A global monetary policy factor in sovereign bond yields

We document the existence of a global monetary policy factor in sovereign bond yields, related to the size of the aggregate balance sheet of nine major central banks of developed economies that have implemented programs of large-scale asset purchases. Balance sheet policies of these central banks reduced the net supply of safe assets in the global economy, triggering a decline in global yields as investors rebalanced their portfolios towards more risky assets. We find that central banks' large-scale asset purchases have contributed to significant and persistent declines in long-term yields globally, ranging from around 330 bps for AAA-rated sovereigns to 800 bps for non-investment grade sovereigns. The stronger decline in yields of high-risk sovereigns can be partly attributed to the decline in the foreign exchange risk premium as their currencies appreciated. Global central bank asset purchases during the Covid-19 crisis have more than counterbalanced the effects of expanding fiscal deficits on global bond yields, driving them to even lower levels. Our findings have important policy implications: normalizing monetary policy by scaling down central bank balance sheets to pre-crisis levels may lead to sharp increases in sovereign bond yields globally, widening spreads and currency depreciations of vulnerable sovereigns with severe consequences for financial stability and the global economy. © 2023 Elsevier B.V.

Post-COVID-19 syndrome: nature of symptoms and associated factors

Aim: Post-COVID-19 syndrome is defined as continuous symptoms related to SARS-CoV-2 infection, which can persist for several weeks or months. Previous studies identified risk factors associated with post-COVID-19 syndrome, including female sex, hypertension, and allergic respiratory diseases. This study aims to investigate the frequency of this syndrome among Arabic patients. Subject and methods: A cross-sectional study was conducted from March to August 2022. The study included 520 Arabic patients with confirmed COVID-19 diagnosis, who were asked about possible symptoms persisting for ≥28 days. Results: Twenty-five percent (25%) of the included patients developed post-COVID-19 syndrome. The most common recorded symptoms were cough (32%), anosmia (32%), fatigue (28%), headache (19%), muscle pain (19%), and shortness of breath (17%). It was found that female sex, hospitalization due to initial COVID-19 infection, and the presence of chronic diseases were significant risk factors for developing post-COVID-19 syndrome. Conclusion: The study recorded post-COVID-19 syndrome among 25% of Arabic participants. Initial COVID-19 hospitalization, initial symptomatic COVID-19, and female sex were significant risk factors for developing post-COVID-19 syndrome. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Linking maternal psychopathology to children's excessive crying and sleeping problems in a large representative German sample—The mediating role of social isolation and bonding difficulties

Attaining self-regulation is a major developmental task in infancy, in which many children show transient difficulties. Persistent, clinically relevant difficulties in self-regulation include excessive crying or sleeping disorders. Many families with affected children are burdened with multiple psychosocial risk. This suggests that regulatory problems are best conceptualized as the maladaptive interplay of overly burdened parents and a dysfunctional parent–child interaction. The current study examines whether social isolation and bonding difficulties function as mediating mechanisms linking maternal psychopathology to (1) children's excessive crying and (2) sleeping problems. The sample comprised N = 6598 mothers (M = 31.51 years) of children between zero to three years of age (M = 14.08 months, 50.1% girls). In addition to socio demographic data, the written questionnaire included information on maternal depression/anxiety, isolation, bonding, and children's regulatory problems. Hypotheses were tested with a mediation model controlling for psychosocial risk and child characteristics. As expected, maternal symptoms of depression/anxiety were linked to infants‘ excessive crying and sleeping problems. Social isolation and bonding difficulties mediated this association for excessive crying as well as for sleeping problems, but social isolation was a single mediator for sleeping problems only. The findings provide important insights in the mediating pathways linking maternal psychopathology to children's regulatory problems.

