关键词： SARS-CoV-2   COVID-19   K18-hACE2   angiotensin-converting enzyme inhibitors   ACEi   lisinopril   ANGIOTENSIN-CONVERTING ENZYME   RECEPTOR BLOCKERS   CORONAVIRUS   INHIBITORS   SARS   PATHOGENESIS   OUTCOMES   RISK  

摘要： COVID-19 causes more severe and frequently fatal disease in patients with pre-existing comorbidities such as hypertension and heart disease. SARS-CoV-2 virus enters host cells through the angiotensin-converting enzyme 2 (ACE2), which is fundamental in maintaining arterial pressure through the renin-angiotensin system (RAS). Hypertensive patients commonly use medications such as angiotensin-converting enzyme inhibitors (ACEi), which can modulate the expression of ACE2 and, therefore, potentially impact the susceptibility and severity of SARS-CoV-2 infection. Here we assessed whether treatment of ACE2-humanized (K18-hACE2) mice with the ACEi Lisinopril affects lung ACE2 levels and the outcome of experimental COVID-19. K18-hACE2 mice were treated for 21 days with Lisinopril 10 mg/kg and were then infected with 105 PFU of SARS-CoV-2 (Wuhan strain). Body weight, clinical score, respiratory function, survival, lung ACE2 levels, viral load, lung histology, and cytokine (IL-6, IL-33, and TNF-alpha) levels were assessed. Mice treated with Lisinopril for 21 days showed increased levels of ACE2 in the lungs. Infection with SARS-CoV-2 led to massive decrease in lung ACE2 levels at 3 days post-infection (dpi) in treated and untreated animals, but Lisinopril-treated mice showed a fast recovery (5dpi) of ACE2 levels. Higher ACE2 levels in Lisinopril-treated mice led to remarkably higher lung viral loads at 3 and 6/7dpi. Lisinopril-treated mice showed decreased levels of the pro-inflammatory cytokines IL-6 and TNF-alpha in the serum and lungs at 6/7dpi. Marginal improvements in body weight, clinical score and survival were observed in Lisinopril-treated mice. No differences between treated and untreated infected mice were observed in respiratory function and lung histology. Lisinopril treatment showed both deleterious (higher viral loads) and beneficial (anti-inflammatory and probably anti-constrictory and anti-coagulant) effects in experimental COVID-19. These effects seem to comp

关键词： COVID-19  

摘要： Understanding students' preferences and learning satisfaction during COVID-19 has been primarily centred on online learning and has focused on learning attributes such as self-efficacy, performance, and engagement. Although existing efforts have constructed statistical models capable of accurately identifying significant factors impacting learning satisfaction, these models do not necessarily explain the complex relationships among these factors in depth. This study aimed to understand several facets related to student learning preferences and satisfaction during the pandemic such as individual learner characteristics, instructional design elements, and social and environmental factors. This could aid institutions and educators tailor more effective teaching strategies. Responses from 302 students from Sungkyunkwan University in South Korea were collected between November 2021 and November 2022. Information gathered included their gender, study major, satisfaction and motivation levels when learning, perceived performance, emotional state and learning environment. Wilcoxon Rank sum test and Explainable Boosting Machine (EBM) were performed to determine significant differences in specific cohorts. The two core findings of the study are as follows: (1) Using Wilcoxon Rank Sum test, we can attest with 95% confidence that students who took offline classes had significantly higher learning satisfaction, among other attributes, than those who took online classes as with Science, Technology, Engineering and Medicine (STEM) versus Humanities and Social Sciences (HASS) students; (2) An explainable boosting machine (EBM) model fitted to 95.08% accuracy determined the top five factors affecting students’ learning satisfaction as: their perceived performance, their perception on participating in class activities, their study majors, their ability to conduct discussions with classmates and the study space availability at home. Positive perceived performance and ability to discus

关键词： Mentorship Program   Mixed method   Performance   Challenges   Interventions   Family medicine   Postgraduate   COVID-19   High-risk trainees   MENTORING RELATIONSHIPS   STUDENTS   OPPORTUNITIES   HEALTH  

