Impact of COVID-19 Pandemic on Mental Health of Health Care Workers and Its Determining Factors: A Systematic Review

Abstract Background Since the outbreak of COVID-19, the global pandemic has taken a toll in mental wellbeing of people around the world, especially health care workers. Health care workers have heavy work burden and are compelled to isolate themselves. Their mental health has worsened with increased symptoms of anxiety and depression affecting their quality of life. This review aims to identify the magnitude of psychological distress in health care workers and their major contributing factors during the COVID-19 pandemic for strengthening their mental health in present and upcoming pandemics. Methods The search databases such as ScienceDirect, Embase, Cochrane library, PubMed, and Google scholar were used for finding favorable studies. The search was conducted until 16th May, 2020 and articles from February 2020 to April 2021 were included in the review. Result A total of 2879 articles were identified and 18 studies were selected for the review. The psychological impact in the studies-anxiety and depression were prevalent in range from 10-90 percentage of total participants. Insomnia and stress were also commonly reported with maximum prevalence of 98.5% of total participants. These impacts were often associated with nursing profession and females, further aggravated by inadequate personal protective equipment, stigmatization and self-isolation.   Conclusion Various mediators such as female gender, young adulthood, comorbidity, nursing profession, previous history of mental illness, stigmatization, and employment in high risk areas, heavy workload, and poor infection control practices are major contributing factors for poor mental outcome in health care workers during COVID-19 pandemic. This raises the necessity of consideration of psychological health of health care workers and its promotion through supportive work environment, psychological preparedness and material adequacy. Keywords COVID-19, mental health, psychological disorders, health care workers, depression, anxiety

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Changes in Cropland Status and Their Driving Factors in the Koshi River Basin of the Central Himalayas, Nepal

In recent decades, human activities have significantly transformed land use and land cover (LULC) and the environment of the Central Himalayas region. LULC is a major component of environmental and climatic research. The aim of this study was to determine the changes in cropland status and its drivers in the Koshi River Basin (KRB) of the Central Himalayas region of Nepal between 1978 and 2010. The cropland status in 1978 was obtained from the Land Resources Mapping Project (LRMP) datasets. The cropland status in 1992 and 2010 was determined on the basis of satellite imagery, with an object-oriented classification method, together with field investigations. Advanced geographical tools were used for data processing and binary logistic regression models were used for the statistical analysis of potential driving factors of cropland change. A noticeable overall change in cropland area was found, with rapid increases from 1978 onward at differing rates and to different extents. The cropland area covered 7165 km2 in 1978. It peaked at 7867.49 km2 in 1992, and had reduced slightly (by 90 km2) to 7776.66 km2 by 2010. The change in cropland area was mainly related to four potential driving factors: topography (elevation, slope, and soil types), socioeconomics (population and foreign labor migration), climate (annual mean temperature and precipitation), and neighborhood factors (roads, rivers, and settlements). However, the effects of the different variables have occurred over various stages and at different rates. An understanding of long-term changes in cropland status in the KRB would be useful, and this could be extended to spatial reconstructions with the help of historical data, including cropland and climatic archives

A Supply-Demand Framework for Eco-Compensation Calculation and Allocation in China’s National Key Ecological Function Areas—A Case Study in the Yangtze River Economic Belt

China’s National Key Ecological Function Areas (NKEFAs) provide important ecosystem services but lose significant development opportunities. An NKEFA consists of a few National Key Ecological Function Counties (NKEFCs). China’s central government annually makes fiscal transfers to NKEFCs to compensate for their fiscal imbalance and ecosystem protection costs. The eco-compensation coefficient (ECC), together with the fiscal revenue and expenditure gap (FREG), determines the transfer payment, but the central government fails to provide practical methods for its estimation. This article proposes a framework for ECC estimation by integrating ecosystem service supply (ESS), ecosystem protection cost (EPC), and public service provision capability (PSC) of NKEFCs, and clarifies the criteria and indicators for ESS, EPC, and PSC evaluation. The framework was implemented in the Yangtze River Economic Belt (YZEB), and the results were compared with the payments in the current central-to-local fiscal transfer (CTLFT) system. The key findings and conclusions include: (1) The payment in the current CTLFT system mainly depends on the FREG rather than ESS and EPC of NKEFCs. (2) Some counties are notably under-compensated because their ESS or EPC are underestimated, or the province that administers them has a stronger fiscal capability. (3) The framework contributes to fair allocation and efficient use of eco-compensation payments by improving the ECC estimation method and identifying the main stressors and public service weaknesses in NKEFAs. This study gives the following policy implications: (1) Inner-provincial and cross-provincial watershed eco-compensation programs need to be developed to supplement the central-to-local eco-compensation program in the YZEB. (2) Environmental management strategies should be based on the characteristics of stressors and people’s livelihood in NKEFAs

Do Ecological Restoration Projects Undermine Economic Performance? A Spatially Explicit Empirical Study in Loess Plateau, China

