关键词： COVID-19   Intensive care   Grounded theory   Nursing ethics   Pandemic   Moral distress   Critical care nursing   ICU nurses   Qualitative research   HEALTH-CARE WORKERS   MENTAL-HEALTH   MORAL DISTRESS   INTENTIONS   BURNOUT  

摘要： Background: The coronavirus (COVID-19) pandemic presented unprecedented challenges to healthcare systems worldwide, with intensive care unit (ICU) nurses at the forefront of patient care. To date, there is limited evidence into ICU nurses'experiences of the pandemic in Kuwait. Research question/aims/objectives: To elucidate the challenges faced by ICU nurses in Kuwait during the pandemic, by considering two research questions: "What contributed to intensified pressure for the ICU nurses?" and "How were the nurses affected?". Research design: This was a qualitative study which utilised semi-structured interviews. Interviews were conducted between January 2021 and June 2022 with ICU nurses who worked during the COVID-19 pandemic. The data were analysed using Charmaz's grounded theory methodology. Participants and research context: 25 nurses from three ICUs in Kuwait. Ethical considerations: The study was approved by the University Ethics Committee and by the Ministry of Health in Kuwait. Findings/Results: The analysis identified two themes (the factors contributing to intensified pressure in the ICU, and the impact on the nurses) and seven sub-themes. The pressure in the ICU intensified due to the rise in the number of patients, staff shortages, and the requirement to adhere to unrealistic new procedures for infection control. Restricted and cancelled leave, as well as impaired autonomy at work, impeded the nurses' ability to recover from stress. The heightened stress also contributed to a worsening in interpersonal relationships between the nurses and their colleagues. The nurses' care was compromised by these challenges, leading to moral distress and a range of mental health symptoms (e.g., stress, anxiety, emotional exhaustion). Conclusions: The study accords with other research conducted during the pandemic in revealing a significant mental health toll among healthcare workers during the pandemic. The stressors were similar to those which have been reported in oth

关键词： Chromosome-Y   Haplogroups   COVID-19   Hypertension   CORONARY-ARTERY-DISEASE   SUSCEPTIBILITY  

摘要： The main objective of this study was to determine whether the common Y-haplogroups were be associated with the risk of developing severe COVID-19 in Spanish male. We studied 479 patients who required hospitalization due to COVID-19 and 285 population controls from the region of Asturias (northern Spain), They were genotyped for several polymorphisms that define the common European Y-haplogroups. We compared the frequencies between patients and controls aged <= 65 and >65 years. There were no different haplogroup frequencies between the two age groups of controls. Haplogroup R1b was less common in patients aged <= 65 years. Haplogroup I was more common in the two patients groups compared to controls (p = 0.02). Haplogroup R1b was significantly more frequent among hypertensive patients, without difference between the hypertensive and normotensive controls. This suggested that R1b could increase the risk for severe COVID-19 among male with pre-existing hypertension. In conclusion, we described the Y-haplogroup structure among Asturians. We found an increased risk of severe COVID-19 among haplogroup I carriers, and a significantly higher frequency of R1b among hypertensive patients. These results indicate that Y-chromosome variants could serve as markers to define the risk of developing a severe form of COVID-19.

关键词： Tourism management   Social media big data   National parks   COVID-19   Geographical weighted regression   DYNAMICS   TWITTER  

摘要： COVID-19 posed challenges for global tourism management. Changes in visitor temporal and spatial patterns and their associated determinants pre- and peri-pandemic in Canadian Rocky Mountain National Parks are analyzed. Data was collected through social media programming and analyzed using spatiotemporal analysis and a geographically weighted regression (GWR) model. Results highlight that COVID-19 significantly changed park visitation patterns. Visitors tended to explore more remote areas peri-pandemic. The GWR model also indicated distance to nearby trails was a significant influence on visitor density. Our results indicate that the pandemic influenced tourism temporal and spatial imbalance. This research presents a novel approach using combined social media big data which can be extended to the field of tourism management, and has important implications to manage visitor patterns and to allocate resources efficiently to satisfy multiple objectives of park management.

关键词： SARS-CoV2   COVID-19   antibody   vaccine   mutation   immune response   IFIH1   interferon   SARS-COV-2 SPIKE-PROTEIN   RIG-I   RESVERATROL   EFFICACY   VIRUS   MDA5  

摘要： SARS-CoV2 is a novel respiratory coronavirus and, understanding its molecular mechanism is a prerequisite to developing effective treatment for COVID-19. This RNA genome-carrying virus has a protein coat with spikes (S) that attaches to the ACE2 receptor at the cell surface of human cells. Several repurposed drugs are used to treat COVID-19 patients that are proven to be largely unsuccessful or have limited success in reducing mortalities. Several vaccines are in use to reduce the viral load to prevent developing symptoms. Major challenges to their efficacy include the inability of antibody molecules to enter cells but remain effective in the bloodstream to kill the virus. The efficacy of vaccines also depends on their neutralizing ability to constantly evolve new virus strains due to novel mutations and evolutionary survival dynamics. Taken together, SARS-CoV2 antibody vaccines may not be very effective and other approaches based on genetic, genomic, and protein interactome could be fruitful to identify therapeutic targets to reduce disease-related mortalities.

