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1.
Risk Manag Healthc Policy ; 15: 1741-1749, 2022.
Article | MEDLINE | ID: covidwho-2166181

ABSTRACT

Purpose: This study aimed to investigate the impact of characteristic ischemic stroke and outcomes during the first COVID-19 pandemic lockdown. Patients and Methods: A retrospective, observational cohort study of a comprehensive tertiary stroke center was conducted. Patients with ischemic stroke were divided into pre-COVID-19 lockdown (11/1/2019 to 1/30/2020) and COVID-19 lockdown (1/31/2020 to 4/30/2020) period groups. Patient data on stroke admission, thrombolysis, endovascular treatment, and 3-month routine follow-up were recorded. Data analysis was performed using SPSS according to values following a Gaussian distribution. Results: The pre-COVID-19 lockdown period group comprised 230 patients compared to 215 patients in the COVID-19 lockdown period group. Atrial fibrillation was more predominant in the COVID-19 lockdown period group (11.68% vs 5.65%, p=0.02) alongside patients who were currently smoking (38.8% vs 28.7%, p=0.02) and drinking alcohol (30.37% vs 20.00%, p=0.012) compared with that of the pre-COVID-19 lockdown period group. For patients receiving thrombolysis, the median door-to-CT time was longer in the COVID-19 lockdown period group (17.0 min (13.0, 24.0) vs 12.0 min (8.0, 17.3), p=0.012), median door to needle time was 48.0 minutes (35.5, 73.0) vs 43.5 minutes (38.0, 53.3), p=0.50, compared with that of the pre-COVID-19 lockdown period group. There were no differences for patients receiving mechanical thrombectomy. The median length of hospitalization (IQR) was no different. Discharge mRS scores (IQR) were higher in the COVID-19 lockdown period group (1.0 (1.0, 3.0) vs 1.0 (1.0, 2.0), p=0.022). Compared with the pre-COVID-19 lockdown period, hospitalization cost (Chinese Yuan) in the COVID-19 period group was higher (13,445.7 (11,009.7, 20,030.5) vs 10,799.2 (8692.4, 16,381.7), p=0.000). There was no difference observed in 3-month mRS scores. Conclusion: Patients presenting with ischemic stroke during the COVID-19 pandemic lockdown period had longer median door-to-CT time and higher hospitalization costs. There were no significant differences in 3-month outcomes. Multidisciplinary collaboration and continuous workflow optimization may maintain stroke care during the COVID-19 pandemic lockdown.

2.
Risk Manag Healthc Policy ; 15: 1859-1868, 2022.
Article in English | MEDLINE | ID: covidwho-2166176

ABSTRACT

Background: To prevent the spread of COVID-19 and carry out a successful vaccination program especially in low-income countries, people must have faith on scientists and health experts. The most significant challenge to vaccination programs' efficacy is now regarded to be a lack of information and trust in immunization due to myths and misinformation spread in the community. Therefore, this study aimed to identify the myth and misconceptions that are propagated about the COVID-19 vaccine, the refusal rate of the vaccine and determine the factors associated with COVID-19 vaccine refusal. Methods: A community-based cross-sectional study was conducted from December 7 to January 25, 2022. Face-to-face interviews with a standardized questionnaire were used to collect data on the variables. Data were entered into the statistical tool Epi data version 3.1 and then exported to SPSS version 25 for analysis. Binary logistic regression, both bivariable and multivariable, was conducted. In the multivariable binary logistic regression model, the adjusted odds ratio with 95% confidence interval was used to declare statistically significant factors based on a p value less than 0.05. Results: Out of the total 574 respondents, 60.3% [95% CI (55.5, 64.2)] of them refused to take COVID-19 vaccine. In this study, respondent's age [AOR = 2.1 at 95% CI: (1.8, 4.9)], perception on COVID-19 vaccine [AOR = 3.0 at 95 CI: (1.9, 4.6)], eHealth literacy [AOR = 2.7 at 95% CI: (1.7, 4.1)], source of information about the vaccine [AOR = 2.9 at 95% CI: (1.9, 4.4)], computer literacy [AOR = 2.8 at 95 CI: (1.8, 4.2)] and frequency of internet use [AOR = 2.2 at 95 CI: (1.8, 5.3)] were identified as determinant factors for COVID-19 vaccine acceptance. Conclusion: Factors like eHealth literacy, source of information about the vaccine, frequency of internet use, respondent's perception about the vaccine and computer literacy were found to be determinant factors for COVID-19 vaccine acceptance.

