Impact of COVID-19 on the social, economic, environmental and energy domains: Lessons learnt from a global pandemic

Chaos theory in the understanding of COVID-19 pandemic dynamics

The chaos theory, a field of study in mathematics and physics, offers a unique lens through which to understand the dynamics of the COVID-19 pandemic. This theory, which deals with complex systems whose behavior is highly sensitive to initial conditions, can provide insights into the unpredictable and seemingly random nature of the pandemic's spread. In this review, we will discuss some literature data with the aim of showing how chaos theory could provide valuable perspectives in understanding the complex and dynamic nature of the COVID-19 pandemic. In particular, we will emphasize how the chaos theory can help in dissecting the unpredictable, non- linear progression of the disease, the importance of initial conditions, and the complex interactions between various factors influencing its spread. These insights are crucial for developing effective strategies to manage and mitigate the impact of the pandemic.

A complex fuzzy decision model for analysing the post-pandemic immuno-sustainability

The post-effects of the COronaVIrus Disease (COVID-19) vary depending on socioeconomic and biological factors. Similarly, the effects of vaccination on people's immunity vary across several factors. After the pandemic, real-life post-vaccination anomalies significantly impact women's health, access to medical treatments and medications, mental well-being, and daily physical activities. However, there has been scant investigation into the physical, psychological, social, and economic ramifications of vaccine effects on women in the post-pandemic era. Therefore, conducting a comprehensive risk assessment is crucial to safeguard women from the post-vaccination effects.To address this issue, the research encompasses complex bipolar spherical fuzzy ℵ-soft set, which has two-sided periodic ambiguous data due to its parametric properties as an adaptable ℵ-soft set and distinguishing criteria as a complex bipolar spherical fuzzy set. In addition, some fundamental operations and properties are presented in a complex bipolar spherical fuzzy ℵ-soft environment. Furthermore, the robust assessment of a real-world application demonstrate the efficacy of the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) approach to optimise the decision result. Finally, the provided decision-making approach is compared with existing techniques to illustrate their remarkable credibility and integrity.

Recent Advances in Lateral Flow Assays for Viral Protein Detection with Nanomaterial-Based Optical Sensors

Controlling the progression of contagious diseases is crucial for public health management, emphasizing the importance of early viral infection diagnosis. In response, lateral flow assays (LFAs) have been successfully utilized in point-of-care (POC) testing, emerging as a viable alternative to more traditional diagnostic methods. Recent advancements in virus detection have primarily leveraged methods such as reverse transcription-polymerase chain reaction (RT-PCR), reverse transcription-loop-mediated isothermal amplification (RT-LAMP), and the enzyme-linked immunosorbent assay (ELISA). Despite their proven effectiveness, these conventional techniques are often expensive, require specialized expertise, and consume a significant amount of time. In contrast, LFAs utilize nanomaterial-based optical sensing technologies, including colorimetric, fluorescence, and surface-enhanced Raman scattering (SERS), offering quick, straightforward analyses with minimal training and infrastructure requirements for detecting viral proteins in biological samples. This review describes the composition and mechanism of and recent advancements in LFAs for viral protein detection, categorizing them into colorimetric, fluorescent, and SERS-based techniques. Despite significant progress, developing a simple, stable, highly sensitive, and selective LFA system remains a formidable challenge. Nevertheless, an advanced LFA system promises not only to enhance clinical diagnostics but also to extend its utility to environmental monitoring and beyond, demonstrating its potential to revolutionize both healthcare and environmental safety.

Higher Levels of SARS-CoV-2 Genetic Variation in Immunocompromised Patients: A Retrospective Case-Control Study

BACKGROUND

A severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection lasts longer in immunocompromised hosts than in immunocompetent patients. Prolonged infection is associated with a higher probability of selection for novel SARS-CoV-2 mutations, particularly in the spike protein, a critical target for vaccines and therapeutics.

METHODS

From December 2020 to September 2022, respiratory samples from 444 immunocompromised patients and 234 health care workers positive for SARS-CoV-2, diagnosed at 2 hospitals in Paris, France, were analyzed using whole-genome sequencing using Nanopore technology. Custom scripts were developed to assess the SARS-CoV-2 genetic diversity between the 2 groups and within the host.

RESULTS

Most infections were SARS-CoV-2 Delta or Omicron lineages. Viral genetic diversity was significantly higher in infections of immunocompromised patients than those of controls. Minor mutations were identified in viruses sequenced from immunocompromised individuals, which became signature mutations for newer SARS-CoV-2 variants as the epidemic progressed. Two patients were coinfected with Delta and Omicron variants. The follow-up of immunocompromised patients revealed that the SARS-CoV-2 genome evolution differed in the upper and lower respiratory tracts.

CONCLUSIONS

This study found that SARS-CoV-2 infection in immunocompromised patients is associated with higher genetic diversity, which could lead to the emergence of new SARS-CoV-2 variants with possible immune evasion or different virulence characteristics.

Important Barriers to COVID-19 Vaccination Among African Americans in Black Belt Region

BACKGROUND

To identify important barriers to COVID-19 vaccination among African Americans living in the Black Belt region.

METHODS

A cross-sectional, web-based questionnaire survey was conducted using best-worst scaling case 1 (the object case). Thirty-two potential barriers to COVID-19 vaccination were identified from the literature and confirmed by an expert. A nested balanced incomplete block design was used to generate 62 sets of 16 choice tasks. Each choice task included six barriers. Participants were asked to choose the most and least important barriers to their COVID-19 vaccination in each choice task of one set. The natural logarithm of the square root of best counts divided by the worst counts of each barrier was calculated to rank the importance of barriers.

RESULTS

Responses from a total of 808 participants were included. Among 32 barriers to COVID-19 vaccination, the five most important barriers were "safety concern of COVID-19 vaccines," "rapid mutation of COVID-19," "ingredients of COVID-19 vaccines," "Emergency Use Authorization (Fast-track approval) of COVID-19 vaccines," and "inconsistent information of COVID-19 vaccines." On the other hand, the five least important barriers were "religious reasons," "lack of time to get COVID-19 vaccine," "no support from my family and friends," "political reasons," and "fear of the needle."

CONCLUSIONS

Important barriers to the COVID-19 vaccination for African Americans living in the Black Belt region centered around the issues that could be resolved by communication strategies.

Effects of atmospheric particulate pollution on lung function of athletes

There is a knowledge gap on how ground-level particulate pollution affects labor productivity in emerging nations due to a lack of study, especially when it comes to outdoor work settings like couriers in the express delivery industry. Combining findings from two research projects, this paper examines the socioeconomic consequences of particulate matter and ground-level particulate pollution. Special panel dataset from China's express delivery companies are used, we study how particulate pollution affects courier productivity. The instrumental variable of our analysis was built by particulate pollution data from upwind towns. Moreover, a comparable rise in particulate levels during the 30 days caused a significant 23.7% decline in worker productivity. This draws attention to a neglected area of the economic effects of particulate pollution, especially in underdeveloped countries. Our results also highlight the wider health hazards connected to outdoor activities in high-pollution locations, drawing comparisons on outdoor exercisers and particulate matter concentrations. The critical need for coordinated policy attention addressing both ground-level Particulate and particle matters in developing nations is highlighted by the increased risk of lung function impairment among outdoor exercisers owing to excessive particulate matter concentrations. The interrelated risks that air pollution poses to public health and economic productivity are clarified by this Comprehensive viewpoint.

Daily routine disruptions and psychiatric symptoms amid COVID-19: a systematic review and meta-analysis of data from 0.9 million individuals in 32 countries

BACKGROUND

There is currently a deficit of knowledge about how to define, quantify, and measure different aspects of daily routine disruptions amid large-scale disasters like COVID-19, and which psychiatric symptoms were more related to the disruptions. This study aims to conduct a systematic review and meta-analysis on the probable positive associations between daily routine disruptions and mental disorders amid the COVID-19 pandemic and factors that moderated the associations.

METHODS

PsycINFO, Web of Science, PubMed, and MEDLINE were systematically searched up to April 2023 (PROSPERO: CRD42023356846). Independent variables included regularity, change in frequency, and change in capability of different daily routines (i.e., physical activity, diet, sleep, social activities, leisure activities, work and studies, home activities, smoking, alcohol, combined multiple routines, unspecified generic routines). Dependent variables included symptoms and/or diagnoses of mental disorders (i.e., depression, anxiety, post-traumatic stress disorder, and general psychological distress).

