摘要： In addition to physical symptoms such as dyspnea, fatigue, post-exertional malaise, and pain, a subgroup of patients with Post-COVID-19 syndrome (Post-Acute Sequelae of COVID-19, PASC) suffers from mental illnesses such as anxiety, depression, and neurocognitive impairments. To date, there are no causal treatments available for PASC. While initial studies show that psychotherapy improves psychological symptoms, PASC-related fatigue, and psychosocial functioning, further research is needed to evaluate the effectiveness of psychotherapeutic treatment for PASC. This study presents a non-randomized controlled trial aimed at evaluating the effectiveness of a five-week multimodal inpatient psychosomatic treatment program for individuals experiencing PASC symptoms and comorbid mental illness. A total of 118 patients presented at the Post-COVID Center at the Universitätsklinikum Erlangen will be assigned to the intervention group receiving inpatient psychosomatic treatment or the control group receiving treatment as usual. The inclusion criteria for the intervention group are a diagnosis of PASC and at least one condition of mental distress and problems with coping with illness. The primary objective of the intervention is to reduce mental ailments, including depression and anxiety, as well as neurocognitive deficits, and to address PASC symptoms such as fatigue and pain. The core elements of the treatment are psychotherapy in individual and group settings, medical treatment, neurocognitive training, and physical therapy, adapted to the individual’s capacity and oriented towards the concept of pacing. After enrollment, participants will undergo a 6-month follow-up to assess long-term results and the sustainability of the intervention effects. This study examines the effectiveness of inpatient psychotherapeutic treatment in PASC patients with comorbid mental illness in comparison with a control group based on treatment as usual. The results of the study can contribute to the

关键词： Osteoarticular mucormycosis   COVID-associated mucormycosis   Disseminated mucormycosis  

摘要： A 38 year old man with no known comorbidities presented with pain and swelling over the knee joint a few days after recovery from severe COVID-19. Initial debridement and cultures revealed growth of Mucorales affecting a large segment of the distal femur with also positive cultures obtained from the maxillary sinus and the lower lobe of the right lung. Due to this involvement of a long segment of the femur, right lung and left maxillary sinus, a multidisciplinary approach of above knee amputation along with debridement of left maxillary sinus and lobectomy of right lung lower lobe was performed to decrease the fungal load and favour good prognosis. This report warrants the need for early imaging and surgical debridement of tissue for fungal cultures and biopsy in immunocompromised individuals.

摘要： In India, the spatial coverage of air pollution data is not homogeneous due to the regionally restricted number of monitoring stations. In a such situation, utilising satellite data might greatly influence choices aimed at enhancing the environment. It is essential to estimate significant air contaminants, comprehend their health impacts, and anticipate air quality to safeguard public health from dangerous pollutants. The current study intends to investigate the spatial and temporal heterogeneity of important air pollutants, such as sulphur dioxide, nitrogen dioxide, carbon monoxide, and ozone, utilising Sentinel-5P TROPOMI satellite images. A comprehensive spatiotemporal analysis of air quality was conducted for the entire country with a special focus on five metro cities from 2019 to 2022, encompassing the pre-COVID-19, during-COVID-19, and current scenarios. Seasonal research revealed that air pollutant concentrations are highest in the winter, followed by the summer and monsoon, with the exception of ozone. Ozone had the greatest concentrations throughout the summer season. The analysis has revealed that NO2hotspots are predominantly located in megacities, while SO2hotspots are associated with industrial clusters. Delhi exhibits high levels of NO2pollution, while Kolkata is highly affected by SO2pollution compared to other major cities. Notably, there was an 11% increase in SO2concentrations in Kolkata and a 20% increase in NO2concentrations in Delhi from 2019 to 2022. The COVID-19 lockdown saw significant drops in NO2concentrations in 2020; specifically, − 20% in Mumbai, − 18% in Delhi, − 14% in Kolkata, − 12% in Chennai, and − 15% in Hyderabad. This study provides valuable insights into the seasonal, monthly, and yearly behaviour of pollutants and offers a novel approach for hotspot analysis, aiding in the identification of major air pollution sources. The results offer valuable insights for developing effective strategies to tackle air pollution, safeguard pu

关键词： COVID-19   Influenza   Influenza-like illness   Acute respiratory infection   Diagnosis   Healthcare personnel  