关键词： Cystic fibrosis   Pandemic   Environments   Youth   SOCIAL DETERMINANTS   HEALTH  

摘要： The pandemic disproportionately influenced marginalized communities in North America. However, the social and spatial inequalities impacting marginalized rare genetic disease communities - such as those living with cystic fibrosis - have not been heard in mainstream pandemic narratives. Sensitized by the social determinants of health, this qualitative study explored the experiences of 12 youth with Cystic Fibrosis (CF) during the pandemic. Content analysis revealed four themes. Youth with CF experienced changes across physical spaces, faced pandemic anxiety, and struggled with access to digital and medical spaces. Youth also reflected on being "used to" life-long physical distancing as a result of CF. Our findings show the complexity of environments for youth with CF during the pandemic while demonstrating how Covid-19 shaped the lives of rare disease communities. Our findings also illustrate spatial and social inequities among marginalized, rare genetic disease communities.

关键词： Telomere length   COVID-19   Mendelian randomization   Genetic correlation   Mediation analysis   MENDELIAN RANDOMIZATION   TOBACCO SMOKING   DISEASE   BIAS   INSTRUMENTS   PERSISTENCE   INTEGRATION   SYMPTOMS   HEALTH   POWER  

摘要： Background: Observational studies suggested that leukocyte telomere length (LTL) is shortened in COVID-19 patients. However, the genetic association and causality remained unknown. Methods: Based on the genome-wide association of LTL (N = 472,174) and COVID-19 phenotypes (N = 1086,211-2597,856), LDSC and SUPERGNOVA were used to estimate the genetic correlation. Cross-trait GWAS meta-analysis, colocalization, fine-mapping analysis, and transcriptome-wide association study were conducted to explore the shared genetic etiology. Mendelian randomization (MR) was utilized to infer the causality. Upstream and downstream two-step MR was performed to investigate the potential mediating effects. Results: LDSC identified a significant genetic association between LTL and all COVID-19 phenotypes (rG < 0, p < 0.05). Six significant regions were observed for LTL and COVID-19 susceptibility and hospitalization, respectively. Colocalization analysis found rs144204502, rs34517439, and rs56255908 were shared causal variants between LTL and COVID-19 phenotypes. Numerous biological pathways associated with LTL and COVID-19 outcomes were identified, mainly involved in -immune-related pathways. MR showed that longer LTL was significantly associated with a lower risk of COVID-19 severity (OR [95% CI] = 0.81 [0.71-0.92], p = 1.24 x103) and suggestively associated with lower risks of COVID-19 susceptibility (OR [95% CI] = 0.96 [0.92-1.00], p = 3.44 x10-2) and COVID-19 hospitalization (OR [95% CI] = 0.89 [0.80-0.98], p = 1.89 x10-2). LTL partially mediated the effects of BMI, smoking, and education on COVID-19 outcomes. Furthermore, six proteins partially mediated the causality of LTL on COVID-19 outcomes, including BNDF, QPCT, FAS, MPO, SFTPB, and APOF. Conclusions: Our findings suggested that shorter LTL was genetically associated with a higher risk of COVID-19 phenotypes, with shared genetic etiology and potential causality.

关键词： Radiation therapist practice   Work environment   Job satisfaction   COVID-19   Radiation therapy   Patient care   Policies and procedures   ONCOLOGY   INVOLVEMENT   EXPERIENCE  

摘要： Introduction: There were many policy and procedure (P&P) changes implemented in health care facilities to combat the spread of the coronavirus disease 2019 (COVID-19). Common changes included an increase in personal protective equipment usage, room occupancy limits, limitations in visitors/family members and the absence of volunteers. This study evaluated the current views and opinions of Radiation Therapists (RTs) in British Columbia relating to how COVID19 P&P changes have impacted their clinical practice. The goal was to identify gaps in the areas of RT practice, allow for self-reflection among RTs and potentially guide future P&Ps with patient-centred care at the forefront. Methods: A 24-item cross-sectional questionnaire was created and sent via e-mail to all RTs working across the province. Key sections explored in the questionnaire were: 1) patient care delivery, 2) staff- work environment, and 3) work satisfaction. Descriptive analysis was performed on the questionnaire responses. Results: Of the approximate 300 invited participants, 107 responses were received from all areas of Radiation Therapy (Treatment units, CT simulation, Dosimetry, etc.) and from all cancer centres in the province. RT staff indicated that COVID-19 P&P negatively impacted patient care, including the ability to verbally and non-verbally communicate with patients (82 %), assess for side effects (85 %), and build rapport (62 %). A majority (79 %) of RT staff felt that communication with co-workers had been negatively impacted as well. When queried regarding the impact on staff environment, 51 % of RT staff agreed that the absence of volunteers increased their workload and the responses were polarized (46 % disagree, 35 % agree) when asked if RT staff have enough time for cleaning their clinical areas with new COVID-19 P&Ps in place. 78 % of RTs were aware of where to go with COVID-19 safety concerns and thought they received adequate education concerning COVID P&Ps. When asked to rank th

