Amphotericin-b-induced chronic kidney disease in a post-covid-19 patient with widespread rhinocerebral mucormycosis and pneumonia: A CASE REPORT.

BACKGROUND: The COVID-19 pandemic has posed a unique challenge to the medical community due to potential co-infections with bacteria and fungi. We report a case of Rhino cerebral mucormycosis infection in a 67-year-old patient after recovery from COVID-19. OBJECTIVE: To report a case of Rhino cerebral mucormycosis in a 67-year-old patient with pre-existing health conditions after recovering from COVID-19 and to highlight the importance of early detection and treatment of co-infections in patients with pre-existing health conditions. CASE REPORT: The patient had pre-existing health conditions, including uncontrolled diabetes, hypertension, and Chronic obstructive pulmonary disease (COPD), which made him more vulnerable to complications after COVID-19. He was admitted to the hospital after experiencing a dark discharge from his left eye, later confirmed to be due to mucormycosis. Histopathological examination revealed invasive mucormycosis, highlighting the importance of early detection and treatment. However, the patient experienced Acute kidney injury (AKI) after only 5 days of treatment with conventional amphotericin B, underscoring the need for careful monitoring and adjustment of treatment regimens. DISCUSSION: The case underscores the need for early detection and treatment of co-infections in vulnerable patients. The patient's pre-existing conditions and immunocompromised state made him more susceptible to the infection. The case also highlights the importance of careful monitoring and adjustment of treatment regimens to minimize the risk of adverse effects. CONCLUSION: While COVID-19 has presented challenges and uncertainties, it has also provided valuable insights into the interactions between infectious agents and the human body. Continued research and vigilance are necessary to mitigate the impact of co-infections and improve outcomes for patients.

Qualidade de vida no trabalho de profissionais que atuaram na atenção primária à saúde durante a pandemia da Covid-19 / Quality of working life of professionals who worked in primary health care during the Covid-19 pandemic

A qualidade de vida no trabalho está relacionada aos aspectos físicos, ambientais e psicológicos. Objetivo: avaliar a influência da pandemia da COVID-19 na qualidade de vida no trabalho de profissionais da saúde. Método: Pesquisa realizada com 26 profissionais, entre eles, enfermeiros, médicos e técnicos em enfermagem, que trabalharam na atenção primária à saúde, e atuaram na pandemia da COVID-19. Estudo transversal, de abordagem quantitativa, realizado entre junho e julho de 2022, com aprovação no Comitê de Ética em Pesquisa em Seres Humanos. Utilizou-se uma ficha de dados sociodemográficos e o Questionário de Qualidade de Vida no Trabalho (QWLQ-78) que abrange 4 domínios: físico/saúde, psicológico, pessoal e profissional. Resultados: Os profissionais de saúde apresentaram, por domínio, e no geral, qualidade de vida considerada satisfatória no trabalho. Conclusão: o estudo permitiu identificar que, mesmo no período pandêmico, os profissionais de saúde do município de Giruá apresentaram QVT satisfatória.

The quality of life at work is related to physical, environmental, and psychological aspects. Objective: to evaluate the influence of the COVID-19 pandemic on the quality of life at work of health professionals. Method: Research carried out with 26 professionals, including nurses, physicians, and nursing technicians, who worked in primary health care and worked in the COVID-19 pandemic. Cross-sectional quantitative study, carried out between June and July 2022, with approval by the Human Research Ethics Committee. A sociodemographic data form and the Quality of Life at Work Questionnaire (QWLQ-78) were used, including 4 domains: physical/health, psychological, personal, and professional. Results: Health professionals presented, by domain, and in general, satisfactory quality of life at work. Conclusion: The study identified that even during the pandemic period, health professionals in the municipality of Giruá had a satisfactory QWL.

The economic impacts of COVID-19 and city lockdown: Early evidence from China.

