Search Results (47,363)

Artificial intelligence (AI) applications are everywhere, including within churches and other faith communities. Churches are complex systems, and the incorporation of new people and things over the lifetime of these communities changes them. New technology, in general, and AI tools in specific are no exception. In Christian ministry, innovation is no stranger: witness how quickly churches adopted online worship during the COVID-19 pandemic. Given that AI is already present in the complex system of churches, care must be taken to assess the opportunities and threats associated with its intentional adoption before doing so. This report advocates for ministry to make use of an approach borrowed from scientific exploration for the evaluation of opportunities and threats and for managing the process of introducing and managing new elements into a complex system: systems engineering (SE) principles and processes. SE methodology enables scientific exploration in environments that are difficult to explore due to danger, cost or technological immaturity by rigorously managing the development, introduction and life cycle of technology that will be used in the complex system of exploration. Such an approach would be promising for increasing the safety of a technology that comes with some inherent danger, easing its integration into church operation, mission, formation and worship and in turn allowing ministry leaders agency in determining the future of their relationship with artificial intelligence. Full article

Cities play a vital role in creating wealth and ensuring the well-being of all their inhabitants. However, major international efforts aimed at fostering fairer, healthier, and a more sustainable world have been compromised by the widespread effects of the COVID-19 pandemic. The objective of this research is to determine key priorities for addressing the pandemic’s impact in both the present and in a future urban context. Therefore, this study applies the Delphi method to a panel of 24 experts in order to identify the most and least important targets from Sustainable Development Goal 11 for post-COVID-19 sustainable urban planning in Cuenca, Ecuador. Out of the twelve targets, only five were prioritized, including “Target 11.1 Affordable housing”, Target 11.3 Sustainable Urbanization”, “Target 11.9 Implement policies for inclusion and property rights”, and “Target 6.3 Improve water quality”. These findings can serve as a foundation for future public policies and strategies for sustainable urban planning of the city. Full article

This review examines the clinical data and basic science research to evaluate the potential of the Selective Cytopheretic Device (SCD) in mitigating Extracorporeal Membrane Oxygenation (ECMO)-associated inflammation. In brief, SCD is an immunomodulatory device used within extracorporeal blood circuits along with the use of citrate anticoagulation. SCD has been shown to be a novel, first-in-its-class device (being marketed as QUELimmune by SeaStar Medical), which is capable of the autologous processing of hyper-inflamed leukocytes to reduce systemic inflammation. Strong preclinical data gathered for SCD in the context of both Cardio-Pulmonary Bypass (CPB) as well as ECMO set the stage for SCD to be used in these life support circuits. ECMO played a crucial role during the COVID-19 pandemic, during a time period when SCD therapy was being evaluated in clinical trials, generating initial clinical data in this setting. SCD has also been utilized in the setting of pediatric acute kidney injury (AKI) and multiorgan dysfunction (MOD), where ECMO can be common. Full article

Background/Objectives: This study explores the adaptation and implementation of a positive psychological intervention based on the Emotional Styles model to improve well-being and reduce stress in employees with and without intellectual disabilities (IDs). Methods: A longitudinal intervention was conducted in a social foundation with 45 participants (12 with ID). The program, based on Davidson’s six emotional dimensions, included six weekly sessions adapted through Easy Read strategies and COVID-19 adjustments. Data were collected at pre-test, post-test, and six-month follow-up using the Emotional Styles Questionnaire, PERMA Profiler, and UWES-3. Results: Significant improvements were found in outlook, resilience, engagement, relationships, and reduction in negative emotions, with stronger effects for non-ID participants, although context sensibility improved in the ID group. High satisfaction (93% very satisfied) confirmed the program’s acceptability. Conclusions: The adapted intervention effectively enhances emotional well-being in heterogeneous workplaces, supporting inclusive positive psychology practices. Full article

The US has undertaken both unconventional and conventional monetary policy stances in response to the COVID-19 pandemic and the Ukraine–Russia conflict, and there has been much debate on the effects of these various monetary policies on global financial markets. Our study considers the debate in the context of South Africa and uses the quantile–frequency connectedness approach to examine static and dynamic systemic spillover between the US shadow short rate (SSR) and South African equity, bond and currency markets between 1 December 2019 and 2 March 2023. The findings from the static analysis reveal that systemic connectedness is concentrated at their tail-end quantile distributions and US monetary policy plays a dominant role in transmitting these systemic shocks, albeit these shocks are mainly high frequency with very short cycles. However, the dynamic estimates further reveal that US monetary policy exerts longer-lasting spillover shocks to South African financial markets during periods corresponding to FOMC announcements of quantitative ‘easing’ or ‘tapering’ policies. Overall, these findings are useful for evaluating the effectiveness of the Reserve Bank’s macroprudential policies in ensuring market efficiency, as well as for enhancing investor decisions, portfolio allocation and risk management. Full article

