Global inequalities in tuberculosis

The global burden of TB disease is characterised by inequalities throughout the cascade of care. These inequalities are evident across regions and within countries. Indeed, populations with the highest burden of TB disease have the least access for TB health services for prevention, timely diagnosis, appropriate treatment and follow-up. In the face of global health emergencies such as COVID-19, these inequalities increase, resulting in worse outcomes for key populations that are already disproportionately affected by TB disease. Children bear the biggest brunt of the inequalities in the TB cascade of care. There is therefore an urgent need to address these, in line with the United Nations SDGs for improving health and well-being for all.Copyright © ERS 2023.

Peacekeeping Operations: Challenges and Opportunities in the Midst of Health Crises

The COVID-19 crisis has brought about significant challenges to international organizations operating in fragile contexts. Among others, the case of United Nations (UN) and its peacekeeping operations (PKOs) counting more than 80, 000 personnel from 121 countries is certainly prominent. Not only do PKOs rely on international personnel's frequent rotations, but they also rely on freedom of movement to carry out their mandate. How have PKOs adapted and responded to the crisis? How do PKOs balance the need to protect vulnerable civilians with support to governments' responses to the crisis and safeguard legitimacy? This chapter explores the impact of the health crisis due to the COVID-19 pandemic on PKOs by focusing on two key aspects. First, it evaluates the current PKO efforts in managing the crisis in light of two previous health emergencies occurring in the midst of PKOs, namely Ebola in Western Africa and cholera in Haiti. It will reflect on the legitimacy costs associated with the risk of UN personnel being seen as vector of the disease. Second, it identifies challenges and opportunities created by the emergency. The key challenges stem from the inevitable delay or interruption of ongoing negotiation processes, and the associated risks of armed groups taking advantage of the uncertain situation. But there are some opportunities to consider. Operational adaptation becomes a need as missions have to prioritize civilians' protection without violating governments' policies on movement. Furthermore, halting frequent personnel rotations has likely increased cohesion within missions among soldiers but also between soldiers and missions' leaders. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Bringing health information exchange to the Middle East and North Africa: the case of Malaffi in Abu Dhabi

Launched in 2019, Malaffi is the first health information exchange (HIE) platform in the Middle East and North Africa region. It safely and securely connects public and private healthcare providers in the Emirate of Abu Dhabi. Malaffi allows for meaningful, real-time exchange of patient health information between the providers, establishing a centralized database of unified patient records, thus improving healthcare quality and patient outcomes. Now that the foundation has been firmly established by collating 99% of all patient episodes in the Emirate, Malaffi is implementing tools to support population health. Recently these activities were focused on COVID-19 response. In the future, these population health services will offer insights to improve care delivery. This case study demonstrates the HIE status in the UAE and focuses on the establishment of Malaffi in Abu Dhabi. © 2023 Elsevier Inc. All rights reserved.

MULTILINGUAL COMMUNITIES ENGAGING IN DISTANCE LEARNING: What Lessons Can Be Learned?

While distance education technology combines individual locations virtually, distance education communities are shaped by how participants share resources. Distance education communities are established over time through overlapping spheres of influence. Research is needed that considers how transnational families and students are either invited or discouraged from sharing their linguistic and cultural resources within distance education communities. This article describes the results of a 2-year qualitative study that examined distance education communities containing transnational multilingual elementary students and families. This article discusses factors that should be considered when supporting distance education programs.