As the first major developing country heavily struck by the COVID-19 pandemic, China adopted the world's most stringent lockdown interventions to contain the virus spread. Using macro- and micro-level data, this paper shows that both the pandemic and lockdown policies have had negative and significant impacts on the economy. Gross regional product (GRP) fell by 9.5 and 0.3 percentage points in cities with and without lockdown interventions, respectively. These impacts represent a dramatic recession from China's average growth of 6.74% before the pandemic. The results indicate that lockdown explains 2.8 percentage points of the GDP loss. We also document significant spill-over effects of the pandemic in adjacent areas but no such effects of lockdown. Reduced labor mobility, land supply, and entrepreneurship are among the most significant mechanisms underpinning the impacts of the pandemic and lockdown. Cities with higher share of secondary industry, higher traffic intensity, lower population density, lower internet access, and lower fiscal capacity suffered more. However, these cities seem to have recovered well from the recession and quickly closed the economic gap in the aftermath of the pandemic and city lockdown. Our findings have broader implications for the global interventions in pandemic containment.

Satisfacción laboral y calidad de vida de los médicos residentes españoles en los meses posteriores a la terminación del estado de alarma por la COVID-19 y al año de la misma / Job satisfaction and quality of life of Spanish medical residents in the months after the end of the state of alarm due to COVID-19 and one year later

Introducción: Describir y analizar la percepción existente acerca de la satisfacción laboral (SL) y la calidad de vida (CV) de los/las médicos/as residentes españoles/as en los meses posteriores a la terminación del estado de alarma por la COVID-19 y al año de la misma. Método: Estudio descriptivo-correlacional, siendo la población diana los/las residentes españoles/as a quienes se preguntó, mediante formulario online, en dos cortes (1º de 01/11 al 31/12 de 2020 y 2º entre 01/11 y 31/12 de 2021). Para la SL se utilizó el cuestionario Font-Roja y para la CV el WHOQOL-BREF (ambos mediante escala Likert de 5 valores). Resultados: Respondieron 404 residentes (1er corte) y 411 (2º corte). Los resultados para a SL global mostraron Rho = 0,09; p = 0,081, sin diferencias entre sus medias (-0,07; p = 0,090). La CV global, medida a través del cuestionario, indicó baja correlación entre ambos cortes (Rho = 0,10; p = 0,041), con diferencias entre sus medias (-0,14; p < 0,001). Conclusiones: En relación a la SL no se constató asociación entre los dos periodos estudiados. Respecto a la CV se evidenciaron mejores datos, en el 2º corte, tanto en la CV autopercibida como en el resultado global del cuestionario (AU)

Introduction: To describe and analyze the existing perception about job satisfaction (SL) and quality of life (QoL) of Spanish resident doctors in the months which follow the end of the state of alarm due to COVID-19 and one year after that.Method: A Descriptive-correlational study, being the Spanish residents the target population who was asked, using an online form, in two periods (1st from 11/01 to 12/31, 2020 and 2nd between 11/01 and 12/31, 2021). For SL, the Font-Roja questionnaire was used and for QoL, the WHOQOL-BREF (both using a 5-point Likert scale).Results: 404 residents responded (1st cut) and 411 (2nd cut). The results for the global SL showed Rho = 0.09; p = 0.081, without differences between their means (-0.07; p = 0.090). The global QoL, measured through the question-naire, evinced a low correlation between both cut-offs (Rho = 0.10; p = 0.041), with variations between their means (-0.14; p < 0.001).Conclusions: In relation to SL, no association was revealed between the two periods studied. Regarding QoL, more positive data were found in the 2nd period, both in self-perceived QoL and in the global result of the questionnaire (AU)

Direct SARS-CoV-2 Detection System Utilizing Simple-to-Use Capillary Gel Electrophoresis Sample-to-Result.

We present a Direct SARS-CoV-2 Detection System that achieves sample-to-results in less than two hours in three simple steps. The Detection System includes Direct one-step Reverse Transcription PCR (RT-PCR) reagents (Qexp-MDx kit), a portable thermal cycler (Qamp-mini) with a pre-programmed chip and a simple-to-use Capillary Gel Electrophoresis system &amp;#40;Qsep Series Bio-Fragment Analyzer&amp;#41; with high fluorescence detection sensitivity to solve the problems associated with traditional real-time PCR (qPCR) systems which produces inaccurate test results with high false negative and false positive rates. The proposed simple-to-use detection platform can provide high detection sensitivity (identify less than 20 copies), fast results (less than 120 minutes) and cost-effective results which should be suitable for decentralized testing application of COVID-19.

Carbapenem-resistant Klebsiella pneumoniae outbreak in a COVID-19 intensive care unit; a case-control study.