RESULTS

Fifty-three eligible studies (51 independent samples, 910,503 respondents) were conducted in five continents. Daily routine disruptions were positively associated with depressive symptoms (r = 0.13, 95% CI = [0.06; 0.20], p < 0.001), anxiety symptoms (r = 0.12, 95% CI = [0.06; 0.17], p < 0.001), and general psychological distress (r = 0.09, 95% CI = [0.02; 0.16], p = 0.02). The routine-symptom associations were significant for physical activity, eating, sleep, and smoking (i.e., type), routines that were defined and assessed on regularity and change in capability (i.e., definition and assessment), and routines that were not internet-based. While the positive associations remained consistent across different sociodemographics, they were stronger in geo-temporal contexts with greater pandemic severity, lower governmental economic support, and when the routine-symptom link was examined prospectively.

CONCLUSIONS

This is one of the first meta-analytic evidence to show the positive association between daily routine disruptions and symptoms of mental disorders among large populations as COVID-19 dynamically unfolded across different geo-temporal contexts. Our findings highlight the priority of behavioral adjustment for enhancing population mental health in future large-scale disasters like COVID-19.

Systems biology approaches to identify driver genes and drug combinations for treating COVID-19

Corona virus 19 (Covid-19) has caused many problems in public health, economic, and even cultural and social fields since the beginning of the epidemic. However, in order to provide therapeutic solutions, many researches have been conducted and various omics data have been published. But there is still no early diagnosis method and comprehensive treatment solution. In this manuscript, by collecting important genes related to COVID-19 and using centrality and controllability analysis in PPI networks and signaling pathways related to the disease; hub and driver genes have been identified in the formation and progression of the disease. Next, by analyzing the expression data, the obtained genes have been evaluated. The results show that in addition to the significant difference in the expression of most of these genes, their expression correlation pattern is also different in the two groups of COVID-19 and control. Finally, based on the drug-gene interaction, drugs affecting the identified genes are presented in the form of a bipartite graph, which can be used as the potential drug combinations.

A qualitative study exploring community pharmacists' awareness, attitudes and perceptions about drive-thru community pharmacy service in Malaysia during COVID-19

Introduction

Drive-thru services are not given sufficient focus in the community pharmacy setting which was highlighted during COVID-19, particularly in Malaysia. This study aimed to explore the community pharmacists' perspectives regarding drive-thru community pharmacy service during COVID-19 in Malaysia.

Methods

In-depth online semi-structured individual interviews were conducted among 25 community pharmacists working in Malaysia. All interviews were conducted between March 2022 and May 2022 and were audio-recorded and transcribed verbatim, and then analysed by thematic analysis.

Results

Thematic analysis yielded seven major themes, 1-familiarity with drive-thru community pharmacy service during COVID-19, 2-willingness toward this service during COVID-19, 3-perceived benefits toward drive-thru community pharmacy service during COVID-19, 4-perceived disadvantages toward this service, 5-barriers toward drive-thru community pharmacy service, 6-factors affecting the preference toward this service, and 7-facilitators to drive-thru community pharmacy service. Enhancing social distancing and preventing the spread of COVID-19 were the major perceived benefits of this service during COVID-19 as reported by participants.

Conclusion

Overall, community pharmacists reported positive attitudes toward drive-thru community pharmacy service during COVID-19. However, concerns about poor communication between the pharmacist and the patient, limited counselling, and dispensing errors were acknowledged. These concerns would need to be addressed to improve the provision of drive-thru community pharmacy service.

The pandemic effect on GHG emission variation at the sub-national level and translation into policy opportunities

Greenhouse gas (GHG) emissions inventories are commonly compiled at country level to monitor national progress towards nationally or internationally agreed targets. While they can support national climate change mitigation strategies, accounting for the intra-national heterogeneity of a country can draw different conclusions directly linked to the socio-economic and environmental sub-national context. This means that more refined and accurate policies and mitigation strategies can be designed when supported by GHG inventories at sub-national scale. The differences between sub-national territorial emissive behavior can be revealed by subjecting different territories to the same stress factors. A complete GHG emissions inventory, based on the Intergovernmental Panel on Climate Change (IPCC) Guidelines, is compiled for three diverse administrative territories, in terms of scale, socio-economic contexts, and environmental conditions. By selecting three diverse sub-national contexts belonging to the same national territory - Italy - the analysis provides highly detailed information on the emissive status and behavior and delivers insights that national inventories fail to provide. The COVID-19 pandemic is considered as a stress factor; therefore, the reference years are 2019 and 2020 during which GHG emissions are detected. The study will test the capacity of sub-national GHG emission inventories, compiled by scaling the IPCC methodology to the sub-national level, to detect such differences through the lens of the pandemic. This allows obtaining detailed information and linking the pandemic effect to the GHG emissions of particular activities, which can inspire effective sub-national context-specific mitigation actions. Furthermore, we show that environmental and economic metrics are not as strictly coupled as they would appear at national level.

Headache-related clinical features in teleworkers and their association with coping strategies during the COVID-19 pandemic

Objectives

The objectives were (1) to describe and compare headache-related clinical features between teleworkers with migraine and those with tension-type headache (TTH) and (2) to determine the association between coping strategies and headache frequency, and intensity in the context of the COVID-19 pandemic.

Methods

This cross-sectional online survey was conducted with 284 teleworkers (127 with migraine and 157 with TTH). Sociodemographic data, information related to work factors, headache clinical features, coping strategies used during the COVID-19 pandemic, and headache-related clinical features were compared between headache profiles. Bivariate logistic regression analyses were used to determine the association between coping strategies and headache frequency, and intensity.

Results

Results showed that teleworkers with migraine had longer and more painful headache episodes than teleworkers with TTH (ps < 0.001). Higher migraine frequency was associated with the use of the denial coping strategy (p = 0.006) while lower migraine intensity was associated with planning (p = 0.046) and the use of positive reframing (p = 0.025). Higher TTH frequency was associated with the use of venting, self-blame, and behavioral disengagement (ps < 0.007) while higher TTH intensity was associated with substance use and behavioral disengagement (ps < 0.030). All associations remained significant after adjusting for BMI as a covariate.

Discussion/conclusion

Teleworkers with migraine had more intense and longer headache episodes than teleworkers with TTH. This could be explained by the fact that a greater proportion of individuals suffering from migraine experienced headaches prior to the beginning of the pandemic compared with teleworkers suffering from TTH. Regarding coping strategies, both primary headache profiles were associated with different types of coping strategies. Most of the coping strategies associated with headache frequency or intensity were maladaptive except for planning and positive reframing that were found to be inversely associated with migraine intensity.

Factors Driving China's Carbon Emissions after the COVID-19 Outbreak

The outbreak of the coronavirus disease 2019 (COVID-19) may exert profound impacts on China's carbon emissions via structural changes. Due to a lack of data, previous studies have focused on quantifying the changes in carbon emissions but have failed to identify structural changes in the determinants of carbon emissions. Here, we use China's latest input-output table and apply structural decomposition analyses to understand the dynamic changes in the determinants of carbon emissions from 2012 to 2020, specifically the impact of COVID-19 on carbon emissions. We find that final demand per capita contributed to emissions growth at a slower pace, but production structure drove a greater carbon emissions increase than before the pandemic. Export-led emissions growth rebounded, and investment-led emissions were more concentrated in the construction sector. The carbon intensity of several heavy industries increased, e.g., the nonmetallic products sector, the metal products sector, and the petroleum, coking, and nuclear fuel sector. In addition, lower production efficiency and increased reliance on carbon-intensive inputs indicated a deterioration in production structure. For policy implications, efforts should be undertaken to increase investment in low-carbon industries and increase the proportion of consumption in GDP to shift investment-led growth to consumption-led growth for an inclusive and green recovery from the pandemic.

Reliability and validity of the Malay version of the drive-thru community pharmacy service questionnaire and the Malaysian public's awareness, attitudes, and perceptions of drive-thru community pharmacy during COVID-19

INTRODUCTION

Understanding general public's experiences of using drive-thru pharmacies during COVID-19 in different countries is imperative for establishing these services by standardizing global guidelines for drive-thru pharmacies. The objectives of this study were to validate a Malay version of the drive-thru community pharmacy service questionnaire for use among Malaysians and to obtain a better understanding of the public's awareness, attitudes, and perceptions of drive-thru community pharmacy service during COVID-19.

