Rapid, sensitive detection of intact SARS-CoV-2 using DNA nets and a smartphone-linked fluorimeter

We report a single-step, room-temperature, 5-10 minute SARS-CoV-2 saliva self-monitoring method that overcomes the limitations of existing approaches through the use of fluorophore-releasing Designer DNA Nanostructures (DDNs) that bind with the multivalent pattern of spike proteins on the exterior intact virions and an inexpensive smartphone-linked, pocket-size fluorimeter, called a "V-Pod” for its resemblance to an Apple AirPod™ headphone case. We characterize the V-Pod fluorimeter performance and the DDN-based assay to demonstrate a clinically relevant detection limit of 104 virus particles/mL for pseudo-typed WT SARS-CoV-2 and 105 virus particles/mL for real pathogenic variants, including Delta, Omicron, and D614g. © 2023 SPIE.

Impact of COVID-19 pandemic on healthcare-associated infections at intensive care units in South Korea: data from the Korean National Healthcare-Associated Infections Surveillance System (KONIS).

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has influenced hospital infection control practices. AIM: To evaluate the impact of the COVID-19 pandemic on healthcare-associated infections (HAIs) in intensive care units (ICUs). METHODS: A retrospective analysis using data from the Korean National Healthcare-Associated Infections Surveillance System was conducted. Comparisons between incidence rates and micro-organism distributions of bloodstream infection (BSI), central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infection (CAUTI), and ventilator-associated pneumonia (VAP) before and during the COVID-19 pandemic were performed according to hospital size. FINDINGS: The incidence rate of BSI significantly decreased during the COVID-19 pandemic compared to the pre-COVID-19 period (1.38 vs 1.23 per 10,000 patient-days, relative change -11.5%; P < 0.001). The incidence rate of VAP (1.03 vs 0.81 per 1000 device-days, relative change -21.4%; P < 0.001) significantly decreased during the COVID-19 pandemic compared to the pre-COVID-19 period, whereas rates of CLABSI (2.30 vs 2.23 per 1000 device-days; P = 0.19) and CAUTI (1.26 vs 1.26 per 1000 device-days; P = 0.99) were similar between the two periods. The rates of BSI and CLABSI significantly increased during the COVID-19 pandemic compared to the pre-COVID-19 period in large-sized hospitals, whereas these rates significantly decreased in small-to-medium-sized hospitals. The rates of CAUTI and VAP significantly decreased in small-sized hospitals. There were no significant changing trends in the rates of multidrug-resistant pathogens isolated from patients with HAI between the two periods. CONCLUSION: The incidence rates of BSI and VAP in ICUs decreased during the COVID-19 pandemic compared to the pre-COVID-19 period. This decrease was mainly seen in small-to-medium-sized hospitals.

Nurses' Intentions for COVID-19 Vaccination in South Korea in 2022

Purpose: This study was to identify nurses' intentions for COVID-19 vaccination in 2022. Methods: A questionnaire survey was conducted among 222 nurses in Korea. The collected data were analyzed using the independent t-test, one-way analysis of variance, the Wilcoxon rank sum test, Pearson's correlation coefficients, and multiple regression analysis. Results: The score for intention to be vaccinated against COVID-19 in 2022 was 2.70 points on a 5-point scale, significantly lower than in 2020 (3.02 points on a 5-point scale). The average score for knowledge related to COVID-19 was 7.22 out of 10 points. Positive correlations were found between the intention for COVID-19 vaccination in 2022 and preventive health behavior, as well as between nurses' intentions for COVID-19 vaccination in 2022 and 2020. The factors affecting nurses' intentions for COVID-19 vaccination in 2022 were preventive health behavior (β=.11, p=.045) and nurses' intentions for COVID-19 vaccination in 2020 (β=.65, p<.001). This model showed a significant explanatory power of approximately 45% (F=36.88, p<.001) for the COVID-19 vaccination intention in 2022. Conclusion: This result points to the importance of managing nurses' preventive health behaviors to promote COVID-19 vaccination uptake. Nurses' vaccination intentions are an important issue for the safety of both nurses and patients. A safe vaccination environment and national policy should be prepared to reduce nurses' hesitations about COVID-19 vaccination. © 2023 Korean Academy of Fundamentals of Nursing.

