Search Results (6,377)

Background/Objectives: The COVID-19 pandemic caused pronounced disorder in healthcare delivery globally, including ophthalmology. Our study explores how ophthalmologists in Puerto Rico (PR) altered their practices during the pandemic, confronting obstacles such as resource shortages, evolving public health mandates, and unique socio-economic and geographic constraints. The study aims to enhance preparedness for future public health crises. Methods: We conducted descriptive analyses on four online surveys distributed at crucial time points of the pandemic (March 2020, May 2020, August 2020, August 2021) to all practicing ophthalmologists in PR (N ≈ 200), capturing data on closures, patient volume, personal protective equipment (PPE) access, telemedicine use, and financial relief. Results: Survey responses ranged from 41% (n = 81) to 56% (n = 111). By March 2020, 22% (24/111) of respondents closed their offices. By May 2020, 20% (19/93) of respondents maintained a closed office, while 89% (64/72) of open offices reported seeing less than 25% of their usual patient volume. Access to PPE was a challenge, with 59% (65/111) reporting difficulty obtaining N95 masks in March 2020. Telemedicine usage increased initially, peaking in May 2020 and declining in July 2020. By August 2021, all respondents were fully vaccinated and most practices returned to pre-pandemic levels. Overall, 86% (70/81) of respondents found the surveys to be useful for navigating practice changes during the pandemic. Conclusions: PR ophthalmologists showed adaptability during the COVID-19 pandemic to maintain care given limited resources. Guidelines from professional organizations and real time surveys play an important role in future crisis preparedness. Full article

This study estimates the prevalence of co-use of alcohol and cannabis, assesses the sociodemographic risk factors of co-use, and examines the associations between mental health and heavy episodic drinking (HED) and alcohol–cannabis co-use in Canada during the early years of the COVID-19 pandemic. Nine successive cross-sectional surveys, held from May 2020 to January 2022, of adults (aged ≥18 years) living in Canada were pooled for 9011 participants. The prevalence of co-use was calculated across sociodemographic groups. Logistic regressions were used to assess associations. Alcohol–cannabis co-use was associated with a greater likelihood of engaging in HED and experiencing symptoms of anxiety, depression, and loneliness. The prevalence of co-use of alcohol was different across sociodemographic groups. The highest prevalence was among TGD people (35.5%), followed by individuals aged 18–39 years (14.5%). Additionally, being TGD (aOR = 3.61, 95% CI 2.09–6.25), separated/divorced/widowed (aOR = 1.60, 95% CI 1.23–2.07), living in an urban area (aOR = 1.26, 95% CI 1.07–1.56), and having a high household income (aOR = 1.41, 95% CI 1.09–1.82) increased the likelihood of reporting alcohol–cannabis co-use. These findings underscore the fact that developing public health and clinical interventions for preventing and treating excessive alcohol or cannabis use must consider both alcohol and cannabis use patterns and should be tailored to the highest-risk TGD and young adults. Full article

The work presents a comprehensive analysis and costing of sugar beet cultivation in 2020–2022, for individual farms of the Lublin region. About 120 farms were analyzed. Based on this analysis, the criteria for a model farm were determined and adopted for the calculation of sugar beet production costs. ARIMA process modeling was performed, based on which forecasts were determined for several selected parameters. Customs tariffs introduced by the USA have a drastic impact on the economy. The effects of the COVID19 pandemic may also have a significant impact on the current market situation. Forecasting in the current geopolitical situation is very difficult because of the lack of stationarity of parameters. The financial result obtained by growers is mainly influenced by indirect costs absorbing 61.31% of total costs in 2020. In 2021 and 2022, indirect costs were 61.16% and 59.61% of production income, respectively. Among this group of costs, the largest share is accounted for by the costs of sowing services, sugar beet harvesting, and soil liming amounting from 14.27% to 15.92%. During the analyzed period, sugar beet cultivation remained profitable, with a production profitability index of 1.31 in 2020 and 2021, and 1.10 in 2022. The unit cost of production increased every year. In 2020, it was 14.27% and in 2021, it increased to 15.19%. The unit cost of production in 2022 was the highest, at 23.41%. Sugar beet cultivation is one of the profitable activities in agricultural production, but it is characterized by high production costs, which increased during the years analyzed (2020 to 2022), topping out at 90.87% of total revenue. The information and data presented in this study will be used in the development of a farmer-oriented application and will support the creation of an expert system for sugar beet growers. Cost forecasting will enable farmers to plan their production more effectively. Full article

