Impact of covid-19 epidemic and large-scale emergency vaccination on the concept and experience of routine immunization among children's parents

Objective To understand the impact of Coronavirus disease 2019 (COVID-19) epidemic and mass emergency vaccination on parents' perception and experience of immunization. Methods From May 6, 2021 to June 20, 202l, an online questionnaire survey was conducted among 4 171 parents of children using the mobile APP of vaccination service in Guangzhou. Results Of all the respondents, 1 911 of them (45.8%) agreed with the suspension of routine immunization measures during the COVID-19 epidemic, and 1 508 respondents (36.2%) would actively postpone child immunization even if the vaccination clinic was not stopped during the COVID-19 epidemic. 2 959 (70.9%), 2 558 (61. 3%) and 2 399 (57. 5%)respondents were satisfied with the protective measures, on-site order and service quality a ter the resumption of vaccination, respectively. 3 437 respondents (82. 4%) indicated that the COVID-19 epidemic had enhanced their attention to vaccination. A total of 1 415 (33.9%) parents of children said that the discontinuation of vaccination clinics weakened their attention to the timeliness of vaccination, and 1 380 (33.1%) parents agreed that "the postponement of vaccination will not affect the vaccination effect”. Compare to parents with higher education (university or above), parents with young children, parents with secondary education (below university), and parents with older children who were older in age themselves were relatively satisfied with the various protective measures taken by vaccination units during the period of suspension of vaccination clinics and the resumption of vaccination. They believed that the field order and the quality of vaccination service were improved. They were more sensitive to the COVID-19 epidemic and tend to actively delay vaccination. They pay more attention to the importance and timeliness of vaccination, and were vulnerable to the impact of COVID-19 epidemic and medical suspension. Due to the COVID-19 epidemic and the control measures after the resumption of vaccination, 1 882 (45. 1%) children missed routine vaccination. The top three reasons were that the outpatient clinic only had the appointment number but could not make an appointment, the outpatient clinic reduced the daily dose of vaccination, and the outpatient discontinuation. Conclusion The satisfaction of parents of children in Guangzhou with the prevention and control measures of vaccination clinics during the COVID-19 epidemic and after the resumption of vaccination is above the medium level. The COVID-19 epidemic and the suspension of vaccination clinics have a two-way impact on the immunization concept and behavior of parents of children in Guangzhou, and some parents increase their attention to immunization. A small number of parents weakened their emphasis on the timeliness of vaccination, suggesting that vaccination units need to arrange staff and vaccination time reasonably, relieve the pressure on vaccination caused by the backlog of COVID-19 epidemic, carry out targeted positive publicity and guidance, and spread the correct knowledge of vaccination, so as to eliminate the doubts of children's parents. © 2023, Editorial Department of Medical Pest Control. All rights reserved.

Telemedicine for diabetes management during COVID-19: what we have learnt, what and how to implement.

The past two decades have witnessed telemedicine becoming a crucial part of health care as a method to facilitate doctor-patient interaction. Due to technological developments and the incremental acquisition of experience in its use, telemedicine's advantages and cost-effectiveness has led to it being recognised as specifically relevant to diabetology. However, the pandemic created new challenges for healthcare systems and the rate of development of digital services started to grow exponentially. It was soon discovered that COVID-19-infected patients with diabetes had an increased risk of both mortality and debilitating sequelae. In addition, it was observed that this higher risk could be attenuated primarily by maintaining optimal control of the patient's glucose metabolism. As opportunities for actual physical doctor-patient visits became restricted, telemedicine provided the most convenient opportunity to communicate with patients and maintain delivery of care. The wide range of experiences of health care provision during the pandemic has led to the development of several excellent strategies regarding the applicability of telemedicine across the whole spectrum of diabetes care. The continuation of these strategies is likely to benefit clinical practice even after the pandemic crisis is over.

Supervised interprofessional student pain clinic program - efficacy with the utilization of zoom.