Impact of Coronavirus Disease 2019 pandemic on healthcare-associated infections at intensive care unit in South Korea: Data from Korean National Healthcare-associated Infections Surveillance System (KONIS)

Background. Coronavirus Disease 2019 (COVID-19) pandemic has influenced hospital infection control practices. We evaluated the impact of the COVID-19 pandemic on healthcare-associated infections (HAIs) in the intensive care unit. Methods. We conducted a retrospective analysis using data from the Korean National Healthcare-Associated Infections Surveillance System (KONIS). KONIS has conducted nationwide prospective surveillance of HAIs in intensive care units. Comparisons of incidence rates of bloodstream infection (BSI), central lineassociated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), and ventilator-associated pneumonia (VAP) before (Jan 2018-Dec 2019) and during the COVID-19 pandemic (Jan 2020-Jun 2021) were performed according to hospital size. The microorganism distributions in BSI, urinary tract infection, and pneumonia were compared between the period before and during the COVID-19 pandemic. Results. The incidence rate of BSI significantly decreased during the COVID-19 pandemic than in the pre-COVID-19 period (1.38 vs. 1.19 per 10,000 patient-days;P < 0.001) [Table 1]. Incidence rates of CLABSI (2.30 vs. 2.17 per 1,000 device-days;P = 0.03) and VAP (1.03 vs. 0.81 per 1,000 device-days;P < 0.001) decreased significantly during the COVID-19 pandemic than in the pre-COVID-19 period, whereas that rate of CAUTI was similar between the two periods. The annual trends of incidence rate of CLABSI and VAP also has decreased (Figure 1). According to the hospital size, the incidence rate per 1,000 device-days of CLABSI significantly decreased during the COVID-19 pandemic than in the pre-COVID-19 period in small to medium-sized hospitals (300-699 beds). The incidence rate per 1,000 device-days of VAP significantly decreased only in small-sized hospitals (200-449 beds). The microorganism distributions in HAIs did not change significantly. Conclusion. The incidence rates of CLABSI and VAP decreased during the COVID-19 pandemic than in the pre-COVID-19 period, which was attributable to the changes in small to medium-sized hospitals. (Figure Presented).

Regorafenib in patients (pts) with unresectable hepatocellular carcinoma (uHCC) in real-world practice in Asia: Final analysis of the prospective, observational REFINE study

