Role of noscomial infection informatics surveillance system in the prevention and control of multidrug-resistant organisms infections

OBJECTIVE: To analyze the role of nosocomial infection informatics surveillance system in the prevention and control of multidrug-resistant organisms(MDROs) infections. METHODS: The First Affiliated Hospital of Guangdong Pharmaceutical University was selected as the study subjects, which had adopted the nosocomial infection informatics surveillance system since Jan.2020. The period of Jan.to Dec.2020 were regarded as the study period, and Jan.to Dec.2019 were regarded as the control period. The situation of nosocomial infection and MDROs infections in the two periods were retrospectively analyzed. RESULTS: The incidence of nosocomial infections and underreporting of nosocomial infection cases in this hospital during the study period were 2.52%(1 325/52 624) and 1.74%(23/1 325), respectively, and the incidences of ventilator associated pneumonia(VAP), catheter related bloodstream infection(CRBSI), catheter related urinary tract infection(CAUTI)were 4.10(31/7 568), 2.11(14/6 634), and 2.50(25/9 993) respectively, which were lower than those during the control period(P< 0.05). The positive rate of pathogenic examination in the hospital during the study period was 77.95%(1 269/1 628), which was higher than that during the control period(P<0.05), the overall detection rate of MDROs was 15.77%(206/1 306), the detection rates of MDROs in Escherichia coli, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus epidermidis, Pseudomonas aeruginosa and Staphylococcus aureus were lower than those during the control period(P<0.05). CONCLUSION: The development and application of the informatics technology-based surveillance system of nosocomial infection could effectively reduce the incidence of nosocomial infections and device related infections, decrease the under-reporting of infection cases, and also reduce the detection rate of MDROs as well as the proportion of MDROs detected in common pathogenic species.

Analysis of pathogen detection results of upper respiratory tract specimens from fever clinic patients

Objective: To explore the pathogen composition and distribution characteristics of pathogens in respiratory samples from patients with fever of unknown origin. Methods: A total of 96 respiratory samples of patients with unknown cause fever with respiratory symptoms were collected from four hospitals above grade II in Shijiazhuang area (Hebei Provincial Hospital of Traditional Chinese Medicine, Luancheng District People's Hospital, Luquan District People's Hospital, Shenze County Hospital) from January to April 2020, and multiplex-fluorescent polymerase chain reaction(PCR)was used to detect influenza A virus, influenza B virus, enterovirus, parainfluenza virus I/II/III/IV, respiratory adenovirus, human metapneumovirus, respiratory syncytial virus, human rhinovirus, human bocavirus, COVID-19, Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila, Pseudomonas aeruginosa, Streptococcus pneumoniae, Klebsiella pneumoniae, Group A streptococcus, Haemophilus influenzae, Staphylococcus aureus nucleic acid detection, the results were analyzed for chi-square. Results: A total of 8 pathogens were detected in the upper respiratory tract samples of 96 fever patients, including 1 kind of virus, 6 kinds of bacterias, and Mycoplasma pneumoniae. There were 12 viruses including influenza virus and parainfluenza virus, Legionella pneumophila and Chlamydia pneumoniae were not detected. The pathogen detection rates in descending order were Streptococcus pneumoniae (58/96, 60.42%), Haemophilus influenzae(38/96, 39.58%), Klebsiella pneumoniae (14/96, 14.58%), Staphylococcus aureus (10/96, 10.42%), Mycoplasma pneumoniae (8/96, 8.33%), Pseudomonas aeruginosa (6/96, 6.25%), Group A streptococcus (4/96, 4.17%) and human rhinovirus (2/96, 2.08%). The proportions of single-pathogen infection and multi-pathogen mixed infection in fever clinic patients were similar, 41.67% (40/96) and 45.83% (44/96), respectively, and 12.50% (12/96)of the cases had no pathogens detected. The infection rate of Mycoplasma pneumoniae in female patients with fever (21.43%) was higher than that in male patients with fever (2.94%) (P < 0.05). There was no statistical difference between the distribution of of other pathogens and gender and age(P > 0.05). Conclusions: The upper respiratory tract pathogens were mainly bacterial infections, and occasional human rhinovirus and Mycoplasma pneumonia infections. In clinical diagnosis and treatment, comprehensive consideration should be given to the pathogen detection.

