Guideline for the Management of Neonates Born to Mothers With COVID-19.

For the extended duration of the coronavirus disease 2019 (COVID-19) pandemic, reports emerged that mother-to-child transmission rates were low. However, the pandemic protocols including strict isolation, testing for severe acute respiratory syndrome coronavirus 2, and negative pressure isolation remained in Korea. Recently, the guideline for the management of neonates born to mothers with COVID-19 have been revised based on guidelines in other countries. Here, we introduce this newly developed guideline and review the foreign guidelines that were used for reference.Copyright © 2022 The Korean Society of Pediatric Infectious Diseases.

Using a Claims-Based Frailty Index to Investigate Frailty, Survival, and Healthcare Expenditures among Older Adults Hospitalized for COVID-19 at an Academic Medical Center

Background Frailty is associated with mortality in older adults hospitalized with COVID-19, yet few studies have quantified healthcare utilization and spending following COVID-19 hospitalization. Objective To evaluate whether survival and follow-up healthcare utilization and expenditures varied as a function of claims-based frailty status for older adults hospitalized with COVID-19. Design Retrospective cohort study Participants 136 patients aged 65 and older enrolled in an Accountable Care Organization (ACO) risk contract at an academic medical center and hospitalized for COVID-19 between March 11, 2020 - June 3, 2020 Measurements We linked a COVID-19 Registry with administrative claims data to quantify a frailty index and its relationship to mortality, healthcare utilization, and expenditures over 6 months following hospital discharge. Kaplan Meier curves and Cox Proportional Hazards models were used to evaluate survival by frailty. Kruskal-Wallis tests were used to compare utilization. A generalized linear model with a gamma distribution was used to evaluate differences in monthly Medicare expenditures. Results Much of the cohort was classified as moderate to severely frail (65.4%), 24.3% mildly frail, and 10.3% robust or pre-frail. Overall, 27.2% (n=37) of the cohort died (n=26 during hospitalization, n=11 after discharge) and survival did not significantly differ by frailty. Among survivors, inpatient hospitalizations during the 6-month follow-up period varied significantly by frailty (p=0.02). Mean cost over follow-up was $856.37 for the mild and $4914.16 for the moderate to severe frailty group, and monthly expenditures increased with higher frailty classification (p <.001). Conclusions In this cohort, claims-based frailty was not significantly associated with survival but was associated with follow-up hospitalizations and Medicare expenditures. Electronic Supplementary Material Supplementary material is available for this article at 10.14283/jfa.2023.15 and is accessible for authorized users.

Guideline for the Management of Neonates Born to Mothers With COVID-19

For the extended duration of the coronavirus disease 2019 (COVID-19) pandemic, reports emerged that mother-to-child transmission rates were low. However, the pandemic protocols including strict isolation, testing for severe acute respiratory syndrome coronavirus 2, and negative pressure isolation remained in Korea. Recently, the guideline for the management of neonates born to mothers with COVID-19 have been revised based on guidelines in other countries. Here, we introduce this newly developed guideline and review the foreign guidelines that were used for reference. © 2022 The Korean Society of Pediatric Infectious Diseases.

Using a Claims-Based Frailty Index to Investigate Frailty, Survival, and Healthcare Expenditures among Older Adults Hospitalized for COVID-19 at an Academic Medical Center.

BACKGROUND: Frailty is associated with mortality in older adults hospitalized with COVID-19, yet few studies have quantified healthcare utilization and spending following COVID-19 hospitalization. OBJECTIVE: To evaluate whether survival and follow-up healthcare utilization and expenditures varied as a function of claims-based frailty status for older adults hospitalized with COVID-19. DESIGN: Retrospective cohort study. PARTICIPANTS: 136 patients aged 65 and older enrolled in an Accountable Care Organization (ACO) risk contract at an academic medical center and hospitalized for COVID-19 between March 11, 2020 - June 3, 2020. MEASUREMENTS: We linked a COVID-19 Registry with administrative claims data to quantify a frailty index and its relationship to mortality, healthcare utilization, and expenditures over 6 months following hospital discharge. Kaplan Meier curves and Cox Proportional Hazards models were used to evaluate survival by frailty. Kruskal-Wallis tests were used to compare utilization. A generalized linear model with a gamma distribution was used to evaluate differences in monthly Medicare expenditures. RESULTS: Much of the cohort was classified as moderate to severely frail (65.4%), 24.3% mildly frail, and 10.3% robust or pre-frail. Overall, 27.2% (n=37) of the cohort died (n=26 during hospitalization, n=11 after discharge) and survival did not significantly differ by frailty. Among survivors, inpatient hospitalizations during the 6-month follow-up period varied significantly by frailty (p=0.02). Mean cost over follow-up was $856.37 for the mild and $4914.16 for the moderate to severe frailty group, and monthly expenditures increased with higher frailty classification (p <.001). CONCLUSIONS: In this cohort, claims-based frailty was not significantly associated with survival but was associated with follow-up hospitalizations and Medicare expenditures.