3.
International Journal of Clinical and Health Psychology ; : 100364, 2022.
Article in English | ScienceDirect | ID: covidwho-2165365

ABSTRACT

The present study examined the impact of the COVID-19 pandemic on the emotional quality of dreams, the incorporation of pandemic-related themes, and the occurrence of lucid dreaming. Dream reports and lucidity ratings of psychiatric outpatients (n = 30) and healthy controls (n = 81) during two lockdowns in Germany were compared to those of healthy controls (n = 33) before the pandemic. Results confirmed previous reports that pandemic-specific themes were incorporated into dreams. Overall, however, incorporation into dreams was rare. Contrary to expectations, psychiatric outpatients did not differ from controls in the frequency of dream incorporation of pandemic-related content. Moreover, incorporation was independent of psychiatric symptoms and loneliness. Loneliness was, however, associated with threat-related content, suggesting that it represents a risk for bad dreams but not for crisis-specific dream incorporation. Regarding lucid dreaming, both groups had similar scores for its underlying core dimensions, i.e., insight, control, and dissociation, during the two lockdowns. Scores for control and dissociation but not insight were lower compared to the pre-pandemic sample. Our working hypothesis is that REM sleep during lockdowns intensified as a means of increased emotional consolidation, rendering the associated mental state less hybrid and thereby less lucid.

4.
International Journal of Biological Macromolecules ; 229:413-421, 2023.
Article in English | ScienceDirect | ID: covidwho-2165363

ABSTRACT

Fucoidan is a highly sulfated polysaccharide with a wide range of bioactivities, including anti-pathogenic activity. However, the relationship between structure and activity of fucoidan in inhibiting pathogen infections remains unclear. Here, different-molecular-weight fucoidans were prepared by photocatalytic degradation followed by membrane ultrafiltration, and their chemical structures and anti-pathogenic microbiota activity were compared. Results showed that photocatalytic degradation could effectively degrade fucoidan while its structure block and sulfate groups were not destroyed obviously. Fucoidan (90.8 kDa) of 5 mg/mL could inhibit the growth of S. aureus, S. typhimurium and E. coli, but its degradation products, Dfuc1 (19.2 kDa) and Dfuc2 (5.5 kDa), demonstrated lower inhibitory effect. In addition, compared to Dfuc1 and Dfuc2, fucoidan showed stronger capability to prevent the adhesion of S. aureus, L. monocytogenes, V. parahaemolyticus and S. typhimurium to HT-29 cells. Moreover, the inhibitory effect against SARS-CoV-2 and the binding activity to S protein were also positively correlated to molecular weight. These results indicate that natural fucoidan with higher molecular weight are more effective to inhibit these pathogenic bacteria and SARS-CoV-2, providing a better understanding of the relationship between structure and activity of fucoidan against pathogenic microbiota.

5.
International Journal of Antimicrobial Agents ; : 106708, 2023.
Article in English | ScienceDirect | ID: covidwho-2165360

ABSTRACT

Nirmatrelvir/ritonavir (N/R) is among the most effective antiviral drugs against SARS-CoV-2. We review here the preclinical development, pharmacodynamics and pharmacokinetics of N/R. Randomized clinical trials have been exclusively run with pre-Omicron variants of concern, but in vitro studies show that efficacy against all Omicron sublineages is preserved, as confirmed by post-marketing observational studies. Nevertheless, investigations of large viral genome repositories have shown that mutation in the main protease causing resistance to N/R are increasingly frequent. In addition, virological and clinical rebounds after N/R discontinuation have been reported in immunocompetent patients. This finding is of concern when translated to immunocompromised patients, for which N/R efficacy has never been formally investigated in clinical trials. We finally discuss economical sustainability and perspectives for this therapeutic arena

