关键词： Narrative   discourse   health equity   foreign policy   neoliberalism  

摘要： Despite self-congratulatory rhetoric, Canada compromised COVID-19 vaccine equity with policies impeding a proposed global waiver of vaccine intellectual property (IP) rules. To learn from Canada's vaccine nationalism we explore the worldview - a coherent textual picture of the world - in a sample of Government of Canada communications regarding global COVID-19 vaccine sharing. Analysed documents portray risks and disparities as unrelated to the dynamics and power relations of the Canadian and international economies. Against this depoliticised backdrop, economic growth fueled by strict IP rules and free trade is advanced as the solution to inequities. Global vaccine access and distribution are pursued via a charity-focused public-private-partnership approach, with proposals to relax international IP rules dismissed as unhelpful. Rather than a puzzling lapse by a good faith 'middle power', Canada's obstruction of global COVID-19 vaccine equity is a logical and deliberate extension of dominant neoliberal economic policy models. Health sector challenges to such models must prioritise equity in global pandemic governance via politically assertive and less conciliatory stances towards national governments and multilateral organisations. Mobilisation for health equity should transform the overall health-damaging macroeconomic model, complementing efforts based on specific individual health determinants or medical technologies.

关键词： Avian influenza   cardiovascular   COVID-19   endothelial dysfunction   pandemic   statins   H5N1 influenza virus   pandemic   statins   VIRUS   H5N1   PATHOGENESIS   DYSFUNCTION   INFECTION   MOTHER  

摘要： There is growing concern that the severe respiratory disease in birds (avian influenza or 'bird flu') caused by the H5N1 influenza virus, might potentially spread more widely to humans and cause a pandemic. Here we discuss clinical issues related to human infections by the highly pathogenic H5N1 subtype of the avian influenza A virus and make a clinical comparison with recent information obtained from studies of SARS-CoV-2 infection. Firstly, we consider the potential increase in cardiovascular events in humans infected with the H5N1 virus. Like SARS-CoV-2 infection, H5N1 infection may result in endothelial dysfunction and the associated procoagulant and prothrombotic state, and via this mechanism, the infection can potentially increase cardiovascular morbidity, especially in vulnerable individuals with pre-existing cardiovascular disease. Secondly, we discuss the potential beneficial role of statin use, both in the prophylaxis and the treatment of individuals with influenza A(H5N1), as was found favorable for the treatment of COVID-19 caused by SARS-CoV-2 infection. [GRAPHICS]

关键词： SARS-CoV-2   mouse model   K18-hACE2 knock-in mouse   severe pneumonia   Omicron   antivirals   SARS   CORONAVIRUS   INFECTION  

摘要： Animal models of COVID-19 facilitate the development of vaccines and antivirals against SARS-CoV-2. The efficacy of antivirals or vaccines may differ in different animal models with varied degrees of disease. Here, we introduce a mouse model expressing human angiotensin-converting enzyme 2 (ACE2). In this model, ACE2 with the human cytokeratin 18 promoter was knocked into the Hipp11 locus of C57BL/6J mouse by CRISPR - Cas9 (K18-hACE2 KI). Upon intranasal inoculation with high (3 x 105 PFU) or low (2.5 x 102 PFU) dose of SARS-CoV-2 wildtype (WT), Delta, Omicron BA.1, or Omicron BA.2 variants, all mice showed obvious infection symptoms, including weight loss, high viral loads in the lung, and interstitial pneumonia. 100% lethality was observed in K18-hACE2 KI mice infected by variants with a delay of endpoint for Delta and BA.1, and a significantly attenuated pathogenicity was observed for BA.2. The pneumonia of infected mice was accompanied by the infiltration of neutrophils and pulmonary fibrosis in the lung. Compared with K18-hACE2 Tg mice and HFH4-hACE2 Tg mice, K18-hACE2 KI mice are more susceptible to SARS-CoV-2. In the antivirals test, REGN10933 and Remdesivir had limited antiviral efficacies in K18-hACE2 KI mice upon the challenge of SARS-CoV-2 infections, while Nirmatrelvir, monoclonal antibody 4G4, and mRNA vaccines potently protected the mice from death. Our results suggest that the K18-hACE2 KI mouse model is lethal and stable for SARS-CoV-2 infection, and is practicable and stringent to antiviral development.

