Plague God Image in the Clinic.

This paper selects four dreams before and during COVID-19 which constellated the Plague God image in Chinese culture. The author argues that this shows evidence that the origins of the modern psyche, although hidden, are preserved and living within the ancient anima mundi.

Cet article sélectionne quatre rêves produits avant et pendant la pandémie de COVID-19 et qui montrent la constellation de l'image divine de la peste dans la culture Chinoise. L'auteur soutient que ceci montre la preuve que les origines de la psyché moderne, bien que cachées, sont préservées et vivantes au sein de l'ancien anima mundi.

El presente artículo selecciona cuatro sueños antes y durante la pandemia del COVID-19 que constelan la imagen del dios de la peste en la cultura China. El autor argumenta que esto demuestra que los orígenes de la psique moderna, aunque ocultos, se conservan y viven dentro de la antigua anima mundi.

The Relationship between Short Video Flow, Addiction, Serendipity, and Achievement Motivation among Chinese Vocational School Students: The Post-Epidemic Era Context.

Since the COVID-19 outbreak, people have been spending more time in the online world because of restrictions on face-to-face communication due to epidemic prevention controls. This has also brought the issue of Internet addiction, including the overuse and negative effects of short videos, to the forefront of attention. Past research has found that Internet addiction has a negative impact on well-being. However, there is a special concept of positive emotion called "serendipity" (). Serendipity provides a small, fleeting but positive experience, yet it is often associated with negative perceptions from an outside perspective. However, the relationship between short video addiction and serendipity is not yet known. Based on this, a theoretical model was developed in the context of the I-PACE model. To understand the relationship between short video addiction and serendipity among college students, in this study, we conducted snowball sampling and distributed online questionnaires using the Wenjuanxing platform. The target population of the questionnaire distribution was vocational college students in China, of whom 985 valid study participants responded, yielding a valid return rate of 82.1%. Of the respondents, 410 (41.6%) were male and 575 (58.4%) were female. The results were as follows: a. short video flow had a positive relationship with serendipity, a negative relationship with achievement motivation, and a positive effect on short video addiction; b. short video addiction had a positive effect on serendipity and a negative effect on achievement motivation; and c. serendipity had a negative impact on achievement motivation. This shows that short video addiction, like other Internet addictions, can have a negative impact on students' learning.

Psychometric analysis of the Escala de Cansancio Emocional in Ecuadorian college students during the COVID-19 outbreak

(Portuguese) O esgotamento emocional academico e o primeiro estagio da Sindrome de Burnout Academico, sendo necessario avalia-lo e intervir precocemente, pois as consequencias sao significativas para as pessoas. O objetivo desta pesquisa e realizar uma analise psicometrica da Escala de Cansaco Emocional (Escala de Cansancio Emocional, ECE) para avaliar sua estrutura interna, invariancia de medida e confiabilidade da consistencia interna, em uma amostra de estudantes universitarios equatorianos no contexto da pandemia COVID-19. Participaram 453 estudantes universitarios do Equador (76,21 % mulheres) entre 17 e 35 anos (M = 22,76 anos). Os resultados mostram que a estrutura unidimensional possui suporte estatistico, e invariavel em relacao ao sexo e apresenta adequada confiabilidade de consistencia interna. Conclui-se que a ECE possui propriedades psicometricas adequadas que permitem seu uso em estudantes universitarios equatorianos. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Spanish) El agotamiento emocional academico es la primera etapa del sindrome de burnout academico, y es necesario evaluarlo e intervenir temprano ya que las consecuencias son significativas para las personas. El objetivo de esta investigacion es realizar un analisis psicometrico de la Escala de Cansancio Emocional (ECE) para evaluar su estructura interna, invariancia de medida y confiabilidad de consistencia interna, en una muestra de estudiantes universitarios ecuatorianos en el contexto de la pandemia COVID-19. Participaron 453 estudiantes universitarios de Ecuador (76.21 % mujeres) de entre 17 y 35 anos (M = 22.76 anos). Los resultados muestran que la estructura unidimensional tiene soporte estadistico, es invariante en cuanto al sexo y muestra una adecuada confiabilidad de consistencia interna. Se concluye que la ECE tiene propiedades psicometricas adecuadas que permiten su uso en estudiantes universitarios ecuatorianos. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Isolated arteritis misdiagnosed as bilateral orbital tumors in a patient with acute ischemic stroke.

