Premiums or Discounts? The State of Real Estate Investing in the U.S. and Mexico

Among these is Green Street Advisors, who are a meritorious source for information on various indicators of the behavior of real estate, including their analysis of the Premiums (or Discounts) on the Net Asset Value, of each of the sectors that make up the large Commercial Real Estate group. In the podcast on FIBRAs and Capital Markets under COVID-19, Colliers International and SiiLA Mexico, agree that the industrial sector is one of the least affected by COVID.2 However, SiiLA indicates ("The Value of Post COVID-19 Properties")3 that the logistics sector, being one of the most defensive, will have the challenge of organizing its supply chain. In some cases, during turbulent times, market conditions change in such a way that despite the high risk affected by most sectors, as in this case are Retail, Lodging and Office, given the high demand for quality space and strategic location for e-Commerce or for Nearshore Manufacturing, the industrial properties that meet these requirements benefit by becoming attractive opportunities.

Physical Therapist Training Challenges for an Embedded Pragmatic Trial: Fibromyalgia TENS in Physical Therapy Study

Transcutaneous electrical nerve stimulation (TENS), a non-pharmacological treatment, is safe and effective for movement-evoked pain in individuals with Fibromyalgia (FM). The purpose of our NIH-funded pragmatic clinical trial, Fibromyalgia TENS in PT Study (FM-TIPS), assesses feasibility and effectiveness of adding TENS to usual physical therapy (PT) treatment in individuals with FM. We partnered with 33 sites in 6 healthcare systems, training 150+ Midwest clinicians. Outpatient PT clinic sites are cluster randomized to a TENS or a No-TENS intervention, stratified by system and clinic size. We will recruit ∼600 patients with a primary or secondary diagnosis of FM. We developed comprehensive communication and training procedures to ensure study fidelity and adapted over the course of the study to enhance learning. We will provide an overview and the impact of the pandemic on these procedures. Representatives for each healthcare system, each clinic and the study team were identified for communication and training. Training included initial study introduction, human subjects protection, and study procedures. We used a hybrid approach with written, video, onsite, and virtual instruction. All materials and procedures, for clinician and patient-facing materials, website, videos, equipment use (iPad for screening, TENS units), and clinician procedures for PT visits 1-3, were piloted and reviewed by clinicians from each healthcare system. Additional communication and feedback include weekly enrollment reports, monthly newsletters, relationship building with clinicians, enrollment incentives, and continuing education webinars. The pandemic required creative and evolving solutions to maintain study involvement and recruitment. Barriers for enrollment are screening PT Visit 1, comfort level of clinicians for PT Visits 2 and 3, delays/alterations in training and planning, clinician demands, clinicians/patient illness, and staff shortages in the clinics. Current enrollment, study training and implementation has been affected by COVID-19 and we developed creative methods for training and implementation for FM-TIPS. Grant support from Research supported in this USASP was supported by National Institutes of Health Heal Initiative Grant UG3/UH3 AR076387-01 and UL1TR002537.

Spatial variation of fine particulate matter levels in Nairobi before and during the COVID-19 curfew: implications for environmental justice

The temporary decrease of fine particulate matter (PM2.5) concentrations in many parts of the world due to the COVID-19 lockdown spurred discussions on urban air pollution and health. However there has been little focus on sub-Saharan Africa, as few African cities have air quality monitors and if they do, these data are often not publicly available. Spatial differentials of changes in PM2.5 concentrations as a result of COVID also remain largely unstudied. To address this gap, we use a serendipitous mobile air quality monitoring deployment of eight Sensirion SPS 30 sensors on motorbikes in the city of Nairobi starting on 16 March 2020, before a COVID-19 curfew was imposed on 25 March and continuing until 5 May 2020. We developed a random-forest model to estimate PM2.5 surfaces for the entire city of Nairobi before and during the COVID-19 curfew. The highest PM2.5 concentrations during both periods were observed in the poor neighborhoods of Kariobangi, Mathare, Umoja, and Dandora, located to the east of the city center. Changes in PM2.5 were heterogeneous over space. PM2.5 concentrations increased during the curfew in rapidly urbanizing, the lower-middle-class neighborhoods of Kahawa, Kasarani, and Ruaraka, likely because residents switched from LPG to biomass fuels due to loss of income. Our results indicate that COVID-19 and policies to address it may have exacerbated existing air pollution inequalities in the city of Nairobi. The quantitative results are preliminary, due to sampling limitations and measurement uncertainties, as the available data came exclusively from low-cost sensors. This research serves to highlight that spatial data that is essential for understanding structural inequalities reflected in uneven air pollution burdens and differential impacts of events like the COVID pandemic. With the help of carefully deployed low-cost sensors with improved spatial sampling and at least one reference-quality monitor for calibration, we can collect data that is critical for developing targeted interventions that address environmental injustice in the African context.

Impact of COVID-19 on a Pragmatic, Cluster Randomized Clinical Trial for Fibromyalgia

Our objective was to present our experience on adapting to the challenges of COVID-19 pandemic on a pragmatic clinical trial. Transcutaneous Electrical Nerve Stimulation (TENS) in Physical Therapy (PT) Study (FM-TIPS) is a pragmatic, cluster-randomized clinical trial examining if the addition of TENS to routine PT improves movement-evoked pain in fibromyalgia (FM). FM patients (n=600) were enrolled from 24 PT clinics (12 PT only, 12 PT with TENS) across five healthcare systems. COVID-19 has significantly impacted PT practice and in-person interactions. In response, all PT clinics saw reduced volumes of patients, some clinics furloughed PTs, and some clinics were permanently closed. This led us to put contracts, reliance agreements, and training of clinics on hold and to seek additional clinics that could fill the gap for those who could no longer participate. It also led to a delay in onboarding healthcare systems and inpatient enrollment. In order to protect the integrity of the study and minimize missing data due to potential restrictions of in-person visits we developed alternative strategies. This includes procedures for home instruction of TENS via telehealth, a plan for bringing on backup clinics, and a plan for training virtually and in-person using personal protective equipment and social distancing. Assessment of primary outcome and questionnaire data were transitioned for the patient to perform at home through a patient-portal with embedded patient-specific videos. We have also set up a phone line for patients to call with additional questions or concerns. The impact of COVID-19 on statistical design and analysis was discussed including a plan for uneven enrollment across clinics and a sub-analysis of data for patients enrolled during or after the pandemic. In conclusion, COVID-19 altered the original study design of this large-pragmatic trial to account for greater flexibility for providers and patients to facilitate continued enrollment. NIH.