METHODS

This study was a cross-sectional study, conducted online using a Google form survey using a convenient sampling method among the Malaysian public. The English version of the drive-thru community pharmacy service questionnaire was translated into the Malay language according to international guidelines. The content and face validity of the questionnaire were examined by experts. Then, the questionnaire was pilot tested on 15 native speakers. Reliability was assessed using Cronbach's alpha coefficients. The test-retest reliability was measured with Cohen's κ coefficient.

RESULTS

A total of 519 participants completed the questionnaire. Face and content validity were satisfactory, as noticed by both the experts and pilot study participants. For test-retest reliability (32 participants), most perception statements had very good coefficient agreement values. Cronbach's alpha of the perception part was 0.833, indicating strong internal consistency. The median age of study participants was 50.0 (IQR = 31.0) and about half of them were females (50.3%, n = 261). Despite 20.4% (n = 106) of the participants reported that the drive-thru community pharmacy service was available in their cities, only 10.4% (n = 54) reported using it. Most participants were in favor of introducing drive-thru services in community pharmacies throughout the country. Drive-thru community pharmacies, according to more than half of the participants (n = 394), would be beneficial to the public. Participants acknowledged that community pharmacies with drive-thru services were useful during the COVID-19 and quarantine periods due to the enhanced social distance 43.5% (n = 226), reduced the spread of the COVID-19 virus 47.0% (n = 244), and relieved pressure on other healthcare settings 38.2% (n = 198).

CONCLUSIONS

The translated questionnaire was valid and reliable in assessing the perceptions toward drive-thru community pharmacy service during COVID-19 in Malaysia. The participants expressed good awareness and favorable attitudes and perceptions toward drive-thru community pharmacy service during COVID-19. Furthermore, they perceived those services helped to increase social isolation and stop the COVID-19 virus from spreading.

Psychological disturbances encountered by selected undergraduates studying at the University of Ruhuna, Sri Lanka during the Covid-19 pandemic: a cross-sectional study

University undergraduates are increasingly recognized as a vulnerable population with a higher level of psychological disturbances. During the Covid-19 pandemic, universities closed all over the world, resulting in the psychological well-being of this population being severely affected across the globe. This study examined the prevalence of stress, anxiety, and depressive symptoms encountered by undergraduates of the selected five faculties at the University of Ruhuna in Southern Sri Lanka due to the Covid-19 pandemic, its associated factors, and the correlations between stress, anxiety, and depressive symptoms. An online, cross-sectional, descriptive study was conducted among undergraduates using pre-tested, self-administered questionnaires from the randomly selected five faculties: Allied Health Sciences, Engineering, Humanities and Social Sciences, Management and Finance, and Medicine. Undergraduates were invited to complete the Google Form. Socio-demographic details and a 21-item Depression, Anxiety, and Stress Scale (21-DASS) were used for data collection. Stress, anxiety, and depressive symptoms were evaluated using a Sinhala version of the 21-DASS scale. Ethical permission was granted by the Ethics Review Committee of the Faculty of Allied Health Sciences, University of Ruhuna. Among the 359 undergraduates, the majority were represented by females (62.1%). The mean age of the sample was 23.67 years (SD ± 1.6). Stress, anxiety, and depressive symptoms were found to be prevalent in 53.7%, 41.8%, and 63.8% of undergraduates respectively. Younger and female undergraduates had more impact on psychological issues than their counterparts. It revealed a significant positive correlation between anxiety and depressive symptoms (r = 0.646, p < .001), anxiety and stress (r = 0.868, p < .001), and stress and anxiety (r = 0.786, p < .001). Most undergraduates experienced considerable levels of stress, anxiety, and depressive symptoms during the Covid-19 as increasing stress, anxiety, or depressive symptoms, tend to increase all types of psychological disturbances. The development of mental health among undergraduates is essential and needs innovative strategies to improve the psychological well-being of undergraduates. The initiation of a stress management programme and expanded available counseling services are also important. Further studies are needed to be conducted on the extended topic of how the Covid-19 era is affecting the psychological well-being of undergraduates from different universities (state/non-state), locations, and different study departments.

Public health leadership in the COVID-19 era: how does it fit? A scoping review

The COVID-19 pandemic has put a lot of pressure on all the world's health systems and public health leaders who have often found themselves unprepared to handle an emergency of this magnitude. This study aims to bring together published evidence on the qualities required to leaders to deal with a public health issue like the COVID-19 pandemic. This scoping literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. A search of relevant articles was performed in the PubMed, Scopus and Web of Science databases. A total of 2499 records were screened, and 45 articles were included, from which 93 characteristics of effective leadership were extrapolated and grouped into 6 clusters. The qualities most frequently reported in the articles were human traits and emotional intelligence (46.7%) and communication skills such as transparency and reliability (48.9%). Responsiveness and preparedness (40%), management skills (33.3%) and team working (35.6%) are considered by a significant percentage of the articles as necessary for the construction of rapid and effective measures in response to the emergency. A considerable proportion of articles also highlighted the need for leaders capable of making evidence-based decisions and driving innovation (31.1%). Although identifying leaders who possess all the skills described in this study appears complex, determining the key characteristics of effective public health leadership in a crisis, such as the COVID-19 pandemic, is useful not only in selecting future leaders but also in implementing training and education programmes for the public health workforce.

Point-of-Care Devices for Viral Detection: COVID-19 Pandemic and Beyond

The pandemic of COVID-19 and its widespread transmission have made us realize the importance of early, quick diagnostic tests for facilitating effective cure and management. The primary obstacles encountered were accurately distinguishing COVID-19 from other illnesses including the flu, common cold, etc. While the polymerase chain reaction technique is a robust technique for the determination of SARS-CoV-2 in patients of COVID-19, there arises a high demand for affordable, quick, user-friendly, and precise point-of-care (POC) diagnostic in therapeutic settings. The necessity for available tests with rapid outcomes spurred the advancement of POC tests that are characterized by speed, automation, and high precision and accuracy. Paper-based POC devices have gained increasing interest in recent years because of rapid, low-cost detection without requiring external instruments. At present, microfluidic paper-based analysis devices have garnered public attention and accelerated the development of such POCT for efficient multistep assays. In the current review, our focus will be on the fabrication of detection modules for SARS-CoV-2. Here, we have included a discussion on various strategies for the detection of viral moieties. The compilation of these strategies would offer comprehensive insight into the detection of the causative agent preparedness for future pandemics. We also provide a descriptive outline for paper-based diagnostic platforms, involving the determination mechanisms, as well as a commercial kit for COVID-19 as well as their outlook.

A cross-jurisdictional comparison on residential waste collection rates during earlier waves of COVID-19

There is currently a lack of studies on residential waste collection during COVID-19 in North America. SARIMA models were developed to predict residential waste collection rates (RWCR) across four North American jurisdictions before and during the pandemic. Unlike waste disposal rates, RWCR is relatively less sensitive to the changes in COVID-19 regulatory policies and administrative measures, making RWCR more appropriate for cross-jurisdictional comparisons. It is hypothesized that the use of RWCR in forecasting models will help us to better understand the residential waste generation behaviors in North America. Both SARIMA models performed satisfactorily in predicting Regina's RWCR. The SARIMA D_CV model's performance is noticeably better during COVID-19, with a 15.7% lower RMSE than that of the benchmark model (SARIMA B_CV). The skewness of overprediction ratios was noticeably different between jurisdictions, and modeling errors were generally lower in less populated cities. Conflicting behavioral changes might have altered the residential waste generation characteristics and recycling behaviors differently across the jurisdictions. Overall, SARIMA D_CV performed better in the Canadian jurisdiction than in U.S. jurisdictions, likely due to the model's bias on a less variable input dataset. The use of RWCR in forecasting models helps us to better understand the residential waste generation behaviors in North America and better prepare us for a future global pandemic.

Inflammatory markers and COVID-19 disease progression

BACKGROUND

The COVID-19 pandemic has resulted in a global humanitarian crisis. Despite ongoing research, transmission risks and many disease characteristics remained unclear. Most patients have displayed elevated levels of certain inflammatory markers, which we sought to investigate further in relation to disease severity. The aim of this study was to examine the correlation between inflammatory markers and the severity of COVID-19 among patients.

METHODS

We conducted a cross-sectional study from April to September 2020, involving 143 COVID-19 PCR-positive patients from Ziauddin Hospital. Electronic patient records provided data on demographics, clinical status, and laboratory results.

