Search Results (212)

Innate immune cells appear to have an important implication in the resolution and/or the aggravation of the COVID-19 pathogenesis after infection with SARS-CoV-2. To better appreciate the role of these cells during COVID-19, changes in blood eosinophil, the neutrophil and monocyte count, and levels of surface protein markers have been reported. However, analyses at several timepoints of multiple surface markers on granulocytes and monocytes over a period of one month after a SARS-CoV-2 infection are missing. Therefore, in this study, we performed blood eosinophil, neutrophil, and monocyte phenotyping using a list of surface proteins and flow cytometry during a period of 30 days after the hospitalization of patients with severe SARS-CoV-2 infections. Blood cell counts were reported at seven different timepoints over the 30-day period as well as measures of multiple mediators in serum using a targeted multiplex assay approach. Our results indicate a 95% drop in the blood eosinophil count by D1, with eosinophils displaying a phenotype defined as CD69/CD63/CD125^high and CCR3/CD44^low during the early phases of hospitalization. Conversely, by D7 the neutrophil count increased significantly and displayed an immature, activated, and immunosuppressive phenotype (i.e., 3% of CD10/CD16^low and CD10^lowCD177^high, 6.7% of CD11b^highCD62L^low, and 1.6% of CD16^highCD62L^low), corroborated by enhanced serum proteins that are markers of neutrophil activation. Finally, our results suggest a rapid recruitment of non-classical monocytes leaving CD163/CD64^high and CD32^low monocytes in circulation during the very early phase. In conclusion, our study reveals potential very early roles for eosinophils and monocytes in the pathogenesis of COVID-19 with a likely reprogramming of eosinophils in the bone marrow. The exact roles of the pro-inflammatory neutrophils and the functions of the eosinophils and the monocytes, as well as these innate immune cell types, interplays need to be further investigated. Full article

The COVID-19 crisis has turned teleworking from a minority option into an imposed and generalized way of life and has called into question its contribution to corporate sustainability. The present review is the first systematic review of the effects of telework on the environmental, social, and economic pillars of corporate sustainability in the scholarly literature published from 2020 to 2024. A total of 50 studies from three databases (Scopus, Science Direct, and Taylor and Francis) were reviewed according to PRISMA guidelines by both a data bibliometric analysis and narrative synthesis. The findings show that telework has the potential to improve environmental sustainability by decreasing commuting emissions (29–54% depending on its deployment intensity), but rebound effects such as increased residential energy use work against this (in part) positive regard. From a social point of view, telework is double-edged between helping balance personal and work life and possessing the potential to lead to greater isolation and aggravate existing inequalities, particularly in developing countries. Economically, it drives operational costs down and expands the talent pool, with micro-, meso-, and macroeconomic impacts. The possibility of telework as a tool of sustainable development is substantially moderated by organizational culture, digital infrastructure, sociodemographic reality, and even the physical environment. We argue that telework is a potentially transformative driver of corporate sustainability if deployed strategically within a given context; however, disciplinary fragmentation and methodological lacunae in common metrics remain, especially with regard to long-term effects and implementation in developing economies. Full article

The end of the pandemic has been officially declared; however, the requirement to ensure hygienic living conditions in tourist accommodations remains a top priority for all hotel establishments and a prerequisite for every customer. Our systematic review studied the level of effectiveness of existing technological means and practices in order to limit COVID-19 infections and to protect customers from other factors aggravating their health, focusing on hotel restaurants. The PRISMA-S method was used. Database research (ABI/INFORM, ProQuest, Scopus EBSCO Business Source Premier, CBCA Business, Pubmed, and Embase) was undertaken between 6/2020 and 4/2024 with keywords comprising “hotels restaurants”, “health and safety”, “effectiveness/efficacy”, “primary analysis”, secondary analysis”, etc. In total, 1110 articles were initially identified, but eventually, 20 papers were selected comprising customer-level questionnaires, systematic reviews, and expert opinions/surveys. Different criteria were used for study assessment according to the type of study. So far, only a very limited number of studies have focused on the effectiveness of different health and safety measures in hotel restaurants. Even though the studies focusing on AI, robotics, and further technological means for enhancing customer satisfaction and the overall level of cleanliness are quite limited, the constant investment of hotels and restaurants in new technologies appears to be a one-way road. Full article

