Global Online Interest in HIV/AIDS care Services in the time of COVID-19: A Google Trends Analysis.

The Covid-19 pandemic has compounded the challenge of HIV/AIDS elimination, creating difficulties in accessing HIV care services such as early testing and treatment. This paper characterized the global online interest in HIV care services-related search terms before and during the pandemic. Global online search interest for HIV was measured using the Google Trends™ database. Spearman's rank-order correlation correlated country-specific characteristics and HIV prevalence data with the search volume index (SVI). We found a significant decrease in the global online search interest for HIV/AIDS care services-related search terms during the Covid-19 pandemic. The top countries with the highest online interest for "HIV/AIDS" search terms were Zambia, Eswatini, Malawi, Lesotho, and Zimbabwe. In addition, search volume indices for HIV correlated positively with HIV prevalence and negatively with GDP, GDP per capita, and the number of physicians. This result highlights that resource-poor countries with a high prevalence of HIV have a high online interest in HIV/AIDS. Therefore, there is a need to improve internet access, the quality of HIV-related health information, and online health literacy to improve health-seeking behavior, especially in areas with a high disease burden. Overall, our study shows that the infodemiologic approach through Google Trends™ can be used to assess the online interest of the public toward HIV infection and related healthcare services.

Trends in Stimulant Prescription Fills Among Commercially Insured Children and Adults - United States, 2016-2021.

Prescription stimulant use, primarily for the treatment of attention-deficit/hyperactivity disorder (ADHD), has increased among adults in the United States during recent decades, while remaining stable or declining among children and adolescents (1,2). MarketScan commercial claims data were analyzed to describe trends in prescription stimulant fills before and during the COVID-19 pandemic (2016-2021) by calculating annual percentages of enrollees aged 5-64 years in employer-sponsored health plans who had one or more prescription stimulant fills overall and by sex and age group. Overall, the percentage of enrollees with one or more prescription stimulant fills increased from 3.6% in 2016 to 4.1% in 2021. The percentages of females aged 15-44 years and males aged 25-44 years with prescription stimulant fills increased by more than 10% during 2020-2021. Future evaluation could determine if policy and health system reimbursement changes enacted during the pandemic contributed to the increase in stimulant prescriptions. Stimulants can offer substantial benefits for persons with ADHD, but also pose potential harms, including adverse effects, medication interactions, diversion and misuse, and overdoses. Well-established clinical guidelines exist for ADHD care, but only for children and adolescents* (3); clinical practice guidelines for adult ADHD could help adults also receive accurate diagnoses and appropriate treatment.

Antecedents to COVID-19 vaccine uptake among patients and employees in the Veterans Health Administration.

The present study sought to understand the antecedents to COVID-19 vaccination among those reporting a change in vaccine intention in order to improve COVID-19 vaccine uptake in the United States. We employed semi-structured interviews and one focus group discussion with vaccinated and unvaccinated Veterans Health Administration (VHA) employees and Veterans at three Veterans' Affairs medical centers between January and June 2021. A subset of these participants (n=21) self-reported a change in COVID-19 vaccine intention and were selected for additional analysis. We combined thematic analysis using the 5C scale (confidence, collective responsibility, complacency, calculation, constraints) as our theoretical framework with a constant comparative method from codes based on the SAGE Working Group on Vaccine Hesitancy. We generated 13 themes distributed across the 5C constructs that appeared to be associated with a change in COVID-19 vaccine intention. Themes included a trusted family member, friend or colleague in a healthcare field, a trusted healthcare professional, distrust of government or politics (confidence); duty to family and protection of others (collective responsibility); perceived health status and normative beliefs (complacency); perceived vaccine safety, perceived risk-benefit, and orientation towards deliberation (calculation); and ease of process (constraints). Key factors in promoting vaccine uptake included a desire to protect family; and conversations with as key factors in promoting vaccine uptake. Constructs from the 5C scale are useful in understanding intrapersonal changes in vaccine intentions over time, which may help public health practitioners improve future vaccine uptake.

