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Rationale: Vocal cord dysfunction (VCD) is often under-recognized and/or misdiagnosed as asthma. Although post-viral syndrome has been suggested as a contributing factor in VCD, there is little data on infectious-associated VCD and no information with COVID-19. The purpose of this ongoing, prospective registry study is to characterize risk factors contributing to VCD. Methods: Subjects age ≥ 12 years referred for VCD assessment at the time of provocation challenge-rhinolaryngoscopy were eligible to participate. Enrollment initiated September, 2021. An investigator designed questionnaire of potential risk factors for VCD including COVID-19 infection was administered with data chart collection. Results: Of 31 subjects currently enrolled, 52% (N=16) reported VCD symptoms either 1) onset following respiratory infection (N=9, 29%) or 2) worsened following COVID-19 infection (N=7, 23%). Those reporting infectious-associated VCD symptoms were more likely to report gastroesophageal reflux disease (p=0.017) with approaching significance for symptoms of throat clearing (p=0.097), chronic sinus infections (p=0.095), and age > 40 years (p=0.097) when compared to subjects who denied infectious-associated VCD symptoms. Additionally, the noninfectious-associated VCD group was approaching significance for reporting increasing number of triggers over time (p=0.051) versus infectious-associated VCD. There was no difference (p>0.05) between groups in Pittsburgh VCD Index scores, BMI, sex, co-morbid asthma, smoking status, environmental allergy history, or symptoms of shortness of breath, cough, wheezing, or throat tightness. Conclusions: Our early results suggest an important role for infectious etiologies, including COVID-19, in triggering and/or worsening VCD. Clinical awareness of these associations is warranted to rapidly address and provide appropriate therapeutic care.
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The COVID-19 pandemic highlighted the intricate relationships between human health and the social-ecological system in an era of climate and global change. Widespread COVID-19 adversely affected farmers' employment, production practices, and livelihood resilience. At the same time, climate change is a key issue limiting agricultural production worldwide. Emissions of greenhouse gases, such as carbon dioxide, are a major factor leading to global climate change. Greenhouse gas emissions from agricultural production are receiving increasing attention. Therefore, it is particularly important to develop low-carbon agriculture. Based on data from 920 family farms in Jiangsu province and Shaanxi province, this study constructs a structural equation model and empirically tests the relationship between the variables using the bootstrap method. The results show that: (1) climate change awareness did not directly stimulate farmers' willingness to pursue low-carbon production;(2) climate change awareness has an impact on low-carbon production willingness through perceived ease of use and consequence awareness;and (3) anti-risk ability can effectively moderate the impact of climate change awareness on low-carbon production behavior in agriculture. The theoretical model framework proposed in this study provides a reference for research in the field of low-carbon agriculture and also provides some insights and suggestions for environmentalists and governments. In addition, policymakers should effectively raise the sense of responsibility of farmers to address climate change and promote low-carbon agricultural production to achieve healthy and sustainable agricultural development. © 2022 by the authors.
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Modular construction has been implemented to achieve shorter project duration, lower cost, and higher productivity for construction projects. This option is especially helpful to reduce on-site activities and interaction under and after COVID impact. However, additional planning and support in engineering, procurement, and delivery are required to facilitate modular construction. Unreliable prefabrication and delivery can deteriorate subsequent activity productivity and overall project performance. This research aims to develop an automatic incentive—penalty enforcement system for modular construction based on the situation awareness of delivery tracking. The research selected a high-rise residential project in Singapore as a case study. The project used modular construction for making and installing 120 Prefabricated Bathroom Units. Based on the empirical data of delivery, on-site lifting, and installation, we built STROBOSCOPE simulation models to understand the impact on productivity and schedule from five scenarios at various delivery reliability levels of the Prefabricated Bathroom Units. Smart Contract rules were developed based on the impact. A Blockchain platform was established so that once a real-time delivery is identified and the information is entered into the Smart Contract, the associated incentive or penalty can be triggered instantly. The Smart Contract based incentive—penalty enforcement system will be beneficial for construction projects to monitor and track modular delivery, motivate reliable supply, reduce payment disputes, and improve productivity. © 2023, Canadian Society for Civil Engineering.