Background: Long-term care facilities (LTCFs) remain highly vulnerable to COVID-19. Despite reduced virulence, Omicron’s high transmissibility poses ongoing risks. The effect of infection under strict control measures and early antiviral treatment remains unclear. Methods: We conducted a retrospective cohort study in a 450-bed LTCF, which implemented rigorous infection control and early antiviral use, evaluating survival outcomes during repeated Omicron outbreaks from January 2022 to December 2023 using Cox regression with time-dependent covariates, adjusted for age, sex, comorbidities, and vaccination status. Mortality trends were also compared across three periods: pre-COVID-19 (2018–2019), COVID-19 present in Japan but absent in our facility (2020–2021), and the Omicron outbreak period (2022–2023). Results: Among 623 residents, 253 were infected. Mortality was lower in the infected group than in the uninfected group (16% vs. 26%), and infection was not significantly associated with increased mortality (HR = 1.36; 95% CI: 0.91–2.04; p = 0.14). Although stratified analysis showed higher mortality among infected females, overall mortality during the outbreak period was unexpectedly lower than in prior periods. Conclusions: In LTCFs with rigorous infection control and early antiviral use, Omicron infection did not raise mortality. Enhanced protocols may have improved survival, even among uninfected residents. Full article

Background/Objectives: Older adults are particularly susceptible to undernutrition and conditions that can aggravate it, such as frailty and conditions associated with swallowing difficulties or dysphagia. To address these challenges, it is important to consider the perspectives of older adults and their caregivers, especially those with conditions such as frailty or cognitive impairment, as they can provide valuable insights on supporting nutrition in these vulnerable populations. This participatory approach requires structures formed by scientific research committees working together with other stakeholders, involving various actors at all stages of the research process. The aim of this study is to analyze the methodology for involving patients aged 65 and older with malnutrition or at risk of malnutrition as co-investigators in research. Methods: This protocol has been developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-P) checklist. A literature search will be carried out in the following electronic databases: PubMed/MEDLINE, EMBASE and CINAHL. Through the COVIDENCE program, the research team will independently review the different screening phases of the identified studies for possible inclusion or exclusion. Expected Results: This systematic review will provide up-to-date evidence on the use of non-scientific actors at different stages of research. The main limitation stems from the use of non-scientific agents in a topic as specific as adults with or at risk of undernutrition, which may make it difficult to extrapolate the results to other settings. The registration number in PROSPERO is CRD42024444374. Full article

The COVID-19 pandemic has significantly increased the incidence of post-infection cardiovascular events, particularly myocardial infarction, in individuals over 40. While the underlying mechanisms remain elusive, this study employs a hybrid machine learning approach to analyze epidemiological data in assessing 13 key heart attack risk factors and their susceptibility. Based on a unique dataset that combines demographic, biochemical, ECG, and thallium stress tests, this study aims to design, develop, and deploy a clinical decision support system. Assimilating outcomes from five clustering techniques applied to the ‘Kaggle heart attack risk’ dataset, the study categorizes distinct subpopulations against varying risk profiles and then divides the population into ‘at-risk’ (AR) and ‘not-at-risk’ (NAR) groups using clustering algorithms. The GMM algorithm outperforms its competitors (with clustering accuracy and Silhouette coefficient scores of 84.24% and 0.2623, respectively). Subsequent analyses, employing Pearson correlation and linear regression as descriptors, reveal a strong association between the likelihood of experiencing a heart attack and the 13 risk factors studied, and these are statistically significant (p < 0.05). Our findings provide valuable insights into the development of targeted risk stratification and preventive strategies for high-risk individuals based on heart attack risk scores. The aggravated risk for postmenopausal patients indicates compromised individual risk factors due to estrogen depletion that may be further compromised by extraneous stress impacts, like anxiety and fear, aspects that have traditionally eluded data modeling predictions. The model can be repurposed to analyze the impact of COVID-19 on vulnerable populations. Full article

