关键词： aspergillosis   COVID-19   galactomannan   invasive fungal infection   secondary bacterial infections   ANTIBIOTICS  

摘要： Background Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is a life-threatening fungal infection. Studies focusing on CAPA in low- and middle-income countries are *** This retrospective matched case-control study was conducted at a tertiary care center in South India. Cases of CAPA were classified using the 2020 European Confederation of Medical Mycology/International Society for Human and Animal Mycology consensus criteria. A total of 95 cases were matched 1:1 with COVID-19 patients without CAPA. Matching was done based on age and period of admission. Inverse probability weighting was used to account for imbalances in COVID-19 severity and intensive care unit (ICU) admission. Data on demographics, clinical details, microbiologic and radiologic data, and treatment outcomes were collected. A predictive score for CAPA was developed from baseline risk *** The predictive score identified lymphopenia, European Organisation for Research and Treatment of Cancer risk factors, and broad-spectrum antibiotic use as the main risk factors for CAPA. Positivity for bacterial pathogens in blood or bronchoalveolar lavage samples reduced the risk of CAPA. The predictive model performed well in cross-validation, with an area under the curve value of 82%. CAPA diagnosis significantly increased mortality and shift to *** The predictive model derived from the current study offers a valuable tool for clinicians, especially in high-endemic low- and middle-income countries, for the early identification and treatment of CAPA. With further validation, this risk score could improve patient outcomes. In low- and middle-income country settings, a model that incorporates risk factors such as lymphopenia, any European Organisation for Research and Treatment of Cancer risk factor, the use of broad-spectrum antimicrobials and absence of positive bacterial cultures from blood or respiratory secretions is a useful tool for predicting C

关键词： COVID-19   intensive care units   mechanical ventilation   risk factors   IMPACT  

摘要： Several risk factors were associated with mortality in patients with coronavirus disease 2019 (COVID-19) infection in intensive care units (ICU). We assessed the effect of risk factors related to the characteristics and clinical history of the population, laboratory test results, drug management, and type of ventilation on the probability of survival/discharge from the ICU. A retrospective cohort multicentric study of adults with COVID-19 admitted to the ICU between March 2020 and December 2021. Data were collected from 6 hospitals in 5 cities in Ecuador. The primary outcome was ICU survival/discharge. Survival analysis was conducted using semi-parametric Cox proportional hazards models. Of those admitted to the ICU with COVID-19, (n = 991), mean age was 56.76 +/- 13.14, and 65.9% were male. Regarding the primary outcome, 51.1% (n = 506) died and 48.9% (n = 485) survived. Of the group that died, their mean age was higher than the survivors (60.7 vs 52.60 years, respectively), and they had a higher prevalence of comorbidities such as arterial hypertension (37.2% vs 20.4%, respectively) and diabetes mellitus (26.9% vs 15.7%, respectively), with P < .001. In ventilatory management, 32.7% of patients used noninvasive ventilation and high-flow nasal cannula, and 67.3% required invasive ventilatory support. After adjusting for confounders, Cox regression analysis showed that patients were less likely to be discharged alive from the ICU if they met the following conditions: arterial hypertension (hazard ratio [HR] = 0.83 95% CI 0.723-0.964), diabetes mellitus (HR = 0.80 95% CI 0.696-0.938), older than 62 years (HR = 0.86 95% CI 0.790-0.956), obese (body mass index >= 30) (HR = 0.78 95% CI 0.697-0.887), 1 unit increase in SOFA score (HR = 0.94 95% CI 0.937-0.961), PaO2/FiO(2) ratio <100 mm Hg (HR = 0.84 95% CI 0.786-0.914), and the use of invasive mechanical ventilation (HR = 0.68 95% CI 0.614-0.769). Risk factors associated with increased mortality were older age, obesity,