Objectives: The adoption of telemedicine, which is the delivery of healthcare services through digital platforms, exploded during the COVID-19 pandemic as a means to ensure the continuity of care while minimizing infection risks. While this modality improved access and convenience for many, disparities in adoption have emerged, particularly in rural and underserved populations. This study aims to evaluate the impact of telemedicine on patient satisfaction before and during the pandemic, with a focus on chronic disease management—notably hypertension—and to identify factors influencing the equitable adoption of telehealth. Methods and Procedures: This study used a mixed method approach, combining quantitative survey data and causal loop modeling to analyze patient satisfaction levels and the interplay between telehealth adoption, healthcare access, and demographic disparities. Patient-reported satisfaction data were collected in two time periods—before and during the pandemic. Causal modeling was used to explore systemic relationships between provider support, technology access, patient engagement, and health equity. Results: The findings revealed that telemedicine significantly enhanced healthcare access during the pandemic, with a notable increase in patient satisfaction scores. Patients with chronic conditions, especially those diagnosed with hypertension, reported the improved continuity of care and reduced geographic barriers. However, disparities in telehealth access were more pronounced in non-metropolitan areas and among older adults and minority populations. Causal analysis highlighted key enablers of telehealth success, i.e., provider support, digital literacy, and access to reliable internet and devices. Conclusions: Telemedicine presents a transformative solution for equitable healthcare delivery, especially in chronic disease management. Strategic efforts are needed to address adoption disparities and ensure the sustained and inclusive integration of telehealth after the pandemic. Full article

Identification of temporal relations among suicide mortality and economic/political implementations provides important information for not only planning suicide prevention but also socioeconomic/psychosocial measures. This cross-sectional observation study analyzed temporal fluctuations and causalities of suicide mortalities of working-age individuals, disaggregated by age/gender/social standing (employed/unemployed), in Japan from 2009 to 2024, using government databases, by joinpoint and vector-autoregressive analyses. Suicide mortality among total and employed females decreased until the COVID-19 pandemic outbreak but sharply increased, synchronized with the pandemic outbreak, before resuming a downward trend. Among males, the decreasing trends attenuated from 2016, followed by a transient increase in 2022. Unemployed males aged 40–69 exhibited four joinpoints: 2016 (decreasing–increasing), 2018 (increasing–decreasing), 2022 (decreasing–increasing), and 2023 (increasing–stable). In contrast, suicide mortality among unemployed females aged 40–69 sharply increased in 2022 and maintained the high level. Among individuals aged 30–39, suicide mortality reversed from decreasing to increasing in 2016 (males) and 2018 (unemployed females). Economic expansion was protective for employed individuals but had no significant effect on unemployed populations. The government management instability (AENROP) index was positively associated with suicide mortality among employed and unemployed males and employed females. Unemployed females aged 30–39 were sensitive to AENROP but not economic conditions, while those aged 40–69 were largely unaffected by either. Increasing employment of individuals with psychiatric disabilities was positively associated with suicide mortality among unemployed males (30–69) and females under 40. Positive impacts of the employment rates of individuals with psychiatric disabilities and unemployment enhanced from 2016 and 2022, respectively, whereas the impacts were inconstantly affected by political rather than economic factors. Suicide mortality among unemployed individuals has emerged as a critical public health concern in Japan, with rates more than doubling among males and tripling among females in the 2020s. These findings underscore the need for integrated suicide prevention policies that address both labor market vulnerabilities and psychosocial determinants. Full article

Pulmonary coinfection involving both viral and opportunistic pathogens is an emerging challenge in immunosuppressed patients. We report the case of a 59-year-old man with rheumatoid arthritis on long-term immunosuppressive therapy who developed necrotizing pneumonia and acute respiratory failure and was ultimately diagnosed with triple pulmonary coinfection by SARS-CoV-2, Nocardia cyriacigeorgica, and Aspergillus fumigatus. Diagnosis required comprehensive imaging, bronchoscopy with BAL, and microbiological work-up. The case was complicated by septic shock, multiple organ failure, and family-driven end-of-life decisions. This report highlights the diagnostic and therapeutic complexity of triple coinfection in the ICU, emphasizing the importance of systematic microbiology, imaging, and interdisciplinary care in critically ill immunocompromised hosts. Full article