Background: In an interim analysis of Asian pts with uHCC in the observational REFINE study of regorafenib (NCT03289273), treatment-emergent adverse events (TEAEs) were consistent with those reported in the global, phase 3 RESORCE trial. Here, we present the final analysis of Asian pts with uHCC in REFINE. Method(s): REFINE is an international, prospective, multicenter study that enrolled pts with uHCC for whom a decision to treat with regorafenib was made by the treating physician prior to enrollment, according to the local health authority approved label. The primary objective is safety, including the incidences of TEAEs and dose modifications due to TEAEs (NCI-CTCAE v4.03). Secondary endpoints include overall survival, progression-free survival, and treatment duration. Result(s): Of the 1005 evaluable pts, 557 (55%) were from Asia (Korea [31%], Japan [26%], Taiwan [24%], China [18%], Thailand [1%]) and 82% were male. At baseline, median age was 65 years (range 21-94) and the most common HCC etiology in Asian pts was hepatitis B (60%) and in non-Asian pts was alcohol use (36%;Table). More Asian pts (71%) had received prior transarterial chemoembolization vs non-Asian pts (42%). The initial daily regorafenib dose was 160/120/80/40 mg in 51%/12%/35%/3% of Asian pts and 42%/9%/45%/4% of non-Asian pts. The median treatment duration was 3.7 months (range 0-34.4) in Asian pts and 3.6 months (range 0-38.9) in non-Asian pts. The most common TEAEs in Asian pts were hand-foot skin reaction (40%), diarrhea (27%), and decreased appetite (17%). TEAEs led to dose modification in 44% of Asian pts. [Formula presented]. Conclusion(s): These final data from REFINE confirm the safety and effectiveness of regorafenib in Asian pts with uHCC from a broad population in real-world practice. Final analyses from REFINE are ongoing and will be presented at the conference. Clinical trial identification: NCT03289273. Editorial acknowledgement: Editorial assistance in the preparation of this manuscript was provided by Matthew Reynolds of OPEN Health Communications (London, UK), with financial support from Bayer. Legal entity responsible for the study: Bayer. Funding(s): Bayer. Disclosure: Y.J. Kim: Financial Interests, Personal, Advisory Role: Bayer, Bristol Myers Squibb, Samil, PharmaKing, Celltrion, Bukwang;Financial Interests, Personal, Invited Speaker: Roche, AbbVie, Eisai, Ipsen, Boston Scientific, Bristol Myers Squibb, BTG, Bayer, MSD, Gilead Sciences, Novo Nordisk, Green Cross Cell, Boehringer Ingelheim, AstraZeneca;Financial Interests, Personal, Funding: BTG, Bayer, Boston Scientific, AstraZeneca, Gilead Sciences, Samjin, BL&H. M. Kurosaki: Financial Interests, Personal, Speaker's Bureau: Gilead Sciences, AbbVie, Eisai, Chugai, Lilly, Takeda. H.Y. Lim: Financial Interests, Personal, Advisory Role: Bayer, Eisai, Roche, Ipsen. M. Ikeda: Financial Interests, Personal, Advisory Board: AstraZeneca, Chugai, Eli Lilly Japan, Eisai, Nihon Servier, Novartis, Ono, Takeda, GlaxoSmithKline;Financial Interests, Personal, Invited Speaker: AstraZeneca, Bayer, Bristol Myers Squibb, Chugai, Eli Lilly Japan, Eisai, Nihon Servier, Novartis, Taiho, Yakult, Teijin Pharma, AbbVie, Abbott Japan, Fujifilm Toyama Chemical, Incyte Biosciences Japan, ASLAN, Chugai, Nihon Servier, Takeda;Financial Interests, Institutional, Invited Speaker: Bayer, Bristol Myers Squibb, Eisai, AstraZeneca, Eli Lilly Japan, Chugai Pharmaceutical, Merck Serono, MSD, Ono, Yakult, Novartis, Takeda, J-Pharma, Pfizer, Chiome Bioscience, Nihon Servier, Delta-Fly Pharma, Syneos Health, Merus.N.V. M. Kudo: Financial Interests, Personal, Invited Speaker: Eisai, Chugai, Eli Liiy, Bayer, Takeda, MSD;Financial Interests, Institutional, Research Grant: Otsuka, Sumitomo Dainippon Pharma, EA Pharma, Taiho, Eisai, AbbVie, Gilead Sciences, Takeda, GE Healthcare, Chugai. Y. Huang: Financial Interests, Personal, Advisory Role: Eisai, Bayer, BMS, Ono, Gilead, Lilly, AbbVie, Roche;Financial Interests, Personal, Invited Speaker: Eisai, Bayer, BMS, Ono, Gilead, Lilly, AbbVie, Roche;Financial Inte ests, Personal, Speaker's Bureau: Eisai, Bayer, BMS, Ono, Gilead, Lilly, AbbVie, Roche;Financial Interests, Institutional, Funding: Gilead. N. Kato: Financial Interests, Personal, Invited Speaker: Gilead Sciences Inc., AbbVie G.K., Ohtsuka Pharmaceutical Co., Ltd., Bayer Yakuhin Ltd., Chugai Pharmaceutical Co., Ltd., AstraZeneca K.K., Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Co., Ltd., Zeria Pharmaceutical Co., Ltd., Olympus Corporation, Eisai Co., Ltd., Aska Pharmaceutical Co., Ltd., Tsumura & Co., Mochida Pharmaceutical Co., Ltd., Miyarisan Pharmaceutical Co., Ltd., Covidien Japan Inc., Eli Lilly Japan K.K., Nobelpharma Co., Ltd., Kowa Company, Ltd., Incyte Biosciences Japan GK, Yakult Honsha Co.,Ltd., Olympus Marketing, Inc., Taisho Pharmaceutical Co.,Ltd., Janssen Pharmaceutical K.K.;Financial Interests, Institutional, Research Grant: AbbVie G.K., Ohtsuka Pharmaceutical Co., Ltd., Bayer Yakuhin Ltd., Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Sumitomo Dainippon Pharma Co., Ltd., Shionogi & Co., Ltd., Eisai Co., Ltd., Tsumura & Co., Nippon Kayaku Co., Ltd., JIMRO Co., Ltd., Kowa Company, Ltd. C. Hsu: Financial Interests, Personal, Speaker's Bureau: Bristol Myers Squibb, Ono Pharmaceutical, Merck Sharp & Dohme, Roche, Eisai;Financial Interests, Institutional, Funding: Ono Pharmaceutical, AstraZeneca, MSD, Merck Serono, Taiho Pharmaceutical, Bristol Myers Squibb, BeiGene, NuCana BioMed, Johnson & Johnson, Roche/Genentech, BeiGene;Financial Interests, Personal, Advisory Role: Ono Pharmaceutical, MSD, Bristol Myers Squibb, Merck Serono, Roche/Genentech. B. Chewaskulyong: Financial Interests, Personal, Advisory Role: Pfizer, STADA;Financial Interests, Personal, Invited Speaker: AstraZeneca, Pfizer, DKSH, Janssen, BMS, MSD, Roche, TAIHO;Financial Interests, Personal, Speaker's Bureau: AstraZeneca, Pfizer, DKSH, Janssen, BMS, MSD, Roche, TAIHO;Financial Interests, Institutional, Funding: Bayer. J. Khan: Financial Interests, Institutional, Full or part-time Employment: Bayer. K. Ozgurdal: Financial Interests, Institutional, Full or part-time Employment: Bayer;Financial Interests, Personal, Stocks/Shares: Bayer. All other authors have declared no conflicts of interest. Copyright © 2022