Introduction: Current medical education curricula in pain management are insufficient to match the prevalence of chronic pain and the needs of patient populations. The Supervised Student Inter-professional Pain Clinic Program (SSIPCP) aims to train healthcare professional students to improve their abilities in chronic pain management in interprofessional (IP) teams. Due to the COVID-19 pandemic, Zoom was employed to allow the program to continue. In this study, survey data from students who participated during and before the COVID-19 pandemic were compared to determine if the program carried out via Zoom can maintain its effectiveness. Methods: Student pre- and post-program survey data were entered into Microsoft Excel spreadsheet and then graphed and analyzed with Sigma Plot. Surveys assessed knowledge in chronic pain physiology and management, attitude towards IP practice, and perceived team skills in the form of questionnaires and open-ended questions. Paired t-tests and Wilcoxon Signed-rank tests were used for two-group comparisons and two-way repeated ANOVA followed by the Holm-Sidak post-hoc tests were used for multiple group comparisons. Results: Overall, students continued to exhibit significant improvement in major areas assessed even with the use of Zoom. Strengths of the programs were also shared across student cohorts regardless of Zoom usage. However, despite their improvements, students who utilized Zoom stated that they would have preferred in-person program activities. Conclusion: Although students prefer in-person activities, the SSIPCP successfully trained healthcare students in chronic pain management and working in an IP team through Zoom.

Study of haematological parameters in Covid-19 positive patients at tertiary care hospital

Introduction: Apart from clinical symptoms and pulmonary computed tomography (CT) findings in, confirmed COVID-19 patients' Blood tests have an important role in early diagnosis of the disease and they provide valuable information to physicians regarding the inflammatory status in body. Material(s) and Method(s): A retrospective cross-sectional study was conducted from January 2020 to March 2020 in the Pathology Department of Rural Medical College, Loni. Total of 120 patients from different groups, both genders and between 18 and 75-year age were studied. Result(s): TLC, Neutrophil, NLR, PLR, D-Dimer values were found to have statistical significant (p<0.05) positive correlation with Covid -19 severity.Blood investigations like Lymphocyte and Monocyte count have statistical significant (p<0.05) negative correlation with Covid -19 severity. No significant correlation was observed between haematological tests like Hb, HCT, PLT, LMR and tests of coagulation like PT & APTT with Covid -19 severity. Conclusion(s): We concluded that TLC, NLR and D-dimer tests are important to predict about the severity of disease.Copyright © 2022 Pravara Institute of Medical Sciences. All rights reserved.

Cellular and humoral responses after second and third SARS-CoV-2 vaccinations in patients with autoimmune diseases treated with rituximab: specific T cell immunity remains longer and plays a protective role against SARS-CoV-2 reinfections.

Background: Humoral and cellular immune responses are known to be crucial for patients to recover from COVID-19 and to protect them against SARS-CoV-2 reinfection once infected or vaccinated. Objectives: This study aimed to investigate humoral and T cell responses to SARS-CoV-2 vaccination in patients with autoimmune diseases after the second and third vaccine doses while on rituximab and their potential protective role against reinfection. Methods: Ten COVID-19-naïve patients were included. Three time points were used for monitoring cellular and humoral responses: pre-vaccine to exclude virus exposure (time point 1) and post-second and post-third vaccine (time points 2 and 3). Specific IgG antibodies were monitored by Luminex and T cells against SARS-CoV-2 spike-protein by ELISpot and CoVITEST. All episodes of symptomatic COVID-19 were recorded. Results: Nine patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis and one with an undifferentiated autoimmune disease were included. Nine patients received mRNA vaccines. The last rituximab infusion was administered for a mean (SD) of 15 (10) weeks before the first vaccine and six patients were CD19-B cell-depleted. After a mean (SD) of 19 (10) and 16 (2) days from the second and third vaccine dose, IgG anti-SARS-CoV-2 antibodies were detected in six (60%) and eight (80%) patients, respectively. All patients developed specific T cell responses by ELISpot and CoVITEST in time points 2 and 3. Previous B cell depletion correlated with anti-SARS-CoV-2 IgG levels. Nine (90%) patients developed mild COVID-19 after a median of 7 months of the third dose. Conclusion: Rituximab in patients with autoimmune diseases reduces humoral responses but does not avoid the development of T cell responses to SARS-CoV-2 vaccination, which remain present after a booster dose. A steady cellular immunity appears to be protective against subsequent reinfections.