We analysed a carbapenem-resistant Klebsiella pneumoniae (CRKP) outbreak in the coronavirus disease (COVID) ICU. We retrospectively collected data from ICU records. We identified 25 cases between 12 November 2020 and 19 December 2020, and compared them to 42 controls present in the ICU during the same period. The presence of a femoral haemodialysis catheter was strongly associated with invasive CRKP infections (cases, 9 [36%]; controls, 0 [0%]; odds ratio [OR] 95% confidence intervals [CIs], 21 (5; 89)). We found a significant association between old age and CRKP infection with adverse outcomes. Sequence analysis revealed three distinct carbapenemase genes: blaNDM-1, blaOXA-48 and blaKPC-2. We launched rectal swab sampling upon admission to the ICU, cohorted colonized patients and cases and conducted an intensive training programme for newly employed staff. This study revealed that the emergence and dissemination of CRKP in COVID ICUs were associated with increased adverse outcomes. The presence of a femoral haemodialysis catheter was a significant risk factor for CRKP infections.

Cuckoo optimization algorithm in reverse logistics: A network design for COVID-19 waste management.

Today, reverse logistics (RL) is one of the main activities of supply chain management that covers all physical activities associated with return products (such as collection, recovery, recycling and destruction). In this regard, the designing and proper implementation of RL, in addition to increasing the level of customer satisfaction, reduces inventory and transportation costs. In this paper, in order to minimize the costs associated with fixed costs, material flow costs, and the costs of building potential centres, a complex integer linear programming model for an integrated direct logistics and RL network design is presented. Due to the outbreak of the ongoing global coronavirus pandemic (COVID-19) at the beginning of 2020 and the consequent increase in medical waste, the need for an inverse logistics system to manage waste is strongly felt. Also, due to the worldwide vaccination in the near future, this waste will increase even more and careful management must be done in this regard. For this purpose, the proposed RL model in the field of COVID-19 waste management and especially vaccine waste has been designed. The network consists of three parts - factory, consumers' and recycling centres - each of which has different sub-parts. Finally, the proposed model is solved using the cuckoo optimization algorithm, which is one of the newest and most powerful meta-heuristic algorithms, and the computational results are presented along with its sensitivity analysis.

Ajustes Curriculares de las Escuelas de Odontología Chilenas en Periodo de Pandemia COVID-19

RESUMEN: Dada la expansión de la pandemia por COVID-19, se han implementado diversas medidas restrictivas, las cuales han afectado todos los ámbitos, incluido el educacional. A nivel internacional, las universidades han realizado diversos ajustes a sus programas curriculares para adaptarse a esta situación, siendo la carrera de Odontología particularmente afectada a causa de los cierres de clínicas y retraso en la adquisición de competencias clínicas. El objetivo del estudio es describir los principales ajustes curriculares de las carreras de Odontología de universidades chilenas, realizadas en periodo de pandemia en el año 2020, recopiladas a través de una encuesta. Se realizó un estudio observacional descriptivo, a través de una encuesta enviada a todos los representantes de las escuelas de Odontología de universidades chilenas. Se recopiló información sobre el contexto sanitario local, accesibilidad a las clínicas odontológicas, disponibilidad de tratamientos, vía de enseñanza, apoyo al bienestar mental e implicaciones futuras en la educación dental. De las 27 escuelas de Odontología nacionales, se obtuvieron 23 respuestas. Un 57% de las escuelas tuvo limitaciones en el acceso y en el tipo de tratamientos odontológicos realizados en sus centros clínicos. Todas las escuelas implementaron una modalidad online para reemplazar las actividades lectivas presenciales y un 42 % realizó actividades clínicas presenciales durante el año 2020. Todas las evaluaciones teóricas fueron realizadas de forma online, y un 82 % de las evaluaciones de competencias clínicas se retrasaron para ser realizadas posteriormente. Debido a las medidas restrictivas de la pandemia, las clases presenciales, evaluaciones teóricas y algunas actividades prácticas se realizaron en modalidad online. Dependiendo del contexto comunal y políticas internas universitarias, algunas escuelas de odontología pudieron realizar actividades prácticas presenciales. El plan de estudios académico en las escuelas de odontología se ha visto afectado de diferentes maneras como resultado de la pandemia de COVID-19.