In this study of the Veteran and VA employee population, we aimed to understand what factors led to a decision to receive a COVID-19 vaccine. As part of a quality improvement project, we interviewed individuals at three Veterans' Affairs sites in the first six months of 2021. We then used a smaller sample of 21 participants who reported a change in their intentions to receive a COVID-19 vaccine to analyze for this study. This analysis utilizes constructs from the 5C scale, which was developed to understand the conditions required for an individual to decide to receive a vaccine (confidence, collective responsibility, complacency, calculation, constraints). The coding process revealed a number of recurring themes across the interviews falling under each of the five constructs, but concepts relating to vaccine confidence (i.e., level of trust in those developing and disseminating the vaccine) were most common, and constraints (i.e., psychological and structural barriers that stand in the way of vaccination) appeared least frequently in our interviews. We found that significant motivators to receive the vaccine included a desire to protect family and conversations with trusted clinicians, particularly mental healthcare providers. Our study was unique in using the 5Cs to understand changes in vaccine changes over time. Findings show that change in vaccine attitudes is possible even in the presence of concerns and shed light on approaches that public health providers could use to improve vaccine and booster rates.

Predictors of mortality among inpatients with COVID-19 infection in a tertiary referral center in the Philippines.

Objectives: The aim of this study was to determine the predictors of mortality and describe laboratory trends among adults with confirmed COVID-19. Methods: The medical records of adult patients admitted to a referral hospital with COVID-19 were retrospectively reviewed. Demographic and clinical characteristics, and laboratory parameters, were compared between survivors and non-survivors. Predictors of mortality were determined by multivariate analysis. Mean laboratory values were plotted across illness duration. Results: Of 1215 patients, 203 (16.7%) had mild, 488 (40.2%) moderate, 183 (15.1%) severe, and 341 (28.1%) critical COVID-19 on admission. In-hospital mortality was 18.2% (0% mild, 6.1% moderate, 15.8% severe, 47.5% critical). Predictors of mortality were age ≥ 60 years, COPD, qSOFA score ≥ 2, WBC > 10 × 109/L, absolute lymphocyte count < 1000, neutrophil ≥ 70%, PaO2/FiO2 ratio ≤ 200, eGFR < 90 mL/min/1.73 m2, LDH > 600 U/L, and CRP > 12 mg/L. Non-survivors exhibited an increase in LDH and decreases in PaO2/FiO2 ratio and eGFR during the 2nd-3rd week of illness. Conclusion: The overall mortality rate was high. Predictors of mortality were similar to those of other reports globally. Marked inflammation and worsening pulmonary and renal function were evident among non-survivors by the 2nd-3rd week of illness.

SELF-REPORTED CHEMOSENSORY CHANGES IN ALCOHOL CONSUMPTION GROUPS AND ASSOCIATED IMPACT ON QUALITY OF LIFE

Purpose: Chemosensory alteration in excessive alcohol drinkers substantially impacts their quality of life (QoL). Early assessment of chemosensory loss can help in early prediction of disease severity and associated comorbidities in heavy drinkers (HDs). In the present study we examined smell and taste self-reports of individuals with different alcohol drinking behaviors and association with change in overall QoL. Methods: Participants (n = 466;224 females/242 males) were recruited between June 2020 and September 2021 into the COVID-19 Pandemic Impact on Alcohol Study. Alcohol Use Disorders Identification Test (AUDIT) consumption scores across four time points (at enrollment, and after four, eight and twelve weeks) were analyzed by group based trajectory modeling to stratify participants into three groups (non-drinkers, NDs;moderate drinkers, MDs;and HDs). Results: Linear mixed effects analysis of self-reported taste abd smell data revealed that, in HDs compared to NDs, there was a significant reduction smell ability (F1,224 = 4.40, p = 0.03) after adjusting for age and smoking status, but group differences in taste ability did not reach statistical significance (F1,241 = 3.55, p = 0.06). The smell/taste measures did not significantly differ between the MDs and NDs. Further, the reduced smell and taste ability of HDs was significantly associated with deterioration in several QoL domains, including physical health (smell: coeff = 0.13, 95% CI 0.04 to 0.21, p = 0.003;taste: coeff = 0.13, 95% CI 0.03 to 0.22, p = 0.01), psychological (smell: coeff = 0.15, 95% CI 0.06 to 0.24, p = 0.001;taste: coeff = 0.13, 95% CI 0.03 to 0.24, p = 0.01), social relationships (smell: coeff = 0.20, 95% CI 0.10 to 0.30, p < 0.001;taste: coeff = 0.30, 95% CI 0.19 to 0.41, p < 0.001), and environmental health (smell: coeff = 0.18, 95% CI 0.09 to 0.26, p < 0.001;taste: coeff = 0.21, 95% CI 0.12 to 0.31, p < 0.001). Conclusion: The reduced olfactory and taste function of HDs and association with poorer QoL indicates that early assessment of chemosensory changes may be crucial in identifying the risk for poorer outcomes in heavy drinkers.