Introduction

L'industrie automobile est a la croisée des chemins, car elle est soumise a une conjonction d'externalités d'une ampleur et d'une intensité rarement vues : absorption de toutes les crises récentes, celles du Covid et des semi-conducteurs, mais aussi celle de la hausse des prix de l'énergie. C'est celui de parvenir å intégrer ces techniques afin de parvenir a réinventer l'automobile de demain, une automobile connectée, robotisée et traitant automatiquement de grands volumes de données afin de progresser en intelligence, et de mettre celle-ci au service de l'humain, pour un usage réinventé de l'automobile et pour instaurer un systéme de mobilité plus durable. Il appelle ainsi a mieux cibler l'accompagnement des fournisseurs pour faire émerger une nouvelle génération d'ETI et aussi l'apparition de grands équipementiers leaders dans le monde de l'électrique, de l'hydrogene et, plus globalement, de l'automobile de demain. Il demande aussi que l'Europe se donne du temps pour s'adapter a la transition en protégeant temporairement, a l'instar des États-Unis, son marché intérieur.

The French automotive industry faces the challenge of the ecological transition

[...]the vehicle of the future must be considered within the broader framework of the mobility of the future, taking into account the entire value chain. Transforming our future into a sustainable future: planning for the automotive transition Didier Sepulchre de Condé, Mechanical industry The automotive industry is in turmoil, firstly because of the economic situation, with a market deeply affected by Covid, shortages of materials and components and disoriented customers;and secondly because of the structural situation, with the forced transition to electrification. The four paradoxes of the ecological transition of the European car industry Alois Kirchner, Former Director of Cabinet of the Minister for Industry The energy transition in the automotive sector is essential for achieving French and European climate objectives. [...]the actions implemented come up against four paradoxes, which must be overcome if this transition is to succeed: * the regulation on the reduction of CO2 emissions from the tank to the wheel, to the exclusion of other sources which now represent the majority of emissions from new vehicles;* the steering of vehicle traffic restrictions based on Crit'air stickers, leading to the prohibition of access to certain cities for vehicles that are more virtuous than others that are still allowed to enter;* the inability to implement policies to support the production of vehicles on European soil that are sufficiently powerful to halt the fall in associated jobs;a situation that benefits production sites that are not subject to the same environmental standards;* and the rising price of "green" vehicles, leading to a slowdown in the renewal of the fleet and the maintenance of a high level of pollution and carbon emissions.

Evaluation of Quality-of-Care Indicators Among Patients With Crohn's Disease and Ulcerative Colitis in the United States: 2019-2020

Introduction: Crohn's disease (CD) and ulcerative colitis (UC) can be difficult to manage and, due to a lack of meaningful quality measures, patient (pt) care may vary by provider. To understand where gaps in care may exist for these pts, this study assessed specific healthcare resource utilization (HRU) and medication metrics that may be potential quality of care (QOC) indicators. Method(s): Using a large commercial US claims database (2019-2020), pts with CD or UC were identified. Potential QOC indicators were selected based on clinical guidelines and recommendations from measures of quality organizations and included CD or UC prevalence;gastroenterologist (GE) and IBD-related non-GE outpatient visits;IBD-related emergency department visits or hospitalizations;excessive steroid use (prednisone equivalent >=10 mg/day for >=60 consecutive days or a single prescription of >=600 mg prednisone);excessive steroid users on corticosteroid (CS)-sparing therapy;excessive steroid users with central dual-energy X-ray absorptiometry (DEXA) or osteoporosis pharmacologic treatment;use of targeted immunomodulators (TIMs) and oral mesalamine (CD only);imaging assessments;and assessment of inflammatory biomarkers. National percentages of pts achieving each metric are reported. Result(s): In total, 41,555 CD and 52,507 UC pts were identified in 2019, resulting in a 0.3% and 0.4% prevalence, respectively (Table). Over a third of CD pts (39.8%) and almost half of UC pts (45.5%) did not visit a GE in 2019. Around 10% CD pts, and up to 6.4% of UC pts, had IBD-related ED visits or hospitalizations. 17.1% CD and 14.5% UC pts were excessive steroid users, yet < 9% CD and UC pts, received DEXA scans and/or bone treatments. A third of excessive steroid users with CD (34.5%), and over half (53.0%) of those with UC, did not receive CS-sparing therapy. The rate of TIM use was over two times higher in CD vs UC pts (CD: 44.3%;UC: 18.9%). Despite evidence that mesalamine is ineffective in CD, 18.7% of pts with CD were prescribed it. Inflammatory biomarker level testing rates were < 50% in both CD and UC. Similar outcomes were reported in 2020, with lower HRU, possibly due to COVID-19. Conclusion(s): This analysis of QOC indicators highlights various areas for improvement that may provide better treatment outcomes and reduce HRU for pts with CD and UC. Future research is needed to assess outcomes in pts that are not being routinely monitored. (Table Presented).