The added predictive role of echocardiography in patients with mild or moderate Coronavirus Disease 2019

Aims: Recently, several therapeutic agents have decreased the progression to critical disease in patients with mild/moderate COVID-19. However, their use is limited to patients with ≥1 clinical risk factor. We aimed to evaluate echocardiographic features that may aid in risk stratification for patients with mild/moderate COVID-19. Methods: 278 consecutive patients with mild/moderate COVID-19 underwent prospective clinical and echocardiographic examination, ≤7 days of symptoms, as part of a predefined protocol. Analysis to identify echocardiographic predictors of outcome was performed. Results: In the multivariable risk model, E/e′, TAPSE, and pulmonary acceleration time (PAT) were associated with the composite outcome (p = 0.01, 0.005, 0.05, respectively). Stepwise analyses showed that the addition of echocardiography on top of having ≥1 clinical risk factor and even using each parameter separately improved the prediction of outcomes. If patients were re-categorized as high risk only if having both ≥1 clinical and ≥ 1 echocardiography risk parameter (E/e′ > 8, TAPSE<1.8 cm, PAT<90 msec), or even one echo parameter separately, then specificity, positive predictive value, and accuracy improved. If patients were re-classified as high risk if having either ≥1 clinical risk factor or ≥ 1 high-risk echocardiography parameter, all five individuals who were missed by the ≥1 risk factor "rule”, were correctly diagnosed as high risk. Similar analyses, including only patients with mild disease, showed that the addition of TAPSE improved the prediction of outcomes. Conclusions: In patients with mild/moderate COVID-19, a very limited echocardiographic exam is sufficient for improved outcome prediction, and may improve resource allocation for new anti-COVID-19 agents. Translational aspect of the work: We show that among patients with mild/moderate COVID-19, several easily obtained echocardiographic findings are strongly correlated with mortality or progression to the need for invasive/non-invasive mechanical ventilation, even when adjusted for the presence or absence of ≥1 clinical risk factor. Furthermore, even a limited echocardiographic exam is sufficient to develop a strategy of risk stratification. We believe that our data have important implications for the clinicians involved in the acute treatment of patients with COVID-19. © 2022 Elsevier B.V.

Immunogenicity of COVID-19 vaccines in chronic liver disease patients and liver transplant recipients: A systematic review and meta-analysis

Background and aims: Chronic liver disease (CLD) patients and liver transplant (LT) recipients have an increased risk of morbidity and mortality from coronavirus disease 2019 (COVID-19). The immunogenicity of COVID-19 vaccines in CLD patients and LT recipients is poorly understood. The present study aimed to evaluate the immunogenicity of COVID-19 vaccines in CLD patients and LT recipients. Methods: We searched electronic databases for eligible studies. Two reviewers independently conducted the literature search, extracted the data and assessed the risk of bias of included studies. The rates of detectable immune response were pooled from single-arm studies. For comparative studies, we compared the rates of detectable immune response between patients and healthy controls. The meta-analysis was conducted using the Stata software with a random-effects model. Results: In total, 19 observational studies involving 4191 participants met the inclusion criteria. The pooled rates of detectable humoral immune response after two doses of COVID-19 vaccination in CLD patients and LT recipients were 95% (95% confidence interval [CI] = 88%–99%) and 66% (95% CI = 57%–74%) respectively. After two doses of vaccination, the humoral immune response rate was similar in CLD patients and healthy controls (risk ratio [RR] = 0.96;95% CI = 0.90–1.02;p =.14). In contrast, LT recipients had a lower humoral immune response rate after two doses of vaccination than healthy controls (RR = 0.68;95% CI = 0.59–0.77;p <.01). Conclusions : Our meta-analysis demonstrated that COVID-19 vaccination induced strong humoral immune responses in CLD patients but poor humoral immune responses in LT recipients. © 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Vocal Cord Dysfunction: Do Infections Drive Disease?

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.

How Sweden approached the COVID-19 pandemic: Summary and commentary on the National Commission Inquiry

Aim: Sweden initially chose a different disease prevention and control path during the pandemic than many other European countries. In June 2020, the Swedish Government established a National Commission to examine the management of COVID-19 in Sweden. This paper summarises, and discusses, its findings. Methods: Three reports published by the Commission were analysed. The first focused on the care of older people during the pandemic. The second examined disease and infection transmission and control and health care and public health. The third updated the first two reports and also covered economic aspects, crisis management and public communication. Results: By 25 February 2022, when the final report was published, 15 800 individuals, 1.5 per 1000 Swedish inhabitants, had died after COVID-19. The death rates were high in spring 2020, but overall excess mortality in 2020–2021 was +0.79%, which was lower than in many other European countries. The Commission suggested that the voluntary measures that were adopted were appropriate and maintained Swedes' personal freedom during the pandemic. However, more extensive and earlier measures should have been taken, especially during the first wave. Conclusion: The Swedish COVID-19 Commission felt that earlier and more extensive pandemic action should have been taken, particularly during the first wave. © 2022 The Author. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

Novel case of Candida auris in the Veterans Health Administration and in the state of South Carolina

The emerging pathogen Candida auris poses major infection prevention challenges as the organism can remain on surfaces for unknown timeframes and can cause severe illness. These challenges are exacerbated in the health care environment with potential spread to a vulnerable population. This report describes the Columbia Veterans Administration Health Care System's encounter with this significant pathogen beginning in October 2020 during the COVID19 pandemic.