Impact of hypertension on long-term humoral and cellular response to SARS-CoV-2 infection.

It was shown that hypertension delays SARS CoV-2 viral clearance and exacerbates airway hyperinflammation in the respiratory tract. However, it is unknown whether hypertension determines the long-term cellular and humoral response to SARS Cov2. Health care workers (HCWs) after an outbreak of SARS Cov-2 infections were analyzed. Infected HCWs were not vaccinated before blood collection. 5-14 months (median 7 months) after detection of SARS CoV-2 infection, blood was taken to analyze humoral response (S1 IgG and SARS CoV-2 neutralizing antibodies) and cellular (T cell responses to SARS-CoV-2 with Lymphocyte Transformation Test). To identify clinical factors that determine the immune response, a multivariate regression analysis was done considering age, BMI, sex, diabetes, hypertension, smoking, COPD, asthma and time between PCR positivity and blood collection as confounding factors. Infected hypertensive HCWs more often needed to be hospitalized than non-hypertensive HCWs, but were less likely to develop anosmia and myalgia. The long-term humoral and cellular immune response was significantly strengthened in hypertensive versus normotensive infected HCWs. Multivariate regression analysis revealed that hypertension was independently associated with the humoral response to SARS CoV-2 infection. Multivariate regression analysis using same confounding factors for the humoral response showed a clear trend for an association with the cellular response to SARS CoV-2 infection as well. In conclusion, SARS CoV-2 infection strengthened immune response to SARS CoV-2 infection in hypertensive HCWs independent of other risk factors.

The retrospective study of the metabolic patterns of BCG-vaccination in type-2 diabetic individuals in COVID-19 infection.

Background: The cross-protective nature of Bacillus Calmette-Guerin (BCG) vaccine against SARS-CoV-2 virus was previously suggested, however its effect in COVID-19 patients with type 2 diabetes (T2D) and the underlying metabolic pathways has not been addressed. This study aims to investigate the difference in the metabolomic patterns of type 2 diabetic patients with BCG vaccination showing different severity levels of COVID-19 infection. Methods: Sixty-seven COVID-19 patients were categorized into diabetic and non-diabetic individuals who had been previously vaccinated or not with BCG vaccination. Targeted metabolomics were performed from serum samples from all patients using tandem mass spectrometry. Statistical analysis included multivariate and univariate models. Results: Data suggested that while BCG vaccination may provide protection for individuals who do not have diabetes, it appears to be linked to more severe COVID-19 symptoms in T2D patients (p = 0.02). Comparing the metabolic signature of BCG vaccinated T2D individuals to non-vaccinated counterparts revealed that amino acid (sarcosine), cholesterol esters (CE 20:0, 20:1, 22:2), carboxylic acid (Aconitic acid) were enriched in BCG vaccinated T2D patients, whereas spermidine, glycosylceramides (Hex3Cer(d18:1_22:0), Hex2Cer(d18:1/22:0), HexCer(d18:1/26:1), Hex2Cer(d18:1/24:0), HexCer(d18:1/22:0) were higher in BCG vaccinated non- T2D patients. Furthermore, data indicated a decrease in sarcosine synthesis from glycine and choline and increase in spermidine synthesis in the BCG vaccinated cohort in T2D and non-T2D groups, respectively. Conclusion: This pilot study suggests increased severity of COVID-19 in BCG vaccinated T2D patients, which was marked by decreased sarcosine synthesis, perhaps via lower sarcosine-mediated removal of viral antigens.