RESULTS

The majority of PCR-positive patients were elderly males with comorbidities such as diabetes and hypertension. Almost all patients exhibited increased levels of various inflammatory markers, with procalcitonin (97.2%) being the most common. Statistically significant differences were observed in the levels of TLC (p = 0.005), CRP (p = 0.001), LDH (p = 0.001), Ferritin (p = 0.001), D-dimer (p = 0.001), and procalcitonin (p = 0.028), in relation to COVID-19 severity.

CONCLUSIONS

The data suggest a significant association between levels of inflammatory markers and COVID-19 severity. All markers, except procalcitonin, demonstrated a significant correlation with disease severity. These results could enhance our understanding of COVID-19 pathogenesis and help predict and manage severe cases.

Students' perception of e-learning during the Covid-19 pandemic: a survey study of Iranian nutrition science students

BACKGROUND

COVID-19 pandemic caused university closures, which created learning challenges for students worldwide. Switching to online educational systems had significant impact on students' performances. The current study aims to investigate the perception of university students from the Nutrition Science department regarding e-learning in Iran.

METHODS

The design of the study is cross-sectional. Data were collected through online surveys from Iranian students from the Nutrition Sciences Department. Stratified random sampling was used to randomly select 955 participants. A self-administered validated questionnaire was used for data collection. Descriptive statistics, Analysis of Variance (ANOVA) and Chi-Square tests were used for analysis of the data.

RESULTS

Results revealed that 67.2% of students didn't have any former experience of e-learning. About 38.3% had moderate levels of Information Technology (IT) skills. Our results revealed that based on students' responses, being able to stay at home was one of the most common benefits of e-learning (39.1%). However, the most common challenge that students faced was related to technical problems (39.6%). When compared to e-learning, most students preferred face-to face type of learning. Students believed that this method no only increased their knowledge but also their skills and social competence as compared to e-learning. Only 28% of students rated e-learning as enjoyable. Furthermore, acceptance of online based education was statistically associated with students' degree level.

CONCLUSION

In conclusion, students reported both advantages and disadvantages of e-learning but still reported that face-to-face learning is considered the most effective form of learning.

Role of microbial electrosynthesis system in CO2 capture and conversion: a recent advancement toward cathode development

Microbial electrosynthesis (MES) is an emerging electrochemical technology currently being researched as a CO₂ sequestration method to address climate change. MES can convert CO₂ from pollution or waste materials into various carbon compounds with low energy requirements using electrogenic microbes as biocatalysts. However, the critical component in this technology, the cathode, still needs to perform more effectively than other conventional CO₂ reduction methods because of poor selectivity, complex metabolism pathways of microbes, and high material cost. These characteristics lead to the weak interactions of microbes and cathode electrocatalytic activities. These approaches range from cathode modification using conventional engineering approaches to new fabrication methods. Aside from cathode development, the operating procedure also plays a critical function and strategy to optimize electrosynthesis production in reducing operating costs, such as hybridization and integration of MES. If this technology could be realized, it would offer a new way to utilize excess CO₂ from industries and generate profitable commodities in the future to replace fossil fuel-derived products. In recent years, several potential approaches have been tested and studied to boost the capabilities of CO₂-reducing bio-cathodes regarding surface morphology, current density, and biocompatibility, which would be further elaborated. This compilation aims to showcase that the achievements of MES have significantly improved and the future direction this is going with some recommendations. Highlights - MES approach in carbon sequestration using the biotic component.- The role of microbes as biocatalysts in MES and their metabolic pathways are discussed.- Methods and materials used to modify biocathode for enhancing CO₂ reduction are presented.

Depression is associated with worse health-related quality of life, lower physical activity levels, and inadequate sleep quality in a Greek elderly population

The present study is a cross-sectional study that aimed to investigate the potential associations between depression status, health-related quality of life, physical activity levels and sleep quality in a representative Greek elderly population. Three thousand four hundred five (3405) men and women over 65 years old from 14 different Greek regions were enrolled. Geriatric Depression Scale (GDS) was used to assess depression status, Health-Related Quality of Life (HRQOL) was evaluated using Short Form Health Survey, physical activity levels were assessed via the International Physical Activity Questionnaire (IPAQ) and sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). A high prevalence of depression and an increased incidence of poor quality of life, low physical activity levels and inadequate sleep quality among the elderly population were recorded. Depression status was independently associated with worse quality of life, poor physical activity, inadequate sleep quality, female gender, BMI and living alone after adjustment for potential confounding factors. Elderly age, low muscle mass, educational and financial status were also identified as indicators of depression; however, their impact on depression status was considerably attenuated after adjusting for confounding factors. In conclusion, depression was associated with worse health-related quality of life, poor physical activity and inadequate sleep quality in a Greek elderly population. Future randomized control trials should be performed to confirm the findings of this cross-sectional study.

Intranasal delivery of an adenovirus-vector vaccine co-expressing a modified spike protein and a genetic adjuvant confers lasting mucosal immunity against SARS-CoV-2

The ongoing COVID-19 pandemic caused by SARS-CoV-2 infection has threatened global health. Since the first case of infection was reported in December 2019, SARS-CoV-2 has rapidly spread worldwide and caused millions of deaths. As vaccination is the best way to protect the host from invading pathogens, several vaccines have been developed to prevent the infection of SARS-CoV-2, saving numerous lives thus far. However, SARS-CoV-2 constantly changes its antigens, resulting in escape from vaccine-induced protection, and the longevity of immunity induced by vaccines remains an issue. Additionally, traditional intramuscular COVID-19 vaccines are insufficient at evoking mucosal-specific immune responses. Because the respiratory tract is the primary route of SARS-CoV-2 entry, the need for mucosal vaccines is strong. Using an adenoviral (Ad) vector platform, we generated Ad5-S.Mod, a recombinant COVID-19 vaccine that encodes modified-spike (S) antigen and the genetic adjuvant human CXCL9. Intranasal delivery of Ad5-S.Mod elicited superior airway humoral and T-cell responses over traditional intramuscular vaccines and protected mice from lethal SARS-CoV-2 infection. cDC1 cells were required for the generation of antigen-specific CD8⁺ T-cell responses and CD8⁺ tissue-resident memory T-cell development in intranasal Ad5-S.Mod vaccinated mice. Furthermore, we confirmed the efficacy of the intranasal Ad5-S.Mod vaccine in terms of transcriptional changes and identified lung macrophages as a key supporter of maintenance of lung-resident memory T and B cells. Our study demonstrates Ad5-S.Mod has the potential to confer protective immunity against SARS-CoV-2 and that lung macrophages support the maintenance of vaccine-induced tissue-resident memory lymphocytes.

Constructing an emergency preparedness evaluation index system for public use during major emerging infectious disease outbreaks: a Delphi study

BACKGROUND

The major emerging infectious diseases (MEIDs) have occurred frequently and become increasingly serious in the world. Sufficient personal emergency preparedness is critical for the general people in efficiently responding to and recovering from MEIDs. Nevertheless, few specific indicators are available for assessing the individual emergency preparedness of the general public during these periods. Therefore, the aim of this study was to construct an index system for comprehensively evaluating the personal emergency preparedness of the public regarding MEIDs.

METHODS

Based on the global national-level emergency preparedness index framework and a literature review, a preliminary index system was constructed. From June 2022 to September 2022, a panel of 20 experts from nine provinces and municipalities across multiple research areas participated in this Delphi study. They rated the importance of pre-defined indicators using a five-point Likert scale and provided their qualitative comments. According to the feedback of each round of experts, the indicators of the evaluation index system were revised.

RESULTS

After two rounds of expert consultation the evaluation index system reached a consensus, containing five first-level indicators, cooperating with prevention and control work, improving emergency response capacity, securing supplies and equipment, preparing economic resources, maintaining physical and mental health with affiliated 20 s-level indicators and 53 third-level indicators. The expert authority coefficient of consultation was 0.88 and 0.90. The Kendall's coefficient of concordance of expert consultations was 0.294 and 0.322, respectively. The differences were statistically significant (P < 0.05).

CONCLUSION

A valid, reliable and scientific evaluation index system was established. This personal emergency preparedness index system, as a precursor form, will further lay the foundation for the formation of an assessment instrument. At the same time, it could provide a reference for future education and training of emergency preparedness for the general public.