6.
Infectious Disease Modelling ; 2023.
Article in English | ScienceDirect | ID: covidwho-2165358

ABSTRACT

Normalized interventions were implemented in different cities in China to contain the outbreak of COVID-19 before December 2022. However, the differences in the intensity and timeliness of the implementations lead to differences in final size of the infections. Taking the outbreak of COVID-19 in three representative cities Xi'an, Zhengzhou and Yuzhou in January 2022, as examples, we develop a compartmental model to describe the spread of novel coronavirus and implementation of interventions to assess concretely the effectiveness of Chinese interventions and explore their impact on epidemic patterns. After applying reported human confirmed cases to verify the rationality of the model, we apply the model to speculate transmission trend and length of concealed period at the initial spread phase of the epidemic (they are estimated as 10.5, 7.8, 8.2 days, respectively), to estimate the range of basic reproduction number (2.9, 0.7, 1.6), and to define two indexes (transmission rate vt and controlled rate vc) to evaluate the overall effect of the interventions. It is shown that for Zhengzhou, vc is always more than vt with regular interventions, and Xi'an take 8 days to achieve vc > vt twice as long as Yuzhou, which can interpret the fact that the epidemic situation in Xi'an was more severe. By carrying out parameter values, it is concluded that in the early stage, strengthening the precision of close contact tracking and frequency of large-scale nucleic acid testing of non-quarantined population are the most effective on controlling the outbreaks and reducing final size. And, if the close contact tracking strategy is sufficiently implemented, at the late stage large-scale nucleic acid testing of non-quarantined population is not essential.

7.
Infectious Disease Modelling ; 2022.
Article in English | ScienceDirect | ID: covidwho-2165355

ABSTRACT

Background Vaccination has been the most important measure to mitigate the COVID-19 pandemic. The vaccination coverage was relatively low in Hong Kong Special Administrative Region China, compared to Singapore, in the early 2022. Hypothetically, if the two regions, Hong Kong (HK) and Singpaore (SG), swap their vaccination coverage rate, what outcome would occur? Method We adopt the Susceptible – Vaccinated – Exposed – Infectious – Hospitalized – Death - Recovered model with a time-varying transmission rate and fit model to weekly reported COVID-19 deaths (the data up to 2022 Nov 4) in HK and SG using R package POMP. After we obtain a reasonable fitting, we rerun our model with the estimated parameter values and swap the vaccination rates between HK and SG to explore what would happen. Results Our model fits the data well. The reconstructed transmission rate was higher in HK than in SG in 2022. With a higher vaccination rate as in SG, the death total reported in HK would decrease by 37.5% and the timing of the peak would delay by 3 weeks. With a lower vaccination rate as in HK, the death total reported in SG would increase to 5.5-fold high with a peak 6-week earlier than the actual during Delta variant period. Conclusions Vaccination rate changes in HK and SG may lead to very different outcome. This is likely due that the estimated transmission rates were very different in HK and SG which reflect the different control policies and dominate variants. Because of strong control measure, HK avoided large scale community transmission of Delta variant. Given the high breakthrough infection rate and transmission rate of Omicron variant, increasing vaccination rate in HK will likely yield a mild (but significant) contribution in terms of lives saved. While in SG, lower vaccination coverage to the level of HK will be disastrous.

8.
Heart & Lung ; 58:204-209, 2023.
Article in English | ScienceDirect | ID: covidwho-2165350

ABSTRACT

Background Extracorporeal membrane oxygenator (ECMO) is one of the life-saving modalities for the treatment of multiple organs dysfunction, particularly the heart and the lungs. Objective To evaluate the benefit of ECMO for the treatment of SAR-COV-2 infection and its outcomes, complications, and mortality rate. Methods A comprehensive search for articles was performed using MEDLINE and SCOPUS from December 2019 to December 2020. Two independent reviewers selected eligible studies, extracted the data, assessed the quality of the studies, reviewed the full study protocols, and reported the findings according to the PRISMA protocol. The meta-analyses were performed using the Comprehensive Meta-Analysis software version 2.0. Results Pooled data from 57 studies was analyzed. There were 7,035 patients with SAR-COV-2 infection with event rate of ECMO treatment was 58.10% (95%CI: 43.70–71.20). The mortality rate was 16.66% (95%CI: 11.49–23.53). The mean mortality rate of ECMO supported patients was 35.60% (95%CI: 30.60 to 41.00). Thirty-one percent (95%CI: 24.50–38.40) of the patients had venous thromboembolic events, 30.90% (95%CI: 17.90–47.80) of the patients had ECMO circuit thrombosis, and 24.50% (95%CI: 12.50–42.40) of the patients had bleeding. In the subgroup analysis, the mortality rate was higher among patients who were treated with ECMO, the pooled odds ratio was 4.47 (95%CI: 2.39–8.35, p < 0.001), and was significantly higher in Asia with an odds ratio of 7.88 (95%CI: 2.40–25.85, p = 0.001). Conclusion Mortality rate among patients who received ECMO therapy was high. A system of care, including patient selection, resource management and referral system, can impact the outcomes of ECMO therapy.