Efficacy of chlorin dioxide wipes in disinfecting airway devices contaminated with Covid-19.

Background: Reprocessing and disinfecting endoscopes is a routine practice in otolaryngology. An effective, safe, and rapid disinfection technique is essential during the COVID-19 pandemic. Objective: To validate the efficacy of chlorine dioxide wipes in disinfecting three types of airway endoscopes contaminated with COVID-19-positive patient secretions. Methods: Chlorine dioxide wipes were tested on rigid nasal endoscopes, laryngoscope blades, and flexible bronchoscopes. The endoscopes were disinfected using the wipes after exposure to COVID-19-positive patients. The tested scope was included in the study if the post procedure pre disinfection swab was positive for COVID-19 virus using RT-PCR. We analyzed 38 samples for 19 subjects (scopes) pre and post disinfection with chlorine dioxide wipes from July 2021 to February 2022. Results: A total of four rigid endoscopes, four flexible bronchoscopes, and four laryngoscopes were included in the study which represent 24 pre and post disinfection swabs. The others were excluded because of negative pre disinfection swab. All the post disinfection PCR swab results were negative. Conclusion: Chlorine dioxide is a convenient, fast, and effective disinfection technique for COVID-19-contaminated airway endoscopes.

Immunometabolic interference between cancer and COVID-19.

Even though cancer patients are generally considered more susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the mechanisms driving their predisposition to severe forms of coronavirus disease 2019 (COVID-19) have not yet been deciphered. Since metabolic disorders are associated with homeostatic frailty, which increases the risk of infection and cancer, we asked whether we could identify immunometabolic pathways intersecting with cancer and SARS-CoV-2 infection. Thanks to a combined flow cytometry and multiomics approach, here we show that the immunometabolic traits of COVID-19 cancer patients encompass alterations in the frequency and activation status of circulating myeloid and lymphoid subsets, and that these changes are associated with i) depletion of tryptophan and its related neuromediator tryptamine, ii) accumulation of immunosuppressive tryptophan metabolites (i.e., kynurenines), and iii) low nicotinamide adenine dinucleotide (NAD+) availability. This metabolic imbalance is accompanied by altered expression of inflammatory cytokines in peripheral blood mononuclear cells (PBMCs), with a distinctive downregulation of IL-6 and upregulation of IFNγ mRNA expression levels. Altogether, our findings indicate that cancer not only attenuates the inflammatory state in COVID-19 patients but also contributes to weakening their precarious metabolic state by interfering with NAD+-dependent immune homeostasis.

The Effect of Epidemics on Theatre Past and Present

This research discusses the effect of epidemics on theatre: taking two historical models, the Greek and the Elizabethan theatre, plus researching two other contemporary models from Jordanian Theatre;first, the dramaturge experience during Covid -19, of the author Mr. Ali Elian's new play "Touch line”, and second, the Liberal Theatre Group's new experience in presenting their annually festival online. The research concludes that epidemics affected dramaturgies for both play writers Sophocles and William Shakespeare. Moreover, it also affected theatre workers and theatre halls. The research finds out that the effect of new virus Covid - 19 in our time on Jordanians theatre also affected Jordanian dramaturgies and audience. For the audience theatre workers had to find new ways to communicate with them such as using T.V tools to display their works and relying on "online” the new media communication method. Finally, the research suggests the ability to use Drama and Music as a healing process to help those who were wounded by epidemics. Finally, it recommends that governmental and private academic institutions support researchers to dig deeper into this subject matter. © 2022 DSR Publishers/The University of Jordan.

Post-COVID-19 condition in children.