ABSTRACT: The COVID-19 pandemic has caused several disruptions in medical education worldwide. Universities made curricular adjustments in order to adapt to this situation. Dentistry has been particularly affected by the lockdown measures resulting in the closure of dental clinics and the disruption of face to face personal training of students. The objective of this study was to describe the main curriculum adjustments made by the dental schools in Chile during 2020. A cross-sectional online survey was carried out which included representatives from all Dental Schools in Chilean Universities. The survey requested information related to local sanitary situations, accessibility to dental clinics, availability of treatments, teaching modality, support for mental well-being and future implications of dental education. Of 27 dental schools a total of 23 responses were received. It was found that 57 % of schools had limited access to dental clinics. All schools had implemented online modality to replace face-to-face theoretical training, 42 % were able to conduct clinical activities during 2020 and 82 % of clinical competency assessments were postponed. Due to the restrictive measures of the pandemic, the face-to-face classes, theoretical evaluations and some practical activities were performed online. Depending on the communal context, dental schools were able to execute practical activities. The academic curriculum in dental schools has been severely affected in different ways as a result of the COVID-19 pandemic.

B Cell Response Induced by SARS-CoV-2 Infection Is Boosted by the BNT162b2 Vaccine in Primary Antibody Deficiencies.

BACKGROUND: Patients with primary antibody deficiencies are at risk in the current COVID-19 pandemic due to their impaired response to infection and vaccination. Specifically, patients with common variable immunodeficiency (CVID) generated poor spike-specific antibody and T cell responses after immunization. METHODS: Thirty-four CVID convalescent patients after SARS-CoV-2 infection, 38 CVID patients immunized with two doses of the BNT162b2 vaccine, and 20 SARS-CoV-2 CVID convalescents later and immunized with BNT162b2 were analyzed for the anti-spike IgG production and the generation of spike-specific memory B cells and T cells. RESULTS: Spike-specific IgG was induced more frequently after infection than after vaccination (82% vs. 34%). The antibody response was boosted in convalescents by vaccination. Although immunized patients generated atypical memory B cells possibly by extra-follicular or incomplete germinal center reactions, convalescents responded to infection by generating spike-specific memory B cells that were improved by the subsequent immunization. Poor spike-specific T cell responses were measured independently from the immunological challenge. CONCLUSIONS: SARS-CoV-2 infection primed a more efficient classical memory B cell response, whereas the BNT162b2 vaccine induced non-canonical B cell responses in CVID. Natural infection responses were boosted by subsequent immunization, suggesting the possibility to further stimulate the immune response by additional vaccine doses in CVID.

Gastrointestinal Manifestation of COVID-19 in Hospitalized Patients.

INTRODUCTION: During the initial phase of the pandemic, gastrointestinal (GI) symptoms were less frequent but during the later stages, GI manifestations have become more frequent. This study aims to explore the prevalence of GI symptoms in COVID-19 patients, and also focuses on the frequency of these symptoms. METHODS: This longitudinal study was conducted in a COVID-19 unit of a tertiary care hospital, Pakistan. Data of patients hospitalized with COVID-19 infection between June 2021 and July 2021 was included in the study. A total of 412 participants were enrolled in the study via consecutive convenient non-probability sampling. Participants' symptoms and demographics were noted in a self-structured questionnaire. The collected data were analyzed using Statistical Package for Social Sciences (SPSS), version 23.0 (IBM Corp., Armonk, NY). RESULTS: A total of 261 (63.3%) participants had a minimum of one GI symptom. The most common symptom was anorexia (43.9%), followed by diarrhea (24.7%) and nausea/vomiting (17.9%). CONCLUSION:  Our study indicates high frequency of COVID-19 patients reporting GI symptoms. Anorexia, diarrhea, nausea, and vomiting were commonly reported symptoms. Therefore, COVID 19 testing should be considered with patients presenting with GI symptoms.

