Search Results (2,558)

During the coronavirus 2019 pandemic, sports activities were restricted, raising concerns about their impact on the physical condition of adolescent athletes, which remained largely unquantified. This study was designed with two primary objectives: first, to precisely quantify and elucidate the differences in the physical condition of adolescent athletes before and after activity restrictions due to the pandemic; and second, to innovatively develop and validate a non-contact medical checkup application. Medical checks were conducted on 563 athletes designated for sports enhancement. Participants were junior high school students aged 13 to 15, and the sample consisted of 315 boys and 248 girls. Furthermore, we developed a smartphone application and compared self-checks using the application with in-person checks by orthopedic surgeons to determine the challenges associated with self-checks. Statistical tests were conducted to determine whether there were statistically significant differences in range of motion and flexibility parameters before and after the pandemic. Additionally, items with discrepancies between values self-entered by athletes using the smartphone application and values measured by specialists were detected, and application updates were performed. Student’s t-test was used for continuous variables, whereas the chi-square test was used for other variables. Following the coronavirus 2019 pandemic, athletes were stiffer than during the pre-pandemic period in terms of hip and shoulder joint rotation range of motion and heel–buttock distance. The dominant hip external rotation decreased from 53.8° to 46.8° (p = 0.0062); the non-dominant hip external rotation decreased from 53.5° to 48.0° (p = 0.0252); the dominant shoulder internal rotation decreased from 62.5° to 54.7° (p = 0.0042); external rotation decreased from 97.6° to 93.5° (p = 0.0282), and the heel–buttock distance increased from 4.0 cm to 10.4 cm (p < 0.0001). The heel–buttock distance and straight leg raising angle measurements differed between the self-check and face-to-face check. Although there are items that cannot be accurately evaluated by self-check, physical condition can be improved with less contact by first conducting a face-to-face evaluation under appropriate guidance and then conducting a self-check. These findings successfully address our primary objectives. Specifically, we demonstrated a significant decline in the physical condition of adolescent athletes following pandemic-related activity restrictions, thereby quantifying their impact. Furthermore, our developed non-contact medical checkup application proved to be a viable tool for monitoring physical condition with reduced contact, although careful consideration of measurable parameters is crucial. This study provides critical insights into the long-term effects of activity restrictions on young athletes and offers a practical solution for health monitoring during infectious disease outbreaks, highlighting the potential for hybrid checkup approaches. Full article

A multilayer linear response model (MLRM) is proposed to generate time-series data based on linear response theory. The proposed MLRM is designed to generate data for anomalous dynamics by extending the conventional single-layer linear response model (SLRM) into multiple layers. While the SLRM is a linear equation with respect to external forces, the MLRM introduces nonlinear interactions, enabling the generation of a wider range of dynamics. The MLRM is applicable to various fields, such as finance, as it does not rely on machine learning techniques and maintains interpretability. We investigated whether the MLRM could generate anomalous dynamics, such as those observed during the coronavirus disease 2019 (COVID-19) pandemic, using pre-pandemic data. Furthermore, an analysis of the log returns and realized volatility derived from the MLRM-generated data demonstrated that both exhibited heavy-tailed characteristics, consistent with empirical observations. These results indicate that the MLRM can effectively reproduce the extreme fluctuations and tail behavior seen during high-volatility periods. Full article

