A Systematic Review and Meta-analysis to Identify Risk Factors for Developing Long COVID-19.

AIM: This systematic review and meta-analysis was undertaken to identify the risk factors of long coronavirus disease 2019 (COVID-19) to provide insight for selecting cases for more aggressive monitoring and treatment after COVID-19 infection and reduce morbidity due to long COVID-19. MATERIALS AND METHODS: All relevant studies published till July 2022 were searched for in PubMed, Trip database, and the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library). Reference lists of the studies selected for appraisal were also considered. The National Institute of Health Clinical Database and Google Scholar were searched for unpublished studies. All cohort studies which studied risk factors for long COVID-19 in adults (>18 years age-group) were included. Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were used for data extraction and bias assessment were. The outcomes were risk factors identified as being related with persistent symptoms 3 months after recovery from COVID-19. Random-effects model (RevMan 5.3) was used to pool the data. RESULTS: Total nine studies were included with overall quality scores ranging from 16 to 19 out of the maximum 22. Pooled results demonstrated statistically significant association of long COVID-19 with female gender [odds ratio (OR) -1.67; 95% confidence interval (CI) 1.33-2.09], need of hospitalization (OR -1.80; 95% CI 1.22-2.64), and hospital stay (OR 2.41; 95% CI 0.75-4.07). CONCLUSION: Female gender, need for hospitalization and duration of hospitalization during acute COVID-19 infection are the risk factors for later development of long COVID-19. There should be specific guidelines for monitoring and treatment of this population after acute COVID-19 infection.

Characterization of human extreme heat exposure using an outdoor thermal manikin.

Extreme heat is a current and growing global health concern. Current heat exposure models include meteorological and human factors that dictate heat stress, comfort, and risk of illness. However, radiation models simplify the human body to a cylinder, while convection ones provide conflicting predictions. To address these issues, we introduce a new method to characterize human exposure to extreme heat with unprecedented detail. We measure heat loads on 35 body surface zones using an outdoor thermal manikin ("ANDI") alongside an ultrasonic anemometer array and integral radiation measurements (IRM). We show that regardless of body orientation, IRM and ANDI agree even under high solar conditions. Further, body parts can be treated as cylinders, even in highly turbulent flow. This geometry-rooted insight yields a whole-body convection correlation that resolves prior conflicts and is valid for diverse indoor and outdoor wind flows. Results will inform decision-making around heat protection, adaptation, and mitigation.

A simple three-cylinder radiometer and low-speed anemometer to characterize human extreme heat exposure.

As populations and temperatures of urban areas swell, more people face extreme heat and are at increasing risk of adverse health outcomes. Radiation accounts for much of human heat exposure but is rarely used as heat metric due to a lack of cost-effective and accurate sensors. To this end, we fuse the concepts of a three-globe radiometer-anemometer with a cylindrical human body shape representation, which is more realistic than a spherical representation. Using cost-effective and readily available materials, we fabricated two combinations of three cylinders with varying surface properties. These simple devices measure the convection coefficient and the shortwave and longwave radiative fluxes. We tested the devices in a wind tunnel and at fourteen outdoor sites during July 2023's record-setting heat wave in Tempe, Arizona. The average difference between pedestrian-level mean radiant temperature (MRT) measured using research-grade 3-way net radiometers and the three-cylinder setup was 0.4 ± 3.0 °C ( ±  1 SD). At most, we observed a 10 °C MRT difference on a white roof site with extreme MRT values (70 °C to 80 °C), which will be addressed through discussed design changes to the system. The measured heat transfer coefficient can be used to calculate wind speed below 2 m·s-1; thus, the three cylinders combined also serve as a low-speed anemometer. The novel setup could be used in affordable biometeorological stations and deployed across urban landscapes to build human-relevant heat sensing networks.

Analysis of glove local microclimate properties for various glove types and fits using 3D scanning method.