Best practices for pediatricians in diagnosing and treating asthma

Additionally, they can treat atopic comorbidities such as atopic dermatitis, chronic urticaria, nasal polyps, eosinophilic esophagitis, and hypereosinophilic syndrome, resulting in improved quality of life for our patients. Parents should be made aware of its updated black box warning for possible effects on mental health and behavior changes,3 including but not limited to suicidal ideation. FDA requires boxed warning about serious mental health side effects for asthma and allergy drug montelukast (Singulair);advises restricting use for allergic rhinitis.

Outcomes of Patients Receiving Bezlotoxumab for the Prevention of Recurrent Clostridioides difficile Infection - A Multicenter Study

Introduction: Clostridioides difficile infection (CDI) is the most common healthcare-associated infection in the United States (US). Treatment guidelines have evolved resulting in better outcomes however recurrent disease remains a major issue associated with significant morbidity despite best practices. Bezlotoxumab (BEZ) is a fully humanized monoclonal antibody approved by FDA in 2017 for prevention of recurrent CDI (rCDI). Limited real-world data are available regarding BEZ usage outside of clinical trials. In this multicenter study, we aim to report our experience with BEZ at a large healthcare system in northeast US. Method(s): We retrospectively reviewed all consecutive adult patients who received BEZ from 1/2017 until 12/2021 at Yale-New Haven Health System and had at least 90 days of follow up. Data collected for each patient included demographics, medical co-morbidities, adverse events to BEZ and rates of rCDI following BEZ. Result(s): A total of 114 patients were included with a mean age of 67.3 years (range 25-97);74 (64.9%) were female. There has been a recent increased utilization of BEZ with more than half of our sample (n=73, 64%) being since the beginning of COVID-19 pandemic and 38.6% in 2021 alone. Most patients were treated with vancomycin (88.6%) while 11 (9.7%) received fidaxomicin. Median time from most recent CDI episode to BEZ infusion was 22.5 days. Notably, 17.5% were not on active CDI treatment when they received BEZ. 30 (26.3%) received BEZ after initial CDI, 52 (45.6%) had one prior recurrent episode while 32 (28.1%) had 2 or more previous recurrences. Among those who received BEZ, 10 patients (8.8%) experienced 90-day rCDI, of these 9 (90%) had history of at least 1 episode of rCDI. There were no statistically significant differences in baseline characteristics between r-CDI and non-rCDI groups (Table). Furthermore, no statistical difference in rCDI between those who were on CDI treatment at the time of BEZ and those who completed it before BEZ [9/94 (9.6%) vs 1/20 (5.0%);p=0.511]. Conclusion(s): Our real-life data confirms that Bezlotoxumab appears to be safe and effective in preventing rCDI in this population whether given during CDI treatment or after. BEZ represents an important treatment option in this highly morbid population. Further studies are needed to determine the benefit of early administration of BEZ after index CDI in those at risk and to consider utilization shifts following the 2021 ACG updated guideline recommendations advising it's usage.

Highlights from this issue

The final act of Philip Roth's achingly poignant novel, Nemesis, based on the 1944 polio epidemic condenses the trajectories of each of the main protagonists' lives as a result of events that sultry summer, Bucky Cantor, swapping life stories with a former pupil at his school. [...]the implications for long term (psychological and physical) health are arguably worse: late presentation for other febrile illness (EDs have never been so empty—something is wrong);fear of infection by dint of ‘exposure' to a health facility;interruption of standard health surveillance particularly vaccination;mental health;child abuse as a result of prolonged internment and loss of, at least the social side of, education. The reasons for less aggressive disease are still not completely understood, though there are a number of candidate explanators: host-response factors;lower infective dose (as most often from an adult household member);age related ACE receptor differences and more recent exposure to antigenically similar coronaviruses conferring relative immunity.

