[Cross-sectional study on the use of masks among occupational groups with high-risk positions for overseas import and pollution transmission].

Objective: To investigate the wearing of masks and the knowledge of masks among high-risk positions for overseas import and pollution transmission. Methods: From May 14 to 17, 2022, a convenient sampling method was used to conduct an online survey among 963 workers in high-risk positions for overseas import and pollution transmission in Beijing. The behaviors of individual use and wearing masks, the distribution and supervision of the unit, the knowledge of personal mask protection and the subjective feelings of wearing masks were analyzed. The χ(2) test and logistic regression model were used to analyze the influencing factors of the correct selection of masks. Results: The majority of the workers in high-risk positions for overseas import and pollution transmission were male (86.0%, 828/963), age concentration in 18-44 years old (68.2%, 657/963), and the majority of them had college or bachelor degrees (49.4%, 476/963). 79.4%(765/963) of the workers chose the right type of masks, female, 45-59 years old and high school education or above were the risk factors for correct selection of masks (P <0.05). Workers had good behaviors such as wearing/removing masks, but only 10.5% (101/963) could correctly rank the protective effect of different masks. 98.4% (948/963) of the workers believed that their work units had provided masks to their employees, and 99.1% (954/963) and 98.2%(946/963) of them had organized training and supervision on the use of masks, respectively. 47.4%(456/963) of the workers were uncomfortable while wearing masks. Conclusion: The overall selection and use of masks among occupational groups in high-risk positions for overseas import and pollution transmission in China need to be further standardized. It is necessary to strengthen supervision and inspection on the use of masks among occupational groups, and take improvement measures to improve the comfort of wearing masks.

Vaccine hesitancy in primary care: Building bridges by understanding barriers.

Adult vaccination is an accepted part of health care and diabetes care. In spite of evidence regarding the efficacy and utility of vaccination in preventing disease, we continue to encounter vaccine hesitancy and vaccine skepticism. As physicians, it is our duty to encourage the public to get vaccinated. In this article, we create a simple framework which helps assess the barriers to vaccine acceptance, and create bridges to overcome vaccine hesitancy and skepticism. We use an interesting mnemonic, NARCO, to remind ourselves, and our readers, of the appropriate hierarchy of interviewing related to vaccine acceptance.

Exploring pandemic metaphors in educational contexts: a survey on the language of teachers and educators in Reggio Emilia, Italy.

This study aimed to explore how metaphors were used to interpret the pandemic and to address its challenges in primary and secondary schools in Reggio Emilia, Italy. A questionnaire was administered to educators and teachers to understand how languages, images, and metaphors were used by themselves and their students to talk about the pandemic and their experiences of living with it. The goal of the questionnaire was to guide critical reflection and encourage more informed language choices. While the existing literature points out the alleged overuse of war metaphors and military frames in public discourse, our findings show that war metaphors are relatively frequent, with other metaphorical frames widely used by teachers and educators to foster resilient attitudes in students. Moreover, in their professional contexts, teachers and educators mostly use metaphorical frames involving resilient attitudes. Our interpretation of the results supports the hypothesis that the purposeful use and deliberate production of metaphors support the choice of metaphors with positive, constructive implications. Finally, some implications of these findings on the theory of metaphor and the methodology of the research are discussed.

Creativity and resilience: a mini-review on post-pandemic resources for adolescents and young adults.

Background: Two years after the outbreak of the pandemic, several studies look at the consequences for the well-being and mental health of young people. In particular, creativity and resilience are cited in the scientific literature as resources that promote this well-being in adolescents and young adults. Purpose: This mini-literature review was created with the aim of examining how many articles have explored the relationship between creativity and resilience in adolescents and young adults since the onset of the pandemic. Methods: Particular attention was paid to how many of the articles actually related to the consequences of the pandemic, in which country they were published, their target population, and the models, instruments and variables used to analyze them. Results: Only 4 articles emerged from the screening, of which only one was actually related to pandemic consequences. All articles were published in Asian countries with a target group of university students. Three of the articles used mediation models to examine the relationship between resilience as an independent variable and creativity as a dependent variable. All articles used self-assessment instruments for creativity and resilience, both at the individual and group level. Significance: This mini-review offers us the opportunity to reflect on the lack of studies that have addressed the issue of youth resources in the form of creativity and resilience since the beginning of the pandemic. The results show us a still underdeveloped interest in creativity in the scientific literature, in contrast to what the media reports on the promotion of creativity in daily life.