Exploring the complex relationship between ecological restoration and economic development is valuable for decision makers to formulate policy for sustainable development. The large-scale environmental restoration program—Grain for Green—was mainly implemented in the Loess Plateau of China to improve the soil retention service. However, whether this world-famous program affects local economic development has not been fully explored. In this study, using the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) model and spatializing the gross domestic product (GDP) based on the remotely sensed nightlight data, we explored the tradeoff between environment (i.e., soil retention service) and economy (i.e., GDP) for the Loess Plateau in a spatially explicit way. We found that the soil retention service increased prominently over the past 40 years, especially after implementing the Grain for Green project. Meanwhile, the GDP increased about nine-fold over the past four decades from 4.52 to 40.29 × 107 USD. A win–win situation of soil retention and economic development was achieved in the Loess Plateau of China, particularly in the loess gully and loess hilly gully regions of the Loess Plateau. The win–win situation of soil retention and economic development was as a result of the Grain for Green program, the optimization of industrial structure, and the increase in non-agriculture employment. Compared with previous studies, more spatial information was available for the Loess Plateau in this study, which is more valuable to policymakers

Gamma-ray, fast neutron and ion shielding characteristics of low-density and high-entropy Mg–Al–Ti–V–Cr–Fe–Zr–Nb alloy systems using Phy-X/PSD and SRIM programs

This study aimed to assess the radiation shielding properties of ten low-density high-entropy alloys (LWHEAs) using Phy-X/PSD software to analyze various shielding parameters, such as attenuation coefficients (μm and μ), mean free path (λ), effective atomic number (Zeff), and removal cross-section (ΣR), in the energy range of Image 1 to Image 2. A comprehensive evaluation was performed to compare the attenuation outcomes provided by HEAs with a range of shielding materials documented in the literature. The study also calculated the build-up factors (BUFs) of the alloys by using the GP-fitting interpolation method. The stopping power of the alloys against H1/He+2 ions was analyzed using the SRIM Monte Carlo code, considering total stopping power (TSP) and projected range (PR). The results indicated that HEA8 (Al3.88Cr14.95Mo27.58Nb26.71Ti13.76Zr13.11) had the best performance in terms of shielding against γ-rays, fast neutrons, and H1/He+2 ions, as it achieved the highest values of parameters such as μm, μ, Zeff, and ΣR, along with the lowest values of HVL, TVL, λ, BUFs (Image 3Image 4), TSP, and PR. On the other hand, HEA10 (Mg10.77Al11.96Mn24.35Fe24.75Cu28.17) had the lowest BUFs in both lower (Image 5Image 4) and higher (Image 6Image 4) energy regions. The order of μm for the alloys was found to be HEA5<HEA6<HEA9<HEA7<HEA10<HEA4<HEA2<HEA3<HEA1<HEA8. The study concluded that LWHEAs possess superior radiation shielding properties compared to conventional materials, making them a promising new class of materials for radiation shielding applications

Land Use and Land Cover Dynamics and Assessing the Ecosystem Service Values in the Trans-Boundary Gandaki River Basin, Central Himalayas

Land use and land cover is a fundamental variable that affects many parts of social and physical environmental aspects. Land use and land cover changes (LUCC) has been known as one of the key drivers of affecting in ecosystem services. The trans-boundary Gandaki River Basin (GRB) is the part of Central Himalayas, a tributary of Ganges mega-river basin plays a crucial role on LUCC and ecosystem services. Due to the large topographic variances, the basin has existed various land cover types including cropland, forest cover, built-up area, river/lake, wetland, snow/glacier, grassland, barren land and bush/shrub. This study used Landsat 5-TM (1990), Landsat 8-OLI (2015) satellite image and existing national land cover database of Nepal of the year 1990 to analyze LUCC and impact on ecosystem service values between 1990 and 2015. Supervised classification with maximum likelihood algorithm was applied to obtain the various land cover types. To estimate the ecosystem services values, this study used coefficients values of ecosystem services delivered by each land cover class. The combined use of GIS and remote sensing analysis has revealed that grassland and snow cover decreased from 10.62% to 7.62% and 9.55% to 7.27%, respectively compared to other land cover types during the 25 years study period. Conversely, cropland, forest and built-up area have increased from 31.78% to 32.67%, 32.47&ndash;33.22% and 0.19&ndash;0.59%, respectively in the same period. The total ecosystem service values (ESV) was increased from 50.16 &times; 108 USD y&minus;1 to 51.84 &times; 108 USD y&minus;1 during the 25 years in the GRB. In terms of ESV of each of land cover types, the ESV of cropland, forest, water bodies, barren land were increased, whereas, the ESV of snow/glacier and grassland were decreased. The total ESV of grassland and snow/glacier cover were decreased from 3.12 &times; 108 USD y&minus;1 to 1.93 &times; 108 USD y&minus;1 and 0.26 &times; 108 USD y&minus;1 to 0.19 &times; 108 USD y&minus;1, respectively between 1990 and 2015. The findings of the study could be a scientific reference for the watershed management and policy formulation to the trans-boundary watershed