For decades, the U.S. college admissions process has utilized standardized exams as critical indicators of college readiness. With the onset of the COVID pandemic, the majority of 4-year universities implemented the Test-Optional policy to improve college access and enrollment. The Test-Optional policy allows prospective high school students to apply to institutions that have implemented this policy without a SAT or ACT score. This study examined the use of the Test-Optional policy and its relationship with early college success. Forward multiple regression examined which variables of High School GPA, Students of Color, First-Generation Status, Test-Optional, Pell Eligible, and Pre-College Credits best predict undergraduate first-year GPA. The results generated a five-variable model that accounted for 31% of the variability in first-year college GPA. High School GPA was the strongest predictor, while Test-Optional was not entered into the model. Binary logistic regression examined predictors of first-year college completion. Our results revealed the model including High School GPA, which tripled the odds of first-year completion. Again, Test-Optional was not included in the model. Although Students of Color and Pell Eligibility utilized Test-Optional significantly more than their peers, Test-Optional was not a significant predictor of first-year College GPA or first-year completion. Full article

Children with COVID-19 typically experience milder symptoms and lower hospitalization rates, though severe cases do occur. Understanding age-related immune responses is crucial for future preparedness. We characterized immune response dynamics to SARS-CoV-2 in 145 samples from 119 pediatric patients (<18 years) with confirmed infection, assessed at four distinct time points: <14 days, 14 days–3 months, 3–6 months, and 6–12 months post-infection. At infection, patients presented increased activated T-cells, higher levels of exhaustion (i.e., PD-1⁺), lower numbers of unswitched memory B-cells, and increased antibody-secreting cells (ASCs). Both humoral and cellular anti-SARS-CoV-2 responses increased over time (all patients showed measurable responses in the last assessment). Asymptomatic/mildly symptomatic patients (58.6%) showed increased specific cellular responses from infection onwards, along with enriched memory B-cell subsets (but not ASCs), and distinct T-cell activation profiles. Children with severe disease were younger, predominantly boys, displayed altered T/B-cell ratios, and reduced PHA responses when infected. Compared to adolescents, younger children showed lower antibody titers and weaker cellular responses to SARS-CoV-2, possibly underlining the higher prevalence of severe manifestations in younger children. Our study illustrates important age-, gender-, and disease severity-dependent variations in immune responses to SARS-CoV-2, which can be helpful in improving patient management and immunization strategies adjusted to age groups. Full article

Objectives: The aim of the present study was to better understand the antibody concentrations in healthcare workers (HCWs) from a hospital in Mexico City with a high density of COVID-19 patients. Methods: Up to 243 HCWs were recruited in 2020 and 2022 and were sorted into three groups: hybrid immunity (HI, natural infection plus vaccination), vaccine-induced immunity (VI), and unvaccinated but RT-qPCR negative at the beginning of the pandemic (UV). Peripheral blood and nasopharyngeal swab samples were obtained; additionally, saliva samples were obtained from the UV group. The titers of IgG, IgM, and IgA against the SARS-CoV-2 receptor-binding domain (RBD) and nucleocapsid (NCP) proteins were assessed using an in-house ELISA, and positivity to the virus was determined via RT-qPCR. Results: Most HI and VI participants were positive for serum anti-RBD IgG (92.8% and 100%, respectively), while 26.6% (for HI) and 19% (for VI) were positive for anti-NCP IgG. Regarding serum anti-RBD IgA, the VI and HI groups had positive rates of 87.3% and 66%, respectively. In contrast, the UV group showed a rate of 5.7% but the positivity for IgA in saliva was higher (52% for RBD and 35% for NCP). In addition, the highest antibody titers were obtained for anti-RBD IgG and IgA in the HI and VI groups, respectively. In saliva, the IgA antibody titer was higher for the RBD antigen (1:1280). Conclusions: These results strengthen our understanding of antibody concentrations in HCWs during two critical years of the pandemic in a general hospital with many COVID-19 patients. Full article

Objectives: Sex-based disparities in COVID-19 outcomes are well-documented, with men experiencing greater acute severity and women showing increased vulnerability to post-viral syndromes. However, longitudinal immunometabolic trajectories in vaccinated individuals remain underexplored. In this study, sex-based differences in long-term metabolic, endocrine, renal, cardiovascular, and inflammatory responses were investigated among vaccinated individuals recovering from SARS-CoV-2 infection. Methods: This retrospective single-center cohort study included 426 adults (199 females, 227 males) with PCR-confirmed symptomatic COVID-19 and at least two vaccine doses. Serial assessments were conducted at baseline, 18-, 24-, and 30-month post-infection. Parameters included fasting glucose, HbA1c, lipid profile, thyroid function, renal markers, CRP, D-dimer, fibrinogen, troponin, and hematologic indices. Statistical analyses assessed longitudinal changes and sex-stratified correlations. Results: Fasting glucose and HbA1c levels significantly declined over time, more prominently in males. Glucose correlated with age and BMI only in females. Lipid levels remained largely unchanged, although males had higher baseline triglycerides. Females showed rising TSH levels and persistently lower free T3; males exhibited higher creatinine, urea, and troponin levels throughout. Inflammatory markers declined significantly in both sexes, with males displaying higher CRP and troponin, and females showing sustained fibrinogen elevation and a temporary lymphocyte surge. D-dimer was elevated in females at the 30-month point. Conclusions: Sex-specific physiological recovery patterns were evident among vaccinated COVID-19 survivors. Males exhibited earlier metabolic and cardiac alterations, while females had more persistent endocrine and inflammatory shifts. These findings underscore the need for sex-tailored long-term monitoring strategies prioritizing early metabolic and cardiac screening in men and prolonged immunoendocrine surveillance in women. Full article