关键词： COVID-19   End of life care   Quality of care   Health care providers  

摘要： BackgroundDuring the COVID-19 pandemic, the way in which end-of-life care was provided, underwent a lot of changes and therefor different domains of end-of-life care were impacted. The aim of this study is to describe whether health care providers considered end-of-life care (in medical, nursing, psychosocial and spiritual care) limited by the pandemic through the first 18 months of the COVID-19 pandemic, and examine associations with COVID-19 related circumstances of care (e.g. visit restrictions) and health care providers' *** longitudinal survey study among healthcare providers from different healthcare settings who provided end-of-life care during the pandemic's first 18 months. Data of four time periods were analyzed using descriptive statistics and Generalized Estimating *** the respondents (n = 302) the majority had a nursing background (71.8%) and most worked in a hospital (30.3%). Especially in the first wave end-of-life care in all aspects was limited according to a substantial part of health care providers (between 29.7 and 57.7%). Psychosocial and spiritual care were more limited than medical and nursing care during all time periods. Care being limited according to health care providers was associated with visit restrictions, shortness of personal protective equipment or restrictions in caring for the deceased and decreased over *** COVID-19 pandemic impacted different aspects of end-of-life care throughout the pandemic's first 18 months. Over the course of the pandemic health care providers seemed to have invented ways to adjust their work in order to minimize the effect of limiting measures. More involvement of health care providers in decision-making may improve the prioritization of measures to deal with crisis situations in care. These reflections highlight priorities during crises and the role healthcare providers could play in maintaining good end-of-life care. This remains relevant in new health

关键词： DISEASE   DYNAMICS   SPREAD  

摘要： Individual-based models of infectious disease dynamics commonly use network structures to represent human interactions. Network structures can vary in complexity, from single-layered with homogeneous mixing to multi-layered with clustering and layer-specific contact weights. Here we assessed policy-relevant consequences of network choice by simulating different network structures within an established individual-based model of SARS-CoV-2 dynamics. We determined the clustering coefficient of each network structure and compared this to several epidemiological outcomes, such as cumulative and peak infections. High-clustered networks estimate fewer cumulative infections and peak infections than less-clustered networks when transmission probabilities are equal. However, by altering transmission probabilities, we find that high-clustered networks can essentially recover the dynamics of low-clustered networks. We further assessed the effect of workplace closures as a layer-targeted intervention on epidemiological outcomes and found in this scenario a single-layered network provides a sufficient approximation of intervention effect relative to a multi-layered network when layer-specific contact weightings are equal. Overall, network structure choice within models should consider the knowledge of contact weights in different environments and pathogen mode of transmission to avoid over- or under-estimating disease burden and impact of interventions.

关键词： diabetes type 1   children   adolescents   mental disorders   COVID-19 pandemic   EMERGING ADULTS   SUBSTANCE USE   DEPRESSION   RISK  

摘要： Objectives The COVID-19 pandemic affected the mental health of children and adolescents in the general population, yet its impact on those with chronic conditions is relatively unknown. This study aimed to compare the incidences of comorbid mental disorders and substance misuse in children and adolescents with type 1 diabetes before and during the *** A total of 42,975 patients aged 6-18 years from the multicentre DPV (Diabetes prospective follow-up) registry were included. Multivariable regression models were applied to compare newly diagnosed comorbid mental disorders, adjusted for demographic and clinical variables, among them the number of medical visits, during the pre-pandemic period (09/2017-02/2020) and the COVID-19 pandemic period (03/2020-08/2022).Results Analysing both sexes together, there were no differences in the incidence rates of overall mental disorders between the pandemic and the pre-pandemic period. However, girls showed an increased incidence rate (odds ratio 1.2, CI 1.1-1.3) during the pandemic. Adolescent girls also displayed higher incidence rates of depression, eating disorders, and self-harm. Substance misuse declined overall during the pandemic (odds ratio 0.8, CI 0.7-0.9).Conclusions During the COVID-19 pandemic, we found higher incidence rates of overall mental disorders in girls, but not in boys and not in the total study population of children and adolescents with type 1 diabetes. Adolescent girls displayed increased incidence rates of depression, eating disorders, and self-harm. Substance misuse declined substantially. Clinicians should be aware of the high-risk group of adolescent girls during times of increased strain.