Home-Based Exercise Training in the Recovery of Multisystem Inflammatory Syndrome in Children: A Case Series Study.

OBJECTIVE: To assess the potential therapeutic role of exercise on health-related quality of life, assessed by the Pediatric Outcomes Data Collection Instrument (PODCI), coronary flow reserve (CFR), cardiac function, cardiorespiratory fitness, and inflammatory and cardiac blood markers in multisystemic inflammatory syndrome in children (MIS-C) patients. METHODS: This is a case series study of a 12-wk, home-based exercise intervention in children and adolescents after MIS-C diagnosis. From 16 MIS-C patients followed at our clinic, 6 were included (age: 7-16 years; 3 females). Three of them withdrew before the intervention and served as controls. The primary outcome was health-related quality of life, assessed PODCI. Secondary outcomes were CFR assessed by 13N-ammonia PET-CT imaging, cardiac function by echocardiography, cardiorespiratory fitness, and inflammatory and cardiac blood markers. RESULTS: In general, patients showed poor health-related quality of life, which seemed to be improved with exercise. Additionally, exercised patients showed improvements in coronary flow reserve, cardiac function, and aerobic conditioning. Non-exercised patients exhibited a slower pattern of recovery, particularly in relation to health-related quality of life and aerobic conditioning. CONCLUSIONS: Our results suggest that exercise may play a therapeutic role in the treatment of post-discharge MIS-C patients. As our design does not allow inferring causality, randomized controlled trials are necessary to confirm these preliminary findings.

Between a Rock and a Hard Place: The Challenges of Caregiving During a Pandemic for Parkinson's Family Care Partners.

Aim: To understand Parkinson's Disease (PD) care partners' a) specific challenges that led to worsening strain and b) their suggestions for supports to help them during the ongoing pandemic. Method: Using a qualitative descriptive design, semi-structured interviews with family care partners (n = 19) were completed. Participants were recruited from 10 sites across the United States that varied in size, demographics of patient population served, and geographic location (urban, suburban, rural). Interviews were audio-recorded, de-identified, transcribed verbatim, and coded in a phased manner. The research team analyzed the data and identified themes. Results: During the pandemic, the already difficult task of caregiving was made worse by having to choose between poor options. Five themes exemplified PD care partner experiences: (1) Managing risks and benefits of medical care in settings outside the home vs meeting these needs at home; (2) Struggling to maintain employment benefits with the costs of care and risks of bringing in outside caregivers; (3) Struggling to balance caregiving and self-care; (4) Struggling to be supportive and taking on new caregiving roles in the face of less support services; and (5) Wanting social connections and feeling pressured to maintain isolation. Care partners wanted timely access to, and guidance from healthcare teams to help them. Conclusions: Care partner burden was worsened by lack of guidance when confronted by choices that could lead to negative outcomes. Movement disorder and palliative care providers may be able to alleviate some care partner burden through building systems for timely access and guidance.

Comparison of teachers' voice disorders before and during COVID-19 pandemic.