Background/Objectives: In late 2019, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) caused a pandemic called the ‘coronavirus disease 2019’ (COVID-19). After the acute SARS-CoV-2 infection, many individuals (up to 33%) complained of unexplained symptoms involving multiple organ systems and were diagnosed as having Long COVID-19 (LC-19). Currently, LC-19 is inadequately defined, requiring the formation of consistent diagnostic parameters to provide a foundation for ongoing and future studies of epidemiology, risk factors, clinical characteristics, and therapy. LC-19 represents a significant burden on multiple levels. The reduced ability of workers to return to work or compromised work efficiency has led to consequences at national, economic, and societal levels by increasing dependence on community services. On a personal scale, the isolation and helplessness caused by the disease and its subsequent impact on the patient’s mental health and quality of life are incalculable. Methods: In this paper, we used Walker and Avants’ eight-step approach to perform a concept analysis of the term “Long COVID-19” and define its impact across these parameters. Results: Using this methodology, we provide an improved definition of LC-19 by connecting the clinical symptomology with previously under-addressed factors, such as mental, psychological, economic, and social effects. This definition of LC-19 features can help improve diagnostic procedures and help plan relevant healthcare services. Conclusions: LC-19 represents a complex and pressing public health challenge with diverse symptomology, an unpredictable timeline, and complex pathophysiology. This concept analysis serves as a tool for improving LC-19 definition, but it remains a dynamic disease with evolving diagnostic and therapeutic approaches, requiring deeper investigation and understanding of its long-term effects. Full article

Long-term source apportionment of PM_2.5 during high-pollution periods is essential for achieving sustained reductions in both PM_2.5 levels and their health impacts. This study conducted PM_2.5 sampling in Shenzhen from January to March over the years 2021–2024 to investigate the long-term impact of coronavirus disease 2019 and the short-term impact of the Spring Festival on PM_2.5 levels. The measured average PM_2.5 concentration during the research period was 22.5 μg/m³, with organic matter (OM) being the dominant component. Vehicle emissions, secondary sulfate, secondary nitrate, and secondary organic aerosol were identified by receptor model as the primary sources of PM_2.5 during the observational periods. The pandemic led to a decrease of between 30% and 50% in the contributions of most anthropogenic sources in 2022 compared to 2021, followed by a rebound. PM_2.5 levels in January–March 2024 dropped by 1.4 μg/m³ compared to 2021, mainly due to reduced vehicle emissions, secondary sulfate, fugitive dust, biomass burning, and industrial emissions, reflecting Shenzhen’s and nearby cities’ effective control measures. However, secondary nitrate and fireworks-related emissions rose significantly. During the Spring Festival, PM_2.5 concentrations were 23% lower than before the festival, but the contributions of fireworks burning exhibited a marked increase in both 2023 and 2024. Specifically, during intense peak events, fireworks burning triggered sharp, short-term spikes in characteristic metal concentrations, accounting for over 50% of PM_2.5 on those peak days. In the future, strict control over vehicle emissions and enhanced management of fireworks burning during special periods like the Spring Festival are necessary to reduce PM_2.5 concentration and improve air quality. Full article

Although it is more than a century since it was first marketed, acetaminophen remains one of the most popular analgesic agents. In addition, acetaminophen has recently been applied to multimodal analgesia in combination with non-steroidal anti-inflammatory drugs, and its consumption significantly increased during the pandemic of coronavirus disease 2019 as well as diclofenac and ibuprofen. However, the detailed mode of analgesic action of acetaminophen is still unclear. In the present study, we comprehensively discuss conventional, recognized, and postulated mechanisms of analgesic acetaminophen and highlight the current mechanistic concepts while comparing with diclofenac and ibuprofen. Acetaminophen inhibits cyclooxygenase with selectivity for cyclooxygenase-2, which is higher than that of ibuprofen but lower than that of diclofenac. In contrast to diclofenac and ibuprofen, however, anti-inflammatory effects of acetaminophen depend on the extracellular conditions of inflamed tissues. Since the discovery of cyclooxygenase-3 in the canine brain, acetaminophen had been hypothesized to inhibit such a cyclooxygenase-1 variant selectively. However, this hypothesis was abandoned because cyclooxygenase-3 was revealed not to be physiologically and clinically relevant to humans. Recent studies suggest that acetaminophen is deacetylated to 4-aminophenol in the liver and after crossing the blood–brain barrier, it is metabolically converted into N-(4-hydroxyphenyl)arachidonoylamide. This metabolite exhibits bioactivities by targeting transient receptor potential vanilloid 1 channel, cannabinoid receptor 1, Cav3.2 calcium channel, anandamide, and cyclooxygenase, mediating acetaminophen analgesia. These targets may be partly associated with diclofenac and ibuprofen. The perspective of acetaminophen as a prodrug will be crucial for a future strategy to develop analgesics with higher tolerability and activity. Full article