Influencing factors of negative conversion time of nucleic acid detection in 228 patients infected with Omicron variant of SARS-CoV-2 in Shanghai

Objective: To analyze and compare the effects of different clinical characteristics on the negative conversion time of nucleic acid detection after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infection, and to provide a scientific basis for the isolation and treatment of coronavirus disease 2019 (COVID-19). Methods: The epidemiological and clinical data of 228 mild SARS-CoV-2 Omicron variant infected patients diagnosed in Shanghai were retrospectively collected from April 27, 2022 to June 8, 2022 in Wujiaochang designated Hospital, Yangpu District, Shanghai. The negative conversion time of nucleic acid detection was used as the outcome variable, and the patients were divided into A (18 days) and B (>18 days). Univariate and multivariate logistic regression analysis were used to analyze the influencing factors of the negative conversion time of nucleic acid detection. Results: The mean nucleic acid conversion time of 228 patients was (18.7+or-12.1) d, with the median time of 18 (2-46) d. Among them, 120 patients in group A had an average nucleic acid conversion time of (13.2+or-2.0) d, and 108 cases in group B had an average nucleic acid conversion time of (20.8+or-1.3) d. Univariate analysis showed that there were no statistically significant differences in the effects of hypertension, coronary heart disease, diabetes, hypokalemia, malignant tumors, neuropsychiatric diseases, chronic digestive diseases on the negative nucleic acid conversion time (P > 0.05);however, there were significant differences in the effects of combined cerebrovascular disease, leukopenia, chronic respiratory system diseases and vaccination on the negative nucleic acid conversion time (P < 0.05). Further multivariate logistic regression analysis revealed that the combination of chronic respiratory diseases and non-vaccination were significant risk factors for prolongation of negative nucleic acid conversion time (P < 0.05). Conclusions: The results of this study show that gender, age and whether hypertension, coronary heart disease, diabetes mellitus, hypokalemia, malignant tumor, neuropsychiatric disease and chronic digestive disease have no significant effect on the nucleic acid conversion time, whereas chronic respiratory disease and no vaccination are significantly correlated with the prolongation of nucleic acid conversion time in SARS-CoV-2 Omicron-infected patients.

Knowledge, attitudes, and willingness of adolescents towards coronavirus disease 2019 vaccine in Bangkok, Thailand

Background: The outbreak of coronavirus disease 2019 (COVID-19) was declared by the World Health Organization (WHO) as a COVID-19 pandemic on March 11, 2020. Therefore, the availability of vaccines will help develop immunity and protect people from this pandemic. The present systematic study examined knowledge, attitudes, and willingness of adolescents towards COVID-19 vaccine in Bangkok, Thailand. Objectives: The objective of the study was to evaluate the knowledge, attitudes, and willingness toward COVID-19 vaccine of key stage 4A-5 students at Satit Prasarnmit International Programme in Bangkok towards COVID-19 vaccine. Materials and Methods: The study was conducted using an online questionnaire. A total of 136 students participated. Knowledge, attitudes, and willingness of adolescents toward the COVID-19 vaccine were assessed. Differences between outcomes and socio-demographic characteristics of participants were analyzed through independent t-tests and the ANOVA. The level of willingness to vaccinate against COVID-19 was analyzed by a generalized linear model. Results: Students revealed moderate knowledge about COVID-19, correctly answering 11.08 out of 15 points (SD = 1.74), a low level of attitudes toward COVID-19 vaccine 8.49 out of 15 points (SD = 2.51), and low level of willingness to vaccinate against COVID-19 vaccine 2.29 out of 5 points (SD = 1.26), in total of 35 points (28 questions). There are statistically significant positive correlations shown between attitude towards COVID-19 vaccine and the level of willingness to vaccinate against COVID-19 vaccine (I2 = 0.384, P < 0.01%). Conclusion: This study revealed students in Satit Prasarnmit International Programme had moderate knowledge towards COVID-19, negative attitudes toward COVID-19 vaccine and low willingness to vaccinate against COVID-19. Furthermore, it indicates that there is a casual relationship between attitudes toward COVID-19 vaccine and the willingness of individuals to be vaccinated against COVID-19 vaccine. Thus, attitude toward COVID-19 vaccine acts as a major predictive factor toward the willingness to vaccinate against COVID-19 vaccine. Therefore, to increase peopleA's willingness to be vaccinated against COVID-19 vaccine, it is necessary to increase peopleA's attitude toward COVID-19 vaccine.