Covid-19: un reto para los estudiantes de Enfermería en la educación en el trabajo / COVID-19: a challenge for Nursing students in the on-the-job training

RESUMEN Introducción: en las prácticas docentes de Enfermería de la educación en el trabajo, que se realizan en centros hospitalarios, los estudiantes y enfermeros están expuestos al contagio por covid-19. De ahí que se haga necesaria la preparación de este personal para ejercer su labor de un modo exitoso en medio de un escenario complejo. Objetivo: evaluar el enfrentamiento a la covid-19 por parte de educandos y personal de enfermería en las prácticas de la educación en el trabajo. Materiales y métodos: se realizó una investigación de intervención y desarrollo en el Servicio de Neurocirugía del Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, de Matanzas, entre septiembre y octubre de 2020, período de rebrote de la covid. Para ello se trabajó con el universo constituido por 12 pacientes, 12 cuidadores y 6 educandos de 5to año de la carrera de Licenciatura en Enfermería. El estudio se dividió en tres etapas: diagnóstica, entrenamiento y evaluación. Se utilizó la entrevista. Resultados: predominó en los pacientes el grupo etario de 40 a 49 años, con 41,66 % del género masculino. En los cuidadores predominó el femenino, y la edad de 50 a 59 años. El entrenamiento resultó efectivo en un 58,33 %. Conclusiones: la prevención y el autocuidado fueron respuestas estratégicas positivas como formas de actuación en los educandos y el resto del personal que participó en la investigación. La labor asistencial educativa minimizó el riesgo epidemiológico en los pacientes y cuidadores, y logró un incremento en la percepción de riesgo de contraer la enfermedad (AU).

ABSTRACT Introduction: students and nurses are exposed to contagion by COVID-19 during the Nursing teaching practices of on-the-job training carried out in hospitals. Therefore, it is necessary train these staff to carry out their work successfully in the middle of a difficult scenario. Objective: to evaluate COVID-19 facing by students and nursing staff in the practices of on-the-job training. Materials and methods: an intervention and development research was conducted in the Neurosurgery Service of the University Hospital Comandante Faustino Pérez Hernández, of Matanzas, between September and October 2020, period of COVID-19 resurgence. For that we worked with a universe of 12 patients, 12 caregivers and 6 5th-year students of Nursing degree. The study was divided into three stages: diagnosis, training and evaluation. The interview was used. Results: the 40-49 age group predominated among patients, with 41.66 % of the male gender. Among caregivers, female gender predominated and 50-59 age group. The training was effective at 58.33 %. Conclusions: prevention and self-care were positive strategic answers as forms of action in students and the rest of the staff involved in the research. The educational aid work minimized the epidemiological risk in patients and caregivers, and achieved an increase in risk perception of contracting the disease (AU).

Influence of COVID-19 pandemic on stress levels of urologic patients.

INTRODUCTION: Several studies have shown the consequences of COVID-19 pandemic on perceived stress of different populations, but none of them analyzed urological patients who underwent elective surgery. METHODS: We enrolled prospectively patients who underwent elective surgery between March and October 2020. A survey on COVID-19 and the 4-item Perceived Stress Scale (PPS-4) questionnaire were administered at hospital admission. Demographic and medical history data were also collected. Uni- and multivariate analyses were performed to identify independent predictors of higher PSS-4 values (≥7). RESULTS: A total of 200 patients were enrolled. Mean PSS-4 value resulted 6.04. Patients with PSS-4 value ≥7 resulted 43.5% (87/200). In multivariate analysis, PSS-4 value ≥7 was independently associated (p < 0.05) with female gender (OR 6.42), oncological disease (OR 2.87), high (>5 in a range between 0 and 10) fear of intrahospital transmission of SARS-CoV-2 infection (OR 4.75), history of bladder instillation (OR 0.26), and current smokers (OR 0.27). CONCLUSION: High PSS-4 values at hospital admission in urologic surgical patients are positively correlated with female gender, fear of intrahospital transmission of SARS-CoV-2 infection, and oncological disease. PSS-4 questionnaire could be useful to select patients for whom a preadmission counselling is necessary to improve the management of their high stress level.

Correlation between COVID-19 severity, body mass index and radiological hepatic morphology / Correlación entre la gravedad de COVID-19, el índice de masa corporal y la morfología hepática radiológica