Several Ephedra Herb-containing Kampo medicines are common initial treatments for various infections; however, the ephedrine alkaloids in Ephedra Herb can cause side effects by stimulating adrenergic receptors. Accordingly, an ephedrine alkaloids-free Ephedra Herb Extract (EFE) has been developed. This study aimed to evaluate whether EFE can be used effectively and safely in patients with mild coronavirus disease 2019 (COVID-19). We randomized patients with mild COVID-19 to receive EFE equivalent to 6 g of Ephedra Herb per day or a placebo for 14 days. The primary efficacy endpoint was the non-aggravation rate up to Day 15. We allocated 41 and 40 patients to the EFE and placebo groups, respectively. All participants were included in the mITT and safety analysis populations [male ratio, mean age: 31.7%, 42.0 years (EFE); 17.5%, 43.2 years (placebo)]. The non-aggravation rate up to Day 15 for the primary endpoint was 100.0% and 94.6% in the EFE and placebo group, respectively, with no between-group difference. The number of days to the improvement in nausea symptoms was significantly shorter in the EFE group. One patient in the placebo group discontinued the trial due to a side effect. Although EFE demonstrated safety in patients with mild COVID-19, it did not show superior efficacy compared to placebo for symptoms other than nausea. Full article

This paper explores the impact of technology and wellness in the context of students entering post-secondary education. It aims to provide insights into the use of technology and how it affects students’ wellness. The transition from high school into post-secondary education has often been a complex phase in students’ lives, and such complexity may be especially significant for virtual high school graduates, in other words, students who finished their high school education mostly virtually due to school closures during the COVID-19 pandemic. Students starting post-secondary education are usually between 17–19 years old, an age period at which these students are more developmentally vulnerable to the effects of rapid physiological, financial, and social changes. Despite some positive aspects of technology usage in education, challenges remain. Students navigate potential academic losses due to ineffective virtual schooling experiences during school lockdowns. This may aggravate students’ adaptation to higher-education culture and norms and academic expectations, especially formal writing standards often required in university papers. Other challenges may include the over-reliance on technology for academic, social, and personal tasks, accentuating students’ difficulties with wellness and requiring a rethinking of learning practices to eloquently respond to students’ needs in the context of the legacy of the coronavirus pandemic. This paper seeks to contribute to the conversation on how post-secondary institutions respond to the need to balance technology and wellness in the context of education. Ultimately, this paper explores perspectives on potential higher institutions’ responses to the impact of technology on students’ mental health and learning as well as implementing wellness practices while integrating technology into education. Full article

Background: The work main purposes were to identify the sources of problems and demands causing parental burnout and to specify the resources/support factors during the COVID-19 pandemic. The study was based on the Balance Theory of Risk and Support/Resource Factors (BR² Model) by Mikolajczak and Roskam. Methods: The study explored the predictive value of socio-economic variables, religiosity, the meaning of life, positivity, perceived social support, family functionality, and balance between risks and resources in parental burnout using the structural equation modelling method on a sample of 337 parents. Results: The presence of children’s learning difficulties and behavioural problems are the most important risk factors and aggravate parental burnout, and the presence of a meaning of life, support coming from the family, family affection, and relationship lengths are the main protective resources, allowing parental burnout to decrease during the pandemic crisis. Conclusions: The findings are instructive for both theory and practice. The study successfully operationalised the BR² model—the model obtained from the path analysis fits well, confirms the structure of parental burnout theory, and demonstrates the appropriateness of the application of BR² theory in crisis conditions. The most effective way to help parents in a crisis situation is (in addition to psychological support) the effective provision of specialist help for children, resulting in a reduced risk of an unfavourable balance between demands and family resources. The family- or parent-oriented interventions that address professional help in problems with children can be the most effective at reducing the negative consequences of a pandemic on children and their parents. The COVID-19 pandemic has shown the importance of investing in healthcare infrastructures. Full article