Post - COVID - 19 condition in children refers to the presence of physical symptoms or syndromes lasting more than 12 weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which can be manifested as a combination of various signs and symptoms. Girls,school - aged,adolescents,and children with severe illness in the acute phase of COVID - 19 ,with underlying allergic diseases and poor baseline physical and mental health are high - risk factors for post - COVID - 19 condition in children. Pathogenesis may be related to viral persistence, autoimmunity, chronic inflammatory responses, chronic inflammation of vascular endothelial cells, and microthrom-bosis. A comprehensive treatment scheme including symptoms relieving treatment, rehabilitation, and psychological support. This article reviews the epidemiology, clinical manifestations, pathogenesis, diagnosis, treatment, and management of the post - COVID - 19 condition in children to improve clinicians' comprehension of the disease.Copyright © 2022 Chinese Journal of Applied Clinical Pediatrics. All rights reserved.

A Study on the Impact of Covid-19 on the Investment Pattern of Investors with Specific Reference to Traditional Investment (Real Estate and Gold) and Market Based Financial Products (Equities) in Mumbai

Purpose -The purpose of this paper is to study the Impact of Covid-19 on the Investment pattern of Investors with specific reference to Traditional Investment (Real estate and Gold) and and Market based Financial products(Equities) in Mumbai Objectives: - The primary objective of this research paper is to study and analyse the degree of investor preference towards certain asset classes such as Gold, Equity, Real Estate etc, before and after the outbreak of Covid - 19. Design/methodology/approach - Data was collected from 100 respondents across different age/income and qualification groups. Statistical tests of Paired - t test and ANOVA were applied to test the hypotheses and analyse the collected data. Findings-Covid - 19 has had a significant impact on investor preference towards real estate, however the impact on investor preferences towards Gold and Equity has not been significant. Also Qualification and Income too have had significant impact on specific investment avenues. Conclusion(s): - Investor preferences are dynamic. They are influenced by investor behavior and no of external factors. This research has made an honest attempt to comprehend the of preferences of investors in pre and post covid situations. Generally Investors prefer asset classes that ensure constant and steady returns at minimum risk. Ultimately Investment is a rational decision that depends on the individual's risk appetite and return expectations arising out subjective assessment of multiple factors.Copyright © 2020 Ubiquity Press. All rights reserved.

Nurses' Perceptions Regarding Exposure to COVID-19 Risks, and Impact of COVID-19 Outbreak on their Work and Psychosocial Health: A Cross-sectional Study

Introduction: Coronavirus (COVID) is a large family of RNA viruses that cause illnesses ranging from the common cold to more severe symptoms. Objectives: Determine nurses' perceptions in Saudi Arabia regarding their risks, measures and coping mechanisms to prevent COVID-19 infection and transmission and the significant associated factors for their anxiety. Methods: This is a correlational cross-sectional study. A convenience sampling method was used to recruit a total of 345 nurses. A valid and reliable questionnaire was adapted from a previous study and the generalized anxiety disorder-2 items (GAD-2) scale was used to collect the data. Results: The majority of the participants (75.7%) perceived that they were most likely at risk of getting COVID-19. In terms of preventative actions,84.3% said they were avoiding crowded places, 77.4% were adhering to protocols and recommended measures, about 73.0% of participants were taking nutritional supplements and vitamins, practicing exercises, and changing out of work clothes, 54.8% were taking a shower before going home, and 53.9% were temporarily staying away from home in alternative housing to prevent having COVID-19 or transmitting the virus to their relatives. Furthermore, significant association was found between the participants' anxiety and the male gender (r=0.1, p=0.04), less nursing experience (r=0.41, p=0.02), number of children (r=0.35, p=0.03). Additionally, participants exposed to COVID-19 patients, who did not implement the measures and coping mechanisms to prevent COVID-19 were significantly associated with a high level of GAD-2. Conclusion: The majority of nurses perceived that they were at high risk of getting COVID-19 and were concerned that they could easily transmit COVID-19 to their relatives. As a result, many implemented preventive measures to protect themselves and prevent transmission of COVID-19 to their families and relatives. The continued attendance of health education programs about COVID-19 as well as the implementation of basic standard precautions, is essential to protect health workers and their families. © 2022 Elneblawi et al.