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COVID-19 pandemic affects 213 countries and regions around the world. Which the number of people infected with the virus exceeded 26 millions infected and more than 870 thousand deaths until september 04, 2020, in the world, and Peru among the countries most affected by this pandemic. So we proposed a mathematical model describes the dynamics of spread of the COVID-19 pandemic in Peru. The optimal control strategy based on the model is proposed, and several reasonable and suitable control strategies are suggested to the prevention and reduce the spread COVID-19 virus, by conducting awareness campaigns and quarantine with treatment. coronavirus 2019 (COVID-19). Pontryagin's maximum principle is used to characterize the optimal controls and the optimality system is solved by an iterative method. Finally, some numerical simulations are performed to verify the theoretical analysis using Matlab. © 2022
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Background: The prevalence of myopia keeps increasing during the COVID-19 pandemic. We aimed to map the worldwide treatment preferences of ophthalmologists managing myopia control during the first wave of the pandemic. Methods: An online questionnaire inquiring about pharmacological and optical treatment patterns during the first half of 2020 was sent to pediatric ophthalmology as well as general ophthalmology memberships worldwide. The results among pediatric ophthalmologists were compared to a previous study we performed before the pandemic. Results: A total of 2269 respondents from 94 countries were included. Most respondents were pediatric ophthalmologists (64.6%), followed by ophthalmologists from other subspecialties (32.3%). The preferred modality for all geographical regions was a combination therapy of pharmacological and optical treatments. When evaluated independently, the pharmacological treatment was more popular than the optical treatment in most regions other than East Asia (P < 0.001). Compared to a pre-pandemic questionnaire, the participation of pediatric ophthalmologists affiliated with non-university hospitals increased. Additionally, the prevalence of respondents utilizing either any type of pharmacological treatment and those that using only evidence-based treatments increased globally. Although a decline in the use of optical treatment was evident worldwide, the use of evidence-based optical treatments increased. Conclusion: Ophthalmologists around the world preferred a combination therapy of pharmacological and optical treatments. More pediatric ophthalmologists treated myopia progression and preferred a better evidence-based approach to control myopia. These trends reflect a positive response and more awareness of the rising prevalence of myopia due to the increased burden of myopia imposed by the COVID-19 pandemic. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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Objective: Nepal has been participating in the May Measurement Month (MMM) aiming to raise hypertension awareness and improve health seeking behavior to control high blood pressure in communities and present data for policymakers. This study compares the results from 2017 to 2021. Design and Methods: Opportunistic cross-sectional surveys to measure the proportion of hypertension, its awareness, treatment, control, and risk factors among> = 18 years of age annually from 2017 to 2021 in Nepal. Although MMM was not executed globally due to the COVID-19 pandemic in 2020, it was conducted in Nepal by following safety measures. We administered the structured questionnaire and took three BP readings while sitting at 1-minutes intervals. Measures of association were calculated using the logistic regression model adjusting for age and sex. The same definition of hypertension (a mean of 2nd and 3rd BP reading> = 140/90 mmHg, or participants were treated with medicines for known hypertension) was applied for all years. Results: The summary characteristics from 2017 to 2021 are presented in Table 1. Baseline characteristics were similar for all five studies except for low tobacco use in 2017. The proportion of hypertension ranges from 20.6% to 31.3% (24.4% in 2017, 27.8% in 2018, 27.5% in 2019, 31.3% in 2020, and 20.6% in 2021). Awareness, treatment, and control were also similar across five years, ranging from 39.5% to 49.9%, 29.5% to 39.1%, and 46.0% to 56.0% respectively. Smoking, alcohol use, body mass index> = 25, diabetes, and history of myocardial infarction (MI) or stroke were associated with hypertension after adjusting for age and sex across multiple studies. Conclusions: A five-year comparison of the MMM study in Nepal showed that hypertension awareness, treatment, and control have been suboptimal, suggesting an urgent need to implement a nationwide prevention and control program together with a national screening program. (Table Presented).