10.
Heart Rhythm O2 ; 2022.
Article in English | ScienceDirect | ID: covidwho-2165347

ABSTRACT

Background There are limited data on trends in nationwide cardiac electrophysiology (EP) procedures in the US before and during the global COVID-19 pandemic. Objective We aimed to understand contemporary EP procedural trends, and how the COVID-19 pandemic impacted them. Methods Trends were obtained from publicly reported Centers for Medicare and Medicaid Services data from 2013 to 2020 (latest available). Rates of catheter-based EP procedures (EP studies and ablations) and cardiac implantable electronic device (CIED) procedures were analyzed. All procedural rates were calculated per 100,000 Medicare beneficiaries (year specific). Procedure physician subspecialty was also reported. Results From 2013 to 2019, annual rate of all cardiac EP procedures increased from 817.91 to 1089.68 per 100,000 beneficiaries. Catheter-based EP procedures increased from 323.73 to 675.01, while CIED rates decreased from 494.18 to 414.67. While all ablation procedures increased over time, relative proportion of ablation procedures being pulmonary vein isolation (PVI) increased (9.9% of ablations in 2013, to 18.2% in 2019). In 2020, rates of both catheter-based EP procedures and CIED procedures decreased;however, PVI share of ablation continued to increase in 2020 comprising 25.2% of ablation procedures. Conclusions Rates of EP procedures have increased among Medicare beneficiaries, with catheter-based procedures now eclipsing CIEDs. Additionally, a greater proportion of catheter-based EP procedures are PVI, but they still represent a minority of all ablations. In 2020, rates of EP procedures were attenuated, yet proportion of PVI ablations increased to over one-fourth of ablation procedures. These data have important implications for the EP workforce.

11.
Health Policy and Technology ; : 100724, 2023.
Article in English | ScienceDirect | ID: covidwho-2165346

ABSTRACT

Objectives Telehealth use has increased steadily since the mid-2000's when technology shifted from voice-only systems to live video-conferencing and other technologies supported by broadband Internet. More recently, the COVID-19 pandemic has resulted in exponential growth in telehealth use. As telehealth systems become increasingly complex and gain widespread adoption, this study explores how users' digital competences affect telehealth use. Methods We apply a series of multivariate logit models to a representative sample of California adults with Internet access surveyed in early 2021. We estimate the impact of self-reported digital competence–using items from the digital skills assessment scale–on a participant's likelihood of telehealth use during the COVID-19 pandemic as well as the likelihood to continue using telehealth beyond the pandemic. Results The findings show that a one-unit increase in digital competence is associated with 72.8% greater odds of telehealth use (p <.001) and 71.6% greater odds of willingness to continue using telehealth services beyond the pandemic (p<.01). We also found that greater social and economic capital generally were associated with increased odds of telehealth use. Conclusions Improving access to telehealth will require solutions addressing both the first level (i.e., access to broadband and devices) and the second level (i.e., skills and attitudes towards the internet) of digital inequality. Policies and programs seeking to expand internet access must be coupled with investments in digital upskilling and training. Those with limited digital competence will face continued barriers in navigating telehealth systems, further exacerbating disparities in healthcare access and outcomes. Public Interest Summary Digital competence is the ability and confidence to apply one's knowledge and skills to perform tasks through information technology, including computing devices and the internet. This study explores the relationship between digital competence and telehealth use among those with broadband internet access at home. Telehealth has become increasingly common due to its cost-effectiveness and accessibility for patients unable to visit healthcare facilities. Though the COVID-19 pandemic has contributed to a significant increase in telehealth use, it is expected that telehealth services will continue to expand after the pandemic subsides. In our analysis of California adults, a year into the pandemic, we find those with greater digital competence are more likely to have used telehealth during the pandemic. Further, among telehealth users, those with greater digital competence are more likely to continue using telehealth beyond the pandemic. Addressing disparities in healthcare access and outcomes will require improving potential users' digital competence.

