and textural data analysis from social media and the impact of sentiment in forming the herding behavior. We find that the abnormal information creation activity (AICA) for the retail investor is positive and statistically significant with the herding behavior, while informed investors with access to valuable information are negative with relation to the AICA. The herding behavior in firms traded by the retail investor is strongly related to the sentiment in social media at the cross-sectional level and has been more effective after COVID-19.
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Objective: There is a growing interest in subacute thyroiditis (SAT), as this self-limited inflammatory thyroid disorder can be one of the manifestations of SARS-CoV-2 infection or side effects of COVID-19 vaccination. However, studies comparing the clinical characteristics of the SAT patients before and after the onset of COVID-19 pandemic have been scarce. Here, we tried to evaluate the clinical difference of the SAT patients before and after the onset of COVID-19 pandemic. Method(s): A retrospective study was conducted with SAT patients (n = 51) who visited our outpatient clinic between 2011 and 2021. All the patients were diagnosed as SAT with the modified criteria proposed by Stasiak et al., and all of them had at least two times of thyroid ultrasonographies (initial visit and after resolution). The patients were divided into two groups based on the date of the first reported COVID-19 infection (31 patients before and 20 patients after the first reported infection in South Korea, 8th, January 2020), and comparison study was performed. Result(s): Clinical characteristics such as sex and age were similar between the SAT patients before and after the COVID-19 pandemic. Laboratory tests including thyroid function tests, thyroid autoantibodies, complete blood count, inflammatory markers (ESR, CRP) also showed no significant difference. Moreover, the proportion of patients who had bilateral involvement on thyroid ultrasonography, who showed hypothyroid phase during their clinical course and who had persistent hypothyroidism requiring levothyroxine replacement were comparable between the two SAT groups. In addition, the proportion of SAT patients who took prednisolone, their cumulative doses and treatment periods were similar between the groups divided based on the onset of COVID-19 pandemic. Thyroid volumes at initial visit and after resolution also showed no significant difference between the two subgroups. Conclusion(s): This study shows that the clinical characteristics of SAT patients have not been notably changed during the COVID-19 pandemic. Further studies comparing the SAT patients before the SARS-CoV-2 pandemic and SAT patients associated with COVID-19 infection are needed to clarify the association between SARSCoV-2 and SAT in more detail.
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While technologies enable better observation and control over supply chain dynamics through visibility and real-time data analytics, the COVID-19 pandemic has intensified disruption-related challenges to supply chain network dynamics. Thus, these increased uncertainties and risks make it impossible to proactively predict the areas and sizes of surges in COVID-19 infections without limiting people’s freedom of movement. This notion implies that we may need to focus on reactive planning to transfer COVID-19 treatment between hospitals and/or hospital systems. We introduce an optimization model for reactive short-term vehicle routings for such transfers. The optimization model proposed in this study can simultaneously grasp vehicle movement and cargo location information while minimizing the total travel time of vehicles, which can handle the urgency of treatment transfers by changing the value of the limited travel time of vehicles. Although the model does not include every condition that can be considered in the treatment transfers between hospitals, it shows the potential of the model we proposed in the transfer of treatment in case of shortages. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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In order to help adolescents cope with loneliness during the social distancing and isolation imposed by the COVID-19 pandemic, we designed a conversational agent programmed to distract users from negative thoughts and advise them on strategies to improve their wellbeing. In order to assess the effects of the agent intervention on adolescent participants, we performed quantitative analysis of their self-reported mood states and qualitative analysis of their subjective views and opinions on the agent to help us understand their experiences. Trends in the quantitative data point to minimal changes in participants' wellbeing and loneliness after interactions with the experimental agent. However, qualitative data on adolescent experiences suggests short and long-term positive effects of the experimental interactions. In reporting our findings, we aim to bring attention to the importance of the qualitative data for understanding human experiences with technology, as well as the limitations of the instruments developed in the field of psychology for human-information interaction research. 85th Annual Meeting of the Association for Information Science & Technology ;Oct. 29 – Nov. 1, 2022 ;Pittsburgh, PA. Author(s) retain copyright, but ASIS&T receives an exclusive publication license.