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Chronic pelvic pain syndrome (CPPS) is generally defined as pain in the pelvic area that persisted for 3–6 months or longer. The pain can be constant or episodic and functionally disabling. Any dysfunction of the central nervous system can lead to central sensitization, which enhances and maintains pain as well as other symptoms that are mediated by the central nervous system. It occurs in subgroups of nearly every chronic pain condition and is characterized by multifocal pain and co-occurring somatic symptoms. Somatic symptom disorder (SSD) is defined as a condition in which having one or more somatic symptoms, such as excessive worries, pressure, and catastrophic events. These symptoms can be very disruptive to a patient's life and can cause significant distress. SSD cases with severe symptoms frequently undergo repeated medical investigations and the symptoms often lead patients to seek emergency medical treatment and consult with specialists repeatedly, which is a source of frustration for patients and clinicians. Here we report a case that Asian female with persistent CPPS with comorbid SSD, who got in trouble for up to 8 years. This case reminds clinicians to pay excessive attention to the diagnosis of CPPS with comorbid SSD after recovery from acute COVID-19, with hope of raising awareness in the identification of SSD and present new insight into appropriate treatment for each woman who suffers from it.
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Background: Next-generation sequencing (NGS) is recognised by a growing audience of medical professionals as a functional diagnostic tool in oncology. However, adoption in clinical routine proceeds haphazardly in Europe. Methods: A semi-structured interview survey was administered to 68 cancer care professionals in four EU countries between June-August and November-December 2021. Pre-screening questionnaires assessed sufficient NGS expertise, diverse geographical distribution, and professional roles. Results: Our findings provide a better understanding of current clinical, regulatory, and reimbursement practices for NGS in four EU countries. Conclusions: Despite the impending European In-vitro Diagnostic Medical Devices Regulation (IVDR), tortuous national guidelines implementations and limping reimbursement policies are common traits across surveyed countries and produce disparity in access to advanced healthcare services amid regional distinctions. Policy summary: The evident information gap between involved parties and demand for consistent national guidelines could be filled by health economics analyses tailored to local specifics to provide factual leverage for a structured adoption of NGS testing. © 2022 The Authors
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Due to the prevalence of COVID-19, providing safe environments and reducing the risks of virus exposure play pivotal roles in our daily lives. Contact tracing is a well-established and widely-used approach to track and suppress the spread of viruses. Most digital contact tracing systems can detect direct face-to-face contact based on estimated proximity, without quantifying the exposed virus concentration. In particular, they rarely allow for quantitative analysis of indirect environmental exposure due to virus survival time in the air and constant airborne transmission. In this work, we propose an indoor spatiotemporal contact awareness framework (iSTCA), which explicitly considers the self-containing quantitative contact analytics approach with spatiotemporal information to provide accurate awareness of the virus quanta concentration in different origins at various times. Smartphone-based pedestrian dead reckoning (PDR) is employed to precisely detect the locations and trajectories for distance estimation and time assessment without the need to deploy extra infrastructure. The PDR technique we employ calibrates the accumulative error by identifying spatial landmarks automatically. We utilized a custom deep learning model composed of bidirectional long short-term memory (Bi-LSTM) and multi-head convolutional neural networks (CNNs) for extracting the local correlation and long-term dependency to recognize landmarks. By considering the spatial distance and time difference in an integrated manner, we can quantify the virus quanta concentration of the entire indoor environment at any time with all contributed virus particles. We conducted an extensive experiment based on practical scenarios to evaluate the performance of the proposed system, showing that the average positioning error is reduced to less than 0.7 m with high confidence and demonstrating the validity of our system for the virus quanta concentration quantification involving virus movement in a complex indoor environment. © 2022 by the authors.
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Burnout in hospice and palliative care nurses is a growing issue, especially in light of the COVID-19 pandemic. However, few studies have focused specifically on burnout in this population. A scoping review was undertaken to identify what is known about burnout among hospice and palliative care nurses, and to unify disparate findings. Analysis of eight articles revealed three overarching categories: personal factors, organizational/workplace factors, and nursing professional development factors. Each category was then divided into three cross-cutting subcategories: contributory and noncontributory factors, mitigating factors, and workplace issues. Recommendations for individuals include self-care as well as self-awareness of intrinsic characteristics that can predispose one to burnout. Within the workplace, leaders are challenged to support evidence-based practice and ongoing education. Role modeling positive communication skills, effective conflict mitigation, responsiveness, promotion of equity, and workplace commitment also help to create a culture of wellness. Nursing professional development may aid in resilience-building, and promotion of self-efficacy, self-confidence, and assertiveness. Although all identified recommendations were derived from the literature, no interventional studies have been conducted to test the effects of suggested interventions. Future research should include interventional studies as well as qualitative research to capture nuanced experiences of burnout in hospice and palliative care nurses.