12.
Heliyon ; 9(1):e12768, 2023.
Article in English | ScienceDirect | ID: covidwho-2165339

ABSTRACT

Emergency remote teaching in the immediate wake of the COVID-19 pandemic has created a challenging situation for both students and teachers. The purpose of this research is to identify the perceptions and challenges that university students faced during online classes in a women only university in Saudi Arabia. Data was collected by circulating Google forms among students from different colleges, and a total of 542 students submitted their responses. Apart from gathering the personal information of participants, the survey also collected information on aspects such as educational, financial, internet connectivity and volunteering/donations. Chi-squared test was used to determine whether there was a significant difference in opinion between different groups of students on various questions. Stress was identified as the most prevalent issue among students. Students were found to be stressed regardless of their college of study or age. In comparison to others, younger students and students from financially disadvantaged families faced more difficulties. In terms of remote practical class satisfaction, health/medical stream students were the most dissatisfied group. They also faced more difficulties than students from other colleges. The analysis results show that problems such as stress, poor internet connectivity, the need for technical support, a lack of proper interaction with faculty, a lack of proper academic advising, a lack of proper study space at home etc. must be addressed in order to improve the effectiveness of online classes. This paper also includes recommendations for resolving the various issues that students face.

13.
Heliyon ; 9(1):e12753, 2023.
Article in English | ScienceDirect | ID: covidwho-2165336

ABSTRACT

Background Misconceptions about adverse side effects are thought to influence public acceptance of the Coronavirus disease 2019 (COVID-19) vaccines negatively. To address such perceived disadvantages of vaccines, a novel machine learning (ML) approach was designed to generate personalized predictions of the most common adverse side effects following injection of six different COVID-19 vaccines based on personal and health-related characteristics. Methods Prospective data of adverse side effects following COVID-19 vaccination in 19943 participants from Iran and Switzerland was utilized. Six vaccines were studied: The AZD1222, Sputnik V, BBIBP-CorV, COVAXIN, BNT162b2, and the mRNA-1273 vaccine. The eight side effects were considered as the model output: fever, fatigue, headache, nausea, chills, joint pain, muscle pain, and injection site reactions. The total input parameters for the first and second dose predictions were 46 and 54 features, respectively, including age, gender, lifestyle variables, and medical history. The performances of multiple ML models were compared using Area Under the Receiver Operating Characteristic Curve (ROC-AUC). Results The total number of people receiving the first dose of the AZD1222, Sputnik V, BBIBP-CorV, COVAXIN, BNT162b2, and mRNA-1273 were 6022, 7290, 5279, 802, 277, and 273, respectively. For the second dose, the numbers were 2851, 5587, 3841, 599, 242 and 228. The Logistic Regression model for predicting different side effects of the first dose achieved ROC-AUCs of 0.620–0.686, 0.685–0.716, 0.632–0.727, 0.527–0.598, 0.548–0.655, 0.545–0.712 for the AZD1222, Sputnik V, BBIBP-CorV, COVAXIN, BNT162b2 and mRNA-1273 vaccines, respectively. The second dose models yielded ROC-AUCs of 0.777–0.867, 0.795–0.848, 0.857–0.906, 0.788–0.875, 0.683–0.850, and 0.486–0.680, respectively. Conclusions Using a large cohort of recipients vaccinated with COVID-19 vaccines, a novel and personalized strategy was established to predict the occurrence of the most common adverse side effects with high accuracy. This technique can serve as a tool to inform COVID-19 vaccine selection and generate personalized factsheets to curb concerns about adverse side effects.