Simulation analysis of passengers' rescheduling strategies in metro station under COVID-19

The spread of COVID-19 has a great impact on public transport which is closely related to social life. As an essential carrier of the cities, metro has become an important object of concern during the epidemic. Due to the high infection risk of COVID-19 in public space, it is necessary to quantitatively evaluate and perform corresponding epidemic control measures on reducing public health risks in metro station. In this paper, three strategies of passenger rescheduling, i.e. controlling the flows of inbound and outbound passengers in the station, setting route guidance in the crucial areas and shortening the interval time of train, are simulated and analyzed based on Anylogic. The performances of different strategies are characterized and evaluated by the important parameters, which include local passengers' density, inbound and outbound time. Finally, the optimization experiments based on an objective function are carried out to obtain the best strategy combination considering passengers' health safety and travel efficiency. The crucial areas with high density are obtained from the simulation results of the initial model. The three independent strategies are helpful in reducing the maximum passengers' density and average travel time. The optimization results of strategy combination and the specific parameters of each strategy are obtained by the final simulation experiment. The research findings are important reference to enhance the present health risk management level and provide specific measures of passenger organization in metro station under COVID-19. © 2023 Elsevier Ltd

Parental loneliness, parental stress and child mental health during the COVID-19 pandemic: Variations by cumulative socioeconomic risk

Background The COVID-19 pandemic has raised concerns about parent and child mental health, especially within disadvantaged families. However, little is known about how parental stress and loneliness during the pandemic influenced their children and no studies have investigated if these associations could vary by socioeconomic status. Methods In July to September 2021, a large representative sample of parents (N = 4,524) in Québec (Canada) reported on aspects of their own mental health and that of their 9-10 year old child. Outcome variables were child externalizing and internalizing symptoms. Exposure variables were changes in parental loneliness and parental stress since the onset of the pandemic. The moderator variable was cumulative socioeconomic risk. Multiple linear regression analyses were executed and adjusted for confounding factors. Results Child internalizing symptoms were associated with higher levels of parental stress (β = 0.14, p<.001) and loneliness (β = 0.23, p<.001). Child externalizing symptoms were also associated with parental stress (β = 0.13, p<.001) and loneliness (β = 0.18, p<.001). Most of these associations were stronger within the most disadvantaged households. Limitations The cross-sectional design does not allow interpretations about causality. Conclusions Increases in parental stress and loneliness since the onset of the COVID-19 pandemic would be detrimental to parent and child mental health. As these issues were amplified within families experiencing more socioeconomic adversities, our results can inform public policy to support families in times of crisis and direct resources to those most in need.

Child maltreatment and Covid-19: A crisis within a crisis

The fight against the SARS-CoV-2 pandemic was carried out through strong restrictive measures, including general population lockdown, which allowed the convergence of risk factors for child abuse. During this period, the French national hotline for children in danger recorded a 56% increase in calls. Calls followed by an alert to departmental child protection services increased by 30%. Through an algorithm created by our team, we showed a 50% increase in the relative frequency of hospitalizations for physical abuse in children aged 0-5 years during the lockdown. This has fueled thinking about subsequent health measures to protect the youngest children. Our goal is now to use this algorithm for epidemiological purposes as a barometer of abuse or in daily practice to help the diagnosis of physical abuse in young children. © 2023 médecine/sciences à Inserm.;En France, au début de l'année 2020, environ 690 000 vies ont pu être épargnées grâce au confinement général de la population et aux mesures restrictives de lutte contre la Covid-19. Conséquence inattendue, ces mesures ont eu un impact sur une autre frange vulnérable de la population : celle des jeunes enfants, pour lesquels il a été démontré une augmentation des maltraitances subies aÌ cette période. À partir de données de la littérature et de l'apport de nos travaux de recherche dans le domaine, nous proposons une documentation de cette crise des violences intra-familiales, intriquée dans la crise sanitaire de la Covid-19. © 2023 médecine/sciences à Inserm. © 2023 Editions EDK. All rights reserved.