Expressions of miR-21 TGF-beta/Smad signaling pathway in peripheral blood of bronchial asthma patients complicated with respiratory virus infection

OBJECTIVE: To investigate the expressions of peripheral blood microRNA-21(miR-21) and transforming growth factor-beta(TNF-beta)/Smad signaling transduction pathway in patients with bronchial asthma complicated with respiratory virus infection. METHODS: Totally 109 patients with asthma complicated with respiratory virus infection(study group) and 104 patients without virus infection(control group) in the Third People's Hospital of Gansu Province between Feb.2019 and Feb.2021 were selected for the cross-sectional study. The basic data of the two groups were collected, and parameters including vital signs, lung function, peripheral blood miR-21 and TGF-beta/Smad signaling pathway proteins were measured. According to the guidelines, the patients of the two groups were divided into acute exacerbation phase and stable phase. The examination results of each group were compared and the levels of peripheral blood miR-21 and TGF-beta/Smad signaling pathway proteins expression of patients with asthma complicated with respiratory virus infection were analyzed. RESULTS: In study group, the proportion of respiratory virus infection among 109 patients was 33.94% for influenza virus, 23.85% for human rhinovirus, 19.27% for respiratory syncytial virus, 10.09% for parainfluenza virus, 6.42% for adenovirus, 4.59% for human coronavirus and 1.83% for human metapneumovirus respectively. The proportion of patients with acute exacerbation phase in the study group was higher than that in the control group, and the levels of peripheral blood miR-21, TGF-beta1, Smad7, pSmad2 and pSmad3 were higher than those in control group(P<0.05). The levels of miR-21, TGF-beta1, Smad2, Smad3, Smad7, pSmad2 and pSmad3 in peripheral blood of patients with acute exacerbation phase of asthma were higher than those of patients with stable phase of asthma(P<0.05). There were no statistical differences in peripheral blood miR-21, TGF-beta1, Smad2, Smad3, Smad7, pSmad2 and pSmad3 levels in asthma patients with different virus infections. CONCLUSION: Early respiratory virus infections might lead to increased expression of peripheral blood miR-21 and increased activation of TGF-beta/Smad signaling pathway in patients with asthma, which played an important role in acute attack of asthma.

Analyzing the research trends of COVID-19 using topic modeling approach

PurposeThe COVID-19 pandemic has impacted 222 countries across the globe, with millions of people losing their lives. The threat from the virus may be assessed from the fact that most countries across the world have been forced to order partial or complete shutdown of their economies for a period of time to contain the spread of the virus. The fallout of this action manifested in loss of livelihood, migration of the labor force and severe impact on mental health due to the long duration of confinement to homes or residences.Design/methodology/approachThe current study identifies the focus areas of the research conducted on the COVID-19 pandemic. s of papers on the subject were collated from the SCOPUS database for the period December 2019 to June 2020. The collected sample data (after preprocessing) was analyzed using Topic Modeling with Latent Dirichlet Allocation.FindingsBased on the research papers published within the mentioned timeframe, the study identifies the 10 most prominent topics that formed the area of interest for the COVID-19 pandemic research.Originality/valueWhile similar studies exist, no other work has used topic modeling to comprehensively analyze the COVID-19 literature by considering diverse fields and domains.