The coronavirus disease 2019 (COVID-19) pandemic has led to substantial health and financial burdens worldwide, and vaccines provide hope for reducing the burden of this pandemic. However, vaccinated people remain at risk for SARS-CoV-2 infection. Genome-wide association studies (GWASs) may identify potential genetic factors involved in the development of COVID-19 breakthrough infections (BIs); however, very few or no GWASs have been conducted for COVID-19 BI thus far. We conducted a GWAS and detailed bioinformatics analysis on COVID-19 BIs in a European population via the UK Biobank (UKBB). We conducted a series of analyses at different levels, including SNP-based, gene-based, pathway, and transcriptome-wide association analyses, to investigate genetic factors associated with COVID-19 BIs and hospitalized infections. The polygenic risk score (PRS) and Hoeffding’s test were performed to reveal the genetic relationships between BIs and other medical conditions. Two independent loci (LD-clumped at r² = 0.01) reached genome-wide significance (p < 5 × 10⁻⁸), including rs36170929, which mapped to LOC102725191/VWDE, and rs28645263, which mapped to RETREG1. A pathway enrichment analysis highlighted pathways such as viral myocarditis, Rho-selective guanine exchange factor AKAP13 signaling, and lipid metabolism. The PRS analyses revealed significant genetic overlap between COVID-19 BIs and heart failure and between HbA1c and type 1 diabetes. Genetic dependence was also observed between COVID-19 BIs and asthma, lung abnormalities, schizophrenia, and type 1 diabetes on the basis of Hoeffding’s test. This GWAS revealed two significant loci that may be associated with COVID-19 BIs and a number of genes and pathways that may be involved in BIs. Genetic overlap with other diseases was identified. Further studies are warranted to replicate these findings and elucidate the mechanisms involved. Full article

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the 2019 coronavirus disease pandemic. The virus primarily spreads through person-to-person contact via aerosols and droplets, contributing to high case numbers and related morbidities. SARS-CoV-2 targets the respiratory tract, causing acute respiratory distress syndrome, particularly in immunocompromised individuals such as those with cystic fibrosis (CF). CF is a life-threatening genetic disorder caused by mutations in the CF transmembrane conductance regulator (CFTR) gene, leading to impaired respiratory function and recurrent severe respiratory symptoms. Despite their potential vulnerability, CF patients have shown a lower incidence of severe COVID-19, suggesting protective factors against SARS-CoV-2. Differential expression of the ACE2 receptor, crucial for viral entry, and other host factors, such as TMPRSS2, may play a role in this resistance to SARS-CoV-2. Analyzing the genomics and transcriptomics profiles of CF patients could provide insights into potential resistance mechanisms. The potential resistance mechanisms include blood and extracellular ATP levels, a deleted/dysfunctional CFTR gene, ACE and ACE2 regulation and expression, ACE and ACE2 polymorphism effects, host proteins and SARS-CoV-2 interactions, and SMN1 and ACE/ACE2 interactions. This review discusses the underlying factors and potential resistance mechanisms contributing to CF patients’ responses to SARS-CoV-2 infection. The review provides an opportunity to further investigate future therapy and research through understanding the underlying potential resistance mechanisms exhibited by CF patients against SARS-CoV-2, including ACE and ACE2 polymorphisms. Full article