<b> Aim:</b> The aim of the study was to analyze the impact of the COVID-19 pandemic and the related change of the teaching mode from stationary to distance learning on the severity of voice-related ailments among teachers. </br></br> <b> Materials and methods:</b> A questionnaire survey of teachers was conducted to assess voice disorders during stationary and remote work using the Vocal Tract Discomfort (VTDs) scale and Numeric Rating Scale (NRS), and the respondents' subjective feelings were assessed. Demographic and environmental factors associated with voice work were examined. Data on sickness absence, which were obtained from the "Health Needs Maps 2020" Ministry of Health's, were also analyzed. Responses were subjected to statistical analysis. A P-value level below 0.05 was considered statistically significant. </br></br> <b>Results:</b> 128 teachers participated in the survey. The overall assessment of voice disorders using VTDs and NRS scales showed no statistically significant differences for complaints between stationary and remote work. Detailed analysis revealed more se-vere voice disorders in teachers working more than 6 months remotely (P = 0.049) and having more than 20 lessons per week (P = 0.012). Subjective assessment confirmed a significantly lower percentage of teachers reporting voice disorders when wor-king remotely compared to stationary (P = 0.043). This resulted in less sickness absence and a 40% decrease in sick leave related to voice disorders in 2020 compared to 2019. </br></br> <b>Conclusions:</b> During the remote learning period of the COVID-19 pandemic, teachers reported lower severity of voice disor-ders and this influenced the reduction of sickness absences. There were no statistically significant differences in voice complaints as assessed by VTDs and NRS scales for both teaching modes. Several factors affecting the severity of vocal tract disorders were identified - the number of class hours per week (>20) for stationary teaching and a long period of remote teaching (>6 months).

The value of artificial intelligence and imaging diagnosis in the fight against COVID-19.

The outbreak of the new type of coronavirus pneumonia (COVID-19) has caused a huge impact on the world. In this case, only by adhering to the prevention and control methods of early diagnosis, early isolation, and early treatment, can the spread of the virus be prevented to the greatest extent. This article uses artificial intelligence-assisted medical imaging diagnosis as the research object, combines artificial intelligence and CT medical imaging diagnosis, introduces an intelligent COVID-19 detection system, and uses it to achieve COVID-19 disease screening and lesion evaluation. CT examination has the advantages of fast speed and high accuracy, which can provide a favorable basis for clinical diagnosis. This article collected 32 lung CT scan images of patients with confirmed COVID-19. Two professional radiologists analyzed the CT images using traditional imaging diagnostic methods and artificial intelligence-assisted imaging diagnostic methods, and the comparison showed the gap between the two methods. According to experiments, CT imaging diagnosis assisted by artificial intelligence only takes 0.744 min on average, which can save a lot of time and cost compared with the average time of 3.623 min for conventional diagnosis. In terms of comprehensive test accuracy, it can be concluded that the combination of artificial intelligence and imaging diagnosis has extremely high application value in COVID-19 diagnosis.

Intrinsic Kidney Pathology Following COVID-19 Infection in Children and Adolescents: A Systematic Review.

Introduction: COVID-19 infections resulting in pathological kidney manifestations have frequently been reported in adults since the onset of the global COVID-19 pandemic in December 2019. Gradually, there have been an increased number of COVID-19-associated intrinsic kidney pathologies in children and adolescents reported as well. The pathophysiological mechanisms between COVID-19 and the onset of kidney pathology are not fully known in children; it remains a challenge to distinguish between intrinsic kidney pathologies that were caused directly by COVID-19 viral invasion, and cases which occurred as a result of multisystem inflammatory syndrome due to the infection. This challenge is made more difficult in children, due to the ethical limitations of performing kidney biopsies to reach a biopsy-proven diagnosis. Although previous systematic reviews have summarized the various pathological kidney manifestations that have occurred in adults following acute COVID-19 infection, such reviews have not yet been published for children and adolescents. We describe the results of a systematic review for intrinsic kidney pathology following COVID-19 infection in children and adolescents. Methods: A systematic literature search of published data up until 31 October was completed through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. Research articles reporting new-onset or relapsed intrinsic kidney pathology in children or adolescents (≤18 years) following acute COVID-19 infection were included for qualitative review. COVID-19 infection status was defined by a positive result from a RT-PCR, or nuclear antibody testing. Only full-text articles published in the English language were selected for review. Results: Twenty-nine cases from fifteen articles were included in the qualitative synthesis of this systematic review. Nephrotic syndrome, as an umbrella condition, appeared as the most frequently observed presentation (20 cases) with disease remission noted in all cases with steroid treatment. Other cases included numerous glomerulonephritides, such as acute necrotizing glomerulonephritis, MPO vasculitis and collapsing glomerulopathy, and thrombotic microangiopathies, such as aHUS. For patients with transplanted kidneys, T-cell-mediated rejection and mild tubular interstitial infiltration were noted following testing positive for COVID-19. There were no mortalities reported in any of the included cases, although two patients remained dialysis dependent at hospital discharge. Conclusion: This systematic review highlights the various intrinsic pathological kidney manifestations in children and adolescents as a result of acute COVID-19 infection. The clinical timeline and presentation of these cases support the mechanistic hypothesis between COVID-19 infection and the onset of intrinsic kidney pathologies within this context. The progressive introduction of vaccination programs for children and adolescents may hopefully reduce the severity of COVID-19-associated illnesses, and pathological kidney manifestations in this population.