Indian Act Philanthropy: Why are Community Foundations Missing from Native Communities in Manitoba, Canada?: Revue Canadienne de Recherche sur les OSBL et l'Économie Sociale (ANSERJ)

Un modèle philanthropique axé sur le développement communautaire serait-il en train de renforcer les politiques coloniales plutôt que d'offrir des bénéfices économiques équitables? Cette étude analyse les transcriptions de vingt webinaires publics sur la philanthropie et la Loi sur les Indiens et évalue les 54 fondations communautaires établis au Manitoba, Canada. Ces 54 fondations servent seulement les villes et municipalités des colons-il n'y en a pas une seule dans les communautés autochtones. Comme elles ne desservent que leurs régions géographiques spécifiques, les fondations communautaires au Manitoba concentrent la richesse dans les villes et municipalités dominées par les colons, accaparant des ressources qui pourraient aider les communautés autochtones. Ce modèle philanthropique, en excluant les communautés les plus pauvres du Manitoba, renforce la marginalisation, la pauvreté et les risques de santé dans les communautés autochtones.Alternate :Could a philanthropic model aimed at community development enforce colonial policy rather than providing equitable economic opportunity? This research analyzes the transcripts of 20 public webinars on philanthropy and the Indian Act and maps the 54 community foundations in Manitoba, Canada. All 54 community foundations in Manitoba service only settler-dominated cities and municipalities, with none on Native communities. As community foundations serve only their specific geographical areas, the community foundations in Manitoba effectively concentrate wealth in settler-dominated cities and municipalities, taking away needed resources from Native communities. In excluding the poorest communities in Manitoba, this philanthropic model further entrenches marginalization, poverty, and health risks for Native people on Native communities.

Does Covid-19 Increase the Risk of Atrial Fibrillation? A Retrospective Analysis of a Large Administrative Claims Database of Commercially Insured Non-Elderly and Medicare Advantage Beneficiaries in the United States

Background: Studies have suggested that myocardial damage due to severe acute respiratory syndrome-2 (SARS-CoV-2), commonly referred to as COVID-19, may increase the risk of arrhythmias. Objective(s): To compare the one-year incidence of atrial fibrillation (AF) among patients with COVID-19 as compared to patients with non-COVID-19 acute upper respiratory infection (AURI). Method(s): The Optum Clinformatics database, an administrative claims databaseof commercially insured beneficiaries in the United States (US), was used for study purposes. Three cohorts of patients were identified: patients with COVID-19 diagnosis in any setting (April 2020-June 2021);patients with AURI in the pandemic period (April 2020-June 2021);and patients with AURI in the pre-pandemic period (January 2018-December 2018). Patients with prior AF diagnosis were excluded from each cohort. Three sets of analysis comparing AF incidence were performed: COVID-19 cohort vs AURI pandemic cohort;COVID-19 cohort vs AURI pre-pandemic cohort;and AURI pandemic cohort vs AURI pre-pandemic cohort. For each of the three comparisons, a matching weight method was used to help ensure balance among groups on baseline socio-demographic and clinical comorbidities. Logistic regression was used to assess the odds of 1-year incident AF among matched patients. Result(s): When comparing the matched COVID-19 (n=102,227) and AURI pandemic (n=102,101) cohorts, one-year incidence of AF was significantly higher in the COVID-19 cohort (2.2% vs 1.2%;p<0.001), who were 83% more likely to develop AF (odds ratio [OR] 1.83;95% confidence interval [CI] 1.72-1.95) as compared to the AURI group. COVID-19 patients were also observed to have significantly higher risk of incident AF as compared to AURI pre-pandemic cohort (2.7% vs 1.6%;p<0.001;OR 1.70, 95% CI 1.63-1.78). No significant difference was observed in AF incidence among the AURI pandemic versus AURI pre-pandemic cohort (1.1% vs 1.2%;p=0.133;OR 0.95, 95% CI 0.90-1.01). Figure 1 depicts differences in AF incidence across the comparator cohorts. Conclusion(s): Patients with COVID-19 were observed to have a higher incidence of AF as compared to those with upper respiratory infections. Awareness amongst clinicians of an increased AF incidence in COVID-19 affected patients appears warranted. [Formula presented] French language not detected for EMBFRA articles source xmlCopyright © 2023