Vasculitis is a heterogeneous group of disorders characterized by multifocal segmental inflammation of the small and medium vessels of the central nervous system. The predominant symptoms of cerebral vasculitis are stroke, headache, and encephalopathy. Additional symptoms include seizures, cranial nerve palsies, and myelopathy. Imaging techniques play a crucial role in identifying the diagnosis of vasculitis and demonstrating brain involvement. An 89-year-old woman with permanent atrial fibrillation developed an embolic stroke. In treatment, intravenous thrombolysis and thrombectomy with complete antegrade reperfusion of the left middle cerebral artery was used, without the clinical effectiveness. Brain MRI revealed bilateral oval lesions in medial parts of the orbits, which were initially misinterpreted as orbital tumors. Final diagnosis confirmed thickened arterial walls as orbital changes due to inflammatory arteritis. Ten days later, follow-up MRI was performed and showed complete regression of the orbital masses. Primary central nervous system vasculitis, manifesting as acute ischemic stroke, may be reversible with early systemic thrombolytic treatment.

Evidence and Implications of the Affordable Care Act for Racial/Ethnic Disparities in Diabetes Health During and Beyond the Pandemic.

Amid the global pandemic, it becomes more apparent that diabetes is a pressing health concern because racial/ethnic minorities with underlying diabetes conditions have been disproportionately affected. The study proposes a multiyear examination to document the role of the Affordable Care Act (ACA) in racial/ethnic disparities in diabetes health. Using the Behavioral Risk Factor Surveillance System from 2011 to 2019, the study with a pre-post design investigated changes in access to care and diabetes health among non-White minorities compared with Whites before and after the ACA by conducting multivariable linear regression, with state-fixed effects and robust standard errors. Compared with Whites, racial/ethnic minorities showed significant improvements in health insurance coverage, having a personal doctor, and not seeing a doctor because of cost. Blacks (3.2% points, P ≤ 0.000), Hispanics (1.6% points, P = 0.001), and "other" racial/ethnic group (1.5% points, P = 0.003) experienced a greater increase in diagnosed prediabetes than Whites, whereas no and small differences were found in diagnosed diabetes and obesity, respectively. The yearly comparisons of changes in diagnosed prediabetes showed that Blacks compared with Whites had a growing increase from 1.2% points (P = 0.001) in 2014 to 3.3% points (P = 0.001) in 2019. Insurance coverage has declined after 2016, and obesity had an increasing trend across race/ethnicity. The ACA had a positive role in improving access to care and identifying those at risk for diabetes to a larger extent among racial/ethnic minorities. However, the policy impacts have been diminishing in recent years. Continued efforts are needed for sustained policy effects.

The impact of novel coronavirus disease (COVID-19) on emergency and essential surgical care in Gedeo and Sidama zone hospitals: An institutional-based multicenter cross-sectional study.

Background: COVID-19 was initially detected in China's Wuhan, the capital of Hubei Province, in December 2019, and has since spread throughout the world, including Ethiopia. Long-term epidemics will overwhelm the capacity of hospitals and the health system as a whole, with dire consequences for the developing world's damaged health systems. Focusing on COVID-19-related activities while continuing to provide essential services such as emergency and essential surgical care is critical not only to maintaining public trust in the health system but also to reducing morbidity and mortality from other illnesses. The goal of this study was to see how COVID-19 affected essential and emergency surgical care in Gedeo and Sidama zone hospitals. Method: ology: A cross-sectional study was carried out in ten (10) hospitals in the Gedeo and Sidama zone. The information was gathered with the help of the world health organization (WHO) situational analysis tool for determining emergency and essential surgical care (EESC) capability. Infrastructure, human resources, interventions, and EESC equipment and supplies were used to assess the hospitals' capacity. Result: 54.3% of the 35 fundamental therapies indicated in the instrument were available before COVID-19 at all sites, while 25.2 percent were available after the COVID-19 pandemic. During the COVID-19 pandemic, there was a sharing of resources for treatment centers, such as a scarcity of oxygen and anesthesia machines, and emergency surgery was postponed. Before admission, the average distance traveled was 58 km. Conclusion: The COVID-19 pandemic, as well as existing disparities in infrastructure, human resources, service provision, and essential equipment and supplies, reveal significant gaps in hospitals' capacity to provide emergency and essential surgical services and effectively address the growing surgical burden of disease and injury in Gedeo and Sidama zone primary, general, and referral hospitals.