Early-career teachers (ECTs) entered the profession during the COVID-19 pandemic, a period that introduced unique stressors to an already-demanding career phase. This systematic review examines empirical studies published between 2020 and February 2025 to explore how the pandemic influenced ECT wellbeing, with particular attention to stressors and protective factors impacting long-term retention and professional sustainability. Guided by PRISMA protocols, databases including Web of Science, ERIC, Google Scholar, and Scopus were searched, screening 470 records and identifying 30 studies that met inclusion criteria: peer-reviewed, empirical, focused on early-career teachers (within the first five years), and situated in or explicitly addressing the pandemic and its ongoing impacts. The results of Braun and Clarke’s thematic analysis (2006) revealed that pandemic-related challenges such as increased workload, professional isolation, disrupted induction processes, and emotional strain have persisted into the post-pandemic era, contributing to sustained risks of burnout and attrition. Regardless, protective factors identified during the pandemic—including high-quality mentoring, structured induction programmes, collegial support, professional autonomy, and effective individual coping strategies—continue to offer essential support, enhancing resilience and professional wellbeing. These findings underscore the necessity of institutionalising targeted supports to address the enduring effects of pandemic-related stressors on ECT wellbeing. By prioritising sustained mental health initiatives and structural supports, education systems can effectively mitigate long-term impacts and improve retention outcomes for early-career teachers in a post-pandemic educational landscape. Full article

Background/Objective: The COVID-19 pandemic profoundly transformed social life worldwide, indiscriminately affecting individuals across all age groups. Children have not been exempted from the risk of severe illness and death caused by COVID-19. Objective: This paper sought to describe the clinical findings, laboratory and imaging results, and hospital care provided for severe and critical cases of COVID-19 in unvaccinated children, with or without severe asthma, hospitalized in a public referral service for COVID-19 treatment in the Brazilian state of Pernambuco. Methods: This was a case series study of severe and critical COVID-19 in hospitalized, unvaccinated children, with or without severe asthma, conducted in a public referral hospital between March 2020 and June 2021. Results: The case series included 80 children, aged from 1 month to 11 years, with the highest frequency among those under 2 years old (58.8%) and a predominance of males (65%). Respiratory diseases, including severe asthma, were present in 73.8% of the cases. Pediatric multisystem inflammatory syndrome occurred in 15% of the children, some of whom presented with cardiac involvement. Oxygen therapy was required in 65% of the cases, mechanical ventilation in 15%, and 33.7% of the children required intensive care in a pediatric intensive care unit. Pulmonary infiltrates and ground-glass opacities were common findings on chest X-rays and CT scans; inflammatory markers were elevated, and the most commonly used medications were antibiotics, bronchodilators, and corticosteroids. Conclusions: This case series has identified key characteristics of children with severe and critical COVID-19 during a period when vaccines were not yet available in Brazil for the study age group. However, the persistence of low vaccination coverage, largely due to parental vaccine hesitancy, continues to leave children vulnerable to potentially severe illness from COVID-19. These findings may inform the development of public health emergency contingency plans, as well as clinical protocols and care pathways, which can guide decision-making in pediatric care and ensure appropriate clinical management, ultimately improving the quality of care provided. Full article