CircRNAs: Key molecules in the prevention and treatment of ischemic stroke

Ischemic stroke is a prevalent disease that seriously threatens human health. It is characterized by high morbidity, mortality, disability, and recurrence rates, causing a significant economic burden on individuals and society. Circular RNA, a novel non-coding RNA, not only serves as the sponge for microRNAs and proteins but also promotes transcription of their parental genes and translates into peptides. In recent years, circRNAs have emerged as key regulators in ischemic stroke. This article aims to provide new ideas about the pathogenesis and progression of ischemic stroke by reviewing the roles of circRNAs in cerebral ischemic injury and summarizing the association between circRNAs and risk factors for ischemic stroke.

Data-driven two-stage sparse distributionally robust risk optimization model for location allocation problems under uncertain environment

Robust optimization is a new modeling method to study uncertain optimization problems, which is to find a solution with good performance for all implementations of uncertain input. This paper studies the optimal location allocation of processing plants and distribution centers in uncertain supply chain networks under the worst case. Considering the uncertainty of the supply chain and the risk brought by the uncertainty, a data-driven two-stage sparse distributionally robust risk mixed integer optimization model is established. Based on the complexity of the model, a distribution-separation hybrid particle swarm optimization algorithm (DS-HPSO) is proposed to solve the model, so as to obtain the optimal location allocation scheme and the maximum expected return under the worst case. Then, taking the fresh-food supply chain under the COVID-19 as an example, the impact of uncertainty on location allocation is studied. This paper compares the data-driven two-stage sparse distributionally robust risk mixed integer optimization model with the two-stage sparse risk optimization model, and the data results show the robustness of this model. Moreover, this paper also discusses the impact of different risk weight on decision-making. Different decision makers can choose different risk weight and obtain corresponding benefits and optimal decisions. In addition, the DS-HPSO is compared with distribution-separation hybrid genetic algorithm and distributionally robust L-shaped method to verify the effectiveness of the algorithm. © 2023 the Author(s).

Levels and drivers of urban black carbon and health risk assessment during pre- and COVID19 lockdown in Augsburg, Germany

This study aimed to evaluate the levels and phenomenology of equivalent black carbon (eBC) at the city center of Augsburg, Germany (01/2018 to 12/2020). Furthermore, the potential health risk of eBC based on equivalent numbers of passively smoked cigarettes (PSC) was also evaluated, with special emphasis on the impact caused by the COVID19 lockdown restriction measures. As it could be expected, peak concentrations of eBC were commonly recorded in morning (06:00–8:00 LT) and night (19:00–22:00 LT) in all seasons, coinciding with traffic rush hours and atmospheric stagnation. The variability of eBC was highly influenced by diurnal variations in traffic and meteorology (air temperature (T), mixing-layer height (MLH), wind speed (WS)) across days and seasons. Furthermore, a marked "weekend effect” was evidenced, with an average eBC decrease of ∼35% due to lower traffic flow. During the COVID19 lockdown period, an average ∼60% reduction of the traffic flow resulted in ∼30% eBC decrease, as the health risks of eBC exposure was markedly reduced during this period. The implementation of a multilinear regression analysis allowed to explain for 53% of the variability in measured eBC, indicating that the several factors (e.g., traffic and meteorology) may contribute simultaneously to this proportion. Overall, this study will provide valuable input to the policy makers to mitigate eBC pollutant and its adverse effect on environment and human health. © 2022 Elsevier Ltd

Association between ambient sulfur dioxide pollution and asthma mortality: Evidence from a nationwide analysis in China