Selfie Periocular Verification Using an Efficient Super-Resolution Approach

Selfie-based biometrics has great potential for a wide range of applications since, e.g. periocular verification is contactless and is safe to use in pandemics such as COVID-19, when a major portion of a face is covered by a facial mask. Despite its advantages, selfie-based biometrics presents challenges since there is limited control over data acquisition at different distances. Therefore, Super-Resolution (SR) has to be used to increase the quality of the eye images and to keep or improve the recognition performance. We propose an Efficient Single Image Super-Resolution algorithm, which takes into account a trade-off between the efficiency and the size of its filters. To that end, the method implements a loss function based on the Sharpness metric used to evaluate iris images quality. Our method drastically reduces the number of parameters compared to the state-of-the-art: from 2,170,142 to 28,654. Our best results on remote verification systems with no redimensioning reached an EER of 8.89% for FaceNet, 12.14% for VGGFace, and 12.81% for ArcFace. Then, embedding vectors were extracted from SR images, the FaceNet-based system yielded an EER of 8.92% for a resizing of x2, 8.85% for x3, and 9.32% for x4.

Clinical characteristics of patients with asymptomatic and symptomatic COVID-19 admitted to a tertiary referral centre in the Philippines.

Objectives: To describe the clinical profile and outcomes of hospitalized patients with coronavirus disease 2019 (COVID-19) across the spectrum of disease severity. Methods: This retrospective study included adult patients with confirmed COVID-19 infection admitted to a referral hospital. Descriptive statistics, tests for trend, Kaplan-Meier curve and log-rank test were used to compare characteristics and outcomes across disease severity categories. Results: Of 1500 patients with COVID-19, 14.8% were asymptomatic, 13.5% had mild disease, 36.6% had moderate disease, 12.3% had severe disease and 22.7% had critical disease. Asymptomatic patients were admitted for a concurrent condition or for isolation. Patients aged >60 years, male gender and with co-morbidities had more severe disease. Fever, cough, shortness of breath, malaise, gastrointestinal symptoms and decreased sensorium were more common in patients with severe disease. Bilateral pulmonary infiltrates were common (51.1%), with sicker patients having more abnormal findings. The overall mortality rate was 15.1%. Adopting a symptom-based strategy reduced the length of hospitalization from a median of 13 [interquartile range (IQR) 7-21] days to 9 (IQR 5-14) days. Conclusion: The clinical profile and outcomes for this cohort of patients with COVID-19 was consistent with published reports. Asymptomatic infection was common, and universal testing may be a valuable strategy in the correct context, given the implications for infection control. A symptom-based strategy was found to reduce the length of hospitalization considerably.

Safety protocols in an exercise facility result in no detectable sars-CoV2 spread: A case study.