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COVID-19 measures of isolation exacerbated the negative feeling, particularly in younger and older populations. We tested a voice conversational agent designed to support teens by offering interactions based on five types of behavioral interventions (compassion, self-compassion, positive psychology, mindfulness, and humor), and examined teen reactions to these interventions. Thirty-nine adolescents were asked to assess one randomized interaction a day for fifteen days. All five intervention types received positive ratings, with self-compassion scoring the highest and compassion scoring the lowest by the participants. Participants shared more positive than negative feedback about the interaction scenarios, the perceived agent’s personality and conversational flow. Positive feedback emphasized enjoyment and benefits of the interaction, empathetic traits in the agent’s responses, a sense of validation, and moments for self-reflection fostered by the interactions. Participants enjoyed the conversation flow that felt similar to a natural conversation. Negative comments generally revolved around perception of the impersonal agent, inappropriate pace of conversation (too slow/fast) or number of conversational turns, and dislike of some interaction topics. Recommendations based on this exploratory work are included. 85th Annual Meeting of the Association for Information Science & Technology ;Oct. 29 – Nov. 1, 2022 ;Pittsburgh, PA. Author(s) retain copyright, but ASIS&T receives an exclusive publication license.
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BACKGROUND: The COVID-19 pandemic has placed extraordinary strains on a U.S. healthcare system already grappling with an epidemic of physician burnout. Given the negative effects of burnout on patient care, it is critical to explore the perspectives of physicians during this demanding and evolving health crisis. This qualitative study aimed to understand how the COVID-19 pandemic has impacted physicians' wellbeing, sense of purpose, and views on the practice of medicine. METHODS: This study is a continuation of the Project on the Good Physician, a national survey examining physicians' professional and moral development. Of survey respondents, a subset of physicians expressed interest in a follow-up interview regarding physician wellness, spirituality and religion, and meaning in medicine. 21 practicing and retired physicians representing a variety of specialties, practice settings, and religious and non-religious backgrounds participated in a one-hour qualitative phone interview conducted from August 2020-July 2021. Participants answered open-ended, reflective questions concerning key points in their professional development, experiences with burnout and maintaining wellness, and the impact of the COVID-19 pandemic professionally and personally. Transcripts were then coded via a consensus-based iterative process. RESULTS: Of 85 contacted physicians, 21 participated in a phone interview (response rate: 25%). The sample consisted of 11 women (52%), 16 (76%) internal medicine, family medicine, or general practitioners, and 15 (71%) currently practicing physicians. Physicians described fear for themselves, patients, and colleagues during the pandemic, and largely attributed fear to a lack of information and guidance. Similarly, participants expressed frustration with leadership at multiple levels and the politicization of the pandemic. Despite the stresses of the pandemic and describing a greater susceptibility to burnout, many physicians reported no change to or an increased sense of purpose. Additionally, some participants described how the pandemic helped clarify personal and professional priorities and served as a period of reflection regarding their allocation of time and energy. Interviewees also highlighted the importance of maintaining pre-established wellness practices and religious/ spirituality practices. Finally, physicians shared their perspectives on the future of medicine, such as the shift to telemedicine, an increased focus on public and preventative health, and the importance of reestablishing trust in the medical field. CONCLUSIONS: While the COVID-19 pandemic has led to increased physician stress and burnout, the experience has also provided professional affirmation and has served as a catalyst for physicians to reflect on the course of their professional and personal lives. These findings have important implications for how we support physicians as the pandemic continues, and how we prepare future physicians for careers as the practice of medicine evolves.
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In 2020, COVID-19 became a global pandemic;new vocabulary such as self-quarantine, social distancing, and temporary living facilities emerged in tandem with a rising interest for indoor isolation spaces. As a result, more than 80-90% were voluntarily or artificially trapped in an indoor space, essentially making indoor air quality a top priority. Since 2003, the Ministry of Environment in Korea implemented and imposed on local governments the indoor air quality management law as a statutory regulation to monitor and determine if the recommended standard range is exceeded;it measures, diagnoses, evaluates, and informs indoor air quality from sample households during a certain period and a certain number of times each year. Since 2000, many researchers have studied indoor air quality, but research on radon in new apartment buildings is somewhat insufficient. Since 2018, the dangers of domestic and foreign radon have been intensifying. From 2019, Korea was obliged to strengthen the recommendation standards for radon and to notify its measurements and diagnosis. For new apartment buildings with business plans approved after January 1, 2018, residents were provided with obligatory access to the measured and diagnosed indoor air quality. This study examines the administrative notices from 2017 to 2020 regarding the indoor air quality measurements and evaluations of new apartment buildings conducted by the Ministry of Environment. Actual radon measurement data for approximately 3,000 new apartment housing units scheduled to move in between June and October 2021 were analyzed and evaluated to determine how well the recommended radon standards set by the Ministry of Environment were followed. Additionally, achieving the goal of reducing radon from the current standard of 148Bq/㎥ to 100Bq/㎥ by 2024 was assessed. © 2022 Architectural Institute of Korea.