The COVID-19 pandemic triggered unprecedented economic disruptions, raising critical questions about the resilience and adaptability of macroeconomic productivity across countries. This study examines the impact of COVID-19 on macroeconomic efficiency and productivity dynamics in 37 OECD countries using quarterly data from 2018Q1 to 2024Q4. By employing a Slack-Based Measure Data Envelopment Analysis (SBM-DEA) and the Malmquist Productivity Index (MPI), we decompose total factor productivity (TFP) into efficiency change (EC) and technological change (TC) across three periods: pre-pandemic, during-pandemic, and post-pandemic. Our framework incorporates both desirable (GDP) and undesirable outputs (inflation, unemployment, housing price inflation, and interest rate distortions), offering a multidimensional view of macroeconomic efficiency. Results show broad but uneven productivity gains, with technological progress proving more resilient than efficiency during the pandemic. Post-COVID recovery trajectories diverged, reflecting differences in structural adaptability and innovation capacity. Regression analysis reveals that stringent lockdowns in 2020 were associated with lower productivity in 2023–2024, while more adaptive policies in 2021 supported long-term technological gains. These findings highlight the importance of aligning crisis response with forward-looking economic strategies and demonstrate the value of DEA-based methods for evaluating macroeconomic performance beyond GDP. Full article

Background: The surge in COVID-19 cases during the pandemic created a disease burden. An epidemiological study on COVID-19 is required as not much is known about the impact of containment and mitigation on health. We aimed to compare the epidemiological features during the years of the COVID-19 pandemic in the Vidarbha region in Maharashtra, India, to understand the epidemiology changes throughout the pandemic’s progression. Method: All of the cases reported at our testing centers in Nagpur and its periphery during the three years of the pandemic (i.e., from February 2020 to December 2022) were included. Descriptive analyses of variables of interest and statistical measures were compared. Results: There were 537,320 tests recorded during the study period. Of these, 13,035 (13.29%), 42,909 (13.70%), and 19,936 (15.91%) tested positive in 2020, 2021, and 2022, respectively. Hospitalization decreased from 2020 to 2022. An age group shift from 45 to 16–30 years over the pandemic was noticed. Seasonally, positivity peaked in September (27.04%) in 2020, in April (43.4%) in 2021, and in January in 2022 (35.30%). The estimated case fatality ratio was highest in 2021 (36.68%) over the three years in the hospital setting. Conclusion: Understanding the changing epidemiology of SARS-CoV-2 strengthens our perceptive of this disease, which will aid in improving the healthcare system in terms of both controlling and preventing the spread of COVID-19. Full article

Achieving sustainable development goals remains a core issue in global development. In response, China has proposed the development of new quality productive forces (NQPFs) through innovative thinking, emphasizing that fostering NQPFs is both an intrinsic requirement and a pivotal focus for advancing high-quality development. Concurrently, the intelligent transformation of the manufacturing sector serves as a critical direction for China’s economic restructuring and upgrading. This paper places “new quality productive forces” and “intelligent transformation of manufacturing” within the same analytical framework. Starting from the logical chain of “new quality productive forces—three major mechanisms—intelligent transformation of manufacturing,” it concretizes the value implications of new quality productive forces into a systematic conceptual framework driven by the synergistic interaction of three major mechanisms: the mechanism of revolutionary technological breakthroughs, the mechanism of innovative allocation of production factors, and the mechanism of deep industrial transformation and upgrading. This study constructs a “3322” evaluation index system for NQPFs, based on three formative processes, three driving forces, two supporting systems, and two-dimensional characteristics. Simultaneously, it builds an evaluation index system for the intelligent transformation of manufacturing, encompassing intelligent technology, intelligent applications, and intelligent benefits. Using national time-series data from 2012 to 2023, this study assesses the development levels of both NQPFs and the intelligent transformation of manufacturing during this period. The study further analyzes the impact of NQPFs on the intelligent transformation of the manufacturing sector. The research results indicate the following: (1) NQPFs drive the intelligent transformation of the manufacturing industry through the three mechanisms of innovative allocation of production factors, revolutionary breakthroughs in technology, and deep transformation and upgrading of industries. (2) The development of NQPFs exhibits a slow upward trend; however, the outbreak of the pandemic and Sino-US trade frictions have caused significant disruptions to the development of new-type productive forces. (3) The level of intelligent manufacturing continues to improve; however, from 2020 to 2023, due to the impact of the COVID-19 pandemic and Sino-US trade conflicts, the level of intelligent benefits has slightly declined. (4) NQPFs exert a powerful driving force on the intelligent transformation of manufacturing, exerting a significant positive impact on intelligent technology, intelligent applications, and intelligent efficiency levels. Full article