摘要： BackgroundWe implemented a contextualized innovative mentorship program in the Clinical Master in Family Medicine (CMFM) program established in April 2020 at Arabian Gulf University. In this paper, we describe the process of this program and derive the major challenges faced by trainees and related corrective actions and their outcomes on high-risk trainees for optimal *** conducted a mixed-method longitudinal study of 80 trainees, analyzing information extracted from the Moodle learning platform about five key performance indicators as well as the contents (quantitative and qualitative) of mentoring meeting reports submitted through a validated online form between 2020 and 2022. We analyzed frequencies and themes of challenges and compared trainees' performance according to time and level of *** follow-up of all 80 trainees in two cohorts (40 for each cohort) shows that most are female (93.75%) and the mean age is 30.00 +/- 2.19 years with a ratio of mentors to mentees of 1 to 5. Meetings are conducted through phone calls, virtually, and face-to-face in 62%, 29%, and 8.3% respectively. The mean number and duration of meetings are 30.88 +/- 2.31 and 20.08 +/- 9.50 min respectively. Time management is the most reported challenge (41.3%), followed by health, social, and psychological-related issues in 7.6%, 4.6%, and 3% respectively. We extracted four main themes related to trainees, settings of training, e-Portfolio, and the COVID-19 pandemic. The mentorship program captured 12 trainees at high risk for low academic progress (12%) of whom six graduated on time and the remaining had to repeat a few courses the following terms. The performance of the program is stable over time (mean GPA of 3.30 (SE = 0.03), versus 3.34 (SE = 0.05) for cohorts 1 and 2 in the two years respectively, (P = 0.33). However, it is slightly lower among high-risk trainees compared to the remaining (GPA = 3.35 (SE = 0.03) versus 3.14 (SE = 0.08), P = 0.043) though

摘要： Corona virus is a type of virus that has been identified as a cause of disease in the respiratory tract and can spread quickly. To overcome the spread of the virus, a preventive measure is carried out in the form of quarantine in a room or quarantine room. Patients in quarantine rooms certainly need drugs to treat exposure to the corona virus. The delivery process to the quarantine room certainly makes health workers vulnerable to contracting this virus. This drug and food delivery robot was made with the aim of being able to replace the role of health workers in delivering medicine and food to the rooms of Covid-19 quarantine patients. This robot is designed to be able to send medicine or food automatically according to the given room number input. This robot uses the concept of odometry, which is to move along a trajectory in the form of the distance between the starting point and the end point (destination) on the coordinate axis of the robot’s movement. In designing the system using myrio as a controller and programmed with Labview software, a sharp infrared sensor gp2y0a21 as a wall detector, an ultrasonic ping sensor as an obstacle detector in front of the robot, an infrared tcrt5000 sensor as a line detector, and a rotary encoder sensor as a detector for the distance traveled by the robot. Based on the experimental results, this robot has been able to work well in the process of delivering drugs and food to each room according to the given room number input. The time needed is less than 3 minutes with an error rate of 0%.

关键词： PSYCHIATRIC-DISORDERS   NORWEGIAN MOTHER   COHORT PROFILE   CHILD COHORT   SYMPTOMS   ANXIETY   WELL  

摘要： Importance Adolescence is a critical developmental phase when mental health disorders, such as anxiety and depression, often emerge. Stringent public health measures and quarantine mandates during the COVID-19 pandemic could threaten adolescent mental health. Objective To investigate the associations of public health measures and quarantine experiences with mental distress among Norwegian adolescents and to explore if certain vulnerability factors moderate these associations. Design, Setting, and Participants This longitudinal cohort study used repeated measures to capture variations in mental distress explained by the stringency of public health measures and quarantine experiences. Data from the Norwegian Mother, Father, and Child cohort study were linked to national health registries and a national stringency index from April 1, 2020, to February 17, 2021. Participant included 7787 Norwegian adolescents aged 16 to 18 years. Data were analyzed from October 2022 to October 2023. Exposures Stringency index of public health measures and quarantine experiences including recent quarantine (within the last 2 weeks) and quarantine frequency (cumulative number of quarantine episodes). Main Outcome and Measures Mental distress was measured using the Hopkins Symptom Checklist across 6 data collection waves. Results In this study, 7787 participants were included in the analysis (4473 female [57%]; mean [SD] age, 17.0 [0.6] years). Stringent public health measures (beta = 0.18; SE, 0.02; P < .001), recent quarantine (beta = 0.11; SE, 0.02; P < .001), and frequent quarantine (beta = 0.08; SE, 0.01; P < .001) were associated with higher levels of mental distress. The associations between public health measures and mental distress were not moderated by sex, age, prepandemic anxiety or depression, or genetic liability for mental health conditions. Frequency of quarantine appeared to be more strongly associated with mental distress among younger adolescents (beta = -0.04; SE, 0.01;