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Purpose: This study aims to discover whether COVID-19 phobia has a positive and significant effect on the stress, depression and anxiety levels of industrial consumers in addition to reveal whether environmental awareness plays a mediating role between COVID-19 phobia and stress, depression and anxiety. Design/methodology/approach: In this study, a quantitative method was used to reveal the role of anxiety, depression and stress (psychological effects) and environmental awareness caused by covid-19 phobia on industrial consumers. The universe of the study is small and medium-sized enterprises operating in the province of Sanliurfa, which is located in the southeast region of Turkey and the second largest city in the region, and are industrial customers. Questionnaire method was used in the study. In addition, data were collected from 406 people who agreed to participate in the study. In the study, in which intermediary and regulatory analyzes were made, the process macro program was used. Findings: The results show that there is a medium relationship between COVID-19 phobia and environmental awareness;and COVID-19 phobia and stress, depression and anxiety. No relationship was found between environmental awareness and stress, depression and anxiety. COVID-19 phobia was found to have a positive and significant effect on environmental awareness and stress, depression and anxiety, while environmental awareness was found to have no effect on stress, depression and anxiety. Finally, environmental awareness was found to play a mediating role between COVID-19 phobia and stress, depression and anxiety. Research limitations/implications: In this study, four hypotheses were developed. Of these hypotheses, three are for the simple effect and one for the mediation effect. Out of four hypotheses, three were supported. The most important inference obtained from the study was finding the mediation effect of environmental awareness between COVID-19 phobia and anxiety, depression and stress. Originality/value: To the best of the authors' knowledge, no studies in the literature were made on the relationship among COVID-19 phobia, environmental awareness, stress, depression and anxiety. This study also examines the mediating effect of environmental awareness in the relationship between COVID-19 phobia and stress, depression and anxiety. The fact that the study is on the negative effects of the pandemic on one of the most affected occupational group also increases its original value. © 2022, Emerald Publishing Limited.
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Introduction: The COVID-19 pandemic has renewed the interest in telepsychiatry as a way to help psychiatrists care for their patients, but mental health providers' unfamiliarity and concerns may impede implementation of such services. This study aimed to determine the effect of an online educational intervention on awareness, knowledge, attitude, and skills (AKAS) of telepsychiatry among psychiatrists. Methods: The study used a pre-post-test design to compare AKAS of telepsychiatry among psychiatrists participating in an online course of practical telepsychiatry. The telemedicine AKAS questionnaire adapted to telepsychiatry was applied before and after the educational intervention, during the months of October to December 2020. Results: Responses from 213 participants were analyzed before the educational intervention and from 152 after it. The knowledge showed by Spanish psychiatrists before the educational intervention was good in 61% of participants, fair in 37%, and inadequate in 2%. With respect to attitudes toward telepsychiatry, 62% self-reported a high attitude, 33% moderate, and 5% low. With regard self-reported skills, 57% of the participating psychiatrists were highly skilled or experts, 22% moderately skilled, and 9% unskilled in handling telepsychiatry equipment. Despite the high baseline values, the educational intervention significantly improved psychiatrists' awareness, knowledge and attitudes toward telepsychiatry although not their skills. Conclusions: Online course of practical telepsychiatry was effective although future editions need to improve its focus on skills. This educational intervention represents an effort to promote the implementation of telepsychiatry as a health care alternative. © Copyright 2023, Mary Ann Liebert, Inc., publishers 2023.
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The COVID-19 pandemic shows growing demand of robots to replace humans for conducting multiple tasks including logistics, patient care, and disinfection in contaminated areas. In this paper, a new autonomous disinfection robot is proposed based on aerosolized hydrogen peroxide disinfection method. Its unique feature lies in that the autonomous navigation is planned by developing an atomization disinfection model and a target detection algorithm, which enables cost-effective, point-of-care, and full-coverage disinfection of the air and surface in indoor environment. A prototype robot has been fabricated for experimental study. The effectiveness of the proposed concept design for automated indoor environmental disinfection has been verified with air and surface quality monitoring provided by a qualified third-party testing agency. Note to Practitioners - Robots are desirable to reduce the risk of human infection of highly contagious virus. For such purpose, a novel autonomous disinfection robot is designed herein for automated disinfection of air and surface in indoor environment. The robot structure consists of a mobile carrier platform and an atomizer disinfection module. The disinfection modeling is conducted by using the measurement data provided by a custom-built PM sensor array. To achieve cost-effective and qualified disinfection, a full-coverage path planning scheme is proposed based on the established disinfection model. Moreover, for specifically disinfecting the frequently contacted objects (e.g., tables and chairs in offices and hospitals), a target perception algorithm is proposed to mark the localization of these objects in the map, which are disinfected by the robot more carefully in these marked areas. Experimental results indicate that the developed disinfection robot offers great effectiveness to fight against the COVID-19 pandemic. © 2004-2012 IEEE.