SUMMARY: Obesity and fatty liver steatosis are already considered metabolic risk factors which may aggravate the severity of COVID-19. This study aims to investigate the correlation between COVID-19 severity, obesity, and liver steatosis and fibrosis. 230 consecutive patients with laboratory-confirmed COVID-19 aged between 15 and 84? years, admitted to a hospital devoted to COVID-19 patients, were enrolled in the study. COVID-19 severity was classified as severe versus non-severe based on admission to ICU. Obesity was assessed by Body Mass Index (BMI). CT-scan was used to check for the liver steatosis. Fibrosis-4 score was calculated. The study was conducted in March-May 2020. Obesity strongly and positively correlated with severe COVID-19 illness r: 0.760 (P<0.001). Hepatic steatosis had rather less of a correlation with COVID-19 severity r: 0.365 (P<0.001). Multivariable-adjusted association between hepatic steatosis or obesity, or both (as exposure) and COVID-19 severity (as the outcome) revealed increased risk of severe COVID-19 illness with obesity (Adjusted model I OR: 465.3, 95 % CI: 21.9-9873.3, P<0.001), with hepatic steatosis (Adjusted model I OR: 5.1, 95 % CI: 1.2-21.0, P<0.025), and with hepatic steatosis among obese patients (Adjusted model I OR: 132, 95 % CI: 10.3-1691.8, P<0.001). Obesity remained the most noticeable factor that strongly correlated with COVID-19 severity, more than liver steatosis. However, the risk to COVID-19 severity was greater in those with both factors: obesity and liver steatosis.

RESUMEN: La obesidad y la esteatosis del hígado graso ya se consideran factores de riesgo metabólico que pueden empeorar la gravedad de la COVID-19. Este estudio tiene como objetivo investigar la correlación entre la gravedad de COVID- 19, la obesidad y la esteatosis y fibrosis hepática. El estudio se realizó en 230 pacientes consecutivos entre 15 y 84 años con COVID-19 confirmado por laboratorio, ingresados en un hospital dedicado a pacientes con COVID-19. La gravedad de COVID-19 se clasificó como grave, versus no grave según el ingreso a la UCI. La obesidad se evaluó mediante el índice de masa corporal (IMC). Se utilizó una tomografía computarizada para verificar la esteatosis hepática. Se calculó la puntuación de Fibrosis-4. El estudio se realizó entre marzo-mayo de 2020. La obesidad se correlacionó fuerte y positivamente con la enfermedad grave de COVID-19 r: 0,760 (P <0,001). La esteatosis hepática tuvo una correlación bastante menor con la gravedad de COVID-19 r: 0.365 (P <0.001). La asociación ajustada multivariable entre la esteatosis hepática u obesidad, o ambas (como exposición) y la gravedad de COVID-19 (como resul- tado) reveló un mayor riesgo de enfermedad grave por COVID- 19 con obesidad (OR del modelo ajustado I: 465,3, IC del 95%: 21,9 -9873,3, P <0,001), con esteatosis hepática (OR del modelo I ajustado: 5,1, IC del 95 %: 1,2-21,0, P <0,025) y con esteatosis hepática entre los pacientes obesos (OR del modelo I ajustado: 132, IC del 95 % : 10,3-1691,8, P <0,001). La obesidad siguió siendo el factor más notable que se correlacionó significativamente con la gravedad de COVID-19, más que la esteatosis hepática. Sin embargo, el riesgo de gravedad de COVID-19 fue mayor en aquellos con ambos factores: la obesidad y esteatosis hepática.

Prevalence of Burnout Among Respiratory Therapists Amidst the COVID-19 Pandemic.

Background: Burnout is a major challenge in health care, but its prevalence has not been evaluated in practicing respiratory therapist (RTs). The purpose of this study was to identify RT burnout prevalence and factors associated with RT burnout.Methods: An online survey was administered to 26 centers in the United States and between January and March 2021. Validated, quantitative, cross-sectional surveys were used to measure burnout and leadership domains. The survey was sent to department directors and distributed by the department directors to staff. Data analysis was descriptive and logistic regression analysis was performed to evaluate risk factors, expressed as odds ratios (OR), for burnout.Results: The survey was distributed to 3,010 RTs, and the response rate was 37%. Seventy-nine percent of respondents reported burnout, 10% with severe, 32% with moderate, and 37% with mild burnout. Univariate analysis revealed those with burnout worked more hours per week, worked more hours per week in the ICU, primarily cared for adult patients, primarily delivered care via RT protocols, reported inadequate RT staffing, reported being unable to complete assigned work, were more frequently exposed to COVID-19, had a lower leadership score, and fewer had a positive view of leadership. Logistic regression revealed burnout climate (OR 9.38, p<0.001), inadequate RT staffing (OR 2.08 to 3.19, p=0.004 to 0.05), being unable to complete all work (OR 2.14 to 5.57, p=0.003 to 0.20), and missing work for any reason were associated with increased risk of burnout (OR 1.96, p=0.007). Not providing patient care (OR 0.18, p=0.02) and a positive leadership score (0.55, p=0.02) were associated with decreased risk of burnout.Conclusion: Burnout was common among RTs in the midst of the COVID-19 pandemic. Good leadership was protective against burnout while inadequate staffing, inability to complete work, and burnout climate were associated with burnout.