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Purpose - This study's purpose is to analyze which factors are more important to strengthening the competitiveness of global innovative companies by firstly sampling global 40 enterprises, secondly investigating of study models empirically, thirdly finding out significant implications through research, and finally using this result to help improve global companies' competitive edges. Design/methodology - Developing three research models of hypothesis and using 5 variables such as technology innovation, knowledge management, human resource development, sustainable management, and corporate life, this study was empirically carried out by reliability and validity testing, correlation analysis of variables, and multiple regression analysis of three research models. Findings - Through proceeding empirical analysis study, we found out that technology innovation and sustainable management had a significant impact on strengthening competitiveness through the hypothesis test. Those two factors had positive results and a synergy effect through correlation analysis along with process change and human resource development, which are also important areas in global innovative companies. Originality/value - In line with the fourth industrial revolution era's acceleration and COVID-19's large impact on all industries, global companies are newly developing their business models to cope with external environment change. This study's results would be meaningful for global enterprises and domestic companies to improve their overall competitive edge by reinforcing their innovation strategy, preparing next growth engines, diversifying business portfolios, and setting business milestones.
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The effect of decreased human activity on the urban heat island intensity (UHII) was analyzed using the observed temperature data of six sites (including one reference area) in Daejeon Metropolitan City from February to May of 2019 to 2021. Depending on the observation site, UHII decreased by approximately 20% in 2020 and 2021 compared to 2019 before COVID-19. The decrease in human activity increased UHII at night and decreased it during the daytime. Consequently, UHII diurnal amplitude increased by approximately 20% in 2020 and 2021 compared to 2019, irrespective of location. The decrease in UHII did not appear to be significantly correlated with natural factors such as wind speed and social distancing steps. In contrast, UHII was correlated with social distancing and significantly reduced air pollutants after COVID-19, with the most significant correlation observed for NO2.
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In this article, we adopted the Full Information Maximum Likelihood (FIML) Markov-switching model of Yoon to examine the contribution of the UK housing business cycle to the common G7 housing business cycle between housing price and GDP seeking to access the impact of Brexit on G7 properties. Taking a sample of G7 countries we investigated a period of over 50 years, using quarterly data from 1970:II to 2020:IV. Our findings demonstrate that UK GDP is a significant variable contributing to the G7 GDP growth, and furthermore that the UK housing price is a significant variable to the G7 housing prices. Considering common international housing business cycle, we found that the UK is not a significant variable for determining the common international housing business cycle between housing price and the real growth of output in the G7 countries. Finally, applying a FIML Markov-switching model to the G7 countries, we found a common international housing business cycle during the oil shock periods of the 1970s, the financial crisis in 2008, and COVID-19 pandemic. These findings are the first empirical evidence of the comparison of COVID-19 pandemic and other crises in terms of common international housing business cycle, thus providing significant input for policymakers.