Student Perceptions Regarding the Blackboard Learning System Applied in Interior Architecture Project Courses During Covid-19

This article describes students' perceptions and satisfaction levels towards the Blackboard application, which they experienced as a learning tool throughout the design studio course they took during the Covid-19 pandemic. By making sketches, transferring ideas, sharing clear images, and accepting criticism in terms of satisfaction with the Blackboard system of instruction, it is attempted to understand the effects of features such as internet connection, technical infrastructure, and trainer. It has been observed that the lower grades of interior architecture students have a higher level of satisfaction with learning interior design through blackboard than the upper grade students © 2023 Ínanç Işıl Yıldırım & Rengin Zengel;published by UIKTEN. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License

Socratic Method of persuasion in Elia Abu Madi's poetry

The study aims at investigating the power of persuasion and the role of Socratic Method to achieve it in Elia Abu Madi's poetry. This method is composed of methodological procedural steps which direct the addressee and help him to infer knowledge individually. This method has a persuasion idiosyncrasy which was lucid in samples of Elia Abu Madi's poetry regarding turn taking, interaction and harmony between interlocutors. The turn taking and verbal exchange occur at an ideological space where values and thoughts are being produced. All the rhetorical devices used in the text and the mental, emotional and ethical arguments help to convince the addressee and direct his behaviour resulting in the actualisation of artistic and thoughtful ends simultaneously. © 2022 DSR Publishers/The University of Jordan.

Comprehensive Analysis of COVID-19's Effects on the Education System

COVID-19 has influenced all forms of degrees and training in higher education. An experimental structure for the analysis of information related to the education system was presented to measure the impact of the pandemic on university students' learning. The framework brings together the processes of analysing COVID-19's effects on the education system during the pandemic. Data were collected from 104 individuals via a survey w by circulating Google forms among teachers and students It has been put to the test by analysing data from a student survey done during the outbreak. The study's major goals are to analyse students' attitudes toward distant learning and their willingness to participate in it. In the context of the lockdown, to understand the struggles, and prospects of distance learning shortly, and to suggest changes and improvements for a higher quality academic experience. © 2022 IEEE.

Fast, cheap and sensitive: Homogenizer-based RNA extraction free method for SARS-CoV-2 detection by RT-qPCR.

Background: The SARS-CoV-2 gold standard detection method is an RT-qPCR with a previous step of viral RNA extraction from the patient sample either by using commercial automatized or manual extraction kits. This RNA extraction step is expensive and time demanding. Objective: The aim of our study was to evaluate the clinical performance of a simple SARS-CoV-2 detection protocol based on a fast and intense sample homogenization followed by direct RT-qPCR. Results: 388 nasopharyngeal swabs were analyzed in this study. 222 of them tested positive for SARS-CoV-2 by the gold standard RNA extraction and RT-qPCR method, while 166 tested negative. 197 of those 222 positive samples were also positive for the homogenization protocol, yielding a sensitivity of 88.74% (95% IC; 83.83 - 92.58). 166 of those negative samples were also negative for the homogenization protocol, so the specificity obtained was 97% (95% IC; 93.11 - 99.01). For Ct values below 30, meaning a viral load of 103 copies/uL, only 4 SARS-CoV-2 positive samples failed for the RNA extraction free method; for that limit of detection, the homogenizer-based method had a sensitivity of 97.92% (95% CI; 96.01 - 99.83). Conclusions: Our results show that this fast and cheap homogenization method for the SARS-CoV-2 detection by RT-qPCR is a reliable alternative of high sensitivity for potentially infectious SARS-CoV-2 positive patients. This RNA extraction free protocol would help to reduce diagnosis time and cost, and to overcome the RNA extraction kits shortage experienced during COVID-19 pandemic.