Risk factors for COVID-19 incidence and mortality in patients on maintenance hemodialysis

Patients on maintenance hemodialysis (MHD) are highly susceptible to SARS-CoV-2 and with high mortality rates due to Coronavirus disease 2019, mainly because of the older age in this group of patients, comorbidities, compromised immune status due to uremia, as well as inability to keep social isolation because of the necessity for regular physical presence in dialysis facility. Several retrospective studies of patients on MHD in Europe, America and Asia, show high susceptibility to SARS-CoV-2 in this group of patients with very high rates of critical course of the disease and high mortality rates, reaching more than 40% The aim of this retrospective observational study was to identify risk factors among patients on intermittent hemodialysis for infection with SARS-CoV-2 as well as predictors of severe COVID-19 and fatal outcome. Materials and methods. We analyzed 69 patients receiving intermittent dialysis in Aleksandrovska University Hospital - Hemodialysis Unit. 34 of them have been tested positive for SARS-CoV-2 in the period from September 2020 (when the first case of the disease was registered for our dialysis center) up to March 2022, and are compared with a control group of 35 dialysis-dependent patients without COVID-19. Data about comorbidities, main laboratory and radiologic findings, need of hospitalization and treatment in ICU, as well as data for conducted treatment, are collected from electronic medical records. To identify predictors of severe COVID and poor outcome we compared the group of survivors with the one of non-survivors. Results. There are no significant differences between patients on MHD with and without COVID-19 except higher frequency of COPD and hypoproteinemia in the positive group. Older age, female gender, history of smoking, lymphopenia with neutrophilia, treatment in ICU and need of mechanical ventilation, signs of malnutrition - hypoproteinemia and lower levels of serum creatinine, are risk factors for severe disease and fatal outcomes. Conclusions. The course of COVID infection in dialysis-dependent patients is severe and with high mortality rate, in line with other studies worldwide. Malnutrition is the main risk factor for COVID and also main predictor for poor outcomes.

Intention to vaccinate against COVID-19 of Thai people in Trang province, Thailand: a cross-sectional study

Background: Coronavirus disease 2019 (COVID-19) is an epidemic that has greatly affected the daily life of people around the world. This epidemic, in addition to affecting lives, also affects other matters such as the economy or government administration that need to find ways to reduce the epidemic rate. That is to provide adequate quality vaccines for the people of the country. Finally, the government finds measures to stop the spread of COVID-19. Objectives: This study aimed to assess an acceptance to be vaccinated against COVID-19. Materials and Methods: Intention to be vaccinated against COVID-19 was measured with a question A"When a vaccine for COVID-19 is ready for you, will you get vaccinated?A" Response options were A"yes, A" A"not sureA" and A"no.A" Participants who responded A"not sureA" or A"noA" were asked to provide a reason. Results: A total of 400 responses were received. Overall, 38.5% (n = 154) of participants intended to get vaccinated, 29.5% (n = 117) were unsure, and 32.25% (n = 129) were not planning to get vaccinated. Factors that are independently related to vaccine hesitancy (A"not sureA" or A"yesA" response) include being male, risk perception of getting COVID-19, confidence in the government in handling the pandemic. Conclusion: A total of 400 participants, in the study, 38.5% (n = 154) of participants intended to get vaccinated, 29.5% (n = 117) were unsure, and 32.25% (n = 129) were not planning to get vaccinated. Male participants had a higher chance to refuse to vaccinate more than female 2.69 times. Predictive factors for COVID-19 vaccination were risk perception of contracting COVID-19 and lack of confidence in the government handling the pandemic of COVID-19.

