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1.
J Thorac Imaging ; 2023 Apr 07.
Article in English | MEDLINE | ID: covidwho-2300029

ABSTRACT

In this report and analysis of the results of a late 2021 post-COVID pandemic survey of members of the Society of Thoracic Radiology, we compared cardiothoracic radiologist workloads and burnout rates with those obtained from a prepandemic survey of society members. The more recent survey also asked respondents to provide a subjective assessment of their individual workload capacity should they be required to read cases at a section average daily case work volume, and this assessment was correlated with burnout rates. To measure nonrelative value unit workload, we requested data on non-case-related work responsibilities including teaching and multidisciplinary conferences that were not assessed in the first survey. In addition, we asked respondents to provide information on the availability of support services, personnel, and hardware and software tools that could improve work efficiency and reduce radiologist stress levels thereby mitigating burnout. We found that postpandemic case workload and cardiothoracic radiologists' burnout rates were similarly high compared with prepandemic levels with an overall burnout rate of 88% including a 100% burnout rate among women which had significantly increased. The range of radiologists' workload capacity is broad, although 80% of respondents reported that reading at an average sectional case volume was at or above their capacity, and the perceived capacity correlated with burnout measures. The presence of fellows and computer-aided diagnosis/artificial intelligence tools were each associated with significant decreases in burnout, providing 2 potential strategies that could be employed to address high cardiothoracic radiologist burnout rates.

3.
Vaccine ; 39(45): 6601-6613, 2021 10 29.
Article in English | MEDLINE | ID: covidwho-1541007

ABSTRACT

AKS-452 is a biologically-engineered vaccine comprising an Fc fusion protein of the SARS-CoV-2 viral spike protein receptor binding domain antigen (Ag) and human IgG1 Fc (SP/RBD-Fc) in clinical development for the induction and augmentation of neutralizing IgG titers against SARS-CoV-2 viral infection to address the COVID-19 pandemic. The Fc moiety is designed to enhance immunogenicity by increasing uptake via Fc-receptors (FcγR) on Ag-presenting cells (APCs) and prolonging exposure due to neonatal Fc receptor (FcRn) recycling. AKS-452 induced approximately 20-fold greater neutralizing IgG titers in mice relative to those induced by SP/RBD without the Fc moiety and induced comparable long-term neutralizing titers with a single dose vs. two doses. To further enhance immunogenicity, AKS-452 was evaluated in formulations containing a panel of adjuvants in which the water-in-oil adjuvant, Montanide™ ISA 720, enhanced neutralizing IgG titers by approximately 7-fold after one and two doses in mice, including the neutralization of live SARS-CoV-2 virus infection of VERO-E6 cells. Furthermore, ISA 720-adjuvanted AKS-452 was immunogenic in rabbits and non-human primates (NHPs) and protected from infection and clinical symptoms with live SARS-CoV-2 virus in NHPs (USA-WA1/2020 viral strain) and the K18 human ACE2-trangenic (K18-huACE2-Tg) mouse (South African B.1.351 viral variant). These preclinical studies support the initiation of Phase I clinical studies with adjuvanted AKS-452 with the expectation that this room-temperature stable, Fc-fusion subunit vaccine can be rapidly and inexpensively manufactured to provide billions of doses per year especially in regions where the cold-chain is difficult to maintain.


Subject(s)
COVID-19 Vaccines/immunology , COVID-19 , Spike Glycoprotein, Coronavirus/immunology , Animals , Antibodies, Neutralizing , Antibodies, Viral , COVID-19/prevention & control , Immunoglobulin G , Mice , Primates , Rabbits , Recombinant Fusion Proteins/immunology , SARS-CoV-2 , Vaccines, Subunit
4.
Vaccine ; 2021.
Article in English | EuropePMC | ID: covidwho-1451448

ABSTRACT

AKS-452 is a biologically-engineered vaccine comprising an Fc fusion protein of the SARS-CoV-2 viral spike protein receptor binding domain antigen (Ag) and human IgG1 Fc (SP/RBD-Fc) in clinical development for the induction and augmentation of neutralizing IgG titers against SARS-CoV-2 viral infection to address the COVID-19 pandemic. The Fc moiety is designed to enhance immunogenicity by increasing uptake via Fc-receptors (FcγR) on Ag-presenting cells (APCs) and prolonging exposure due to neonatal Fc receptor (FcRn) recycling. AKS-452 induced approximately 20-fold greater neutralizing IgG titers in mice relative to those induced by SP/RBD without the Fc moiety and induced comparable long-term neutralizing titers with a single dose vs. two doses. To further enhance immunogenicity, AKS-452 was evaluated in formulations containing a panel of adjuvants in which the water-in-oil adjuvant, Montanide™ ISA 720, enhanced neutralizing IgG titers by approximately 7-fold after one and two doses in mice, including the neutralization of live SARS-CoV-2 virus infection of VERO-E6 cells. Furthermore, ISA 720-adjuvanted AKS-452 was immunogenic in rabbits and non-human primates (NHPs) and protected from infection and clinical symptoms with live SARS-CoV-2 virus in NHPs (USA-WA1/2020 viral strain) and the K18 human ACE2-trangenic (K18-huACE2-Tg) mouse (South African B.1.351 viral variant). These preclinical studies support the initiation of Phase I clinical studies with adjuvanted AKS-452 with the expectation that this room-temperature stable, Fc-fusion subunit vaccine can be rapidly and inexpensively manufactured to provide billions of doses per year especially in regions where the cold-chain is difficult to maintain.

5.
BJR Open ; 2(1): 20200045, 2020.
Article in English | MEDLINE | ID: covidwho-1013192

ABSTRACT

In this opinion piece derived from a webinar organized by the Radiological Society of North America and conducted in the spring of 2020 during the COVID-19 pandemic, leaders from three large North American and Asian academic radiology programs review the strategies employed at their respective institutions to address the impact of the pandemic on their departments. In the first segment, the author describes the approach taken in the radiology department at an 1800-bed Asian hospital system which focuses on the creation of capacity to accommodate over 5000 COVID-19 patients in early 2020, the sustaining of services during the surge, and the development of adaptive mechanisms to address future surges and pandemics. In the second segment, a large southwestern medical system addresses the creation of a long-term strategy to provide imaging services safely for staff and patients while simultaneously utilizing technology to maintain interprofessional connections. The final segment describes how a large multifacility health-care enterprise in the Pacific Northwest of the United States is developing strategies to successfully reemerge from the forced reduction in imaging services experienced during the COVID-19 surge in early 2020.

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