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Despite increasing the public awareness of ubiquity of microplastics (MPs) in air, the issue on particular source of tire wear particles (TWPs) emission into atmosphere and their exposure-associated human health has not received the attention it deserves. Here we linked vehicle kilometers traveled (VKT) estimates covering demography, socio-environmental, and transportation features and emission factors to predict regional emission patterns of TWP-derived atmospheric MPs. A data-driven probabilistic approach was developed to consider variability across the datasets and uncertainty of model parameters in terms of country-level and vehicle-type emissions. We showed that country-specific VKT from billion to trillion vehicle-kilometer resulted in 103–105 metric tons of airborne TWP-derived atmospheric MPs annually in the period 2015–2019, with the highest emissions from passenger cars and heavy-duty vehicles. On average, we found that airborne TWP emissions from passenger cars by country had substantial decreased (up to ∼33%) during COVID-19 lockdowns in 2020 and pronounced increased (by a factor ∼1.9) from vehicle electrification by the next three decades. We conclude that the stunning mass of airborne TWP is a predominant source of atmospheric MP. We underscore the necessity of TWP emissions control among the United States, China, and India. Our findings can be of great use to environmental transportation planners for devising vehicle/tire-oriented decision support tools. Our data offer information to enhance TWP-exposure estimates, to examine long-term exposure trends, and subsequently to improve health risk assessment during pandemic outbreak and future electrification. © 2022 Elsevier Ltd
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BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic posed new challenges in patient care worldwide. Vaccinations, which have proven efficacious in lowering the COVID-19 hospital burden, are still avoided by large populations. We, therefore, hypothesized that hospital care teams would have worse perceptions regarding the characteristics and care of patients with vaccine hesitancy. AIM To evaluate whether patient vaccine hesitancy affected the hospital care team (HCT) perceptions. METHODS We performed a prospective clinical study using structured questionnaires. We approached physicians and nurses with previous experience caring for COVID-19 patients from 11 medical centers across Israel during the fourth COVID-19 surge (September and October 2021). The participants completed a questionnaire with the following parts: (1) Sociodemographic characteristics;(2) Assessment of anger (STAXI instrument) and chronic workplace stress (Shirom-Melamed burnout measure);and (3) Three tools to assess the effect of patient vaccine hesitancy on the HCT perceptions (the difficult doctor-patient relation questionnaire, the medical staff perception of patient's responsibility questionnaire and the characterological derogation questionnaire). Results were evaluated according to each part of the questionnaire and the questionnaire as a whole. Associations between HCT perceptions and their baseline characteristics, anger or chronic workplace stress were assessed. RESULTS The HCT experienced their relationship with unvaccinated patients as more difficult (P < 0.001, Cohen's d = 0.85), perceived unvaccinated patients as responsible for their medical condition (P < 0.001, d = 1.39) and perceived vaccinated patients as having a higher character value (P < 0.001, d = 1.03). Unvaccinated patients were considered selfish (P < 0.001), less mature (P < 0.001) and less satisfying to care for (P < 0.001). The relationship with unvaccinated patients was more difficult among HCT with higher burnout (r = 0.37, n = 66, P = 0.002). No correlations with baseline characteristics were found. All three study tools showed high internal consistency (α between 0.72 and 0.845). CONCLUSION Our results should raise awareness of the possible effects of vaccine hesitancy on HCT perceptions regarding unvaccinated patients. In order to minimize the potential negative impact on patient care, designated departments should promote specific patient-centered preparations. Further investigations should assess whether vaccine hesitancy directly affects patient quality of care