Management and care of pregnant women in their third trimester with COVID-19 at Tangerang Hospital, Indonesia: a comprehensive approach

COVID-19 is a widespread contagious viral infection that can severely affect the respiratory system. Although many people recover from using the disease without special care or treatment, pregnant women are particularly vulnerable to pulmonary infections due to their hangers systems system and physiology. To investigate the treatment provided to pregnant women who are PCR-positive for COVID-19 in their early three months of pregnancy, a reanalyzed analyzed data from 84 participants who received treatment at Tangerang Regional Hospital in 2 study was the study conducted based on an ases of observational investigation with a cross-sectional approach. It assembled the data for analysis of the chi-square test. The results showed that 92.9% of participants underwent a cesarean section, while the remaining 7.1% were discharged after giving birth typically or recovering. Additionally, the study did not find any correlation between factors such as age, education, work, gravida, ANC visit, and the impact of COVID-19 on the third trimester of pregnancy at Tangerang Hospital in 2022. The study recommends that pregnant women seek information about pregnancy care from healthcare providers, particularly midwives, posyandu officers, and the media, to make well-known decisions about their health and well-being during this critical period, ensuring a safe and healthy pregnancy outcome.

Characteristics of COVID-19 patients and risk factors of mortality in the early times of pandemic, Herat-Afghanistan

Objective: Coronaviruses are a large family of viruses that cause different types of diseases. This study aims to evaluate the risk factors for mortality based on comorbidity and sociodemographic characteristics among COVID-19 patients. Methods: This cross-sectional study conducted in Herat, Afghanistan, from February 24 to July 5, 2020, used data provided by the public health department, including sociodemographics, symptoms, comorbidities, hospitalization, contact history, and COVID-19 test type. The Chi-square test was used to observe differences between categorical variables. In bivariate analysis, all independent variables with a significant p-value were put into the model. Odds ratios and 95% confidence intervals were calculated, and a p-value less than 0.05 was considered statistically significant. Results: The study analyzed 11,183 COVID-19 cases, with a 53.5% positivity rate. Recovery rates in the city and Herat province districts were 96.2% and 94.7%, respectively. Case-fatality rates varied with age, with 0.4% for those aged 1-29 and 33% for those aged 80-105. Mortality rates were highest for those with COPD and cancer, at 12.5% and 18.2%, respectively. In the logistic regression results, age, gender, and COPD were significant variables for COVID-19 mortality. Conclusion: By providing more health service facilities to people in risk groups, especially in rural areas, the mortality rate of COVID-19 and other diseases can be decreased.

Determinant factors of the improvement of nutritional status (based on height-for-age index category) in children during the COVID-19 pandemic: a cohort study of children's growth and development in Bogor

The COVID-19 pandemic is predicted to trigger a global economic and food supply crisis, which further affects children's nutritional status as a vulnerable group. This study aimed to observe alterations in nutritional status before and during the COVID-19 pandemic (during 2019-2021) and determinant factors involved in the improvement of nutritional status (based on the height-for-age Z-score (HAZ) index category) during the COVID-19 pandemic. The findings were intended as evidence-based suggestions for policy formulation concerning the improvement of child nutritional status and stunting reductions. This study was part of a cohort study of children's growth and development conducted by National Institute of Health Research and Development (NIHRD) in Bogor city-Indonesia. The analysis was conducted on 565 children under five in 2019 with height measurement data in 2019 and 2021, environmental conditions, parental education, consumption habits, and social assistance. Children were classified as having an improved nutritional status if the HAZ category increased in 2021 compared to 2019. In addition, multiple logistic regression analyses were performed to predict determinant factors involved in improving the child's nutritional status. In this study, 17.5% of children had improved nutritional status, and 79.3% had a steady nutritional status. However, there were 3.2% of children with decreased nutritional status. Model factors determinant related to improved nutritional status includes consumption more than once per week of red meat (adjusted odds ratio (aOR) = 2.15;95% confidence interval (CI): 1.06-4.35, p=0.034), milk consumption more than once per week (aOR = 1.56;95% CI: 0.89-2.74, p=0.119), and age under 5 years old (aOR = 1.86;95% CI: 1.14-3.15, p=0.016). Children under five years old, the consumption of red meat and milk more than once a week have the opportunity to improve nutritional status (by height-for-age index) in children.