Non-polio enteroviruses continue to cause numerous epidemics world-wide that range from mild to severe disease, including acute flaccid paralysis, meningitis, severe respiratory infections and encephalitis. Using publicly available data we present a comprehensive global and regional temporal distribution of non-polio enteroviruses, with a focus on highly prevalent genotypes. We found that regional distribution did vary compared to global prevalence where the top prevalent genotypes included CVA6 and EV-A71 in Asia, EV-D68 in North America and CVA13 in Africa, while E-30 was prevalent in Europe, South America and Oceania. In 2020, the COVID-19 pandemic did interrupt non-polio enterovirus detections globally, and cases rebounded in subsequent years, albeit at lower prevalence and with decreased genotype diversity. Environmental surveillance for non-polio enteroviruses does occur and has been used in some regions as an early-warning system; however, further development is needed to effectively supplement potential gaps in clinical surveillance data. Overall, monitoring for non-polio enteroviruses is critical to identify true incidence, improve understanding of genotype circulation, provide an early warning system for emerging/re-emerging genotypes and allow for better outbreak control. Full article

Background and Objectives: Preterm birth and stillbirth are primary adverse pregnancy outcomes. Research during the COVID-19 pandemic revealed reductions in preterm birth in some countries, while stillbirth rates increased or remained unchanged. These findings suggest the presence of preventable risk factors associated with changes in physical activity and lower exposure to community-acquired infections due to lockdown measures, altered social interaction patterns or reduced access to antenatal care. Assessing seasonal variation may offer insights into whether lifestyle changes during the COVID-19 lockdown period influenced preterm birth rates. Materials and Methods: This retrospective cohort study used data from the electronic medical records of Bihor and Sibiu counties. Preterm deliveries (<37 weeks) and stillbirths during the COVID-19 pandemic (2020 and 2021) were compared with the corresponding pre-pandemic (2018 and 2019) and post-pandemic (2022 and 2023) period. Preterm birth rates during summer and winter in the pre-pandemic, pandemic, and post-pandemic years were analyzed. A comparison with rates during strict lockdown was made. Results: Out of 52,021 newborn infants, 4473 were born preterm. Preterm birth rates remained stable across all three periods (p = 0.13), and no significant seasonal pattern was identified (p = 0.65). In contrast, stillbirth rates increased notably during the strict lockdown period, with the median incidence almost doubling compared to other periods (0.87%, p = 0.05), while remaining unchanged during the rest of the pandemic (p = 0.52). Conclusions: Our study found that preterm birth rates remained unaffected by the pandemic and lockdown periods, while stillbirths increased significantly during the strict lockdown. These findings highlight the importance of maintaining access to timely antenatal care during public health emergencies to prevent adverse perinatal outcomes. Full article