摘要： Background To evaluate the influenza-like illness (ILI) and acute respiratory infection (ARI) case definitions in the diagnosis of COVID-19 and influenza in healthcare personnel (HCP). Methods We followed a cohort of 5752 HCP from November 2022 to May 2023. Symptomatic HCP were tested for SARS-CoV-2 and influenza by real-time PCR and/or rapid antigen detection test. ILI was defined as the sudden onset of ≥1 systemic symptom and ≥1 respiratory symptom. ARI was defined as the sudden onset of ≥1 respiratory symptom. Patients with respiratory symptoms were grouped either as ILI or as ARI based on the presence of fever, malaise, headache and/or myalgia. Results Overall, 466 ILI cases and 383 ARI cases occurred. HCP with ILI had an adjusted odds ratio (aOR) of 22.05 [95% confidence interval (CI): 6.23–78.04] to be diagnosed with influenza. HCP with ARI had an aOR of 2.70 (95% CI: 1.88–3.88) to be diagnosed with COVID-19. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ILI for influenza were 96.6%, 49.9%, 18.2%, and 99.2%, respectively. The sensitivity, specificity, PPV, and NPV of ARI for COVID-19 were 51.7%, 73.6%, 84.9%, and 34.8%, respectively. ILI and ARI had an overall correct classification rate of 89.6% and 74.1%, respectively. Conclusion Our findings support the use of both ILI and ARI case definitions in the diagnosis of influenza and COVID-19 in HCP.

摘要： COVID-19 case rates in the US wax and wane in wave-like patterns over time, but the spatial patterns of these temporal epidemic waves have not been well characterized. By analyzing state- and county-level COVID-19 case rate data for spatiotemporal decomposition modes and oscillatory patterns, we demonstrate that the transmission dynamics of COVID-19 feature recurrent spatiotemporal patterns. In addition to the well-recognized national-level annual mid-winter surges, we demonstrate a prominent but previously unrecognized six-month north–south oscillation in the eastern US (Eastern US COVID-19 Oscillator—EUCO) that gives rise to regional sub-epidemics and travelling epidemic waves. We also demonstrate a second less prominent pattern that oscillates east–west in the northern US (Northern US COVID-19 Oscillator—NUCO). The drivers of these newly recognized oscillatory epidemic patterns remain to be elucidated.

关键词： SARS-CoV-2   COVID-19 heart samples   Ferroptosis   Bioinformatics   Gene regulatory network   CELL-DEATH   INFLAMMATION   MECHANISMS   DATABASE  

摘要： Background: The coronavirus disease 2019 (COVID-19) was caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which led to a huge mortality rate and imposed significant costs on the health system, causing severe damage to the cells of different organs such as the heart. However, the exact details and mechanisms behind this damage are not clarified. Therefore, we aimed to identify the cell and molecular mechanism behind the heart damage caused by SARS-Cov-2 infection. Methods: RNA-seq data for COVID-19 patients' hearts was analyzed to obtain differentially expressed genes (DEGs) and differentially expressed ferroptosis-related genes (DEFRGs). Then, DEFRGs were used for analyzing GO and KEGG enrichment, and perdition of metabolites and drugs. we also constructed a PPI network and identified hub genes and functional modules for the DEFRGs. Subsequently, the hub genes were validated using two independent RNA-seq datasets. Finally, the miRNA-gene interaction networks were predicted in addition to a miRNA-TF coregulatory network, and important miRNAs and transcription factors (TFs) were highlighted. Findings: We found ferroptosis transcriptomic alterations within the hearts of COVID-19 patients. The enrichment analyses suggested the involvement of DEFRGs in the citrate cycle pathway, ferroptosis, carbon metabolism, amino acid biosynthesis, and response to oxidative stress. IL6, CDH1, AR, EGR1, SIRT3, GPT2, VDR, PCK2, VDR, and MUC1 were identified as the ferroptosisrelated hub genes. The important miRNAs and TFs were miR-124-3P, miR-26b-5p, miR-183-5p, miR-34a-5p and miR-155-5p; EGR1, AR, IL6, HNF4A, SRC, EZH2, PPARA, and VDR. Conclusion: These results provide a useful context and a cellular snapshot of how ferroptosis affects cardiomyocytes (CMs) in COVID-19 patients' hearts. Besides, suppressing ferroptosis seems to be a beneficial therapeutic approach to mitigate heart damage in COVID-19.

关键词： Long COVID   Real world data   Clinical trials  

摘要： Long COVID, a spectrum of symptoms and syndromes that can develop after SARS-COV-2 infection, can significantly affect patients' health, quality of life and impact their ability to productively function in society. There is currently no approved therapy for Long COVID and there is an urgent need for rigorous clinical trials to find such treatments. Although research into the pathophysiology of Long COVID is advancing, investigations into treatment for patients remain underfunded and, as a result, understudied. Owing to the urgency of the Long COVID pandemic and as a research collaborative across a diversity of biomedical innovation value propositions, we are calling for a new approach that parallelizes pathophysiologic and therapeutic research into this condition, leveraging patient-centered research and real-world data to generate hypotheses to assess the effectiveness of existing FDA approved drugs. Accelerated discovery of therapeutics for Long COVID can then be confirmed through efficient and cost-effective adaptive platform clinical trials.