Coronavirus 2019 (COVID-19) disease has been a public health emergency of international concern with millions of confirmed cases globally. Closed environments with reduced ventilation contribute to the spread of COVID-19, including superspreading events. Exercising in closed places further increases the risk for transmission. Therefore, many fitness facilities were closed as part of mandated shutdowns early in the pandemic. Evidence-based safety protocols have now emerged and substantially reduce the risk of transmission. We report three positive cases of SARS-CoV-2 identified at a Dojo exercise facility in Manlius, NY, at three distinct time points. All cases were present in the Dojo 2 days prior to symptoms, a time period considered to be highly infectious. The safety protocols included universal mask wearing (no valves), multiple high-efficiency particulate air (HEPA) filters, and reduced capacity which resulted in no known spread of COVID-19.

Outcomes After Vascular Surgery Procedures in Patients with COVID-19 Infection: A National Multicenter Cohort Study (COVID-VAS).

OBJECTIVES: To analyze the outcome of vascular procedures performed in patients with COVID-19 infection during the 2020 pandemic. METHODS: This is a multicenter, prospective observational cohort study. We analyzed data from 75 patients with COVID-19 infection undergoing vascular surgery procedures in 17 hospitals across Spain and Andorra between March and May 2020. The primary end point was 30-day mortality. Clinical Trials registry number NCT04333693. RESULTS: The mean age was 70.9 (45-94) and 58 (77.0%) patients were male. Around 70.7% had postoperative complications, 36.0% of patients experienced respiratory failure, 22.7% acute renal failure, and 22.7% acute respiratory distress syndrome (ARDS). All-cause 30-days mortality rate was 37.3%. Multivariate analysis identified age >65 years (P = 0.009), American Society of Anesthesiologists (ASA) classification IV (P = 0.004), preoperative lymphocyte count <0.6 (×109/L) (P = 0.001) and lactate dehydrogenase (LDH) >500 (UI/L) (P = 0.004), need for invasive ventilation (P = 0.043), postoperative acute renal failure (P = 0.001), ARDS (P = 0.003) and major amputation (P = 0.009) as independent variables associated with mortality. Preoperative coma (P = 0.001), quick Sepsis Related Organ Failure Assessment (qSOFA) score ≥2 (P = 0.043), lymphocytes <0.6 (×109/L) (P = 0.019) leucocytes >11.5 (×109/L) (P = 0.007) and serum ferritin >1800 mg/dL (P = 0.004), bilateral lung infiltrates on thorax computed tomography (P = 0.025), and postoperative acute renal failure (P = 0.009) increased the risk of postoperative ARDS. qSOFA score ≥2 was the only risk factor associated with postoperative sepsis (P = 0.041). CONCLUSIONS: Patients with COVID-19 infection undergoing vascular surgery procedures showed poor 30-days survival. Age >65 years, preoperative lymphocytes <0.6 (x109/L) and LDH >500 (UI/L), and postoperative acute renal failure, ARDS and need for major amputation were identified as prognostic factors of 30-days mortality.

Psychological impact of the COVID-19 pandemic on five Latin American countries

Introduction: Social distancing and quarantine have proven to have negative effects on the mental health of populations, namely fear, anxiety, depression and post-traumatic stress symptoms. Resilience emerges as a buffering variable for such impact. The objective of this study was to compare the psychological impact of COVID-19 in several Latin American countries. Method: a sample of 1184 participants from Mexico, Cuba, Chile, Colombia and Guatemala was obtained;whose age ranged from 18 to 83 years old (M = 38.78, SD = 13.81). A survey on medical symptoms associated with COVID-19 and three instruments to evaluate: (1) depression, anxiety and stress, (2) impact of the event and (3) resilience were administered. Results: Younger people, with more symptoms associated with COVID-19 and those who reported higher scores of impact of event tended to present greater depressive, anxious and stress symptomatology. The impact of the event was the most determinant predictor. Resilience was protective against the impact of event, depression, anxiety and stress. Conclusions: The results show the differences in the psychological response to COVID-19 in each country and suggesting the need to develop public policies focused on prevention and promotion of integral health when facing sanitary emergencies. (C) 2021 Fundacion Universitaria Konrad Lorenz.