关键词： BA.5   COVID-19   Japan   SARS-CoV-2   vaccine effectiveness   monovalent   BNT162B2 VACCINE   DURABILITY  

摘要： Background: This study aimed to evaluate VE of primary, first, and second booster ancestral-strain monovalent mRNA COVID-19 vaccination against symptomatic infections and severe diseases in Japan. Methods: We conducted a test-negative case-control study. We included medically attended episodes and hospitalizations involving individuals aged >=>= 16 with signs and symptoms from July to November 2022, when Omicron BA.5 was dominant nationwide. To evaluate VE, we calculated adjusted ORs of vaccination among test-positive versus test-negative individuals using a mixed-effects logistic regression. Results: For VE against symptomatic infections among individuals aged 16 to 59, VE of primary vaccination at > 180 days was 26.1% (95% CI: 10.6-38.8%); VE of the first booster was 58.5% (48.4-66.7%) at <=<= 90 days, decreasing to 41.1% (29.5-50.8%) at 91 to 180 days. For individuals aged >=>= 60, VE of the first booster was 42.8% (1.7-66.7%) at <=<= 90 days, dropping to 15.4% (-25.9-43.2%) at 91 to 180 days, and then increasing to 44.0% (16.4-62.5%) after the second booster. For VE against severe diseases, VE of the first and second booster was 77.3% (61.2-86.7%) at <=<= 90 days and 55.9% (23.4-74.6%) afterward. Conclusion: mRNA booster vaccination provided moderate protection against symptomatic infections and high-level protection against severe diseases during the BA.5 epidemic in Japan.

关键词： Covid-19 pandemic   traditional music   Karawitan   resilience   PSYCHOLOGICAL IMPACT  

摘要： This study aims to describe and explain how community resilience needs to be leveraged during the spread of COVID-19 with traditional music 'Karawitan'. This study uses a hermeneutic phenomenological approach. The research was conducted for 26 months in Sodong, Gelangkulon Village, Sampung District, Ponorogo Regency, East Java Province, Indoensia. The research data was taken by interview, observation, and document recording techniques and then analyzed using interactive model qualitative analysis techniques. The results showed that the traditional music 'Karawitan' played a major role in building the resilience of the Sodong Buddhist Village community in facing the Covid-19 pandemic. Traditional music 'Karawitan' communicates various matters relating to the Covid-19 pandemic and strategies to deal with it. Pengrawit, in routine and incidental rehearsals, presents songs with light, happy rhythms (slendro), containing religious, social, human and health values. Those songs not only presented but also explained (air). The traditional music 'Karawitan' also held peduli sasama and distributed them. These activities make community members able to eliminate psychological pressure and be able to adapt, be optimistic, and be able to survive in the face of the Covid-19 pandemic.

关键词： COVID-19   long COVID-19   influenza   work absence   disability claims   employment  

