Factors Associated with Food Insecurity Among Health Sciences Students During the COVID-19 Pandemic

This web-based survey explored factors associated with food insecurity (FI) among health sciences students during the COVID-19 pandemic. FI was assessed using the USDA 6-item tool. Multivariable logistic regression was used for data analyses. Of the 816 respondents, 74.7% were female and 22.1% were food insecure. An annual income of <$25,000, housing instability, use of a food pantry over the past 12 months, and receiving financial support from family were independently associated with increased odds of being food insecure even after adjusting for other covariates. Further research exploring FI screening and interventions among health sciences university students is needed.

Fraudulent loans and the United States paycheck protection program

Purpose: Despite lessons learned from prior disaster relief funding programs, billions of dollars in fraudulent loans were issued by the Paycheck Protection Program (PPP) during the COVID-19 pandemic in the USA. The misuse of funds prevented business owners and their employees who are in true financial need from accessing program funds. The purpose of this paper is to identify techniques perpetrators used to obtain funds from the program illegally since its inception in March 2020 and concludes with suggestions on internal controls to reduce fraud occurrences in future relief packages. Design/methodology/approach: The authors analyze 106 loan fraud cases reported by the US Department of Justice and compiled by the Project on Government Oversight to examine methods individuals used to illegally obtain funds from the program. The authors complement the data with lender characteristics from Call Reports and Business Insights. They further compare the fraud sample to the entire population of PPP loans, which is available on the US Small Business Administration website. The authors report descriptive statistics, correlations and multivariate regressions. Findings: The authors find that most fraud cases falsify tax data to access program loans and inflate payroll numbers to obtain larger loan amounts. Applicants who sought large amounts applied using multiple companies and across multiple lenders, consistent with the use of multiple loans to avoid the scrutiny of a single large loan with a single lender. The authors find that cases with larger amounts relied on less regulated lenders, such as lending companies, rather than more regulated lenders. Originality/value: The PPP is part of the largest ever US stimulus in which the private sector allocated funds. This study provides novel evidence of how fraudsters adapted to the program's rules to defraud the government. © 2021, Emerald Publishing Limited.

Experiences of participants of a dietary intervention trial for African Americans with hypertension and CKD

Background: African Americans are disproportionately affected by hypertension (HTN) and CKD and evidence suggests dietary modifications towards a more Dietary Approaches to Stop Hypertension (DASH)-accordant diet could improve outcomes for this population. We aimed to explicate barriers and facilitators of healthy eating, and the perceived benefits of the intervention among completed participants of a dietary intervention trial for African Americans with HTN and CKD. Participants were randomized to one of two groups: 1) Self-Shopping DASH (S-DASH) diet group with $30/week grocery allowance for 4 mo. but no specific guidance on purchases, followed by no food allowance for 8 mo.;or 2) Coaching DASH (C-DASH) diet advice group with a $30/week food allowance and assistance in purchasing foods for 4 mo., followed by intermittent coaching without food allowance for 8 mo. Methods: We performed a content analysis of transcripts from semi-structured interviews with participants who completed the trial (13 C-DASH;12 S-DASH were randomly selected). Thematic analyses followed 5 stages: 1) reading and rereading all transcripts and utilizing audio recordings as needed for clarity;2) three coders reading two of the same transcripts, coding them, and comparing codes which were then used to create the initial coding framework;3) defining codes, coding additional transcripts, discussing/ revising the coding framework;4) formulating initial themes and 5) diagramming relationships among initial themes to merge overlapping themes. Results: Participants were a mean age of 62 ± 9.3 years, 36% were male. Key themes included healthy diet facilitators (food tracking, motivation, social support, and perception of healthy foods);barriers (transportation, past eating habits, stress and COVID mitigation);and impact of the trial on knowledge and health. Conclusions: Participants of a dietary intervention trial for African Americans with HTN and CKD identified several facilitators and barriers to healthy eating that could inform future efforts to address disease burden in this population.

Analysis of Lung Cancer Patients Receiving SARS-CoV-2 Vaccines Revealed a Minority Subset With Poor Antibody Responses Relative to Controls

Introduction: Patients with lung cancer (LC) were reported to have a high case fatality rate (30-40%) from SARS-CoV-2 infection, raising the question of whether LC patients mount a weaker antibody response to natural infection and/or vaccination, compared to healthy controls (HCs). We previously analyzed antibody responses to SARS-CoV-2 mRNA vaccination in several hundred healthy individuals, stratified by previous SARS-CoV-2 infection status. Using a validated enzyme-linked immunosorbent assay (ELISA) to the full-length spike protein (PMC8183627, PMC7235504), we found strong responses to infection and a robust neutralizing antibody response to vaccination. We compare these results to data from individuals diagnosed with LC undergoing different types of cancer treatment. Methods: This is an ongoing, prospective, control-matched longitudinal cohort study of 750 LC patients in all stages with or without previous SARS-CoV-2 infection and/or vaccination, comparing SARS-CoV-2 antibody titers at baseline (time of enrollment) and at 3-, 6-, 12- and 24-month intervals. We examine the quality, magnitude, and duration of the SARS-CoV-2 antibody titers against the full-length spike protein compared to the matched (age, tobacco history, sex and ethnicity) HC cohort. Types of Analysis and Data Reporting: ELISAs are performed in a CLIA-certified laboratory using an FDA-approved antibody assay along with other well-established, research-grade assays. We hypothesized that LC patients have a weaker antibody response to SARS-Cov-2 infection and/or vaccination due to cancer or its treatment compared to matched HCs. The non-parametric Kruskal–Wallis test was used to test this hypothesis. If confirmed, a tailored vaccination program would be necessary to ensure immune protection in patient with LC. Results: 111 LC patients have been enrolled to date;with 78 receiving at least one vaccination and 33 unvaccinated. Median age is 69, with 58% female. 39 patients were fully vaccinated (defined as 14+ days after second vaccination). Partially vaccinated (after 1st vaccine dose) LC patients had a lower median antibody level than partially vaccinated HCs (p=0.01). Fully vaccinated LC patients had substantial antibody titers but a lower median antibody level than fully vaccinated HCs (p=0.01) with a subset not raising large antibody titers. Especially important were the 30% of partially vaccinated LC patients who did not develop neutralizing antibodies. To date, there were no significant differences in median antibody levels in LC patients by gender, smoking status, age (< or > 65 years old), or treatment (with or without chemotherapy, immune checkpoint inhibitors, or targeted therapy). Conclusion: While most (∼70%+) of LC patients mounted a good antibody response to vaccination, a subgroup had significantly lower anti-spike antibody/neutralizing levels compared to controls. Further studies are required to evaluate the role of further boost vaccinations in this patient population with a particular focus on patients not producing neutralizing antibodies to further understand the lack of response. We will continue to analyze the effect of systemic anti-cancer therapies as more data becomes available. Keywords: SARS-CoV-2, lung cancer, covid-19