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.

Trusted Compliance Enforcement Framework for Sharing Health Big Data

COVID pandemic management via contact tracing and vaccine distribution has resulted in a large volume and high velocity of Health-related data being collected and exchanged among various healthcare providers, regulatory and government agencies, and people. This unprecedented sharing of sensitive health-related Big Data has raised technical challenges of ensuring robust data exchange while adhering to security and privacy regulations. We have developed a semantically rich and trusted Compliance Enforcement Framework for sharing large velocity Health datasets. This framework, built using Semantic Web technologies, defines a Trust Score for each participant in the data exchange process and includes ontologies combined with policy reasoners that ensure data access complies with health regulations, like Health Insurance Portability and Accountability Act (HIPAA). We have validated our framework by applying it to the Centers for Disease Control and Prevention (CDC) Contact Tracing Use case by exchanging over 1 million synthetic contact tracing records. This paper presents our framework in detail, along with the validation results against Contact Tracing data exchange. This framework can be used by all entities who need to exchange high velocity-sensitive data while ensuring real-time compliance with data regulations. © 2021 IEEE.

Conflicts in communities and residents’ attitudes toward the impacts of cruise tourism in the Bahamas

This study explicates the relationships between cruise participants and destination host communities to examine types of conflicts (i.e., conflicts between cruise tourists and residents, residents and local governments, and residents and their fellow residents) and resident perceptions. Survey data from local Bahamians were collected online. The results revealed that residents experiencing different degrees of conflict displayed significant differences in their responses toward cruise tourism. This research further discloses significant factors for predicting the types of conflicts that may arise within host communities. As this research provides insights into the significance of promoting mutual understanding between stakeholders on the impacts of cruise tourism, the findings provide both theoretical and practical implications and suggestions for researchers and cruise destination managers/policy makers on cruise tourism–related sustainable destination development. © 2021 Informa UK Limited, trading as Taylor & Francis Group.

Exploring violent crimes in Chicago during the COVID-19 pandemic: do location, crime type, and social distancing type matter?