摘要： Objectives: This study investigates the utilization of work absence benefits among United States (US) employees diagnosed with COVID-19, examining frequency, duration, cost, and types of work loss benefits used. Methods: This retrospective analysis of the Workpartners Research Reference Database (RRDb) included employees eligible for short- and long-term disability (STD and LTD employer-sponsored benefits, respectively), and other paid work absence benefits from 2018 to 2022. Workpartners RRDb includes over 3.5 million employees from over 500 self-insured employers across the US. Employees were identified by codes from adjudicated medical and disability claims for COVID-19 (2020-2022) and influenza, as well as prescription claims for COVID-19 treatments. Associated payments were quantified for each absence reason. Results: Approximately 1 million employees were eligible for employer-sponsored paid leave benefits between January 2018 and December 2022. The mean age was 37 years (22% >50 years), and 49.4% were females. COVID-19 was the 2nd most common reason for an STD claim (6.9% of all STD claims) and 13th for an LTD claim (1.7% of all LTD claims) from 2020-2022. The mean duration for COVID-19 STD claims was 24 days (N = 3,731, mean claim=$3,477) versus 10 days for influenza (N = 283, mean claim=$1,721). The mean duration for an LTD claim for COVID-19 was 153 days (N = 11, mean claim=$19,254). Only 21.5% of employees with STD claims in the COVID-19 cohort had prior COVID-19-associated medical or pharmacy claims; over half (range 53%-61%) had documented high risk factors for severe COVID-19. Conclusion: COVID-19 and influenza have the potential to cause work loss in otherwise healthy employees. In this analysis, COVID-19 was the second most frequent reason for an STD claim at the start of the pandemic and remained high (ranked 5th) in 2022. These results highlight the impact of COVID-19 on work loss beyond the acute phase. Comprehensively evaluating work loss implica

关键词： Tracheal Diseases   Laryngeal Diseases   Respiration   Artificial   COVID-19   tracheostomy   bronchoscopy   INTUBATION  

摘要： Objective To assess whether laryngotracheal lesions were more prevalent among tracheostomized post- coronavirus disease 2019 (COVID-19) adult patients compared with a matched historical control group of non-COVID-19 *** An analytical, observational, and cross-sectional study was conducted in a weaning and rehabilitation center. Our study was conducted on tracheostomized adult patients who underwent a fiberoptic bronchoscopy at admission. Non-COVID-19 patients of the historical control group were selected through propensity score (PS) matching. Each post-COVID-19 case was matched in a 1:1 ratio to a non-COVID-19 case. The PS was created based on age, days of endotracheal intubation before tracheostomy, days of artificial airway before bronchoscopy, and days of mechanical ventilation in intensive care unitResults Forty-nine matched patients were assessed in each group. The prevalence of airway lesions in post-COVID-19 patients and non-COVID-19 patients of the historical control group was 53.1% and 73.5%, respectively (p = 0.036). In the post-COVID-19 group, 12.2% had severe lesions, and in the historical control group of non-COVID-19 patients, 20.4%. The most prevalent lesion in both groups was granuloma, and lesions were most frequently localized in the subglottic *** Our findings show a lower prevalence of laryngotracheal lesions in matched tracheostomized post-COVID-19 patients compared to a historical control group of non-COVID. The most prevalent lesion in both groups was mild (luminal obstruction < 50%) subglottic *** Our findings show a lower prevalence of laryngotracheal lesions in matched tracheostomized post-COVID-19 patients compared to a historical control group of non-COVID. The most prevalent lesion in both groups was mild (luminal obstruction < 50%) subglottic granuloma.

关键词： Crohn's disease   ulcerative colitis   vaccine hesitancy   SARS-CoV-2   biological drugs   immunosuppressive therapy   immunization rates   vaccine compliance   VACCINATION   IBD  

摘要： Individuals with Inflammatory Bowel Disease (IBD) are more susceptible to experiencing severe complications of COVID-19 if infected. Nevertheless, sub-optimal immunization rates have been reported among these patients. Our study aims to assess COVID-19 VH among a global population of patients with IBD and to investigate the role of healthcare professionals, particularly gastroenterologists, in promoting immunization. Twenty-six studies were systematically selected from scientific articles in the MEDLINE/PubMed, WoK, and Scopus databases from January 1, 2020, to September 15, 2023. The pooled prevalence of COVID-19 VH was 27.2% (95%CI = 20.6-34.2%). A significant relationship was evidenced between COVID-19 vaccine compliance and receiving advice from gastroenterologists or healthcare providers (OR = 2.77; 95%CI = 1.79-4.30). By leveraging their knowledge of IBD, familiarity with patient histories, and trusted patient-doctor relationships, gastroenterologists are pivotal in promoting vaccination. This patient-centered care is crucial in increasing vaccine acceptance among individuals with IBD, contributing to better public health outcomes.