On 11 March 2020, the World Health Organisation (WHO) declared a global pandemic caused by the SARS-CoV-2 coronavirus that earlier in February 2020 the WHO had named COVID-19 (coronavirus disease 2019). There were neither drugs nor vaccines that were known to be effective against the virus, stimulating an urgent worldwide search for treatments. An evaluation of existing drugs by ‘repurposing’ was initiated followed by a transition to de novo drug discovery. Repurposing of an already approved drug may accelerate the introduction of that drug into clinical use by circumventing early, including preclinical studies otherwise essential for a de novo drug and reducing development costs. Early in the pandemic three drugs were identified as repurposing candidates for the treatment of COVID-19: (i) hydroxychloroquine, an anti-malarial also used to treat rheumatoid arthritis and lupus; (ii) ivermectin, an antiparasitic approved for both human and veterinary use; (iii) remdesivir, an anti-viral originally developed to treat hepatitis C. The scientific evidence, both for and against the efficacy of these three drugs as treatments for COVID-19, vied with public demand and politicization as unqualified opinions clashed with evidence-based medicine. To quote Hippocrates, “There are in fact two things, science and opinion; the former begets knowledge, the latter ignorance”. Full article

Objectives: This study aimed to describe the profile and identify the clinical and sociodemographic factors associated with emergency department (ED) use among patients aged ≥65 years. Methods: This was a retrospective cross-sectional study of patients aged ≥65 years who were seen in the emergency department of the Hospital de Mérida (Spain) in 2019, the year before the Coronavirus Disease 2019 (COVID-19) pandemic. Descriptive statistics were calculated for dependent variables such as hours of ED stay, total number of visits, reasons for discharge, and diagnostic specialty, disaggregated by gender, season, age group, day type (work or holiday), shift, and population area (rural or urban). Results: Significant differences in ED hours were found according to gender (p < 0.001), season (p = 0.024), age group (p < 0.001), attention shift (p < 0.001), and population area (p = 0.003). Discharge to home was the most common destination (63.5%), followed by hospital admission (25.7%). Admissions for gastrointestinal surgery and neurology were predominant in men, and admissions for internal medicine and trauma were predominant in women. Patients aged 65–79 years were admitted to internal medicine, and those over 80 years were admitted to cardiology. Among patients who presented to the hospital’s emergency department and required admission, 51.5% were men aged ≥ 75 years, rising to 53.3% among those aged 65 to 74 years. The clinical areas were related to cardiology (27.67%) and pneumology (20.63%). Conclusions: Demands for ED care in those over 65 years of age are associated with sociodemographic and clinical characteristics, which can be used to better plan and manage resources and improve user satisfaction. Full article

Background: Psychological impacts of the coronavirus disease 2019 (COVID-19) pandemic on individuals with chronic medical conditions remain understudied. Chronic kidney disease (CKD) is one of the chronic conditions associated with an increased risk of severe COVID-19 outcomes. The aim of this study was to define the psychological burden of individuals with CKD during the COVID-19 pandemic. Methods: In this cross-sectional study, 219 individuals with CKD were recruited from the Nephrology Outpatient Unit at the University Hospital Essen, Germany, and completed anonymous surveys incorporating validated psychological assessment tools for generalized anxiety (GAD-7) and depressive symptoms (PHQ-2), along with self-generated items addressing COVID-19-specific concerns and behavioral changes. These participants were propensity score matched with controls from the general German population. Results: Individuals with CKD exhibited lower levels of generalized anxiety and depressive symptoms compared to the general population. However, they reported significantly greater risk perceptions regarding the likelihood of experiencing symptoms, a severe disease course, and death from COVID-19. COVID-19-related fear and associated behavioral changes were more frequently reported among CKD patients. Adherent and dysfunctional safety behaviors predominated among the CKD cohort. Conclusions: This study underscores psychological challenges faced by individuals with CKD during the COVID-19 pandemic. The increased risk perceptions and fears of severe disease and mortality from COVID-19 emphasize the need for mental health interventions aimed at improving coping strategies alongside physical health management in this vulnerable population. Full article