Gastrointestinal features of the multisystem inflammatory syndrome in children (MIS-C) following COVID-19 infection in selected referral hospitals in Iran

Background and purpose: Multisystem Inflammatory Syndrome in Children (MIS-C) occurs after having COVID-19. The severity and outcomes of COVID-19 with gastrointestinal symptoms are higher. The aim of this study was to investigate gastrointestinal manifestations in MIS-C patients in selected referral hospitals in Iran to obtain comprehensive information about the treatment and prevention of MIS-C. Materials and methods: In this cross-sectional study, all MIS-C patients <21 years in Dec 2019 to Oct 2021 were included. The patients were identified by the Centers for Disease Control and Prevention (CDC) checklist and data were analyzed applying t-test and Chi-square in STATA11. Results: There were 225 patients with a median age of 55 months (26-96 months), including 59.56% boys and all had fever on admission. At least one gastrointestinal symptom was seen in 200 patients and the most common symptoms were vomiting (60.9%) and abdominal pain (45.77%). Almost 60% of the patients had positive RT-PCR results. Among the patients with and without gastrointestinal symptoms 85.5% and 48% were admitted to intensive care unit (ICU), respectively. There were significant differences between the two groups in respiratory symptoms, ALT, AST, NT-pro BNP, ESR, and PLT (P < 0.05). All patients without gastrointestinal symptoms were discharged but nine patients in the group with gastrointestinal symptoms deceased. Conclusion: According to the current study, gastrointestinal symptoms are common in MIS-C patients and are associated with higher rates of death and intensive care unit admission. Therefore, in providing services to COVID-19 patients, all typical and atypical signs and symptoms should be considered to prevent unnecessary interventions.

The impact of the COVID-19 pandemic on medical education: adaptability and remote learning experience of the Peruvian American Medical Society

The COVID-19 pandemic had a significant impact on medical care and medical education in Peru. In response, the Peruvian American Medical Society (PAMS), a charitable medical organization based in the USA, pursued its medical and educational missions in Peru by adopting virtual learning technology. We developed closer collaborative relationships with several medical schools and the Peruvian Association of Medical Schools (ASPEFAM) while offering a faculty panel of twenty-four members to provide lectures and multidisciplinary webinars in Spanish. We conducted 19 webinars including COVID -19 and non-COVID-19 related topics that over the last two years attracted 14,489 participants from 23 countries. They were the foundation for twenty publications in Peruvian medical journals. Our clinical investigations competition was positively received as was our pilot project on research mentorship. The COVID -19 pandemic had a positive effect on the educational mission of PAMS in Peru.

Surveillance for SARS-CoV-2 in Norway Rats (Rattus norvegicus) from Southern Ontario

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from wildlife has raised concerns about spillover from humans to animals, the establishment of novel wildlife reservoirs, and the potential for future outbreaks caused by variants of wildlife origin. Norway rats (Rattus norvegicus) are abundant in urban areas and live in close proximity to humans, providing the opportunity for spillover of SARS-CoV-2. Evidence of SARS-CoV-2 infection and exposure has been reported in Norway rats. We investigated SARS-CoV-2 infection and exposure in Norway rats from Southern Ontario, Canada. From October 2019 to June 2021, 224 rats were submitted by collaborating pest control companies. The majority of samples were collected in Windsor (79.9%;n = 179), Hamilton (13.8%;n = 31), and the Greater Toronto Area (5.8%;n = 13). Overall, 50.0% (n = 112) were female and most rats were sexually mature (55.8%;n = 125). Notably, 202 samples were collected prior to the emergence of variants of concern (VOC) and 22 were collected while the Alpha variant (B.1.1.7) was the predominant circulating VOC in humans. Nasal turbinate (n = 164) and small intestinal (n = 213) tissue samples were analyzed for SARS-CoV-2 RNA by RT-PCR. Thoracic cavity fluid samples (n = 213) were tested for neutralizing antibodies using a surrogate virus neutralization test (sVNT) (GenScript cPass);confirmatory plaque reduction neutralization test (PRNT) was conducted on presumptive positive samples. We did not detect SARS-CoV-2 RNA in any samples tested. Two out of eleven samples positive on sVNT had neutralizing antibodies confirmed positive by PRNT (1 : 40 and 1 : 320 PRNT70);both were collected prior to the emergence of VOC. It is imperative that efforts to control and monitor SARS-CoV-2 include surveillance of rats and other relevant wildlife species as novel variants continue to emerge.