关键词： Polymyalgia rheumatica   giant cell arteritis   COVID-19 vaccination   pharmacovigilance   clinical study   LARGE-VESSEL INVOLVEMENT   RHEUMATISM/AMERICAN COLLEGE   CLASSIFICATION CRITERIA   EUROPEAN LEAGUE   VACCINES  

摘要： We conducted a national in-depth analysis including pharmacovigilance reports and clinical study to assess the reporting rate (RR) and to determine the clinical profile of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) in COVID-19-vaccinated individuals. First, based on the French pharmacovigilance database, we estimated the RR of PMR and GCA cases in individuals aged over 50 who developed their initial symptoms within one month of receiving the BNT162b2 mRNA, mRNA-1273, ChAdOx1 nCoV-19, and ***2.S vaccines. We then conducted a nationwide survey to gather clinical profiles, therapeutic management, and follow-up data from individuals registered in the pharmacovigilance study. A total of 70 854 684 COVID-19 vaccine doses were administered to 25 260 485 adults, among which, 179 cases of PMR (RR 7. 1 cases/1 000 000 persons) and 54 cases of GCA (RR 2. 1 cases/1 000 000 persons) have been reported. The nationwide survey allowed the characterization of 60 PMR and 35 GCA cases. Median time to the onset of first symptoms was 10 (range 2-30) and 7 (range 2-25) days for PMR and GCA, respectively. Phenotype, GCA-related ischemic complications and -large vessel vasculitis as well as therapeutic management and follow-up seemed similar according to the number of vaccine shots received and when compared to the literature data of unvaccinated population. Although rare, the short time between immunization and the onset of first symptoms of PMR and GCA suggests a temporal association. Physician should be aware of this potential vaccine-related phenomenon.

关键词： COVID-19 pandemic   depression   fatigue   hair cortisone   SARS-CoV-2   stress hormone   EVERYDAY LIFE   HAIR CORTISOL   MENTAL-HEALTH   POPULATION   DEPRESSION   STRESS   IMPACT   STAFF   PAIN  

摘要： The COVID-19 pandemic and consequent lockdowns had a substantial impact on mental health. Distress and fatigue are highly correlated. However, little is known about the determinants of fatigue in the general population during the pandemic. This study aimed to examine the prevalence and predictors of fatigue during the COVID-19 pandemic in the UK population. Online surveys were completed by a UK community cohort in April 2020 (wave 1), July-September 2020 (wave 2) and November-December 2020 (wave 3). In total, 3097 participants completed the wave 1 survey, and 1385 and 1087 participants (85.4% women) completed wave 2 and 3 surveys respectively. Fatigue was assessed using the Chalder Fatigue Scale at waves 2 and 3. Hair samples were provided by 827 participants (90.6% women) at wave 1 and wave 2, which were analyzed to indicate HairE (stress hormone). The mean total fatigue score during wave 2 was 14.7 (SD = 4.7), significantly higher than pre-pandemic levels observed in the community (mean difference 0.50, p = .003). At wave 2, 614 (44.3%) participants met the case definition for fatigue, only 15.6% of whom indicated that fatigue lasted for more than 6 months (suggesting it had started prior to the pandemic). Predictors of fatigue at wave 3 included being in a risk group, depression and belief in having COVID-19, which explained 23.8% of the variability in fatigue scores. Depression at wave 1 was the only significant predictor of remaining a fatigue case at wave 3. Fatigue was highly prevalent in the UK community during the COVID-19 pandemic and limited people's daily function. Depression and sociodemographic variables were significant predictors of fatigue. Fatigue levels between July-December 2020 were higher compared to pre-pandemic *** of fatigue levels 7-8 months later included being a clinical risk group, depression and belief in having had *** was not associated with *** was the only significant predictor of remaining a