Travel before, during and after the COVID-19 pandemic: Exploring factors in essential travel using empirical data

The COVID-19 pandemic has a significant impact on daily life, leading to quarantines and essential travel restrictions worldwide in an effort to curb the virus's spread. Despite the potential importance of essential travel, research on changes in travel patterns during the pandemic has been limited, and the concept of essential travel has not been fully explored. This paper aims to address this gap by using GPS data from taxis in Xi'an City between January and April 2020 to investigate differences in travel patterns across three periods pre, during, and post the pandemic. Spatial statistical models are used to examine the major supply and demand-oriented factors that affect spatial travel patterns in different periods, and essential and nonessential socioeconomic resources are defined based on types of services. Results indicate that the spatial distribution of travel demand was highly correlated with the location of socioeconomic resources and opportunities, regardless of the period. During the "Emergency Response" period, essential travel was found to be highly associated with facilities and businesses providing essential resources and opportunities, such as essential food provider, general hospital and daily grocery supplies. The findings suggest that local authorities may better identify essential travel destinations by referencing the empirical results, strengthening public transit connections to these locations, and ultimately promoting traffic fairness in the post-pandemic era.

The People's War Against Pandemic: protocol for a randomized control trial based on a virtual interactive training system intervention to improve the emergency preparedness of public for major emerging infectious diseases

BACKGROUND

The frequent occurrence and increasing severity of major emerging infectious diseases (MEIDs) have posed considerable public health, economic and social issues worldwide. The emergency preparedness of public is inadequate to respond to and recover from MEIDs. Due to the limitation of time, space and resources, it is also difficult to carry out large-scale emergency preparedness training related to MEIDs. Then we developed a virtual interactive training system to improve emergency preparedness of public, including preparation of legal compliance, emergency knowledge, emergency capacity, economic estimation, material reserve and physical and mental health.

METHODS

A protocol for conducting a randomized controlled trail to evaluate the People's War against Pandemic, a virtual interactive training system aimed to improve emergency preparedness of public for MEIDs. During the intervention, participants need to complete the storyline task at least once a day, watch at least one article and one video in the knowledge corner, and complete a retest of wrong choices in the intelligent evaluation module. The primary outcome is emergency preparedness of public for MEIDs. The secondary outcome is prevention and control knowledge of MEIDs.

DISCUSSION

The People's War Against Pandemic may be an effective approach to provide public with a panoramic understanding of the response to MEIDs, so as to promote their comprehensive preparation and finally achieve effective response.

TRIAL REGISTRATION

This study was funded in 2021 and registered in the Chinese Clinical Trial Registry (registration number: ChiCTR2200060919) in June 2022. Recruitment and enrollment of participants began in July 2022.

Assessment of heavy metal contamination and ecological risk in Morocco's marine and estuarine ecosystems through a combined analysis of surface sediment and bioindicator species: Donax trunculus and Scrobicularia plana

Morocco is one of the most affected regions by heavy metal pollution worldwide. In this study, two ecosystems in Agadir Bay, southern Morocco, were studied seasonally, using surface sediment and bivalve species. The concentrations of Cu, Pb and Cd were determined using the Shimadzu AAS 7000 flame atomic absorption spectrophotometer method. Our results marked average levels corresponding to an unpolluted sediment with a low contamination degree, low ecological risk associated with metal contamination, and levels that did not exceed the thresholds set by EC, USEPA, INERIS and INRH, except for Pb in tourist beach. The principal component analysis findings revealed a positive correlation in the bioaccumulation between the two compartments, with an influence of abiotic parameters. Thus, to better manage environmental pollution in these ecosystems, authorities must implement waste treatment strategies in the surrounding harbor and tourist complexes and prohibit the use of these toxic metals in the coastal areas.

Impacts of COVID-19 on alcohol use among help-seeking adults

The coronavirus (COVID-19) pandemic has been associated with both increased and decreased alcohol use. Authors explored reasons for increased and decreased alcohol use since the COVID-19 lockdown (March 2020) in a sample of help-seeking adults (HSA) participating in a remote-based alcohol reduction text-messaging intervention in the USA. At the time of recruitment, the HSA in this study were interested in reducing rather than stopping their alcohol consumption. An optional self-report questionnaire was completed by 324 participants (mean age 41.6 ± 10.2 years; 71.5% female; 83.9% White) in February 2021. Survey questions assessed sociodemographic factors, social stressors (quarantine conditions, employment status, changes to daily routine), and drinking patterns. Authors fit two ordinal logistic regression models: one for increased drinking and one for decreased drinking, as functions of the potential predictors and control variables. Most participants (n = 281; 87.0%) reported drinking more than usual since COVID-19 lockdown began. The most common self-reported reasons for drinking more were increased stress/anxiety (74.7%), boredom (69.4%), and spending more time at home (65.5%) whereas reasons for drinking less were less socializing (33.7%) and worrying about how alcohol would impact the immune system (31.5%). Identifying as female, severity of changes to daily routine, and increased access to alcohol were significantly associated with drinking more than usual. These data suggest that the general consequences of the pandemic in the general population (e.g., boredom) led to greater alcohol use among help-seeking adults attempting to reduce their drinking. Identifying these factors may help create more targeted interventions during public health crises.

Return connectedness and multiscale spillovers across clean energy indices and grain commodity markets around COVID-19 crisis

The aim of this paper is to examine the return connectedness and multiscale spillovers between the Clean Energy Index and the grain commodity market around COVID-19. Using daily data from January 4, 2017 to July 1, 2022, a time-varying parametric vector autoregressive (TVP-VAR) connectedness approach is first used to reveal connectedness patterns before and during COVID-19. We further used Baruník and Křehlík (2018)'s frequency domain spillover method to assess connectedness in different domain horizons. Our results show spillover effects over time and frequency, with COVID-19 significantly affecting the connectedness of the whole system. Dynamic connectedness peaks significantly after sudden bursts of COVID-19, validating the reported uncertainty. We also documented higher spillover levels in the short term than in the medium and long term. In addition, We find that (i) most clean energy indices are positively affected by the COVID-19 outbreak; (ii) the NASDAQ OMX Bio/Clean Fuels Index and NASDAQ OMX Geothermal Index send spillovers to all grain commodities throughout the sample period, while the WilderHill Clean Energy Index and NASDAQ OMX Wind Energy Index indices are the largest recipients of spillovers from other markets regardless of time horizon; (iii) the OMX Bio/Clean Fuels and OMX Geothermal Energy indices dominate spillover shocks to grain commodity markets. This is the first study to analyse the connectedness and time-frequency dynamics of returns in the green energy index and the grain commodity market. These results provide valuable insights to investors and key policymakers, especially at a time of more significant uncertainty.

Effects of the COVID-19 pandemic on mental health, anxiety, and depression

BACKGROUND

The COVID-19 pandemic affected everyone around the globe. Depending on the country, there have been different restrictive epidemiologic measures and also different long-term repercussions. Morbidity and mortality of COVID-19 affected the mental state of every human being. However, social separation and isolation due to the restrictive measures considerably increased this impact. According to the World Health Organization (WHO), anxiety and depression prevalence increased by 25% globally. In this study, we aimed to examine the lasting effects of the COVID-19 pandemic on the general population.

METHODS

A cross-sectional study using an anonymous online-based 45-question online survey was conducted at Comenius University in Bratislava. The questionnaire comprised five general questions and two assessment tools the Zung Self-Rating Anxiety Scale (SAS) and the Zung Self-Rating Depression Scale (SDS). The results of the Self-Rating Scales were statistically examined in association with sex, age, and level of education.

RESULTS

A total of 205 anonymous subjects participated in this study, and no responses were excluded. In the study group, 78 (38.05%) participants were male, and 127 (61.69%) were female. A higher tendency to anxiety was exhibited by female participants (p = 0.012) and the age group under 30 years of age (p = 0.042). The level of education has been identified as a significant factor for changes in mental state, as participants with higher levels of education tended to be in a worse mental state (p = 0.006).

CONCLUSIONS

Summarizing two years of the COVID-19 pandemic, the mental state of people with higher levels of education tended to feel worse, while females and younger adults felt more anxiety.

Impacts of the COVID-19 pandemic on the social sphere and lessons for crisis management: a literature review

The COVID-19 pandemic is the most difficult challenge that has affected humanity in recent decades. It has disrupted many features of development with domino effects in the social sphere. This study reviews the literature on the social effects of the COVID-19 pandemic and identifies the affected social areas that have undergone dramatic changes during the pandemic. We use inductive content analysis and thematic analysis to review the literature. The results show that there are seven major areas that have been negatively affected by the COVID-19 pandemic: health, social vulnerability, education, social capital, social relationships, social mobility, and social welfare. The literature has reported dramatic psychological and emotional effects, exacerbation of segregation and poverty, disruption in educational systems and formation of an information gap, as well as a declining trends of social capital among communities. We highlight some lessons that can be learned from the pandemic to enhance social resilience in future. Among others, to effectively respond to the pandemic and other potential future adverse events, governments should adopt fair policies, identify the required changes in the socially affected contexts and take necessary responsive actions, and adopt collaboratively designed approaches to increase social resilience.