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Background: The pathogenesis of neuropsychiatric symptoms persisting months after acute SARS-CoV-2 infection is poorly understood. We examined clinical and laboratory parameters in participants with post-acute COVID-19 neuropsychiatric symptom to assess for systemic and nervous system immune perturbations. Methods: Participants with a history of laboratory confirmed COVID-19 and ongoing neurologic symptoms were enrolled in an observational study that collected medical history;detailed post-COVID symptom survey;and paired cerebrospinal fluid (CSF) and blood. In addition to standard clinical labs, neopterin and anti-SARS-CoV-2 antibodies (anti-spike, RBD, and nucleocapsid) were measured by ELISA. Non-parametric tests were used to compare CSF and blood findings between the post-COVID participants and pre-COVID-19 era healthy controls. Results: Post-COVID participants (n=27) and controls (n=21) were similar in age (median 51 and 46 years), but there was a greater proportion of females (67% vs 24%;p=0.004) and white participants in the post-COVID cohort (63% vs 24%;p=0.04). The post-COVID study visit was a median of 264 days (IQR 59-332) after acute COVID-19 symptom onset. 35% were hospitalized during their acute illness;12% required intensive care. 33% had previously been treated with medications for mental health conditions. The most frequent neuropsychiatric symptoms were cognitive impairment (67%), mood symptoms (67%), headache (56%), and neuropathy (41%). Blood c-reactive protein, T cell count, and T cell subset frequency (CD4% and CD8%) were similar between groups, while D-dimer was higher in the post-COVID cohort (median 0.48 vs 0.27 mg/L;p = 0.019) (Figure). CSF WBC, protein, neopterin, and CSF/blood albumin ratio were similar between the groups;the frequency of CSF lymphocytes was lower in the post-COVID cohort (p = 0.05) (Figure 1). Antibodies against at least one SARS-CoV-2 antigen were detected in 7/10 CSF and 8/9 blood samples in the post-COVID CSF (antibody reactivity range 1.5 to 55-fold greater than to control antigens). Conclusion: In this small cohort of post-COVID participants with neurologic symptoms, we found limited differences in CSF and blood markers when compared to pre-pandemic healthy controls. Deeper immunophenotyping in a larger number of participants may provide greater insight into subtle differences. The presence of anti-SARS-CoV-2 antibodies in CSF months after acute infection warrants further investigation.
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Purpose - This study aimed to understand adolescents experiences, negative feelings and coping mechanisms associated with the major disruption caused by the COVID-19 pandemic. The purpose of this study was to develop a baseline for understanding adolescents and their environment to assist future developments of technological and other solutions to mitigate adolescents' loneliness, improve their wellbeing and strengthen their resilience. Design/methodology/approach - The data about adolescents' experiences during the COVID-19 pandemic was collected through virtual interviews conducted via Zoom. A total of 39 adolescents (aged 12 through 18 years) primarily from the North East of the USA participated in the study. The transcripts of the interviews were analyzed using thematic analysis. Findings -This study found evidence of negative disruptions to adolescents' social, learning and emotional routines. This study also found that in dealing with the effects of COVID-19 disruption, most of the participants exhibited five key attributes of individual resilience, including social competence, problem-solving, critical consciousness, autonomy and a sense of purpose. External factors supporting resilience were also mentioned, including technology resources, family, school and broader community. Originality/value - This study relied on fast-hand adolescents' reports of their experiences, feelings and coping strategies during the pandemic. This study applied a resilience framework to interpret the findings and translate them into recommendations for further development of support systems for adolescents.
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Online education is popular for various remote trainings, or it becomes inevitable in anomalous situations, for example, COVID-19 pandemic. One of the well-recognized online education platforms is massive online open courses, whose contents are developed by world-famous experts. However, the learning effectiveness of online education is not yet higher than face-to-face classroom education. It is in part because the online contents are uniformly designed for all heterogeneous online students, even to the students who need the same course topic at different levels. Also when a student needs to revisit a course content to strengthen his or her weakness, typical online infrastructures do not pinpoint their areas of weakness to go over. This chapter proposes both online lecture and mobile assessment platforms to elevate the quality of distance learning. The online platform proposed is the three-layers of four quadrant panes. The online platform has three layers: (1) basic, (2) advanced, and (3) application per course module. Each layer is divided into four quadrants: (a) slides quadrant, (b) videos quadrant, (c) summary quadrant, and (d) quizlet quadrant panes. Students begin with the basic layer first, dive into the advanced layer, and apply the application layer. The other platform is a mobile assessment. One of the critical issues in distance learning is fair assessment management. Smartphone-based assessment of online student learning performance disables the high chance of cheating schemes and enables the building of student learning patterns. Its analytics eventually leads to the reorganization of online course module sequences. The contribution is (1) an accurate recognition of student weakness;(2) an intelligent and automatic answering to student questions;and (3) a mobile phone application-based assessment. © 2021 Elsevier Inc. All rights reserved.