Relationship between social support and psychological resilience and post-traumatic stress disorder in college students

Objective To investigate the characteristics of post-traumatic stress disorder (PTSD) in college students during the outbreak of COVID-19, and to explore the mediating role of psychological resilience between social support and PTSD. Methods By using direct selection method, 572 college students in Anhui and Shanghai were selected and administered with General Characteristics Questionnaire, the PTSD Checklist-Civilian Version(PCL-C), Psychological Resilience Scale(PRS) and Social Support Rating Scale(SSRS). Results Among the participants, 25.0% had moderate PTSD symptoms, 11.7% had obvious PTSD symptoms, and the positive rate of PTSD was 36.7%. The prevalence of PTSD in college students was higher in males than in females (X2=4.31, P < 0.05). The junior students were higher than other students (X2=16.81, P < 0.01). The scores of social support, psychological resilience and PTSD were (33.79+or-4.83), (92.17+or-13.39) and (35.50+or-11.39), respectively. The correlations of all variables were statistically significant(r=-0.49-0.76, P < 0.05);The mediation test showed that social support could not only negatively predict PTSD directly(direct effect was -0.35), but also indirectly affect PTSD through psychological resilience(indirect effect was -0.32). Conclusion More than one third of college students have PTSD symptoms, and psychological resilience plays a partial mediating role in the relationship between social support and PTSD, social support can both directly and negatively predict PTSD and indirectly affect PTSD by increasing an individual's psychological resilience.

Predictors of severity in COVID-19

Background: In the context of home monitoring of severe acute respiratory syndrome coronavirus-2 disease (COVID-19) patients, it is imperative to evaluate the accuracy of finger pulse oximetry oxygen saturation (SpO2) in the assessment of hypoxia. Methods: Retrospective data analysis was performed on (n = 132) hospitalised COVID-19 patients with various levels of severity, in whom SpO2, haematological, biochemical and arterial blood gas (ABG) parameters were measured within 48 h after admission. Discrepancy between SpO2 and arterial blood oxygen saturation SaO2 was compared between mild, moderate and severe COVID-19 to assess the accuracy of finger pulse oximetry. Results: We found that total white blood cell count, neutrophil %, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, ferritin, C-reactive protein and lactate dehydrogenase (LDH) were significantly increased in severe COVID-19, while lymphocyte % was significantly less when compared to mild and moderate cases. Multivariable analysis suggested that red cell distribution width (RDW) and LDH together account for significant variance in the severity of disease. The SpO2 and SaO2 were significantly less in the severe group. The difference between SpO2 and SaO2 has a clinically meaningful albeit statistically nonsignificant trend with the discrepancy greater in severe COVID-19 cases when compared to mild and moderate cases. Conclusions: Finger pulse oximetry has the potential to underestimate the severity of hypoxia in severe COVID-19 and this has implications in the decision to start oxygen therapy. RDW and LDH constitute the best parsimonious set of variables to predict severity.