School refusal behavior, defined as a child’s prolonged voluntary absence from school for reasons unrelated to illness and/or economic hardship, is a growing concern in Japan. The COVID-19 pandemic has worsened this issue by disrupting children’s lives. This review summarizes the prevalence, contributing factors, and health implications of school refusal, particularly in the context of COVID-19. A literature review of government reports and PubMed-indexed studies indicates that school refusal in Japan has been rising for eleven years, reaching a record 340,000 cases in 2023. Middle school students (6.7%) were the most affected, followed by elementary school students (2.1%). The pandemic intensified school-related, family-related, and child-related risk factors. School closures disrupted routines, reduced peer interactions, and increased social isolation, contributing to higher rates of anxiety and depression. Reports of suicides and mental health disorders among children have also surged. Family stressors, including economic hardship and parental mental health struggles, further exacerbate school refusal. Additionally, remote learning has widened socioeconomic disparities in access to education, leaving vulnerable children at greater risk. Addressing school refusal requires a multifaceted approach involving schools, families, healthcare providers, and policymakers. School-based interventions, mental health approach, and flexible educational programs would be essential. The Japanese government’s “COCOLO Plan” represents progress toward a more inclusive education system, and a comprehensive, interdisciplinary strategy is needed. Ensuring all children receive the necessary support to reengage with education is critical to overcoming the long-term challenges posed by school refusal. Full article

Influenza is a serious and global health issue, and it is a major cause of morbidity, fatality, and economic loss every year. Seasonal vaccines exist but are not very effective due to strain mismatches, delays in production, and antigenic drift. This comprehensive overview discusses the current situation of influenza vaccination, including the numerous types of vaccines—inactivated, live attenuated, and recombinant vaccines—and their effectiveness, efficacy, and associated challenges. It highlights the effects of the COVID-19 pandemic on the trends of influenza vaccination and the level to which innovation should be practiced. In the future universal influenza vaccines will be developed that target conserved viral antigens to provide long-term protection to people. In the meantime, novel vaccine delivery platforms, such as mRNA technology, virus-like particle (VLP), and nanoparticle-based systems, and less cumbersome and invasive administration routes, as well as immune responses are also under development to increase access and production capacity. Collectively, these innovations have the potential to not only reduce the global influenza epidemic but also to change the way influenza is prevented and prepare the world for a pandemic. Full article

Background/Objectives: Coronavirus disease 2019 (COVID-19) is associated with gastrointestinal (GI) symptoms. Small intestinal bacterial overgrowth (SIBO) is emerging as a significant GI sequela post-COVID-19 infection. This study aimed to evaluate the prevalence and incidence of SIBO post-COVID-19 infection across different age groups and to identify associated risk factors in a global cohort. Methods: A retrospective study utilized the TriNetX database and included adult patients (≥18 years) diagnosed with SIBO following COVID-19 infection (1 January 2022–30 May 2024). A propensity score matching (1:1) was used to adjust for demographics and SIBO risk factors. Kaplan–Meier survival analysis assessed the SIBO incidence within 12 months. Results: Among 1,660,092 COVID-19 patients and 42,322,017 controls, SIBO was diagnosed in 353 COVID-19 patients without hydrogen breath tests (BT) and 78 with BT, compared to 3368 controls without BT and 871 with BT. Age-specific analysis demonstrated a clear, progressive increase in the SIBO incidence, becoming distinctly significant by 6 months and highest at 12 months post-infection. The highest risks were noted in ages 60–69 (0.011% vs. 0.004%, OR 2.6, p = 0.0003) and 70–79 (0.011% vs. 0.005%, OR 2.0, p = 0.0004), with younger age groups (30–49 years) also showing significantly increased risks. The medication analysis revealed strong associations with chronic opioid, proton pump inhibitor, and antidiarrheal medication. Conclusions: COVID-19 significantly increased the risk of SIBO, particularly within the first 12 months post-infection, across various age groups and, notably, in association with certain chronic medications. Clinical vigilance and targeted management strategies are recommended to mitigate long-term GI consequences. Full article