关键词： Policy learning   Twitter   public administration   time   well-being   Covid-19   SOCIAL MEDIA USE   GOVERNMENT   IMPACT   SATISFACTION   FRAMEWORK   HAPPINESS  

摘要： Drawing on a broader study on perceptions of time and well-being during Covid-19, we show how governments can use social media platforms, such as Twitter, to acquire knowledge for policy learning and design. We argue social knowledge, which includes personal storytelling, emotion, and use of hashtags and emojis, can contribute to policy learning. Using a qualitative approach, we examine citizens' pandemic-related experiences, including changing work routines, mental health and self-care, sleep patterns, domestic violence, and feelings of solidarity. Such data could be useful to policymakers as they provide insights into the impact of the pandemic on citizens' everyday lives.

关键词： COVID-19   Mathematical model   Global stability   Model fitting   Cost-effectiveness analysis  

摘要： In addressing the global challenges posed by COVID-19, this study introduces a mathematical model aimed at investigating the transmission dynamics of COVID-19 and forwarding strategies for controlling it. By employing Lyapunov functions, we perform a thorough stability analysis of both disease-free and endemic equilibria. We calibrated the model using daily COVID-19 data from early 2022 in Ethiopia, after vaccination initiation. A global sensitivity analysis confirmed the robustness of the model. In addition, we extended the model to address optimal control by incorporating vaccination, public health education, and treatment. Our findings highlight the effectiveness of individual control measures and reveal that vaccination, public health educational campaign and treatment is the most cost-effective method for mitigating COVID-19 spread.

关键词： COVID-19   stock markets   internet concern   GARCH type models   high-concern and low-concern periods   VOLATILITY   RETURNS   MODELS  

摘要： The unprecedented outbreak of Corona Virus Disease 2019 (COVID-19) has resulted in extreme volatility in stock markets. This study mainly examines the predictive ability of the Internet concern about COVID-19 on stock index returns, based on the framework of GARCH type models. Instead of using the whole sample period, we divide the Internet concern about COVID-19 into high-concern and low-concern periods by breakpoint test method and then examine its predictive ability for stock returns in different periods, respectively. Using stock indexes of 10 countries and abnormal Google search volume of 'coronavirus' as study samples, the results reveal that (1) the Internet concern about COVID-19 has a negative impact on the stock index returns in the whole and high-concern periods, while its influence in the low-concern period is mixed; (2) the Internet concern about COVID-19 improves the prediction accuracy of stock index returns in the high-concern period, while seems to lose its powerful predictive ability in the whole and low-concern periods.

摘要： When considering the pathogenesis of COVID-19 and post-COVID syndrome, the disorders associated with the immune system come to the forefront. Complexes of immune dysregulation and dissonant responses of the innate and adaptive immune systems of a patient should be considered as the main reasons for the complex pattern of lesions. These processes include cellular inflammation, hemovascular homeostasis disorder, and organ damage. Consistent analysis of these processes is a basis for selecting the schemes of therapeutic strategy, taking into account clinical indices and personal characteristics of patients.

关键词： 生命史策略   疫情压力   问题行为   亲社会行为   青少年  

摘要： 基于生命史理论，个体在COVID-19疫情压力下对自身生命史策略的调整是其适应性的表现之一。本研究采用方便取样的方法，以3所初中的8、9年级共1125名(男生:51.2%,T1时年龄:14.30±0.73)初中生为被试，开展两次追踪研究，结果发现:(1)疫情后青少年快生命史策略水平显著升高，并且疫情压力越大，个体越倾向于快生命史策略;(2)快生命史策略的水平在疫情压力影响内化问题行为水平中起部分中介作用，在影响外化问题行为和亲社会行为的水平中起完全中介作用;快生命史策略的变化在疫情压力影响三类行为变化中均起完全中介作用。研究初步揭示了疫情压力对快生命史策略的影响及其对青少年社会适应的作用。