关键词： SARS-COV-2  

关键词： Hybrid teaching   Online teaching   Physiology education   Teaching model   STUDENTS   EDUCATION  

摘要： BackgroundIn the post-pandemic era of higher education, hybrid teaching has emerged as a prevalent approach and is anticipated to persist as a defining trend in the future teaching reforms worldwide. However, despite its widespread adoption, certain limitations have become apparent. The objective of this study is to identify the genuine factors that impact students' performance, explore strategies that teachers can employ to enhance their teaching effectiveness and enhance students' academic *** study was performed among undergraduate medical students enrolled in Physiology course at Harbin Medical University in 2020 and 2022. Since 2020, influenced by the COVID-19 pandemic, a hybrid teaching method based on an established offline teaching model called BOPPPS was implemented. A questionnaire was performed in both 2020 and 2022 to evaluate students' satisfaction and efficiency of our hybrid teaching. A comparison was also carried out on the final examination scores of students majoring in Pharmacy and Clinical Pharmacy across the years 2020 to *** final examination scores of students in 2022 were significantly lower than those in 2020 and 2021 both in Pharmacy and Clinical Pharmacy majors. There was also a decrease of the score in students of Clinical Pharmacy in 2021 compared to 2020. The questionnaire indicated that over half (52.0%) of the students in 2022 preferred offline teaching method, in contrast to 39.1% in 2020. There were obvious changes in students from 2020 to 2022 about the disadvantages of hybrid teaching, the improvement of students' learning ability and the duration of students' autonomous learning. Through cross statistical analysis, online learning styles, learning ability improvement and students' learning burden have been identified as the primary factors influencing their preference for future teaching *** teaching is still a necessary trend in the future teaching reform base on its multiple

关键词： hypertension   blood pressure   epidemiology   public health   disease management   COVID-19   ADULTS   DIAGNOSIS  

摘要： Background: Arterial hypertension is highly prevalent in Mexico; nevertheless, there are limited insights regarding its management during the COVID-19 pandemic. Here, we estimate the prevalence of clinical and treatment profiles of arterial hypertension and explore associated factors for undiagnosed and uncontrolled hypertension using a cross-sectional survey endorsed by the Collaborative Group on Arterial Hypertension from the Mexican Institute of Social Security. Methods: Our survey was conducted from May to November 2021 using the May-Measurement Month 2021 protocols of the International Society of Hypertension. Arterial hypertension (defined as: blood pressure [BP] >= 140/90 mmHg, previous diagnosis, or taking antihypertensives) and its clinical and treatment profiles were classified according to the World Hypertension League Expert Committee. Mixed-effects logistic regression models were used to explore associated factors for undiagnosed and uncontrolled hypertension. Results: Among 77,145 screened participants (women: 62.4%; median age: 46 [IQR: 32-59] years), the prevalence of arterial hypertension was 35.7% (95% CI: 35.3-36.0, n = 27,540). Among participants with arterial hypertension, 30.9% (95% CI: 30.4-31.5, n = 8,533) were undiagnosed, 6.6% (95% CI: 6.3%-6.9%, n = 1,806) were diagnosed but untreated, 43.4% (95% CI: 42.9-44.0, n = 11,965) had uncontrolled hypertension, and only 19% (95% CI: 18.6%-19.5%, n = 5,236) achieved hypertension control (BP < 130/80 mmHg). Explored associated factors for undiagnosed and uncontrolled hypertension include being men, living in the central and southern regions, lower educational attainments, higher use of pharmacological agents, and previous COVID-19 infection. Conclusion: Our findings suggest that adverse arterial hypertension profiles, mainly undiagnosed and uncontrolled hypertension, were highly prevalent during the context of the COVID-19 pandemic in Mexico.