Mental health in relation to changes in sleep, exercise, alcohol and diet during the COVID-19 pandemic: examination of four UK cohort studies.

BACKGROUND: Responses to the COVID-19 pandemic have included lockdowns and social distancing with considerable disruptions to people's lives. These changes may have particularly impacted on those with mental health problems, leading to a worsening of inequalities in the behaviours which influence health. METHODS: We used data from four national longitudinal British cohort studies (N = 10 666). Respondents reported mental health (psychological distress and anxiety/depression symptoms) and health behaviours (alcohol, diet, physical activity and sleep) before and during the pandemic. Associations between pre-pandemic mental ill-health and pandemic mental ill-health and health behaviours were examined using logistic regression; pooled effects were estimated using meta-analysis. RESULTS: Worse mental health was related to adverse health behaviours; effect sizes were largest for sleep, exercise and diet, and weaker for alcohol. The associations between poor mental health and adverse health behaviours were larger during the May lockdown than pre-pandemic. In September, when restrictions had eased, inequalities had largely reverted to pre-pandemic levels. A notable exception was for sleep, where differences by mental health status remained high. Risk differences for adverse sleep for those with the highest level of prior mental ill-health compared to those with the lowest were 21.2% (95% CI 16.2-26.2) before lockdown, 25.5% (20.0-30.3) in May and 28.2% (21.2-35.2) in September. CONCLUSIONS: Taken together, our findings suggest that mental health is an increasingly important factor in health behaviour inequality in the COVID era. The promotion of mental health may thus be an important component of improving post-COVID population health.

Epicardial and pericoronary adipose tissue in severe COVID-19 infection.

OBJECTIVE: To investigate the association between epicardial and pericoronary adipose tissue thicknesses measured with computed tomography (CT) and severity of COVID-19 infection. METHODS: We recruited 504 patients admitted with RT-PCR-proven diagnosis of COVID-19 infection and underwent simultaneous Chest CT scanning. Epicardial adipose tissue thickness (EAT) and pericardial adipose tissue thickness (PCAT) were measured by CT. Comparisons were performed between ICU admitting and non-ICU admitting patients were performed. RESULTS: Of 504 patients, 423 patients were hospitalised in normal wards or followed as outpatient, and 81 patients were admitted to ICU. EAT and PCAT were significantly increased in ICU patients (5.98[5.06-7.13] mm vs. 8.05[6.90-9.89] mm, p < 0.001 and 9.3[7.4-11.5] mm vs. 11.2[10.3-13.2] mm, p < 0.001, respectively). In multiple logistic regression analyses, EAT and PCAT were independent predictors of ICU admission. A cut-off point of 6.64 mm EAT has a sensitivity of 82.7% and a specificity of 66.7% (AUC = 0.789, 95% CI: 0.744-0.833, p < 0.001) and a cut-off point of 9.85 mm PCAT has a sensitivity of 91.4% and a specificity of 61.2% (AUC = 0.744, 95% CI: 0.700-0.788, p < 0.001). CONCLUSION: We found that both increased EAT and PCAT were associated with the severity of COVID-19 infection defined as the need for ICU admission.

Percutaneous Tracheostomy With a Demistifier Canopy in the COVID-19 Era: A Safe Technique in the Intensive Care Unit.