Due to their geometry and thermal physiology, hands are most vulnerable to cold weather injuries and loss of dexterity. Gloves are the most common for hand protection during exposure to extreme thermal and hazardous environments. Although glove microclimate properties such as area factor, air gap thickness, and contact area play a significant role in thermal protection, identifying local (at individual hand segments) glove microclimate properties is still a research gap. For the first time, the glove-microclimate properties for 16 hand segments at high spatial resolution were analyzed by employing state-of-the-art hand-held 3D scanner and post-processing techniques for different glove types. Our results clearly indicate that the glove area factor for distal phalanges is significantly higher (by 49.8 %) than that for other hand segments, which increases the heat transfer from distal phalanges. In contrast, average air gap thickness was relatively uniform across all hand segments. The glove type had a pronounced effect on glove microclimate properties, e.g., bulky and heavy cold weather protective gloves had a larger average air gap thickness and glove area factor. Regression models are also developed to estimate the glove microclimate properties from simple measurement (i.e., ease allowance). Overall, this study provides essential information for the design and development of protective gloves that can help improve safety, comfort, and dexterity. Methods and mathematical models developed in this study also contribute to facilitating extremity (e.g., hand) focused thermoregulation modeling, hazard simulation, injury prediction, ergonomic design, optimum performance (dexterity and tactility) along with thermal protection.

Factors Influencing the Potential Distribution of Globally Endangered Egyptian Vulture Nesting Habitat in Nepal.

Habitat suitability is crucial to ensure the long-term persistence of species and can be identified based on relationships between species occurrences and underlying abiotic and biotic factors. We identified potential nesting habitat for the Egyptian vulture (Neophron percnopterus) in Nepal using ecological niche modeling with climatic variables. We estimated the currently suitable nesting habitat for Egyptian vulture in Nepal at 38,204 km2. We found a high probability of suitable nesting habitat on east-facing aspects, and the probability of a suitable nesting habitat was greater in more mountainous areas, particularly in central and western regions of Nepal. Precipitation was a major factor for predicting probability of the presence of nest sites for Egyptian vultures. After identifying potentially suitable habitat, we identified environmental factors affecting landscape-level suitable nesting habitat for Egyptian vultures using generalized linear models. For Egyptian vultures, sites near forests and human settlements were most suitable for nesting, roosting, and foraging, especially in central and western Nepal. Based on potentially suitable nesting habitat and previous work on Egyptian vulture foraging and roosting habitat, we recommend protecting forests near water sources and open areas for their long-term conservation.

Perception of Medical Undergraduate Students about an Electronic Practical Examination In Orthopaedics During the COVID-19 Pandemic.

Background/purpose of study: No study has evaluated the perception of medical undergraduate students to the electronic objective structured practical examination (e-OSPE) in orthopaedics. The aim of the present study is to evaluate the feasibility and perception of the medical undergraduate students to e-OSPE conducted by the department of Orthopaedics to assess problem-solving and clinical decision-making skills of medical undergraduate students. Methods: Medical undergraduate students of second and third year at our medical college who completed the orthopaedic clinical posting and appeared for the orthopaedic practical examination during the second wave of the COVID-19 pandemic were included in this prospective observational study. Students appearing for the exams from 20th March 2021 to 26th June 2021 were invited to complete the questionnaire immediately after the e-OSPE. Internal consistency of the survey questions was assessed using Cronbach's alpha. Results: 272 out of 312 eligible students completed the survey and the survey response rate was 87.2%. Nine groups of medical undergraduate students gave the orthopaedic practical exams from 20th March 2021 to 26th June 2021. 91.2% students felt that the e-OSPE represented a valid modality of evaluation of essential orthopaedic practical knowledge during the COVID-19 pandemic. The overall reliability of the 19 questions included in our survey was very high (Internal consistency: Cronbach's alpha = 0.88). Conclusion: The e-OSPE was well received by the medical undergraduate students at our institute and the students had a positive perception about the new examination technique used in orthopaedics during the COVID-19 pandemic.