There is a lack of research on the effects of acute exposure to ambient sulfur dioxide (SO2) on mortality caused by asthma, especially nationwide research in China. To explore the acute effect of exposure to ambient SO2 on asthma mortality using nationwide dataset in China from 2015 to 2020 and further evaluate the associations in subgroups with different geographical and demographic characteristics. We used data from China's Disease Surveillance Points system with 29,553 asthma deaths in China during 2015–2020. The exposure variable was the daily mean concentrations of SO2 from the ChinaHighSO2 10 km × 10 km daily grid dataset. Bilinear interpolation was used to estimate each individual's exposure to air pollutants and meteorological variables. We used a time-stratified case crossover design at the individual level to analyze the exposure response relationship between short-term exposure to SO2 and asthma mortality. Stratified analyses were carried out by sex, age group, marital status, warm season and cold season, urbanicity and region. Significant associations between short-term exposure to ambient SO2 and increased asthma mortality were found in this nationwide study. The excess risk (ER) for each 10 μg/m3 increase in SO2 concentrations at lag07 was 7.78 % (95 % CI, 4.16–11.52 %). Season appeared to significantly modify the association. The associations were stronger in cold season (ER 9.78 %, 95 % CI:5.82 −13.89 %). The association remained consistent using different lag periods, adjusting for other pollutants, and in the analysis during pre-Corona Virus Disease 2019 (COVID-19) period. Our study indicates increased risk of asthma mortality with acute exposures to SO2 in Chinese population. The current study lends support for greater awareness of the harmful effect of SO2 in China and other countries with high SO2 pollution. © 2022 The Authors

Prevalence and Associated Factors of Depression Among Frontline Nurses in Wuhan 6 Months After the Outbreak of COVID-19: A Cross- Sectional

Background: Due to the COVID-19 pandemic, frontline nurses have experienced psychological problems. However, the de-pression of frontline nurses in Wuhan 6 months after the outbreak of COVID-19 has not been studied ade-quately. The purpose of this study was to investigate the depression of frontline nurses in Wuhan 6 months after the COVID-19 outbreak and to analyze possible risk and protective factors. Material/Methods: Data were collected through Wenjuanxing from 612 frontline nurses in Wuhan national COVID-19-designated hospitals between July 27, 2020, and August 12, 2020. The levels of depression, family functioning, and psy-chological resilience were assessed among frontline nurses in Wuhan with a depression scale, family function scale, and 10-item psychological resilience scale, respectively. The factors associated with depressive symp-toms were identified using the chi-square test and binary logistic regression analysis. Results: A total of 126 respondents were included in the study. The overall prevalence of depression was 25.2%. The need for mental health services was a potential risk factor for depressive symptoms, while family functioning and psychological resilience were potential protective factors. The COVID-19 pandemic poses a major chal-lenge to the depressive symptoms of frontline nursing in Wuhan, highlighting the need for all frontline nurses in Wuhan to be screened for depression regularly for timely intervention. Conclusions: To mitigate the impact of the pandemic on depression, psychological interventions for frontline nurses need to be implemented to preserve their mental health.

What We Know (and Do not Know) Regarding the Pathogenesis of Pulmonary Thrombosis in COVID-19

The clinical course of coronavirus disease 2019 (COVID-19) is often complicated by the onset of venous thrombosis and thromboembolism (VTE), encompassing also pulmonary thrombosis. Recent statistics attests that the cumulative frequency of VTE can be as high as 30% in COVID-19 hospitalized patients, increasing to nearly 40 to 70% (depending on systematic screening) in those with severe illness, mechanical ventilation, or intensive care unit admission. The risk of venous thrombosis seems mostly limited to the active phase of disease, and is directly associated with some genetic (i.e., inherited prothrombotic predisposition) and demographical factors (male sex, overweight/obesity), disease severity (risk increasing progressively from hospitalization to development of severe illness, being the highest in patients needing mechanical ventilation and/or intensive care), presence and extent of pulmonary disease, coexistence of multiple risk factors (immobilization, mechanical ventilation, co-or superinfections), along with increased values of inflammatory and thrombotic biomarkers. At least three different phenotypes of pulmonary thrombosis may develop in COVID-19 patients, one caused by typical embolization from peripheral venous thrombosis (e.g., deep vein thrombosis), a second type triggered by local inflammation of nearby pulmonary tissue, and a third one mostly attributable to the prothrombotic state consequent to the pronounced systemic inflammatory response (i.e., the so-called cytokine storm) that is frequently observed in COVID-19. Although the pathogenesis of these three conditions has different features, their discrimination is essential for diagnostic and therapeutic purposes. The prognosis of COVID-19 patients who develop pulmonary thrombosis is also considerably worse than those who do not, thus probably needing frequent monitoring and more aggressive therapeutic management. © 2023 Thieme Medical Publishers, Inc.. All rights reserved.