Changes in Paediatric Injury-Related Emergency Department Presentations during the COVID-19 Pandemic

This study aimed to quantify changes in paediatric injury-related Emergency Department (ED) presentations at a large metropolitan paediatric hospital during the first two years of the COVID-19 pandemic (i.e., 2020 and 2021). This retrospective cohort study included children aged ≤15 years who presented to the ED at the Children’s Hospital at Westmead, Sydney, New South Wales, Australia, with a principal diagnosis of injury during 1 January 2010 to 31 December 2021. Annual and monthly incidence of paediatric injury-related ED presentations from 2010 to 2019 were used to fit autoregressive integrated moving average models, from which forecast estimates with 95% prediction intervals were derived and compared against corresponding observed values to obtain estimates of absolute and relative forecast errors. The distributions of injuries by injury severity in 2020 and 2021 were compared against the 2010–2019 reference period. The annual incidence of paediatric injury-related ED presentations was 7.6% and 4.7% lower than forecasted in 2020 and 2021, respectively, equating to an estimated total of 1683 fewer paediatric injury-related ED presentations during the two-year period. The largest reductions in monthly incidence of paediatric injury-related ED presentations were observed during the periods of major societal restrictions (i.e., March–May 2020 and July–October 2021). Significant reductions in monthly incidence of injury-related ED presentations were observed for minor injuries only, with no discernable reductions in moderate and serious injuries. These findings highlight the impact of the COVID-19 pandemic on paediatric injury-related ED presentations and the need for future epidemiological studies examining secular trends in paediatric trauma volumes to account for the impact of the COVID-19 pandemic.

Effect of green bonds, oil prices, and COVID-19 on industrial CO2 emissions in the USA: Evidence from novel wavelet local multiple correlation approach

This study explores the effect of green bonds, oil prices, and the coronavirus disease 2019 (COVID-19) pandemic on industrial carbon dioxide (CO2) emissions. In this context, this study examines the United States of America (USA), which is the biggest economy in the world, uses weekly data between March 6, 2020 and September 30, 2022, and applies a novel wavelet local multiple correlation (WLMC) approach under time-varying and frequency-varying perspective. The novel empirical findings shows that (i) there is a strong negative (positive) co-movement between industrial CO2 emissions and green bonds in the short-run (long-run); (ii) there is a strong positive (negative) co-movement between industrial CO2 emissions and oil price in the medium-run (long-run); (iii) there is a strong negative (positive) co-movement between industrial CO2 emissions and the COVID-19 pandemic in the medium-run (long-run); (iv) the oil price is the dominant factor, whereas there are changing effect of the variables on each other at different times and frequencies; and (vi) overall, there are long-run asymmetric and dynamic correlations between industrial CO2 emissions and variables. Hence, the empirical results highlight the asymmetric, time-varying, and frequency-varying effects of green bonds, oil prices, and the COVID-19 pandemic on industrial CO2 emissions by presenting fresh and novel evidence. Moreover, the study proposes policy implications for the USA government.

A Qualitative Study to Compare Barriers to Improving Food Security among Households with Young Children in the U.S. as Perceived by Different Types of Stakeholders before and during COVID-19

This qualitative study aimed to determine the perceived barriers of different community stakeholders’ to providing resources for improving food security in households with young children in the U.S. Community stakeholders working with low-income families with children 0–3 years of age in Florida were recruited to represent healthcare (n = 7), community/policy development (n = 6), emergency food assistance (n = 6), early childhood education (n = 7), and nutrition education (n = 6) sectors. In 2020, one-on-one interviews were conducted with each stakeholder in via Zoom, using an interview script based on the PRECEDE–PROCEED model and questions to capture the impacts of COVID-19. The interviews were audio-recorded, transcribed verbatim, and analyzed using a deductive thematic approach. A cross-tab qualitative analysis was used to compare data across categories of stakeholders. Healthcare professionals and nutrition educators indicated stigma, community/policy development stakeholders indicated a lack of time, emergency food assistance personnel indicated a limited access to food, and early childhood professionals indicated a lack of transportation as the main barriers to food security prior to COVID-19. COVID-19 impacts included the fear of virus exposure, new restrictions, lack of volunteers, and a lack of interest in virtual programming as barriers to food security. As perceived barriers may vary with respect to providing resources to improve food security in families with young children and the COVID-19 impacts persist, coordinated policy, systems, and environmental changes are needed.

Designing an optimization model for the vaccine supply chain during the COVID-19 pandemic

The COVID-19 pandemic has affected people's lives worldwide. Among various strategies being applied to addressing such a global crisis, public vaccination has been arguably the most appropriate approach to control a pandemic. However, vaccine supply chain and management have become a new challenge for governments. In this study, a solution for the vaccine supply chain is presented to address the hurdles in the public vaccination program according to the concerns of the government and the organizations involved. For this purpose, a robust bi-level optimization model is proposed. At the upper level, the risk of mortality due to the untimely supply of the vaccine and the risk of inequality in the distribution of the vaccine is considered. All costs related to the vaccine supply chain are considered at the lower level, including the vaccine supply, allocation of candidate centers for vaccine injection, cost of maintenance and injection, transportation cost, and penalty cost due to the vaccine shortage. In addition, the uncertainty of demand for vaccines is considered with multiple scenarios of different demand levels. Numerical experiments are conducted based on the vaccine supply chain in Kermanshah, Iran, and the results show that the proposed model significantly reduces the risk of mortality and inequality in the distribution of vaccines as well as the total cost, which leads to managerial insights for better coordination of the vaccination network during the COVID-19 pandemic.

Regional sustainability: Pressures and responses of tourism economy and ecological environment in the Yangtze River basin, China

The relationship between the tourism economy and the ecological environment is under pressure, and balancing this relationship is crucial for promoting regional sustainability. In this study, the Yangtze River basin, the first largest river in Asia and third largest in the world, was selected as the focus area. The spatial and temporal characteristics of tourism economic development and ecological environmental pressure from 2000 to 2019 were analyzed using the tourism economic development index, ecological environmental pressure index and dynamic change index, and the decoupling process of tourism and the economic system was studied dynamically using the decoupling analysis model. The results show that (1) spatially, the tourism economy in the Yangtze River basin exhibits a pattern of high development in the east and low development in the west, and high in the south and low in the north. Ecological environmental pressures varied greatly, with less pressure in the upstream provinces and more pressure in the middle and downstream provinces. (2) Temporally, the tourism economies of Qinghai and Tibet started with a lower but faster growth rate, while Hunan and Hubei have a higher starting point but limited change. The ecological environmental pressure changes do not show a clear spatial distribution pattern. (3) The decoupling relationship between tourism economy and ecological environment in the Yangtze River basin is moving toward a harmonious development. Achieving a harmonious balance between the two systems is crucial for maintaining ecological balance and regional sustainability.

Visiting Urban Green Space and Orientation to Nature Is Associated with Better Wellbeing during COVID-19

The COVID-19 pandemic has severely challenged mental health and wellbeing. However, research has consistently reinforced the value of spending time in green space for better health and wellbeing outcomes. Factors such as an individual's nature orientation, used to describe one's affinity to nature, may influence an individual's green space visitation behaviour, and thus influence the wellbeing benefits gained. An online survey in Brisbane and Sydney, Australia (n = 2084), deployed during the COVID-19 pandemic (April 2021), explores if nature experiences and nature orientation are positively associated with personal wellbeing and if increased amounts of nature experiences are associated with improvement in wellbeing in the first year of the COVID-19 pandemic. We found that both yard and public green space visitation, as well as nature orientation scores, were correlated with high personal wellbeing scores, and individuals who spent more time in green space compared to the previous year also experienced a positive change in their health and wellbeing. Consistently, people with stronger nature orientations are also more likely to experience positive change. We also found that age was positively correlated to a perceived improvement in wellbeing over the year, and income was negatively correlated with a decreased change in wellbeing over the year, supporting other COVID-19 research that has shown that the effects of COVID-19 lifestyle changes were structurally unequal, with financially more established individuals experiencing better wellbeing. Such results highlight that spending time in nature and having high nature orientation are important for gaining those important health and wellbeing benefits and may provide a buffer for wellbeing during stressful periods of life that go beyond sociodemographic factors.