This research examines the shifting geography of small firm innovation in the U.S. by tracking the location of small business innovation research (SBIR) and small business technology transfer (STTR) awardees between 2010 and 2024. The SBIR and STTR are “seed fund” awards coordinated by the Small Business Administration (SBA) and funded through 11 U.S. federal agencies. Of particular interest is whether the number of individual SBA awards, awarded firms, and/or funding amounts are (1) becoming increasingly concentrated within regional innovation hubs and (2) exhibiting a shift toward or away from urban centers and other walkable, transit-accessible urban neighborhoods, particularly since 2020 and the COVID-19 pandemic. While the rise of remote work and pandemic-related fears may have reduced the desirability of urban spaces for both living and working, there remain significant benefits to spatial agglomeration that may be especially crucial for startups and other small firms in the knowledge- or information-intensive industries. The results suggest that innovative activity of smaller firms has indeed trended toward more centralized, denser, and walkable urban areas in recent years while also remaining fairly concentrated within major metropolitan innovation hubs. The pandemic appears to have resulted in a measurable, though potentially short-lived, cessation of these trends. Full article

The COVID-19 pandemic has exposed and intensified structural tensions surrounding work−life balance, precarity, and gender inequalities in academia. This paper examines the spatial, temporal, and emotional disruptions experienced by early-career and precarious researchers in Italy during the first national lockdown (March–April 2020) and their engagement in remote academic work. Adopting an exploratory and qualitative approach, the study draws on ten narrative video interviews and thirty participant-generated images to investigate how structural dimensions—such as gender, class, caregiving responsibilities, and the organizational culture of the neoliberal university—shaped these lived experiences. The findings highlight the implosion of boundaries between paid work, care, family life, and personal space and how this disarticulation exacerbated existing inequalities, particularly for women and caregivers. By interpreting both visual and narrative data through a sociological lens on gender, work, and organizations, the paper contributes to current debates on the transformation of academic labor and the reshaping of temporal work regimes through the everyday use of digital technologies in contemporary neoliberal capitalism. It challenges the individualization of discourses on productivity and flexibility and calls for gender-sensitive, structurally informed policies that support equitable and sustainable transitions in work and family life, in line with European policy frameworks. Full article

Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus, whose 2020 outbreak was characterized as a pandemic by the World Health Organization. Restriction measures changed healthcare delivery, with telehealth providing a viable alternative throughout the pandemic. This study analyzed a telemedicine platform database with the goal of developing a diagnostic prediction model for COVID-19 patients. This is a longitudinal study of patients seen on the Conexa Saúde telemedicine platform in 2022. A multiple binary logistic regression model of controls (negative confirmation for COVID-19 or confirmation of other influenza-like illness) versus COVID-19 was developed to obtain an odds ratio (OR) and a 95% confidence interval (CI). In the final binary logistic regression model, six factors were considered significant: presence of rhinorrhea, ocular symptoms, abdominal pain, rhinosinusopathy, and wheezing/asthma and bronchospasm were more frequent in controls, thus indicating a greater chance of flu-like illnesses than COVID-19. The presence of tiredness and fatigue was three times more prevalent in COVID-19 cases (OR = 3.631; CI = 1.138–11.581; p-value = 0.029). Our findings suggest potential predictors associated with influenza-like illness and COVID-19 that may distinguish between these infections. Full article