Continuance intention in financial technology: a framework and meta-analysis

PurposeAlthough many studies have sought to address the topic of continuance intention among Fintech customers, the reported findings are fragmented. Therefore, the present study proposes a research model that integrates the main constructs involved in Fintech continuance intention.Design/methodology/approachThe current study uses a meta-analytic-based correlation analysis of effect sizes, meta-regression analysis and meta-analytic structural equation modeling, with 247 effect sizes in 69 studies involving 26,140 respondents.FindingsThe results reveal continuance intention is driven by satisfaction and trust, with ease of use and usefulness being antecedents of satisfaction and trust. The authors also found evidence to show satisfaction partially mediates the relationship between ease of use and continuance intention and that trust fully mediates the relationship between ease of use and continuance intention and partially mediates the relationship between usefulness and continuance intention. In addition, the authors found that in Western countries, with higher Human Development Index levels and greater of use of electronic payment, satisfaction has more impact on continuance intention.Practical implicationsFrom a theoretical standpoint, this meta-analytic study has implications for the literature on Fintech by offering an empirical generalization on the strength of the antecedents of Fintech continuance intentions and by testing possible moderators in a wide range of countries and studies. In other words, this study's goal is to broaden the scope of the research. Regarding managerial implications, it is important to listen to user opinions regarding the positive and negative points of their experience with these technologies and take them into consideration when planning improvements. Additionally, the analysis shows the importance of using data from user interaction with technology, obtained, for example, through big data analytics, whereby companies can see how users behave, how much time they spend accessing certain functions and which technological features they use most, and thus seek to improve whatever is needed.Originality/valueThis meta-analytic study advances the understanding of Fintech continuance intentions. Using the proposed approach, it is possible to generate accurate estimates of the effect size of each analyzed antecedent as the meta-analytic method jointly evaluates the results produced by a wide variety of studies performed in different contexts, allowing more accurate conclusions to be drawn.

Factors Associated with Hospitalization with Symptomatic Coronavirus Disease 2019 among Pregnant Individuals: A Multicenter Retrospective Cohort Study

Background: Pregnant individuals are at increased risk of coronavirus disease 2019 (COVID-19) hospitalization and death, and primary and booster COVID-19 vaccination is recommended for this population. Method(s): Among a cohort of pregnant individuals who received prenatal care at 3 healthcare systems in the United States, we estimated the cumulative incidence of hospitalization with symptomatic COVID-19 illness. We also identified factors associated with COVID-19 hospitalization using a multivariable Cox proportional hazards model with pregnancy weeks as the timescale and a time-varying adjustor that accounted for severe acute respiratory syndrome coronavirus 2 circulation;model covariates included site, age, race, ethnicity, insurance status, prepregnancy weight status, and selected underlying medical conditions. Data were collected primarily through medical record extraction. Result(s): Among 19 456 pregnant individuals with an estimated due date during 1 March 2020-28 February 2021, 75 (0.4%) were hospitalized with symptomatic COVID-19. Factors associated with hospitalization for symptomatic COVID-19 were Hispanic ethnicity (adjusted hazard ratio [aHR], 2.7 [95% confidence interval {CI}, 1.3-5.5]), Native Hawaiian or Pacific Islander race (aHR, 12 [95% CI, 3.2-45.5]), age <25 years (aHR, 3.1 [95% CI, 1.3-7.6]), prepregnancy obesity (aHR, 2.1 [95% CI, 1.1-3.9]), diagnosis of a metabolic disorder (aHR, 2.2 [95% CI, 1.2-3.8]), lung disease excluding asthma (aHR, 49 [95% CI, 28-84]), and cardiovascular disease (aHR, 2.6 [95% CI, 1.5-4.7]). Conclusion(s): Although hospitalization with symptomatic COVID-19 was uncommon, pregnant individuals should be aware of risk factors associated with severe illness when considering COVID-19 vaccination. Copyright © 2022 Published by Oxford University Press on behalf of Infectious Diseases Society of America. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Effective Messaging Strategies for Colorectal Cancer Screening: The Development of the 2022 NCCRT Messaging Guidebook for Black and African American People