The interrelations between psychological outcome trajectories and resource changes amid large-scale disasters: A growth mixture modeling analysis

Currently little is known about the interrelations between changes in psychiatric symptoms and changes in resources (personal, social, financial) amid large-scale disasters. This study investigated trajectories of psychiatric symptoms and their relationships with different patterns of changes in personal, social, and financial resources between 2020 and 2022 amid the COVID-19 pandemic. A population-representative sample (N = 1333) was recruited to complete self-report instruments at the pandemic's acute phase (February-July 2020, T1), and again at 1-year (March-August 2021, T2) and 1.5-year (September 2021-February 2022, T3) follow-ups. Respondents reported depressive and anxiety symptoms, self-efficacy, perceived social support, and financial capacity. Growth mixture modeling (GMM) identified four trajectories of depressive and anxiety symptoms: resilience (72.39-74.19%), recovery (8.40-11.93%), delayed distress (7.20-7.35%), and chronic distress (8.33-10.20%). Four patterns were demonstrated in resource changes: persistent high resources (40.89-47.64%), resource gain (12.08-15.60%), resource loss (6.30-10.43%), and persistent low resources (28.73-36.61%). Loss and gain in financial resources characterized chronic distress and resilience, respectively. Loss in personal resources characterized delayed distress, whereas loss or no gain in social resources was related to chronic/delayed distress. Respondents in resilience were also more likely to have persistent high resources while those with delayed/chronic distress were more likely to have persistent low resources. These results provide an initial evidence base for advancing current understanding on trajectories of resilience and psychopathology in the context of resource changes during and after large-scale disasters.

Pandemic Preparedness among Big Energy Companies: Call to Research and Action

The COVID-19 pandemic, as a global phenomenon, has affected all the working realities, worldwide, with the same issues. The aim of the present work is to assess the experiences of management and their preparedness during the pandemic among big companies, in particular, in the energy sector. Based on an overview of scientific evidence and grey literature, we found that big companies followed evidence-based decision-making practices and offered preparedness and information plans. Specifically, these plans contained recommendations and best practices to be followed to avoid the risk of infection in the workplaces, as well as in the field of epidemiological surveillance and vaccination. Nevertheless, many research efforts are required, and it is important that a large number of big companies and corporations address these challenges worldwide, adopting a new sustainable approach that includes both the productivity and health of the workers. A Call to Action was then issued in order to achieve evidence-based leadership to address current and future public health emergency scenarios.

Improved air quality leads to enhanced vegetation growth during the COVID-19 lockdown in India

The direct effect of pandemic induced lockdown (LD) on environment is widely explored, but its secondary impacts remain largely unexplored. Therefore, we assess the response of surface greenness and photosynthetic activity to the LD-induced improvement of air quality in India. Our analysis reveals a significant improvement in air quality marked by reduced levels of aerosols (AOD, -19.27%) and Particulate Matter (PM 2.5, -23%) during LD (2020)from pre-LD (March-September months for the period 2017-2019). The vegetation exhibits a positive response, reflected by the increase in surface greenness [Enhanced Vegetation Index (EVI, +10.4%)] and photosynthetic activity [Solar Induced Fluorescence (SiF, +11%)], during LD from pre-LD that coincides with two major agricultural seasons of India; Zaid (March-May) and Kharif (June-September). In addition, the croplands show a higher response [two-fold in EVI (14.45%) and four-fold in SiF (17.7%)] than that of forests. The prolonged growing period (phenology) and high rate of photosynthesis (intensification) led to the enhanced greening during LD owing to the reduced atmospheric pollution. This study, therefore, provides new insights into the response of vegetation to the improved air quality, which would give ideas to counter the challenges of food security in the context of climate pollution, and combat global warming by more greening.

Waste management beyond the COVID-19 pandemic: Bibliometric and text mining analyses

The outbreak of the COVID-19 pandemic has significantly increased the demand for personal protective equipment, in particular face masks, thus leading to a huge amount of healthcare waste generated worldwide. Consequently, such an unprecedented amount of newly emerged waste has posed significant challenges to practitioners, policy-makers, and municipal authorities involved in waste management (WM) systems. This research aims at mapping the COVID-19-related scientific production to date in the field of WM. In this vein, the performance indicators of the target literature were analyzed and discussed through conducting a bibliometric analysis. The conceptual structure of COVID-19-related WM research, including seven main research themes, were uncovered and visualized through a text mining analysis as follows: (1) household and food waste, (2) personnel safety and training for waste handling, (3) sustainability and circular economy, (4) personal protective equipment and plastic waste, (5) healthcare waste management practices, (6) wastewater management, and (7) COVID-19 transmission through infectious waste. Finally, a research agenda for WM practices and activities in the post-COVID-19 era was proposed, focusing on the following three identified research gaps: (i) developing a systemic framework to properly manage the pandemic crisis implications for WM practices as a whole, following a systems thinking approach, (ii) building a circular economy model encompassing all activities from the design stage to the implementation stage, and (iii) proposing incentives to effectively involve informal sectors and local capacity in decentralizing municipal waste management, with a specific focus on developing and less-developed countries.

The necessity revealed by COVID-19 pandemic: Paradigm shift of Iran's healthcare system

Background

COVID-19 pandemic has resulted in drastic changes around the world, revealing vulnerable aspects of healthcare systems. This study aimed to explore how Iranian healthcare system experienced the paradigm shift during the pandemic and determine the aspects that need improvement during the pandemic era.

Method

This qualitative study was conducted in 2021. A framework analysis approach was used to analyze the content of the 19 semi-structured interviews with the healthcare system experts from Shiraz University of Medical Sciences (SUMS). The interviews' audio files changed into transcript after each session and data was saturated at the 19 interview. To increase the trustworthiness of the study, Guba and Lincoln's criteria including credibility, transferability, dependability, and confirmability were used. Goldsmith's five-step framework analysis was used applying MAX QDA version 10 software.

Result

Eight main themes and 20 subthemes were explored. The main themes included "strengthening the electronic health infrastructure," "research for evidence-based decision making," "dedicated financing to the pandemic," "prevention of disruption in the effective provision of services and medicines," "enriching the authority of the Ministry of Health by focusing on interactions," "recruiting, managing and empowering health human resources with attention to financial and non-financial incentives," "reforming educational approaches in training students in medical universities," as well as "lessons learned from neglected aspects."

Conclusion

To be ready to respond to a possible future pandemic and for a paradigm shift, bold steps must be taken to make fundamental changes in various aspects of the healthcare system including e-health development, evidence-based decision making, dedicated budgets for pandemics, reinforcement of interactions at the national and international level, as well as sufficient attention to healthcare workers from all financial, non-financial and educational aspects.

The Societal Value of Vaccines: Expert-Based Conceptual Framework and Methods Using COVID-19 Vaccines as a Case Study

Health technology assessments (HTAs) of vaccines typically focus on the direct health benefits to individuals and healthcare systems. COVID-19 highlighted the widespread societal impact of infectious diseases and the value of vaccines in averting adverse clinical consequences and in maintaining or resuming social and economic activities. Using COVID-19 as a case study, this research work aimed to set forth a conceptual framework capturing the broader value elements of vaccines and to identify appropriate methods to quantify value elements not routinely considered in HTAs. A two-step approach was adopted, combining a targeted literature review and three rounds of expert elicitation based on a modified Delphi method, leading to a conceptual framework of 30 value elements related to broader health effects, societal and economic impact, public finances, and uncertainty value. When applying the framework to COVID-19 vaccines in post-pandemic settings, 13 value elements were consensually rated highly important by the experts for consideration in HTAs. The experts reviewed over 10 methods that could be leveraged to quantify broader value elements and provided technical forward-looking recommendations. Limitations of the framework and the identified methods were discussed. This study supplements ongoing efforts aimed towards a broader recognition of the full societal value of vaccines.