14.
Heliyon ; 9(1):e12746, 2023.
Article in English | ScienceDirect | ID: covidwho-2165335

ABSTRACT

Knowledge regarding the sustainability of immune responses after COVID-19 vaccination is important, e.g., to decide whom and when to booster. Thus, we analyzed antibody titers in firefighters six months after vaccination with the mRNA-based vaccine Comirnaty. SARS-CoV-2 spike-binding antibodies (bAb) were quantified and compared to peak responses determined in healthcare workers (HCW). For the firefighters, neutralizing antibodies (nAb) were also analyzed. Six months after the second vaccine dose, all analyzed firefighters had detectable bAb, and 91% exhibited nAb titers above 1:16. However, actual titers six months after vaccination were over 12-fold lower than in the HCW control group four weeks after vaccination. bAb and nAb responses showed a significant correlation, and age correlated inversely with antibody responses. Unexpectedly, participants with a body mass index over 25 had higher neutralization titers after six months. All participants with very low neutralization titers were offered booster vaccination. The booster vaccination improved the extent and sustainability of antibody responses.

15.
Heliyon ; : e12653, 2022.
Article in English | ScienceDirect | ID: covidwho-2165329

ABSTRACT

The recent identification of the involvement of the immune system response in the severity and mortality of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection highlights the importance of cytokines and chemokines as important factors in the clinical outcomes of COVID-19. However, the impact and roles of the BAFF/APRIL cytokine system, homeostatic chemokines (CXCL12, CXCL13, CCL19, and CCL21), as well as Toll-like receptor (TLR)-3/4 in COVID-19, have not been investigated. We sought to assess the expression levels and roles of TLR3/4, BAFF, APRIL, IFN-β, homeostatic chemokines (CXCL12, CXCL13, CCL19, and CCL21), SARS-CoV-2 IgG and IgM antibodies in patients with critical (ICU) and non-ICU (mild) COVID-19 and their association with mortality and disease severity. Significant high levels of TLR-4 mRNA, IFN-β, APRIL, CXCL13, and IgM and IgG antibodies were observed in ICU patients with severe COVID-19 compared to non-ICU COVID-19 patients and healthy controls. On the other hand, BAFF and CCL21 expression were significantly upregulated in non-ICU patients with COVID-19 compared with that in critical COVID-19 patients. The two groups did not differ in TLR-3, CXCL12, and CCL19 levels. Our findings show high expression levels of some inflammatory chemokines in ICU patients with COVID-19. These findings highlight the potential utility of chemokine antagonists as an immune-based treatment for the severe form of COVID-19. We also believe that selective targeting of TLR/spike protein interactions might lead to the development of a new COVID-19 therapy.

16.
Heliyon ; : e12584, 2022.
Article in English | ScienceDirect | ID: covidwho-2165327

ABSTRACT

Nitrogen dioxide (NO2) is the most active pollutant gas emitted in the industrial era and is highly correlated with human activities. Tracking NO2 emissions and predicting their concentrations represent important steps toward controlling pollution and setting rules to protect people's health indoors, such as in factories, and in outdoor environments. The concentration of NO2 was affected by the COVID-19 lockdown period and decreased because of restrictions on outdoor activities. In this study, the concentration of NO2 was predicted at 14 ground stations in the United Arab Emirates (UAE) during December 2020 based on training over a full time period of two years (2019–2020). Statistical and machine learning models, such as autoregressive integrated moving average (ARIMA), seasonal autoregressive integrated moving average (SARIMA), long short-term memory (LSTM), and nonlinear autoregressive neural network (NAR-NN), are used with both open- and closed-loop architectures. The mean absolute percentage error (MAPE) was used to evaluate the performance of the models, and the results ranged from "very good” (MAPE of 8.64% at the Liwa station with the closed loop) to "acceptable” (MAPE of 42.45% at the Khadejah School station with the open loop). The results show that the predictions based on the open loop are generally better than those based on the closed loop because they yield statistically significantly lower MAPE values. For both loop types, we selected stations exhibiting the lowest, medium, and highest MAPE values as representative cases. In addition, we demonstrated that the MAPE value is highly correlated with the relative standard deviation of NO2 concentration values.