COVID-19, caused by the SARS-CoV-2 coronavirus, has significantly impacted global health, particularly among patients with obesity. This study evaluates the prevalence and effects of overweight and obesity on the clinical profiles and complications of COVID-19 patients admitted to a hospital in Northern Mato Grosso. We conducted a retrospective cohort study analyzing medical records of COVID-19 patients hospitalized from March 2020 to March 2021. Patients were classified into normal body weight, overweight, and obesity groups. Data were statistically analyzed using Kruskal–Wallis’s test and Dunn’s post-test (continuous variables) or by the chi-square test (χ²) (categorical variables). Among 145 ward records, 24.1% were normal body weight, 46.2% were overweight, and 29.7% were obese. In the intensive care unit, data from 243 patients indicated that 17.3% were normal body weight, 37.9% were overweight, and 44.9% were obese, highlighting a concerning prevalence of overweight/obesity. Chest computed tomography revealed that moderate pulmonary involvement (25–50%) was most frequent in the overweight group, while severe involvement (>50%) was predominant in the obesity group. The obesity group experienced more complications, including increased use of mechanical ventilation. Notably, in both settings, mortality rates were higher among patients with overweight and obesity. This study concludes that overweight and obesity significantly worsen COVID-19 outcomes. Full article

Background and Objectives: Although reversible cerebral vasoconstriction syndrome (RCVS) is a rare disease, the condition may occur with COVID-19 infection. We aimed to investigate the clinical characteristics of RCVS through a systematic review of case reports and case series that reported on COVID-19-related RCVS. Methods: A literature search was performed in PubMed (MEDLINE), SCOPUS, and Web of Science. The search was confined to articles published between 17 November 2019 and 14 August 2024. The search terms were (“COVID-19” OR “SARS CoV-2”) AND (“RCVS” OR “Reversible cerebral vasoconstriction syndrome”). The search protocol was registered in PROSPERO (CRD42024491818). A total of twenty-four cases were included, nine case series consisting of nineteen cases and five cases from our hospital. Clinical characteristics were investigated, including risk factors, symptoms, brain and angiographic findings, treatment options, and prognoses. Results: The average age was 37.1 years, and females comprised 70.8% of the cohort. COVID-19 vaccination was administered in five cases. Vasoconstriction was most frequently noted in middle cerebral arteries (90.9%). Among the included patients, 12 (50.0%) experienced strokes as a complication of RCVS, and the mortality rate was 9.1%. Follow-up imaging findings were available for 14 of the 24 cases (58.3%). Among these, vasoconstriction was fully improved in 64.3%, partially improved in 28.6%, and aggravated in 7.1%. Conclusions: While the recovery rate of vasoconstriction on brain angiographic findings was not uncommon, our systematic review indicates a potential for a relatively poor neurological prognosis in COVID-19-related RCVS. Full article

Acute cardiovascular disorders are incriminated in up to 33% of maternal deaths, and the presence of sickle cell anemia (SCA) aggravates the risk of peripartum complications. Herein, we present a 24-year-old Caribbean woman with known SCA who developed a vaso-occlusive crisis at 36 weeks of gestation that required emergency Cesarean section. In the early postpartum period, she experienced fever with rapid onset of acute respiratory distress in the context of COVID-19 infection that required tracheal intubation and mechanical ventilatory support with broad-spectrum antibiotics and blood exchange transfusion. Shortly thereafter, transthoracic echocardiography documented severe biventricular dysfunction associated with raising levels of cardiac troponin and ECG signs of myocardial ischemia. Medical treatment with incremental dobutamine and noradrenaline infusion failed to improve cardiac output and blood gas exchange. After consultation with the regional cardiac center, a prompt decision was made to provide cardiac and respiratory support via implantation of femoral cannula and initiation of veno-arterial extracorporeal membrane oxygenation (ECMO, Cardiohelp^®). Under stable ECMO, the patient was transferred by helicopter to a specialized cardiac center. There were no signs of ongoing hemolysis, and progressive recovery of the right and left ventricular function facilitated forward blood flow through the aortic valve. Three days after implantation, ECMO was weaned, and the cannula were removed. One day later, the patient’s chest X-rays showed partial resolution of lung edema. The patient was successfully extubated, and non-invasive ventilation with pulmonary rehabilitation was initiated to speed up her functional recovery. Full article