BACKGROUND: Endoscopic percutaneous tracheostomy (PT) is a safe technique that is performed frequently by otolaryngologists and intensivists. New challenges have been identified in order to maintain the safety of this procedure during the COVID-19 pandemic. A novel approach, using a modified demistifier canopy, was developed during the first wave of the pandemic and implemented for 17 consecutive percutaneous tracheostomies in order to enhance procedural safety. METHODS: A protocol was developed after performing a literature review of tracheostomy in COVID-19 patients. A multidisciplinary tracheostomy team was established, including the departments of otolaryngology, critical care, and respiratory therapy. Simulation was performed prior to each PT, and postoperative debriefings were done. RESULTS: A protocol and technical description of PT using a modified demistifier canopy covering was written and video documented. Data were collected on 17 patients who underwent this procedure safely in our tertiary care hospital. There were no procedure-related complications, and no evidence of COVID-19 transmission to any member of the health care team during the study period. CONCLUSION: As patients continue to recover from COVID-19, their need for tracheostomy will increase. The technique described provides a safe, multidisciplinary method of performing PT in COVID-19 patients.

Perioperative mortality and morbidity of hip fractures among COVID-19 infected and non-infected patients: A systematic review and meta-analysis.

PURPOSE: Hip fractures among elderly patients are surgical emergencies. During COVID-19 pandemic time, many such patients could not be operated at early time because of the limitation of the medical resources, the risk of infection and redirection of medical attention to a severe infective health problem. METHODS: A search of electronic databases (PubMed, Medline, CINAHL, EMBASE and the Cochrane Central Register of Controlled Trials) with the keywords "COVID", "COVID-19″, "SARS-COV-2", "Corona", "pandemic", "hip fracture", "trochanteric fracture" and "neck femur fracture" revealed 64 studies evaluating treatment of hip fracture in elderly patients during COVID-19 pandemic time. The 30-day mortality rate, inpatient mortality rate, critical care/special care need, readmission rate and complications rate in both groups were evaluated. Data were analyzed using Review Manager (RevMan) V.5.3. RESULTS: After screening, 7 studies were identified that described the mortality and morbidity in hip fractures in both COVID-19 infected (COVID-19 +) and non-infected (COVID-19 -) patients. There were significantly increased risks of 30-day mortality (32.23% COVID-19 + death vs. 8.85% COVID-19 - death) and inpatient mortality (29.33% vs. 2.62%) among COVID-19 + patients with odds ratio (OR) of 4.84 (95% CI: 3.13-7.47, p < 0.00001) and 15.12 (95% CI: 6.12-37.37, p < 0.00001), respectively. The COVID-19 + patients needed more critical care admission (OR = 5.08, 95% CI: 1.49-17.30, p < 0.009) and they remain admitted for a longer time in hospital (MD = 3.6, 95% CI: 1.74-5.45, p = 0.0001); but there was no difference in readmission rate between these 2 groups. The risks of overall complications (OR = 17.22), development of pneumonia (OR = 22.25), and acute respiratory distress syndrome/acute respiratory failure (OR = 32.96) were significantly high among COVID-19 + patients compared to COVID-19 - patients. CONCLUSIONS: There are increased risks of the 30-day mortality, inpatient mortality and critical care admission among hip fracture patients who are COVID-19 +. The chances of developing pneumonia and acute respiratory failure are more in COVID-19 + patients than in COVID-19 ‒ patients.

Infectious disease, the climate, and the future.

Emergence and resurgence of infectious diseases are serious threats to population health. The ongoing COVID-19 pandemic has caused an enormous human toll and health crisis. Responses to the pandemic are significantly affecting the global economy. What is most concerning about COVID-19 is not the virus itself, but rather that it may compound with other and more serious crises. Climate change will likely affect human health, economy, and the society more than disease outbreaks. Governments at all levels, from local to international, can chart a greener, healthier, and equitable course for the future, investing in strategies and technologies that minimize and prevent risks, including those posed by climate change and the pandemic, promoting obligations to drastically reduce emissions, enhancing societal equality, improving community resilience, and achieving sustainable development goals.