Introduction: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States (US) and disproportionately impacts Black individuals. The US Preventive Services Taskforce began recommending CRC screening for individuals aged 45-49 in 2021, however effective strategies to increase screening participation in Black individuals in this age group are unknown. Thus, the National Colorectal RoundTable (NCCRT) used a mixed methods approach to identify barriers and facilitators to CRC screening in Black individuals, with specific focus on those age 45-49. Results informed the development of the 2022 NCCRT Messaging Guidebook for Black & African American People. Method(s): We conducted a mixed-methods study in a large, nationally representative sample of unscreened Black individuals. We first conducted semi-structured qualitative interviews with Black individuals over age 45, recruited from the Schlesinger Group qualitative research platform. Findings informed content for a subsequent survey to understand barriers and facilitators, administered broadly via the Prodege online research platform. Messages to encourage screening participation were developed based on learnings from prior ACS and NCCRT work. Message were tested using MaxDiff analytic methods and reviewed by a multidisciplinary advisory committee for inclusion in the Guidebook. Result(s): There were 10 qualitative interview and 490 survey participants. The average age of participants was 52.7 (s.d.56.1) for interviews and 55.3 (s.d.57.3) for surveys. 40.0% were female and 38.2% lived in the Southeast US (Table). The most frequently reported barrier to screening was procrastination (40.0% in age 45-49;42.8% in age 50-65;34.2% in age .55). Procrastination was often attributed to financial concerns (20.8% in age 45-49) and COVID-19 (27.0% in age 50-54;21.8% in age .55) (Figure). Of those age 45-49, the majority preferred to receive screening information from a health care provider (57.5%), however only 31.7% reported that a provider had initiated a screening conversation. Several messages rated as highly effective in encouraging screening were included in the NCCRT Guidebook. Conclusion(s): We identified several age-specific barriers to CRC screening and developed unique messaging to motivate screening among unscreened Black individuals age 45 and over. Messages that tested positively are publicly available as a resource for organizations and institutions that aim to increase screening rates.

Vaccines for COVID-19 arm RSV: An update

[...]in this case, the Pfizer/BioNTech response-which is appropriate-is that if the level of antibodies is too low, we may need a third dose in the age group of 2 to 5 years. All that said, it seems the existing vaccines now have a 3-dose series in adults;we don't know necessarily yet for children if 2 or 3 doses will be necessary for all the mRNA vaccines, but there are reasonably good data that the immune responses induced may still provide a level of protection that is reasonable. Whenever there is a new variant, there are basic science laboratories in various parts of the world that are poised to immediately do studies with model systems in which they can put the variants into a virus that is not pathogenic and ask the question "Do the antibodies from some of the recipients of the vaccine provide some level of protection in a laboratory study?" With the Omicron surge being so big, we were able to get a pretty good idea of whether people who had received the vaccine were significantly less likely to have significant consequences from infection. William J. Muller is an attending physician of infectious diseases and scientific director of clinical and community trials at the Stanley Manne Children's Research Institute at Ann & Robert H. Lurie Children's Hospital of Chicago and an associate professor of pediatrics at Northwestern University Feinberg School of Medicine in Chicago, Illinois.