关键词： SARS-CoV-2   Quantitative real-time PCR   Variant   Delta   BA.1, vaccines  

摘要： Background The emergence and rapid spread of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), poses a significant threat to human health and public safety. While next-generation sequencing (NGS) is capable of detecting and tracking new COVID-19 variants for disease diagnosis and prevention, its high cost and time-consuming nature limit its widespread use. In this study, our aim was to develop a highly adaptable and accurate RT-PCR method for identifying the Delta or BA.1 variants in inactivated COVID-19 vaccine. We devised three two-plex RT-PCR methods targeting specific mutation sites: S: Delta 156-157, S: N211-, L212I, and S: Delta 142-144, Y145D. The RT-PCR method targeting the S: Delta 156-157 mutation site was able to distinguish the Delta variant from other COVID-19 virus strains, while the RT-PCR methods targeting the S: N211-, L212I or S: Delta 142-144, Y145D mutation sites were able to distinguish the BA.1 variant from other COVID-19 virus strains. We separately validated these three two-plex RT-PCR methods, and the results demonstrated good linearity, repeatability, reproducibility, and specificity for each method. Moreover, all three methods can be applied in the production of SARS-CoV-2 variant inactivated vaccines, enabling the identification of Delta or BA.1 variants in virus cultures as well as in inactivated vaccine stocks. This study presents a systematic approach to identify COVID-19 variants using multiple RT-PCR methods. We successfully developed three two-plex RT-PCR methods that can identify Delta and BA.1 variants based on specific mutation sites, and we completed the validation of these three methods.

关键词： COVID-19  

摘要： The COVID-19 pandemic dramatically impacted the global post-secondary education environment beginning March 2020, leaving many classes using the traditional face-to-face delivery method scrambling to adapt. This paper describes the process used in response to COVID to convert a traditional lecture-style business intelligence class to a flipped classroom, while maintaining assignments, groups, and discussion as student engagement techniques. End of term skills assessments of four pre-COVID sections are combined with skills assessments from two during-COVID flipped online sections. The during-COVID sections use pre-recorded Kaltura video lectures, supplemented with Blackboard Collaborate virtual meetings, in a flipped online delivery approach. Partial least squares (PLS) regression results indicate a flipped approach augments other student engagement methods and significantly improves skills attainment. Results also indicate that while group formation continues to enhance in-class assignment completion and reflection, discussion is less impactful in an online environment. This research highlights nuances of business intelligence education and provides suggestions for enhancing approaches for improved skills attainment. © (2023), (ISCAP- Information Systems and Computing Academic Professionals). All Rights Reserved.

摘要： Background: Acute respiratory viral infections have been associated with an increased incidence of adverse cardiovascular events. However, it is unclear whether severe respiratory viral infections are associated with an increased risk of acute aortic syndromes (AAS). This study was designed to assess whether Coronavirus disease 2019 (COVID-19) and Influenza illnesses are associated with an increased incidence of subsequent AAS in the US population. Methods: We used the MarketScan database (2011-2021) to identify patients 18-99 years of age without prior diagnosis of aortic pathology who were diagnosed with COVID-19 or Influenza. Identified patients were matched 1:1 by age and sex to control patients without COVID-19 or Influenza. The primary outcome was incidence of AAS (dissection, intramural hematoma, penetrating aortic ulcer, or aneurysm rupture) within 180-days of a viral infection. The association between infection and risk of developing an AAS was analyzed using multivariate Cox proportional hazards models. Results: We identified 1,775,698 patients, including 779,229 (44%) with mild COVID-19, 42,141 (2%) with severe COVID-19, and 66,479 (4%) with Influenza that were matched to 887,849 (50%) control patients without COVID-19 or Influenza illnesses. A total of 164 patients experienced AAS within 6-months after diagnosis, which was highest among those after severe COVID-19. The predicted incidence of AAS was significantly higher among patients after severe COVID-19 (14.1 events/100,000 person-years), mild COVID19 (13.3 events/100,000), and influenza (13.3 events/100,000) when compared to control patients (2.6 events/100,000). In risk-adjusted Cox regression models, severe COVID-19 (HR:5.4, 95% CI:2.8-10.4; P < 0.01), mild COVID-19 (HR:5.1, 95% CI:3.3-7.7; P < 0.01) and influenza (HR:5.1, 95% CI:2.6-9.7; P < 0.01) diagnoses were associated with a significantly increased risk of AAS within 180-days when compared to matched controls. Conclusions: There is an increas