Cyclodextrin-Derived Drug Delivery Systems in Respiratory Diseases

Respiratory diseases like chronic obstructive pulmonary disease (COPD), chronic bronchitis, asthma, lung cancer, tuberculosis (TB), pneumonia, and, currently, respiratory infection due to novel Coronavirus (2019-nCoV) have been the major cause of concern these days and pose a serious challenge before the medical practitioners. Various types of dosage forms, surgeries, and radiotherapies are available as the major treatment options;however, these approaches are of limited use in the successful management of the above disorders and some seem very expensive. Conventional dosage form-based therapies have many disadvantages, including poor bioavailability, safety issues, poor site specificity, and drug resistance. In recent years, with the recent advancement in research and develop- ment, different novel drug delivery approaches have been aimed for comprehen- sive management of various types of respiratory diseases. Cyclodextrins (CDs) based formulations played a significant role in improving the treatment of respi- ratory diseases. It is utilized to improve the drug's physicochemical properties, however, some of its derivatives offer direct therapeutic efficacy. In this chapter, the derivates of CD, provided with their sources and physicochemical properties, are discussed with their applications in treating major lung diseases like COPD, chronic bronchitis, asthma, lung cancer, pulmonary fibrosis, pneumonia, etc. We have also aimed to showcase, based on the ongoing clinical trials, the recent translational potential of CD-based drug delivery systems used in the respiratory disease therapy. © The Author (s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.

Life expectancy and COVID-19 infection: a population-based cross-sectional study

Background and Objective: Life expectancy and the consequences of its impairment may affect quality of life and suicide. The aim of this study was to assess the impact of COVID-19 on life expectancy in residents of Gonabad city. Methods: This cross-sectional study was conducted on 300 Gonabad residents (general population) from February 2021 to April 2022 using stratified-random sampling method. Data collection was performed through phone interview. Demographic questionnaire and Schneider's life expectancy scale were used. Data analysis was performed using the SPSS software version 23. Findings: Of the 300 participants (53% female and 47% male), 153 were COVID-19 recovered and 147 did not have the history of COVID-19. The average life expectancy score in COVID-19 recovered participants was significantly lower compared to those without the history of COVID-19 (29.17 +or- 5.96 and 31.94+or-4.34, respectively, p=0.001). Also, there was a significant and positive relationship between mean scores of life expectancy and age, gender, education, economic status, the presence of high-risk individuals at home, history of underlying diseases, and smoking (p<0.05). Conclusion: The results of this study stated that life expectancy score in COVID-19 recovered participants was a lower than that of participants without COVID-19 history. Therefore, the role of other variables, including age, gender, and disease history on life expectancy was more prominent on life expectancy in COVID-19 recovered participants.

Knowledge, understanding, attitude, and preventive behavior toward COVID-19: a study among high school students in Loei Pittayakom, Thailand

Background: COVID-19 pandemic has affected humanity in several aspects of life. Not only create health problems, but also economic and social problems. To cope with this pandemic, we need to know and understand how to have the COVID-19 preventive behavior. Hence, this study will be focusing on factors that influence people to have COVID-19 preventive behavior. Objectives: The aim of this study is to assess knowledge, attitude, and COVID-19 preventive behavior of high school students. Materials and Methods: The study was conducted using a questionnaire. A total of 325 students participated. Knowledge, attitude without presence of rules, and attitude with presence of rules toward COVID-19 preventive behavior were assessed. Independent t-test and analysis of variance were used to analyze differences between outcomes and socio-demographic. COVID-19 preventive behavior was analyzed by a generalized linear model. Results: Students revealed a good level of COVID-19 related knowledge, correctly answering 4.48 (standard deviation [SD] = 0.70) questions in a total of 5, good levels of attitude both without and with the presence of rules, average score was 11.05 (SD = 1.16) of four questions and 15.86 (SD = 2.07) of six questions, respectively, and a good level of COVID-19 preventive behavior, the average scores at 44.28 (SD = 6.68), in a total of 11 questions. Conclusion: This study revealed a good level of knowledge, attitude both without and with the presence of rules and COVID-19 preventive behavior among high school students at Loei Pittayakom School, Thailand. Mainly, the factor that may influence them to get a high score in all four sections is staying active with news and the latest information presented on the internet. In addition, the study demonstrated that there was a relationship between attitude with the presence of rules and COVID-19 preventive behavior. Therefore, having regulations can lead to having preventive behavior.