In-situ fabrication of 3D interior hotspots templated with a protein@Au core-shell structure for label-free and on-site SERS detection of viral diseases

Nanoscale plasmonic hotspots play a critical role in the enhancement of molecular Raman signals, enabling the sensitive and reliable trace analysis of biomedical molecules via surface-enhanced Raman spectroscopy (SERS). However, effective and label-free SERS diagnoses in practical fields remain challenging because of clinical samples' random adsorption and size mismatch with the nanoscale hotspots. Herein, we suggest a novel SERS strategy for interior hotspots templated with protein@Au core-shell nanostructures prepared via electrochemical one-pot Au deposition. The cytochrome c and lysates of SARS-CoV-2 (SLs) embedded in the interior hotspots were successfully functionalized to confine the electric fields and generate their optical fingerprint signals, respectively. Highly linear quantitative sensitivity was observed with the limit-of-detection value of 10-1 PFU/ mL. The feasibility of detecting the targets in a bodily fluidic environment was also confirmed using the proposed templates with SLs in human saliva and nasopharyngeal swabs. These interior hotspots templated with the target analytes are highly desirable for early and on-site SERS diagnoses of infectious diseases without any labeling processes.

Guideline for the Management of Neonates Born to Mothers With COVID-19.

For the extended duration of the coronavirus disease 2019 (COVID-19) pandemic, reports emerged that mother-to-child transmission rates were low. However, the pandemic protocols including strict isolation, testing for severe acute respiratory syndrome coronavirus 2, and negative pressure isolation remained in Korea. Recently, the guideline for the management of neonates born to mothers with COVID-19 have been revised based on guidelines in other countries. Here, we introduce this newly developed guideline and review the foreign guidelines that were used for reference. Copyright © 2022 The Korean Society of Pediatric Infectious Diseases.

3D interior hotspots embedded with viral lysates for rapid and label-free identification of infectious diseases

In recent decades, biomedical sensors based on surface-enhanced Raman spectroscopy (SERS), which reveals unique spectral features corresponding to individual molecular vibrational states, have attracted intensive attention. However, the lack of a system for precisely guiding biomolecules to active hotspot regions has impeded the broad application of SERS techniques. Herein, we demonstrate the irreversible active engineering of three-dimensional (3D) interior organo-hotspots via electrochemical (EC) deposition onto metal nanodimple (ECOMD) platforms with viral lysates. This approach enables organic seed-programmable Au growth and the spontaneous bottom-up formation of 3D interior organo-hotspots simultaneously. Because of the net charge effect on the participation rate of viral lysates, the number of interior organo-hotspots in the ECOMDs increases with increasingly positive polarity. The viral lysates embedded in the ECOMDs function as both a dielectric medium for field confinement and an analyte, enabling the highly specific and sensitive detection of SARS-CoV-2 lysates (SLs) at concentrations as low as 10-2 plaque forming unit/mL. The ECOMD platform was used to trace and detect the SLs in human saliva and diagnose of the delta-type SARS-CoV-2 in clinical environments;the results indicate that the proposed platform can provide point-of-care diagnoses of infectious diseases.