Background and Objectives: Ischemic stroke (IS) is a critical health issue, affecting individuals of all ages, sexes, and backgrounds. Mounting evidence suggests that sex indeed could play some distinct role in shaping the incidence, outcomes, and treatment of IS. In the context of the COVID-19 pandemic, contradictory findings from previous studies that also addressed sex differences in cerebrovascular diseases demonstrate the need for further focused research. This study aimed to evaluate the sex discrepancies in the clinical presentation of IS and its outcomes in patients admitted to Kaunas Hospital of the Lithuanian University of Health Sciences (LUHS), Lithuania. Materials and Methods: This is a retrospective record-based single-center study. All the study patients—727 men and 1082 women—enrolled between 1 January 2020, and 27 February 2022; suffered from acute IS; and had absolute contraindications against interventional IS treatment. These patients received a conservative non-interventional IS treatment at the neurological department of the LUHS’s Kaunas Hospital. The sociodemographic data; laboratory findings; comorbidities, including COVID-19; in-hospital complications; and outcome factors were obtained from the patients’ medical records and evaluated by deploying appropriate statistical tests. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated by the Cox proportional hazards regression for in-hospital lethality. Results: The mean age of IS patients was significantly higher in women compared to men (p < 0.001), as was the proportion of in-hospital deaths (19.10% and 15.36%, respectively; p < 0.05). The mean total number of in-hospital complications was again significantly higher in the group of women compared to men (p < 0.05). The prevalence of COVID-19 was higher in men compared to women (p < 0.05). COVID-19 diagnosis (HR = 1.53; p = 0.02) and acute in-hospital pulmonary complications (HR = 1.91; p = 0.008) significantly increased the risk of in-hospital lethality in men. The risk of in-hospital lethality was significantly higher in women with comorbid diabetes mellitus type 2 (DM) compared to those with comorbid isolated arterial hypertension (AH) (HR = 2.25, p = 0.007). Increased C-reactive protein elevated the risk of in-hospital lethality by more than twice in both men and women (HR = 2.46; p < 0.001 and HR = 2.28; p < 0.001, respectively). Conclusions: The following differences between men and women with IS were determined: Acute in-hospital pulmonary complications, including COVID-19, significantly increased the risk of in-hospital lethality in the male group, but not in women. However, women suffering from DM had a significantly increased risk of in-hospital lethality compared with those women IS patients with AH or chronic ischemic heart disease (IHD). Increased C-reactive protein was associated with an elevated risk of in-hospital lethality both in male and female groups. Full article

Background/Objective: A growing body of international research continues to show evidence of worsening youth mental health since the beginning of the COVID-19 global pandemic, yet very little research in this area has included young children under 6 years. Given the potential impact of early life stress during this critical period of development, it is crucial to better understand the effects on this age group. The objective of this study was to better understand the impact of the COVID-19 pandemic on the emotional health of very young children. Methods: This study utilized retrospective chart review of primary care records to compare the prevalence of markers of stress in two cohorts of children under the age of 6 years, comparing children presenting for care prior to the pandemic (1 April 2019–31 March 2020; control period) with those presenting for care during the first year of the pandemic (1 April 2020–31 March 2021; study period) in a large pediatric primary care clinic in Washington, DC, USA. Based on power calculations, charts of 200 patients from each cohort were reviewed and prevalence of stress markers were summarized using counts and percentages and compared between groups using chi-squared tests. Multivariable logistic regression models were also conducted for each domain adjusting for age, gender, and insurance type. Results: Overall, sleep difficulties were significantly more prevalent during the pandemic period compared to the control period (14% vs. 6.5%, p = 0.013). In addition, signs of stress presented differently across age groups. For example, during the pandemic period toddlers (13–35 months) were 13 times more likely (OR = 13, 95% CI [2.82, 60.4], p < 0.001) and preschool-aged children (36–71 months) were 18.5 times more likely (OR = 18.5, 95% CI [4.0, 86], p < 0.001) than infants to present with behavior problems, indicating substantially higher risk of externalizing symptoms in older children compared to infants. Toddlers were less likely than infants to present with mood changes (e.g., fussiness or crying) (OR = 0.15, 95% CI [0.03, 0.65], p = 0.011). In addition, toddlers (OR = 0.55, 95% CI [0.31, 0.97], p = 0.038) and preschool-aged children (OR = 0.15, 95% CI [0.06, 0.4], p < 0.001) were also less likely to present with feeding difficulties compared to infants. Conclusions: One of the very few studies of young children under 6 years (including infants) during the COVID-19 pandemic, this study found that even very young children experienced stress during the pandemic. Signs of emotional stress were identified in a primary care office during routine care, highlighting an important opportunity for early intervention and/or prevention, such as counseling and resources for caregivers, in settings where young children are already presenting for routine care. Full article