Community Health Centers Maintained Initial Increases in Medicaid Covered Adult Patients at 5-Years Post-Medicaid-Expansion.

The Affordable Care Act (ACA) Medicaid expansion created new financial opportunities for community health centers (CHCs) providing primary care in medically-underserved communities. However, beyond evidence of initial policy effects, little is understood in the scholarly literature about whether the ACA Medicaid expansion affected longer-lasting changes in CHC patient insurance mix. This study's objective was to examine whether the ACA Medicaid expansion was associated with lasting increases in the annual percentage of adult CHC patients covered by Medicaid and decreases in the annual percentage of uninsured adult CHC patients at expansion-state CHCs, compared to non-expansion-state CHCs. This observational study examined 5353 CHC-year observations from 2012 to 2018 using Uniform Data System data and other national data sources. Using a 2-way fixed-effects multivariable regression approach and marginal analysis, intermediate-term policy effects of the Medicaid expansion on annual CHC patient coverage outcomes were estimated. By 5-years post-expansion, the Medicaid expansion was associated with an overall average increase of 11.7 percentage points in the percentage of adult patients with Medicaid coverage at expansion-state CHCs, compared to non-expansion-state CHCs. Among expansion-state CHCs, 39.8% of adult patients were predicted to have Medicaid coverage 5-years post-expansion, compared to 19.0% of non-expansion-state adult CHC patients. A state's decision to expand Medicaid was similarly associated with decreases in the annual percentage of uninsured adult CHC patients. Primary care operations at CHCs critically depend on patient Medicaid revenue. These findings suggest the ACA Medicaid expansion may provide longer-term financial security for expansion-state CHCs, which maintain increases in Medicaid-covered adult patients even 5-years post-expansion. However, these financial securities may be jeopardized should the ACA be ruled unconstitutional in 2021, a year after CHCs experienced new uncertainties caused by COVID-19.

Trump v. The ACA.

Before his incoherent response to the COVID-19 pandemic, the focus of President Trump's health policy agenda was the elimination of the Patient Protection and Affordable Care Act (ACA), which he has called a 'disaster'. The attacks on the ACA included proposals to repeal the law through the legislative process, to erode it through a series of executive actions, and to ask the courts to declare it unconstitutional. Despite these ongoing challenges, the ACA remains largely intact as the U.S. heads into the 2020 election. The longer term fate of the law, however, is uncertain and the outcome of the 2020 election is likely to have a dramatic effect on the direction of health policy in the U.S.

The impact of type 2 diabetes and its management on the prognosis of patients with severe COVID-19.

BACKGROUND: Although type 2 diabetes mellitus (T2DM) patients with coronavirus disease 2019 (COVID-19) develop a more severe condition compared to those without diabetes, the mechanisms for this are unknown. Moreover, the impact of treatment with antihyperglycemic drugs and glucocorticoids is unclear. METHODS: From 1584 COVID-19 patients, 364 severe/critical COVID-19 patients with clinical outcome were enrolled for the final analysis, and patients without preexisting T2DM but elevated glucose levels were excluded. Epidemiological data were obtained and clinical status evaluation carried out to assess the impact of T2DM and its management on clinical outcomes. RESULTS: Of 364 enrolled severe COVID-19 inpatients, 114 (31.3%) had a history of T2DM. Twenty-seven (23.7%) T2DM patients died, who had more severe inflammation, coagulation activation, myocardia injury, hepatic injury, and kidney injury compared with non-DM patients. In severe COVID-19 patients with T2DM, we demonstrated a higher risk of all-cause fatality with glucocorticoid treatment (adjusted hazard ratio [HR], 3.61; 95% CI, 1.14-11.46; P = .029) and severe hyperglycemia (fasting plasma glucose ≥11.1 mmol/L; adjusted HR, 11.86; 95% CI, 1.21-116.44; P = .034). CONCLUSIONS: T2DM status aggravated the clinical condition of COVID-19 patients and increased their critical illness risk. Poor fasting blood glucose (≥ 11.1 mmol/L) and glucocorticoid treatment are associated with poor prognosis for T2DM patients with severe COVID-19.