Analysis of the Deactivating Factors for Telework within Architectural Design Organization

The long-term pandemic caused by COVID-19 has changed many aspects of the work environment. Companies stalled to seriously consider telework and many have actually adopted it as an alternative way to work, hi fact 73.9% of overseas architect firms are using the telework while domestic architect firms shows no signs of introducing it yet. Various causes are suggested as to why the telework is not yet implemented in architectural practice even with the necessity of introduction, they are only unverified speculations and in order to understand the causes and solve the problems, a sophisticated analysis of the cause is required, hi addition, telework is not just a temporary option in pandemic situation but it needs to be established as another type of work in arcliitectiiral industiy in preparation for similar situation that may occur in the future. Therefore, this study aims to derive the impediments recognized by architect in introducing telework into domestic architect offices, and based on the results of the analysis from the derived factors, it was attempted to find a way to activate telework. Through the literature review, it is conformed that the research regarding the telework of architect office was insufficient and for this reason, telework consideration factors were derived from related studies targeting general companies. The questionnaire was prepared in consideration of the derived factors and the characteristics of the design work, and it was conducted at a time when the government's social distancing guidelines and telework recommendations were made. The study was conducted using the responses of 103 persons working in architect offices of the metropolitan area. As a result, it was confirmed that the cause of hindrace for teleworking perceived by the workers in the architect office was due to the specific characteristics of the design work, and it was confimed that the communication of visual information was the biggest hindrance factor ill the design work, hi addition, as a result of ANOVA on the questionnaire results, it was confirmed that there was a difference in the perceptions of architects about telework, and the main difference came from the work position and project experience. Afterwards. through factor analysis, specific directions were presented for three aspects: communication of design work when working from home, support within the organization, and establishment of IT infrastructure as a way to revitalize it. © 2022 Architectural Institute of Korea

Development of an Assistive Device for Improving the Consistency and Safety of Nasopharyngeal Swab Sampling

This study proposes a new assistive device that ensures consistency and improves safety in sample collection for detecting upper respiratory diseases such as COVID-19. The COVID-19 pandemic and the various mutations of the coronavirus have increased the demand for swab-sampling–based specimen collection. Currently, the most accurate method of collecting respiratory specimens is to insert a cotton swab through the nasal passage and touch the nasopharyngeal wall. Here, the success of sampling is subjectively determined by the force applied to the swab;test results may therefore vary based on the degree of training of the medical staff, and excess force can sometimes cause pain and aftereffects in patients. Therefore, we developed a device that measures the force applied to the swab when it is inserted up to the nasopharyngeal wall and indicates this to medical staff with an audiovisual signal. In this study, we introduce the details of the sample collection devices and validate the developed device through phantom model experiments. The results of five model experiments confirm that when both visual and auditory signals were given to medical staff, more consistent swab sampling was achieved than the conventional method without signals. © ICROS 2022.

A Toxic Anterior Segment Syndrome-like Ocular Inflammatory Reaction after COVID-19 Vaccination

Purpose: We report a case with bilateral, ocular inflammatory adverse reactions developing a few hours after COVID-19 vaccination. Case summary: A 70-year-old woman complained of headache and sudden visual impairment (both eyes) a few hours after COVID-19 vaccination (Astrazeneca). She had undergone bilateral cataract surgery 4 days before vaccination and her eyesight was good immediately after surgery. The best-corrected visual acuities (BCVA) were 0.2 and 0.1 in the right and left eyes, respectively. Diffuse corneal edema, anterior chamber reactions, inflammatory fibrinoid membranes on the anterior surfaces of the intraocular lenses (IOLs), and cystoid macular edema were observed in both eyes. The anterior chamber and IOL fibrinoid reactions much improved 7 days after the prescription of topical and oral corticosteroids. The aqueous humor polymerase chain reaction was positive for varicella zoster virus (VZV) in both eyes. The BCVA improved to 20/30 in the right eye and 20/50 in the left eye after 3 months of additional treatment. However, the cystoid macular edema did not improve. Conclusions: In patients with a history of herpes zoster infection, adverse ocular inflammatory reactions associated with VZV may occur immediately after COVID-19 vaccination.