Cardiac Arrhythmias among Myocarditis Patients Positive with Covid-19 and Associated Mortality Risk, an Analysis from the 2020 National Inpatient Sample

Background: Viruses are the most common cause of myocarditis. With the ongoing COVID-19 pandemic, several cases of myocarditis have been reported in COVID-19 positive patients. Such patients may also experience a variety of arrhythmias that can provoke death. Objective(s): To evaluate the presence of various cardiac arrhythmias among COVID-19 positive myocarditis patients and understand their impact on mortality. Method(s): COVID-19 positive patients, admitted between April 1st 2020 to December 31st 2020, were recruited from the 2020 National Inpatient Sample. The presence of myocarditis and various cardiac arrhythmias were also identified via their respective ICD-10 codes. Logistic regression models were used to identify the odds of mortality in the presence of myocarditis. We further proceeded to estimate the odds of mortality among myocarditis patients who had various arrhythmias. Result(s): Our study found 6135 (0.4%) patients with myocarditis among 1628110 cases of COVID-19 recorded in the United States between April to December 2020. Age ranged between 0 - 90 years with a mean of 58 years. Multiple cardiac arrhythmias were also observed among myocarditis patients as 310 (5.1%) recorded supraventricular tachycardia, 520 (8.5%) had ventricular tachycardia, 120 (2.0%) had ventricular fibrillation, 520 (8.5%) had paroxysmal atrial fibrillation, 165 (2.7%) had atrial flutter, and 20 (0.3%) had long QT syndrome. The presence of myocarditis was linked with higher odds of mortality among all COVID-19 patients (aOR 2.551, 95% CI 2.405-2.706, p<0.01). Various cardiac arrhythmias were also potential predictors of mortality among myocarditis cases in COVID-19 patients, such as supraventricular tachycardia (aOR 1.346, 95% CI 1.041-1.74, p=0.023), ventricular tachycardia (aOR 1.896, 95% CI 1.557-2.308, p<0.01), ventricular fibrillation (aOR 4.161, 95% CI 2.74-6.319, p<0.01), and atrial flutter (aOR 1.485, 95% CI 1.047-2.106, p=0.026). Conclusion(s): Myocarditis was associated with higher mortality among COVID-19 admissions. Arrhythmias such as supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation, and atrial flutter were predictive of higher mortality in these patients. Continued caution is advised among health-care providers encountering these arrhythmias in myocarditis patients who are COVID-19 positive. [Formula presented] French language not detected for EMBFRA articles source xmlCopyright © 2023

The rise of the variants

Case fatality rates were lower during the Delta-dominated period than the Omicron period, however.3 Additionally, the report included the caveat that vaccination rates also increased from the period of Delta-dominated infections until Omicron took over.3 Although the US increase in the Omicron XBB variant is still relatively new, it has been significant, rising from about 4% of cases in a week to more than 40%,' dwarfing the Australian study's estimates of a weekly growth rate of around 57%.2 It is still too early to estimate the exact impact of the Omicron XBB variant, but some experts believe they have zeroed in on the source of its potency. The mechanism for higher transmis-sibility in this variant is still a mystery, but increased angiotensin-converting enzyme 2 binding in this latest variant explains its superior growth and resistance to antibodies.4 Changes to the spike protein-the major target for vaccines-and monoclonal antibodies in the XBB variant make it more immune evasive than previous Omicron variants, data from another study suggested.5 Omicron, XBB, and children Most of the data on the impact of the Omicron strains that have taken over US COVID-19 infections focus on adult patients, but some reports have estimated the impact on the pediatric population specifically. [...]he said, influenza has taken over both COVID-19 and respiratory syncytial virus (RSV) cases in his community.