Background and Objectives: The coronavirus disease 2019 (COVID-19) pandemic significantly impacted healthcare systems worldwide. As a result, remote areas such as the Penghu Islands have encountered unique challenges related to pediatric care. This study examined the effects of the pandemic on the emergency air medical transport (EAMT) of pediatric patients from the Penghu Islands to Taiwan. Materials and Methods: This retrospective study analyzed 40 pediatric patients who received EAMT from the Penghu Islands to Taiwan between January 2017 and December 2022. This study compared patients before and during the COVID-19 pandemic and focused on patient demographics, reasons for EAMT, and clinical outcomes. Due to the small sample size, non-parametric statistical methods were applied, including the Mann–Whitney U-test for continuous variables and Fisher’s exact test for categorical variables. Results: Among the 40 pediatric patients analyzed, the median age decreased from 3 years (IQR, 0–5 years) before the pandemic to 1 year (IQR, 0–5 years) during the pandemic. While the overall increase in hospital length of stay during the pandemic was not statistically significant, a significant prolongation was observed in preschool-aged children and neonates without trauma (20 days vs. 9 days; p < 0.05). The lack of specialist physicians became an increasingly prominent factor for EAMT during the pandemic (p = 0.056). The most common medical reasons for EAMT were critical illness (35%), neonatal diseases (30%), and neurological conditions (27.5%), with similar distributions across both time periods. Conclusions: The COVID-19 pandemic heightened existing healthcare disparities in the Penghu Islands, particularly by increasing reliance on EAMT due to a shortage of pediatric specialists. Hospital stays for preschool children and neonates significantly increased during the pandemic, suggesting delayed or prolonged care. These findings underscore the need to strengthen local pediatric infrastructure, decentralize specialist services, and improve emergency preparedness to better support vulnerable populations in remote areas during future public health emergencies. Full article

Background/Objectives: The outbreak of coronavirus disease 2019 (COVID-19) has restricted access to healthcare, increasing the risk of poor disease control among patients with COPD (Chronic Obstructive Pulmonary Disease). This study aimed to compare adherence to inhalers in patients with COPD before and during the COVID-19 lockdown and determine the characteristics of patients who were adherent to inhaler medications. Method: A retrospective analysis was conducted on a cohort of patients with severe COPD aged 40 or older using South Korea’s National Health Insurance Service (NHIS) database, which documents all healthcare utilization covered for insured individuals. Medication adherence, measured by the proportion of days covered (PDC), was compared before and during the COVID-19 lockdown using a paired t-test. A multivariable logistic regression model was conducted to identify the characteristics of the adherent patients (socio-demographic, including age, sex, income level, insurance type, and residential area), health-conditions (disease severity, underlying diseases, and disability), and pharmacotherapy characteristics (prescriber practice setting, polypharmacy, medication treatment duration, and inhaler type). Result: A total of 15,971 COPD patients were identified (79.2% men). During the COVID-19 lockdown in 2020, there was a significant decrease in medication adherence to COPD inhalers compared to 2019 (49.8% in 2020 vs. 56.3% in 2019, respectively; p < 0.001). Moreover, the proportion of those adherent (≥80%) during the COVID-19 lockdown decreased (22.0% → 18.0%). Patients who remained adherent to inhaler therapy during the COVID-19 lockdown were typically aged in their 60s, beneficiaries of Medical Aid, residents of rural areas, clinic users, and patients without cardiovascular disease. Conclusions: Patients with COPD encountered significant challenges in accessing inhalers during the COVID-19 lockdown. Healthcare authorities should develop targeted strategies to ensure continued medication access for patients at increased risk of poor medication adherence, particularly during periods of restricted healthcare access, such as public health emergencies or pandemic lockdowns. Full article