Short-Term Dermatology Medical Mission and Global Health: A Retrospective Analysis of Climate Change

Background: The coronavirus disease pandemic has directly impacted global health. In developing countries, health service problems are more serious because of the lack of healthcare infrastructure. In this situation, if medical needs could be predicted, it would be helpful to bridge the medical gap with the provision of appropriate medical support. Objective: The aim of this study was to evaluate the association between climate change and skin diseases in developing countries to better prepare for medical missions. Methods: From 2012 to 2016, except for 2014, we visited a mission site located in Luzon, Philippines, every July. We retrospectively reviewed 499 patient data as well as weather information. Results: The total number of patients decreased each year. The climate change analysis using Pearson correlation showed diat the temperature and ultraviolet index tended to increase every year (r2=0.99, 0.93, respectively;p< 0.05). Conversely, humidity and rainfall decreased (r2= - 0.99, - 0.96, respectively;p<0.05). The Cochran-Armitage test showed that the rate of infectious skin disease diagnoses decreased every year compared to that of eczematous diseases. Conclusion: The total number of patients decreased by approximately 50% during medical service. We believe that the improvement in living standards and hygiene through continuous medical support has influenced the change in the incidence of skin diseases. Climate change was also thought to have affected the rate of skin disease diagnoses;in fact, the rate of infectious disease diagnoses tended to decrease compared to that of eczematous diseases. This analysis would be helpful for preparing for medical support. © 2021 Korean Dermatological Association. All rights reserved.

Towards an Open Global Air Quality Monitoring Platform to Assess Children's Exposure to Air Pollutants in the Light of COVID-19 Lockdowns

This ongoing work attempts to understand and address the requirements of UNICEF, a leading organization working in children's welfare, where they aim to tackle the problem of air quality for children at a global level. We are motivated by the lack of a proper model to account for heavily fluctuating air quality levels across the world in the wake of the COVID-19 pandemic, leading to uncertainty among public health professionals on the exact levels of children's exposure to air pollutants. We create an initial model as per the agency's requirement to generate insights through a combination of virtual meetups and online presentations. Our research team comprised of UNICEF's researchers and a group of volunteer data scientists. The presentations were delivered to a number of scientists and domain experts from UNICEF and community champions working with open data. We highlight their feedback and possible avenues to develop this research further.

ATSC 3.0 ROUTE/DASH Signaling for Immersive Media: New Perspectives and Examples

This paper examines the protocol structure of ATSC 3.0, the next-generation terrestrial broadcasting standard, and explains in-depth the technology of Real-Time Object Delivery over Unidirectional Transport (ROUTE) and MPEG Dynamic Adaptive Streaming over HTTP (DASH). Specifically, it considers both low and service signaling methodologies of ROUTE/DASH, that enable immersive media, stereoscopic 3D, and 360 virtual reality (VR), delivery in ATSC 3.0. Furthermore, this paper also provides the signaling examples to give readers new perspectives on immersive broadcasting through ROUTE/DASH in ATSC 3.0. In the era of COVID-19 pandemics, this kind of type, the ATSC 3.0 immersive media service method is expected to become an alternative to performance and media consumption in the future.

Switching from intravenous to subcutaneous infliximab in patients with active inflammatory bowel disease: post-hoc analysis of pre/post switch outcomes from a multicentre, randomised controlled pivotal

Introduction: A subcutaneous (SC) infliximab (IFX), CT-P13 SC, has received regulatory approval from the European Medicines Agency for indications including inflammatory bowel disease.1 In response to the coronavirus disease 2019 (COVID-19) pandemic, clinical guidance has recommended considering switching from intravenous (IV) treatment to SC alternatives to minimise hospital visits.2 Aims & Methods: In this analysis, data from the pivotal randomised controlled trial (NCT02883452) of CT-P13 SC in patients with active Crohn's disease (CD) and ulcerative colitis (UC) were analysed to investigate the clinical impact of switching from IV to SC IFX.3 Patients in the CT-P13 IV arm of the pivotal trial received CT-P13 5 mg/kg IV every 8 weeks from Week (W) 6 until W22. At W30, patients switched to receive CT-P13 SC every 2 weeks up to W54 (dose 120 mg or 240 mg for patients <80 kg or ≥80 kg, respectively).3 This post hoc analysis compared per-patient pairwise data at W30 (pre-switch) and W54 (post-switch) from the CT-P13 IV arm for the following outcomes: trough serum concentration (Ctrough;5 μg/mL was considered to be the target exposure level), clinical response (for CD patients, ≥100-point decrease in Crohn's Disease Activity Index score;for UC patients, ≥2-point decrease in partial Mayo score with accompanying ≥1-point decrease in rectal bleeding subscore or an absolute rectal bleeding subscore of 0 or 1) and immunogenicity (anti-drug antibody [ADA] and neutralising antibody [NAb] positivity;as measured by a drug tolerant assay;ADA negative was regarded as NAb negative). For pairwise comparisons, patients with missing data at either W30 or W54 were excluded from the analysis. Statistical comparisons used Fisher's exact test. The differences are reported in a descriptive manner. Results: Overall, 65 patients (25 CD;40 UC) were included in the CT-P13 IV arm. The proportion of patients with a Ctrough level exceeding target exposure was significantly higher post-switch (36/41, 87.8%) than pre-switch (8/41, 19.5%;p<0.00001) (Table). Clinical response rates were comparable at both pre- and post-switch timepoints (40/49 [81.6%] vs 44/49 [89.8%], respectively;p=0.3873). Positive ADA and NAb rates at pre-switch and post-switch were also comparable, in which some changes were regarded from patients with marginal value (Table). Conclusion: Switching from IV to SC IFX did not detrimentally affect the clinical outcomes of patients with active CD or UC. Further, switching from IV to SC IFX might confer more favourable pharmacokinetic outcomes, although larger comparative studies are warranted. (Table Presented).