Introduction: The COVID-19 pandemic had a negative impact on mental health in the general population. The fear, stress, and uncertainty surrounding that traumatic period could have contributed to the aggravation or possible new onset of obsessive–compulsive symptoms. Methods: The COvid Mental hEalth Trial (COMET) is a nationwide project organized by the University of Campania “Luigi Vanvitelli”, designed as an observational investigation that aimed to gather data from a representative sample of the Italian general population. The current study is a report from the main project and it focuses on obsessive–compulsive (OC) symptoms. Results: A total sample of N = 20,720 took part in the survey. N = 2332 individuals had a total Obsessive–Compulsive Inventory—Revised (OCI-R) score greater than or equal to 21 (11.3% of the entire sample), indicating the presence of clinically relevant obsessive–compulsive symptoms. By excluding patients with a history of previous mental illnesses, we still obtained a high number of individuals with an OCI-R score greater than or equal to 21 (N = 2024), representing 10.3% of the overall sample, possibly indicating a new incidence of OC symptoms during the pandemic. Discussion: Our study highlights a substantial new incidence of obsessive–compulsive symptoms in the general public. Risk factors or red flags such as being male, being of working age, living in a highly stressful environment such as one of the Italian regions most affected and severely hit by the pandemic, having higher levels of loneliness, and using substances to cope with stress, should be paid particular attention in order to prevent the development of OC symptoms during a critical and traumatic event such as the COVID-19 pandemic. Full article

Background: Diabetes and hypertension are major global health challenges aggravated by COVID-19’s impact on healthcare and lifestyle factors. This study aims to compare the prevalence and associated socio-demographic factors of these conditions before and after the pandemic (2019 vs. 2022). Materials and Methods: We used data from Italy’s “Aspects of Daily Life” survey; 74,294 adults were included. Results: Results show a rise in diabetes prevalence from 7.76% in 2019 to 8.49% in 2022 (p < 0.05), while hypertension did not show this. Logistic regression analysis for the years 2019 and 2022 revealed a statistically significant association between the year 2022 and increased odds of diabetes (OR = 1.08, p = 0.008). BMI’s role as a risk factor intensified, with higher odds ratios (ORs) for both conditions in overweight and obese individuals in 2022. For example, obesity-related ORs for diabetes increased from 2.45 (95%CI 1.73–3.47) in 2019 to 3.02 (95%CI 2.09–4.35) in 2022, and for hypertension from 2.86 (95%CI 2.28–3.58) to 3.64 (95%CI 2.87–4.61). Lower education levels also showed a greater association with hypertension risk in 2022; subjects with only middle or high school diplomas had significantly higher ORs than individuals with higher education; there was a non-significant trend in 2019. However, diabetes risk associated with lower education remained stable and significant in both years. Conclusions: These findings suggest that the pandemic may have increased risk factors for diabetes and hypertension, particularly BMI and educational level, compared with the literature on the increased burden of chronic diseases during COVID-19. Full article

Natural disasters cause extensive infrastructure and significant economic losses, hindering sustainable development and impeding social and economic progress. More importantly, they jeopardize community well-being by causing injuries, damaging human health, and resulting in loss of life. Furthermore, communities often experience delayed disaster response. Aggravating the situation, the frequency and impact of disasters have been continuously increasing. Therefore, fast and effective disaster response management is paramount. To achieve this, disaster managers must proactively safeguard communities by developing quick and effective disaster management strategies. Disruptive technologies such as artificial intelligence (AI), machine learning (ML), and robotics and their applications in geospatial analysis, social media, and smartphone applications can significantly contribute to expediting disaster response, improving efficiency, and enhancing safety. However, despite their significant potential, limited research has examined how these technologies can be utilized for disaster response in low-income communities. The goal of this research is to explore which technologies can be effectively leveraged to improve disaster response, with a focus on low-income communities. To this end, this research conducted a comprehensive review of existing literature on disruptive technologies, using Covidence to simplify the systematic review process and NVivo 14 to synthesize findings. Full article