关键词： Polycyclic aromatic hydrocarbons   Human activities   Long-term   Lockdown   Source apportionment   Risk assessment   HEALTH-RISK ASSESSMENT   SOURCE APPORTIONMENT   PAHS   SEDIMENTS   RIVER   PCBS   AIR   ATMOSPHERE   EXPOSURE   AREA  

摘要： The lockdown restrictions against coronavirus disease 2019 (COVID-19) have led to unprecedented reductions in global anthropogenic activities. Polycyclic aromatic hydrocarbons (PAHs) are carcinogenic combustion-induced pollutants, but the influence of anthropogenic responses to COVID-19 on PAH contamination remains largely unknown. Here we quantified the impacts of lockdown restrictions on 16PAH pollution based on the data in concentrations dissolved in the water phase and absorbed on the suspended particulate matter (SPM) in the Elbe River from 2015 to 2021 and determined the changes in source contributions classified by individual years and stations. Results show that the annual average PAH concentrations in water and SPM were determined as 0.055 mu g center dot L-1-1 and 3.77 mg center dot kg-1-1 from 2015 to 2021, respectively. Pronounced declines in PAH on SPM (up to-18%) were observed during the three lockdowns in Germany from 2020 to 2021. However, dramatic rebounds of anthropogenic activities during the removal of the lockdown led to increases (up to 29 %) in & sum; 16 PAH concentrations compared to the same period in previous years. Through the source apportionment method, vehicle and coal emissions were the two most predominant sources of PAHs in the river. Vehicle contribution decreased during the lockdown, while coal emissions increased by 5 %. Health risks for three age groups were assessed as potential low risk and decreased by 18% from 1.54 x 10-4 -4 in 2015 to 1.27 x 10-4 -4 in 2019, and rebounded to 1.40 x 10-4 -4 in 2020-2021. The findings of this study highlight the strong consistency between PAH concentrations and anthropogenic intensity, implying that source control from improved cleaner production is an effective pathway for mitigating PAH contamination in the aquatic environment.

关键词： Covid-19   Ghana   Pets   Pet owners  

摘要： The study explores the impact of Covid-19 on pets and their owners using a structured questionnaire. One hundred fifty-seven (157) respondents were recruited from six veterinary clinics at strategic points within Accra. Only a third of owners gave their pet(s) special attention out of fear of contracting Covid-19 from their pet(s). 68.2 % of the respondents were interested in learning healthy pet-keeping tips from the electronic media and evident in their willingness (75.2 %) to embrace tele-veterinary services; a potential drift from traditional in-person way of providing veterinary services in Ghana. The decrease in household income (46.5 %), loss of employment for at least one person in the household (17.2 %) and associated spike in prices of pet related commodities affected the feeding of pets in about 44 % of respondents and ability to afford veterinary pet products (17.2 %). This is reflected in a 12.7 % reduction in the ability of pet owners to afford veterinary services. The observations made could be used as a basis for future research exploring the pet culture in Ghana and its evolution as a direct consequence of the pandemic.

摘要： This study aims to explore the perspectives of community leaders (CL) on trusted sources of health information, examine their roles, challenges, and needs in disseminating COVID-19 health information, and identify opportunities to improve public health reach and access for underserved communities. This qualitative study included seven focus groups conducted via online video conferencing from April-June 2021. The participants (n= 9) were CL recruited from the TexasCommunityEngagementAlliance (CEAL) for their experience working with underserved communities in Dallas, Texas. Data were coded deductively and analyzed thematically. The analysis resulted in three themes: (1) Information fatigue, mistrust, and desensitization were experienced by community members and leaders; (2) CL were expected to process, verify, and share accurate and timely COVID-19 health information; (3) CL identified potential strategies to improve COVID-19 health info access and reach. CLs were critical in addressing mis/disinformation and fostering trust in public health communication, particularly in underserved communities. They acted as vital intermediaries for health information, striving to debunk mis/disinformation and disseminate accurate health information. Public health strategies could benefit from prioritizing the integration of CL in communicating health information during crises and rebuilding trust within historically and racially marginalized and underserved communities. Supporting CLs, for example, through resources and training programs to counter misinformation and provide access to culturally and linguistically tailored health resources, may significantly enhance the access and reach of evidence-based health communication during health crises.