Coronavirus disease 2019: Reasons for better clinical course for children compared to adults

There have been several reports on why the clinical course of coronavirus disease 2019 (COVID-19) in pediatric patients is milder than in adults. There are distinctive points in the immune system between children and adults, as well as in the angiotensin-converting enzyme 2 gene expression, the characteristics of the respiratory system, the effects of comorbidities and risk factors, and the effect of infection control. Even though children tend to have mild forms of COVID-19, this does not mean that we should not regard it as a matter of importance.

Virtual frailty assessment in older adults with blood cancers

Background: Frailty and geriatric assessments (GA) in oncology practice remain limited, and the COVID-19 pandemic has reduced the number of in-person visits. We aimed to develop and validate a virtual frailty assessment that incorporates both patient-reported and objective performance measures. Methods: The Older Adult Hematologic Malignancies Program at Dana-Farber is a clinical and research collaboration between geriatricians and oncologists. We have conducted screening GAs in over 800 patients since 2015. From this GA, we assess frailty via the phenotypic and deficit accumulation approaches based on 42 health deficits spanning the domains of function, mobility, comorbidity, and cognition. We adapted the measurement of these deficits to a virtual format, delivered through either videoconference or telephone. Patient-reported items were readily converted to the virtual format. Of the objective performance measures (7), grip strength was replaced with self-reported grip strength. The Clock-in-the-Box test was changed to a simple clock draw that the patient completes on a piece of paper and displays to the camera for scoring. Four-meter gait speed is collected by training a caregiver to administer with a stopwatch and a 4-meter strip of ribbon (mailed to patients). Geriatricians (C.D., T.H., and J.D.) and an oncologist (G.A.) reviewed the virtual GA for content validity. Feasibility will be measured as the proportion of patients who agree to participate and complete the virtual assessment. For reliability, two virtual frailty indices will be measured one week apart and compared. For agreement, the virtual frailty index will be compared against formerly collected in-person frailty indices from age-and gender-matched patients. In a subset of patients, the validity and reliability of virtual gait speed will be assessed by comparing our virtual tests administered in-home by the caregiver with in-person tests administered in-clinic by our research team. Results: Currently enrolling. Conclusions: A virtual frailty assessment that is valid and reliable will expand the delivery of the GA to older adults with blood cancers during and after the pandemic.

Pandemic induced changes in economic activity around African protected areas captured through night-time light data

The importance of tourism for development is widely recognized. Travel restrictions imposed to contain the spread of COVID-19 have brought tourism to a halt. Tourism is one of the key sectors driving change in Africa and is based exclusively on natural assets, with wildlife being the main attraction. Economic activities, therefore, are clustered around conservation and protected areas. We used night-time light data as a proxy measure for economic activity to assess change due to the pandemic. Our analysis shows that overall, 75 percent of the 8427 protected areas saw a decrease in light intensity in varying degrees in all countries and across IUCN protected area categories, including in popular protected area destinations, indicating a reduction in tourism-related economic activities. As countries discuss COVID-19 recovery, the methods using spatially explicit data illustrated in this paper can assess the extent of change, inform decision-making, and prioritize recovery efforts. © 2021 by the authors. LicenseeMDPI, Basel, Switzerland.