Response to COVID-19 in Lebanon: update, challenges and lessons learned

The COVID-19 pandemic remains a public health problem threatening national and global health security. The socio-economic impact of COVID-19 was more severe on developing countries including Lebanon, especially due to the fragile healthcare system, weak surveillance infrastructure and lack of comprehensive emergency preparedness and response plans. Lebanon has been struggling with plethora of challenges at the social, economic, financial, political and healthcare levels prior to the COVID-19 pandemic. The COVID-19 pandemic in Lebanon revealed gaps and challenges across the spectrum of preparedness and response to emergencies. Despite these challenges, the Lebanese response was successful in delaying the steep surge of COVID-19 cases and hospitalisations through imposing strict public health and social measures. The deployment of the national vaccination plan in Lebanon in February 2021 coincided with the reduction in the number of cases and hospitalisation rates. The aim of this manuscript is to advance the epidemiologic evolution of COVID-19 in Lebanon pre- and post-vaccination, the challenges affecting the response and recovery, and the lessons learned.

Awareness, attitudes, and perceptions of drive-thru community pharmacy services among the general public in Malaysia during COVID-19: A cross-sectional study

INTRODUCTION

There is a lack of attention to drive-thru services in the community pharmacy setting, particularly during the COVID-19 period in Malaysia. The main objective of this study was to assess the public awareness, attitudes, and perceptions towards drive-thru community pharmacy services among during COVID-19 in Malaysia.

METHODS

A cross-sectional study was conducted using a self-administrated, web-based survey (Google form) among the public in Malaysia between May and June 2022. Descriptive statistics were used to summarize the socio-demographic characteristics of the participants. Associations between the socio-demographic characteristics of the participants and the use of drive-thru community pharmacy services were assessed using a chi-square test. Regression analyses were carried out to determine whether the socio-demographic characteristics of the participants were associated with perceptions towards drive-thru community pharmacy services.

RESULTS

A total of 565 (70.6%) of the general public completed the survey instrument. The median age of study participants was 40.0 (IQR = 36.0) and about half of them were males (50.6%, n = 286). Although 18.6% (n = 105) of the participants reported the presence of DTCPS in their cities, only 9.0% (n = 51) reported having used this service. Most of the participants were supportive to establish drive-thru services at community pharmacies in the country. Most of the believed advantages among participants were that DTCPS are helpful during COVID-19 and quarantine time 48.0% (n = 271) by enhancing social distancing and reducing the spread of the COVID-19 virus 48.5% (n = 274). Among sociodemographic factors, non-Malaysian nationality (p<0.001), and age above 55 years (p = 0.01) were found to negatively affect participants' perceptions towards drive-thru community pharmacy services.

CONCLUSION

This study showed positive awareness, attitudes, and perceptions toward drive-thru community pharmacy services during COVID-19 in Malaysia among the public. The participants believed that those services were helpful during COVID-19 to enhance social distancing and to reduce the spread of the COVID-19 virus.

Evidence of mental health-related morbidities and its association with socio-economic status among previously hospitalized patients with symptoms of COVID-19 in Bangladesh

Introduction

The long-term impact of COVID-19 on mental health, particularly in relation to socio-economic vulnerabilities, has received little attention. This study reports the prevalence of mental health-related symptoms among previously hospitalized patients after recovery from COVID-19, and its association with socio-economic status (SES).

Methods

Data collection of this cross-sectional study was conducted during February-April 2021, among previously hospitalized patients with COVID-19 like symptoms, on average six months after their discharge from the hospital. Using DASS-21, a validated scale to document symptoms of depression, anxiety, and stress, information on mental health-related symptoms were recorded from 481 respondents along with sociodemographic and economic information through telephone interviews. Chi-square tests were performed to identify significant group differences. Multinomial logistic regression analyzed the association between the changes in socioeconomic characteristics and mental health-related symptoms. Relative index of inequality (RII), slope index of inequality (SII), and concentration index (CIX) were applied to capture relevant inequalities in relation to mental health-related symptoms.

Results

Eleven percent of the respondents reported changes in employment status, nearly half changes in income and expenditure. Forty-five percent reported symptoms of depression, anxiety and/or stress, and 12% reported coexistence of all three symptoms. Women [Adjusted Odds Ratio, AOR: 2.95; 95% Confidence Interval, CI: 1.39-5.68], and those who reported changes in occupation [AOR: 3.04; 95% CI: 1.01-9.08] and expenditure [AOR: 2.46; 95% CI: 1.12-5.37] were more likely to report all three mental health-related symptoms compared to men and those without changes in occupation and expenditure. The older age group was less likely [AOR: 0.96; 95%CI: 0.93-0.99] to report coexistence of all three symptoms compared to their younger counterparts. Negative values of concentration index (CIX) indicate that any one mental health-related symptom was significantly concentrated among those with lower expenditure and poor SES.

Conclusion

This study will help in addressing mental health-related challenges after recovery from COVID-19 among the identified vulnerable groups through relevant community-based and clinical response, including counseling services, in Bangladesh and similar LMIC contexts.

Pakistan's COVID-19 Prevention and Control Response Using the World Health Organization's Guidelines for Epidemic Response Interventions

Massive coronavirus disease 2019 (COVID-19) devastation was anticipated in Pakistan due to poor track record of responding to epidemics. However, by adopting effective and timely response measures under strong government leadership, Pakistan averted a significant number of infections. We present the government of Pakistan's efforts to curb the spread of COVID-19, using the World Health Organization's guidelines for epidemic response intervention. The sequence of interventions is presented under the epidemic response stages, namely anticipation, early detection, containment-control, and mitigation. Key factors of Pakistan's response included decisive political leadership and implementation of a coordinated and evidence-informed strategy. Moreover, early control measures, mobilization of front-line health workers for contact tracing, public awareness campaigns, 'smart lockdowns', and massive vaccination drives are key strategies that helped flatten the curve. These interventions and lessons learnt can help countries and regions struggling with COVID-19 to develop successful strategies to flatten the curve and enhance disease response preparedness.

Evaluating the Effectiveness of E-Learning in Private Schools of Amman, Jordan During and After the Corona Pandemic

This paper aimed to measure the impact of COVID-19 on education in private schools of Amman, Jordan during and after corona pandemic. A questionnaire consisting of (10) paragraphs aimed to answer the study's questions and hypotheses. The study population consisted of (20) private schools in Jordan distributed in the capital city of Amman, where they were selected using the simple random method. Results show that the effectiveness of e-learning during corona pandemic was ranging from medium to low and there is no noticeable difference of teacher’s gender on the effectiveness of e-learning, teacher’s years of experiences has a positive relationship with the effectiveness of e-learning. As for the success of e-learning during corona pandemic, results show that it was low due to the presence of several challenges, the most important of which are technical, social, economic, and infrastructural challenges. The study recommended that e-learning could act as a support education system to the traditional (face-to-face) education, and it could be more effective when applied to literary courses, in addition to promoting the efficiency and readiness of teaching staff, students and parents to implement e-learning through holding workshops in this regard.

Evaluating the Short-term Environmental and Clinical Effects of a Radiation Oncology Department's Response to the COVID-19 Pandemic

PURPOSE

During the COVID-19 pandemic, many radiation oncology departments worldwide adopted the use of shorter and more intense hypofractionated regimens. Hospital foot traffic was reduced through virtual care. This study's primary objective was to assess the collective environmental effect of these strategic changes by identifying sources of carbon dioxide equivalents (CO₂e). The rate of radiation-related adverse events from the increased use of hypofractionated treatments was assessed.

METHODS AND MATERIALS

All patients treated with external beam radiation therapy from April 1, 2019, to March 31, 2021, at our single institution were identified (n = 10,175) along with their radiation therapy visits (176,423 fractions) and unplanned visits to the radiation nursing clinic or emergency department. Out-patient hospital and virtual visits (n = 75,853) during this same period were also analyzed. Environmental effect measures, including linear accelerator power usage, patient travel distances, and personal protection equipment consumption were all converted into CO₂e.

RESULTS

The use of curative hypofractionated regimens increased from 17% to 27% during the pandemic year. Carbon footprint was reduced by 39% during the pandemic year (1,332,388 kg CO₂e) compared with the prepandemic year (2,024,823 kg CO₂e). Comparing patients in the prepandemic versus pandemic year, there was a significant reduction in the proportion of hypofractionated patients who needed a visit to either the radiation nursing clinic (39% vs 25%; P < .001) or emergency department (6% vs 2%; P < .001) during and within 90 days of radiation therapy.

CONCLUSIONS

This is the first study to demonstrate the environmental benefits of increased use of hypofractionated regimens and virtual care, while assuring that there was no added acute radiation-related adverse event. Our findings support their continued use as one of many long-term strategies to reduce the environmental footprint of health care delivery.