Background: Dental professionals were thought to have the most significant risk of coronavirus infection during the pandemic. Since the first Coronavirus Disease 2019 (COVID-19) patient was detected in Japan in January 2020, Japan has faced several waves of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections. However, no cluster of SARS-CoV-2 infections associated with dental procedures has been reported in Japan. In this study, we aimed to investigate the actual status of SARS-CoV-2 infection during the pandemic through antibody testing for dental professionals. We further investigated saliva and oral management-related aerosol to estimate the risk of virus transmission during dental procedures. Methods: SARS-CoV-2 antibody titer in the blood of dental professionals and their families was determined during the pre-vaccinated period of the SARS-CoV-2 wave to see the history of infection in Japan. Viral loads in saliva and in the aerosol generated during the oral management of COVID-19 patients were detected by RT-qPCR. Results: The antibody testing of dental healthcare providers during the early phases of the pandemic in Japan revealed low antibody positivity, which supported the low incidence of infection clusters among dental clinics. The aerosol generated during dental procedures may contain trace levels of SARS-CoV-2, indicating the risk of transmission through dental procedures is limited. Therefore, SARS-CoV-2 did not spread through dental clinics. Conclusions: Very few SARS-CoV-2 infections were observed in dental professionals who took appropriate infection control measures in the early period of the pandemic. Performing dental procedures using standard precautions seems to be sufficient to prevent SARS-CoV-2 infections. Full article

Coronavirus disease 2019 (COVID-19) resulted in significant morbidity and mortality globally. Despite the efficacy of COVID-19 vaccines in reducing morbidity and mortality, uptake in South Africa was sub-optimal due to a number of factors which remain not fully understood, particularly in mandatory vaccination workplace settings. This quantitative, cross-sectional study aimed to understand determinants of COVID-19 vaccination uptake among clinical and non-clinical workers, aged 18 years and older, employed at a large organisation with a mandatory workplace COVID-19 vaccination policy in South Africa. Workers completed a one-off, self-administered, online questionnaire that explored determinants of COVID-19 vaccination, barriers and enablers to accessing vaccines, and perspectives regarding the mandatory workplace vaccine policy. Among the 88 workers enrolled in the study, the frequent reasons for COVID-19 vaccination included preventing the spread of COVID-19 (71%, n = 62), fear of contracting COVID-19 (64%, n = 56), protecting colleagues and patients (63%, n = 55), and the mandatory workplace policy (65%, n = 57). Just under two-thirds of workers (63%, n = 55) were supportive/very supportive of the mandatory COVID-19 vaccine policy. Reasons for support included the fact that vaccination would create a safer work environment, protecting oneself/others from acquiring COVID-19, and receiving support from their employer. Only 15% (n = 13) of workers were not supportive/against the policy. The findings of this study could inform occupational health policy and counselling and support in workplaces in future pandemics. Full article

Objectives: This study comparatively evaluated changes in the food habits and dietary patterns of adults aged ≥65 years before and during the coronavirus disease 2019 (COVID-19) pandemic using a retrospective study. Methods: Data covering the 2018–2021 period were derived from the Korea National Health and Nutrition Examination Survey. Results: Comparing the 2943 individuals in the “Before-COVID-19” individuals with the 2916 people in the “During COVID-19” group, the frequency of drinking four or more times a week decreased among the older adults during the pan-demic, as did the frequency of eating three meals a day and eating-out at least once a week. On the other hand, food security improved during the pandemic compared with before the pandemic. During the pandemic, the intake of cereals and grains decreased, while that of potatoes and starches, legumes, vegetables, eggs, milk and dairy products, and oils and fats increased. Although energy and carbohydrate intake decreased, protein, fiber, calcium, phosphorus, magnesium, potassium, zinc, riboflavin, vitamin E, vitamin C, folic acid, and fat intake increased. However, the intake of vitamin A, vitamin C, and calcium remained lower than the estimated adequate requirement of the Dietary Reference Intakes for Koreans. Additionally, the rate of nutritional insufficiency “During COVID-19” (20.76%) was 1.31–1.42 times higher than that “Before COVID-19” (16.45%). Even in models that adjusted for other factors, the rate of nutritional insufficiency was higher during the pandemic than before. Conclusions: Based on these findings, measures such as dietary education programs and guidelines for proper nutrient intake should be formulated to prevent imbalances in nutrient intake among older Koreans. Full article