A computational study to disclose potential drugs and vaccine ensemble for COVID-19 conundrum.

The nucleocapsid (N) protein of SARS-COV-2, a virus responsible for the current COVID-19 pandemic, is considered a potential candidate for the design of new drugs and vaccines. The protein is central to several critical events in virus production, with its highly druggable nature and rich antigenic determinants making it an excellent anti-viral biomolecule. Docking-based virtual screening using the Asinex anti-viral library identified binding of drug molecules at three specific positions: loop 1 region, loop 2 region and ß-sheet core pockets, the loop 2 region being the most common binding and stable site for the bulk of the molecules. In parallel, the protein was characterized by vaccine design perspective and harboured three potential B cell-derived T cell epitopes: PINTNSSPD, GVPINTNSS, and DHIGTRNPA. The epitopes are highly antigenic, virulent, non-allergic, non-toxic, bind with good affinity to the highly prevalent DRB*0101 allele and show an average population coverage of 95.04%. A multi-epitope vaccine ensemble which was 83 amino acids long was created. This was highly immunogenic, robust in generating both humoral and cellular immune responses, thermally stable, and had good physicochemical properties that could be easily analyzed in in vivo and in vitro studies. Conformational dynamics of both drug and vaccine ensemble with respect to the receptors are energetically stable, shedding light on favourable conformation and chemical interactions. These facts were validated by subjecting the complexes to relative and absolute binding free energy methods of MMGB/PBSA and WaterSwap. A strong agreement on the system stability was disclosed that supported ligand high affinity potential for the receptors. Collectively, this work sought to provide preliminary experimental data of existing anti-viral drugs as a possible therapy for COVID-19 infections and a new peptide-based vaccine for protection against this pandemic virus.

The effect of the 2019 coronavirus disease outbreak on social relationships: A cross-sectional study in Jordan.

BACKGROUND: Social relationships refer to the existing associations between family members, friends, neighbours, co-workers, and other associates. Due to the COVID-19 pandemic, social distancing has been imposed by the curfew program in Jordan. AIM: To evaluate the effects of social distancing on the social relationships of the Jordanian population. METHODS: A cross-sectional study using an online survey was conducted in Jordan between the 6th and the 30th of May, 2020. Our questionnaire was constructed to explore the population's perception of the quarantine period, how it is affecting their relationship with others, and the characteristics of their social relationships and communication with various population categories, including family members and work colleagues. Multiple linear regression was used to identify predictors of better social relationships and communication. RESULTS: A total of 4,301 participants were involved in this study. The average score of the influence of the COVID-19 pandemic on social relationships among the whole study population was 5.68 (SD: 2.33) out of 10 (equal to 56.8%), which indicates the marginal strength of the social relationships. Around 31.6% of the participants reported that their social relationships were affected to a high degree by the COVID-19 pandemic. Participants who were aged 36-45 were positively affected in terms of their social relationships during the COVID-19 pandemic. CONCLUSION: The COVID-19 pandemic is negatively affecting social relationships, which could ultimately lead to negative health implications. Decision-makers are advised to provide educational campaigns that improve the sociological health of the general population.

Influence of conflicts of interest on public positions in the COVID-19 era, the case of Gilead Sciences.

Funding and gifts from the pharmaceutical industry have an influence on the decisions made by physicians and medical experts. In the context of the coronavirus disease 2019 epidemic, several treatments are available to treat patients infected with the virus. Some are protected by patents, such as remdesivir, others0020stare not, such as hydroxychloroquine. We wanted to observe the possible correlation between the fact, for an academic doctor in infectious diseases, of having benefited from funding by Gilead Sciences, producer of remdesivir, and the public positions taken by this doctor towards hydroxychloroquine. Our results show a correlation (Spearman test, p = 0.017) between the amount received from the Gilead Sciences company and public opposition to the use of hydroxychloroquine in France. This should open up the debate on the role of the interest links of doctors with pharmaceutical companies in the medical and scientific public debate.