The current study estimates the impact of the SAH order on violent crimes across public and residential locations: assault, battery, homicide, robbery, and sexual assault. Using interrupted time series analyses, it analyzes weekly crime data in Chicago, Illinois, from 2017 to 2020. The SAH order caused significant decreases in battery and sexual assault across public and residential locations. It also decreased assault in public locations only. Such decreases in assault, battery, and sexual assault were greater under the SAH order when social distancing was strictly enforced, as opposed to during the relaxation of social distancing. On the other hand, there were significant increases in homicide across public and residential locations. Robbery increased in public locations only. There were greater increases in homicide and robbery during the relaxation of social distancing, as opposed to under the SAH order. The study ultimately indicates that the impacts of the containment measures are conditional upon the offense location, type of crime, and level of social distancing being mandated. From a public policy perspective, it is important to allocate staffing and resources for law enforcement accordingly during the enduring pandemic.

A Semantically Rich Knowledge Graph to Automate HIPAA Regulations for Cloud Health IT Services

As healthcare organizations adopt cloud-based services to manage their patient data, compliance with the rules and policies of the Health Insurance Portability and Accountability Act (HIPAA) regulation becomes increasingly complex. At present, HIPAA rules are available only in large textual format and require significant human effort to implement in the Health IT systems. Moreover, every change in the regulation, like the recent relaxation in telehealth policy due to the COVID-19 pandemic, has to be manually implemented in the IT system. We have developed a semantically rich Knowledge graph, using Semantic Web technologies to represent HIPAA rules in a machine-processable format. This will significantly help in automatically reasoning of HIPAA policies. In this paper, we describe our design along with the results of our study of the current status of research on HIPAA ontology. We have validated our design against use cases defined by the US Department of Health and Human Services (HHS). This knowledge graph can be integrated with existing healthcare systems to provide automated compliance with HIPAA policies. © 2021 IEEE.

Modeling COVID-19 positivity rates and hospitalizations in Texas

The aim of this study was to jointly model COVID-19 test positivity rates and hospitalizations in Texas using Bayesian joinpoint regression. The data for both test positivity rates and hospitalizations were obtained from the Texas Department of State Health Services between April 5 and October 19, 2020. The stage 1 model identifies four significant shifts in test positivity rates, three of which occur roughly 9 days after documented policy or behavioral changes statewide. Estimated positivity rates from the first model were then used to predict hospitalization rates and to estimate lag time between changes in positivity and hospitalization. The resulting lag time is 9.056 days (± 3.808). Both models are valuable to policy makers and public health officials as they study the impact of behavioral patterns on disease prevalence and resulting hospitalizations. © 2021 - IOS Press. All rights reserved.

Viral kinetics of SARS-CoV-2 in patients with COVID-19

Background: As only few studies have analyzed viral kinetics between the incubation and symptomatic periods of COVID-19 patients, we investigated the viral kinetics and compared viral loads between patients with mild and severe COVID-19. Methods: We determined the viral kinetics of 10 patients diagnosed with COVID-19 at Chosun University Hospital. Six patients were classified into the “mild” group and 4 into the “severe” group according to supplemental oxygen use during admission. Samples were collected via nasopharyngeal swabs and sputum specimens. SARS-CoV-2 was detected using real-time reverse transcription-polymerase chain reaction (RT-PCR). Chest radiograph scores during hospitalization were obtained Results: Ct values of the upper respiratory tract specimens were low during the early stages after symptom onset but gradually increased over time in both groups. The severe group had lower Ct values than the mild group. The Ct values of the RdRP and E genes on day 6 after symptom onset were significantly lower in the severe group than in the mild group (p < 0.05). Three of 6 patients had positive results on RT-PCR even before symptom onset;2 of them had the lowest Ct values. The chest radiograph scores were higher in the severe group than in the mild group, and the score in the severe group was the highest at approximately 3 weeks after symptom onset. Ct values when the RdRP gene and E gene were targeted to detect SARS-CoV-2 on the basis of the days after symptom onset in all the patients Conclusion: Viral load and chest radiograph scores were significantly different between the severe and mild groups of COVID-19 patients. (Figure Presented).