17.
Heliyon ; : e12487, 2022.
Article in English | ScienceDirect | ID: covidwho-2165325

ABSTRACT

During the coronavirus outbreak, it was noted that pre-existing psychological illnesses worsened, and numerous research indicate that those with contamination-related obsessions and cleaning compulsions (C-OCD) may be more affected. Virtual Reality (VR) and other immersive technologies have shown to be effective for the treatment of disorders related to anxiety, thus showing their potential to transform OCD treatment by means of integrating virtual elements. VR exposure has shown benefits compared to live or imagined exposure, however, to be effective it must be able to elicit high emotional arousal in users. Based on this, the present work aimed to develop different virtual environments scenarios and evaluate their efficacy in generating an emotional response in people with C-OCD symptoms. Based on the literature review, two virtual scenarios were created (dirty public bathroom and unhygienic kitchen). Subsequently, two groups were then constituted: C-OCD group (n = 20, aged between 18 and 48 years) characterized by an obtained score of more than 13 points (cut-point) in the Yale-Brown Scale for Obsessive-Compulsive Disorder (Y-BOCS) and by showing C-OCD symptoms when doing the structured interview (SCID-I), and a control group (n = 20, aged between 18 and 56 years), all participants were residents of the Dominican Republic. Exposure to the virtual environments generated high levels of state and subjective anxiety in both groups, although significantly higher in the C-OCD group. The results obtained indicate that the VR scenarios developed are suitable for eliciting emotional responses and, consequently, that they can be used to complement the treatment of C-OCD.

18.
The Journal of Heart and Lung Transplantation ; 2022.
Article in English | ScienceDirect | ID: covidwho-2165323

ABSTRACT

Shortage of organ donors is an ongoing limiting factor in lung transplantation (LT). Despite increasing prevalence of asymptomatic COVID-19 infection, positive COVID-19 testing from a potential donor remains a contraindication at many LT centers. In this report, we present the outcomes of LT utilizing an algorithm based on donor clinical presentation, and COVID-19 real-time reverse transcription polymerase chain reaction (RT-PCR) with cycle threshold (Ct) values evaluation. The Ct value threshold for organ acceptance was >35. A total of 8 COVID-positive donors were included. No donor-to-recipient transmissions of COVID-19 were observed. Short-term outcomes were comparable to those reported in pre-COVID literature. Survival-to-date is 100% with median POD of 161 days. Our findings support the safety and efficacy of utilizing our algorithm including Ct value threshold for selection of donors with incidental COVID-19 positive testing.

19.
Health Policy ; 2022.
Article in English | ScienceDirect | ID: covidwho-2165322

ABSTRACT

Introduction . Although childbirth services were accessible after Covid-19 outbreak, the measures taken by the Italian Government for contagion containment required some restrictions on the presence of trusted persons for mothers, forcing them to isolation during hospitalization. To preserve companionship, the Regional Health Authority of Tuscany issued a resolution providing partners with the possibility to be present during labour and childbirth for non-asymptomatic women. Objectives . In this study, we: 1) analyse the impact of pandemic on companionship in terms of significant reduction of the possibility for women to be accompanied by a trusted person during labour and childbirth;and 2) ascertain if the regional resolution issued was effective in containing the reduction of companionship. Methods . We performed an interrupted time series analysis to measure the variation of the possibility for women to be accompanied by a trusted person during labour and childbirth, in response to formalization of lock-down due to Covid-19 outbreak and the introduction of the regional resolution aimed at contrasting negative effects on companionship. Results and conclusions . The ITS analysis showed that there was a significant decrease in the women-reported experience of companionship in the month of the formalization of lock-down, namely March 2020, followed by a slight increase in the upcoming months. A trend reversal was observed after May 2020, when the regional resolution was fully operational.

20.
Government Information Quarterly ; : 101787, 2022.
Article in English | ScienceDirect | ID: covidwho-2165312

ABSTRACT

A growing aspect of e-government is healthcare-related. Although preventative e-health services provided by governments like proximity tracing applications (PTAs) can bring important benefits, their adoption is lagging behind expectations. Researchers and policymakers need a better understanding of the factors that influence their adoption. The paper draws from the Unified Theory of Acceptance and Use of Technology (UTAUT) model and extends it by including privacy concerns as an explanatory factor regarding the intention to use PTAs. The study empirically evaluates the impact of privacy concerns together with two of its antecedents – trust in government and trust in technology – on the intention to use a PTA. Data from 762 adult respondents from Slovenia and Germany were collected and analysed using partial least squares structural equation modelling (PLS-SEM). The main findings are: (1) even in the unique context of a PTA the universal predictors of UTAUT have a significant impact;(2) privacy concerns have a direct impact on intention to use;and (3) trust in government and trust in technology both have a significant impact on privacy concerns. The theoretical implications are important for technology adoption research on e-health services provided by the government generally and PTAs in particular.

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