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Objective: To explore the double psychosocial threats of the COVID-19 pandemic, targeted behavior toward Chinese Americans, and the correlates to their mental health. Methods: A quantitative, cross-sectional, and descriptive design was utilized by using a purposive convenience sample of 301 Chinese Americans over the age of 18 residing in the United States. Online data collection was conducted through the social media platform WeChat from April 8–21, 2021. Descriptive statistical analysis was used for the participants' demographic characteristics, Multidimensional Scale of Perceived Social Support (MSPSS), Double Threat Situations, COVID-19 Racial Discrimination, and General Anxiety Disorder-7 (GAD-7). Stepwise logistic regression was conducted to verify predictors for anxiety levels by GAD-7. Results: In this sample (N = 301), 127 (42.19%) were male and 174 (57.81%) were female. The average age was 41.67 (SD = 5.89). Among MSPSS subscales, social support from family (MSPSS-Fam, 79.73%, n = 240) and social support from significant others (MSPSS-SO, 73.75%, n = 222) were high. 231 (76.74%) reported threats due to their Chinese ethnic background during the COVID-19 outbreak. Predictors for the high anxiety level by GAD-7 were COVID-19 racial discrimination from the local community (OR = 0.47, 95% CI = 0.39–0.71, p < 0.001), media/online (OR = 0.36, 95% CI = 0.26–0.53, p < 0.001), the perceived threat from the COVID-19 virus (OR = 0.33, 95% CI = 0.23–0.51, p < 0.001) and Perceived racism threat from Chinese background related to COVID-19 (OR = 0.31, 95% CI = 0.21–0.49, p < 0.001). Conclusions: COVID-19 double-threats (The virus and racial discrimination) situations are significantly related to the high level of anxiety among Chinese Americans. The sense of belonging and social perceptions of Chinese immigrants is closely related to public health problems in Western societies and needs to be addressed at all levels. Our findings call for the attention of healthcare workers to specific racism double-threatened situations and high mental health risks, as well as direct and indirect ethnic discrimination that Chinese Americans are experiencing during this pandemic, the long-term influences and effective coping ways related to this issue should be explored in further research. © 2023, Tech Science Press. All rights reserved.
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Introduction: There is a dearth of information on older users (65+ years) of medical cannabis, who may face unique challenges due to altered metabolism with aging, concurrent medication use, and risk of adverse effects. This observational study aimed to describe a large cohort of older medical cannabis users in Canada. Method(s): From Oct 2014 to Oct 2020, a commercial medical cannabis provider based in Canada collected anonymized data for research purposes from patient volunteers. Data included demographic, social, and health details (at intake) and cannabis products, self-perceived changes in symptoms and change in medications (at follow-up, variable duration). Cannabis products were categorized as cannabidiol (CBD) only, tetrahydocannabinol (THC) only or mixed CBD/THC. Of the mixed, formulations could be in 1:1 ratios (CBD+/THC+), predominantly CBD (CBD+/THC-) or predominantly THC (CBD-/THC+). Result(s): In total, 9766 subjects in the older cohort (65+ years old) completed the entire questionnaire (mean age (SD) = 73.6 (6.8) y, 60% female). They represented 23.1% of the total dataset (N = 42,267, mean (SD) =51.5 (16.8) y). The proportion of adults in the older cohort tended to increase over time (pre-2018: 17.6%;2018: 26.7%;2019: 31.2%;2020: 22.7%, when the overall intake decreased from 8869 to 5644). Among the older cohort, 15.5% were previous cannabis users and 67.7% were referred for chronic pain (mainly arthritis, chronic pain, lower back pain). Concomitant analgesic use was common (over-the-counter analgesics: 44.5%;opioids: 28.3%;NSAIDs: 24.5%). 7.9% of the sample (compared to 19.9% in the whole sample) were referred for psychiatric disorders, though 21.4% indicated antidepressant use and 12.3% indicated benzodiazepine use. Another 7% were referred for neurological disorders. Follow-up data were captured in visits (11,992) from 4698 older patients, averaging 2.5 visits per patient. The type of medical cannabis used changed over time, with increasing use of cannabis oil compared to herbal cannabis. In 2020, of 2478 visits, 78.9% use was cannabis oil and 6.7% was herbal forms (pre-2018: 57.6% vs 36.2%). The composition of cannabis oil demonstrated a preference for cannabinoid oil (CBD+) over tetrahydrocannabinol (THC+) in 6043 visits: 45.2% were using CBD+ preparations, only 3.2% were using THC+ preparations, and for CBD/THC combinations, CBD predominated (CBD+/THC-: 30.5%;CBD+/THC+: 16.8%;CBD-/THC+: 4.3%). Adverse-effects (7062 visits) included dry mouth (15.8%), drowsiness (8.6%), dizziness (4%) and hallucinations (0.6%). Patients reported improved pain, sleep and mood over time, though 15-20% reported no improvement or worsening. Medication use was mostly unchanged, though 40% of opioid users reported requiring reduced dosages. Conclusion(s): These data were drawn from a large convenience sample. The data suggest an increasing proportion of older users of medical cannabis, though COVID-19 may have affected recent use. Female users comprised a higher proportion, and cannabis oil containing CBD was preferred. Systematic studies of effectiveness and safety in older users of cannabinoids are needed given its increasing use. Funding(s): No funding was received for this work.Copyright © 2021
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Objective. The prognosis value of fibrosis-4 score (FIB-4) in COVID-19 is controversial. Hence, we conducted a systematic review and meta-analysis to investigate the association between the FIB-4 index and COVID-19 disease progression. Methods. We performed meta-analysis using the PubMed, Embase, and Cochrane databases. A fixed- or random-effects model was used for evaluating heterogeneity. Results. Thirteen studies were included. The meta-analysis of unadjusted results showed that compared to lower FIB-4 index, patients with higher FIB-4 index had increased odds of mortality (OR=5.1, 95%CI 3.67-7.09;P<0.001), ICU admission (OR=2.32, 95%CI: 1.65-3.25, P<0.00001) and need for mechanical ventilator support (OR=3.51, 95%CI: 2.1-5.85, P<0.001). In addition, the meta-analysis of adjusted results showed patients with higher FIB-4 index was associated with increased risk of mortality (OR=3.01, 95%CI: 2.21-4.09, P<0.001) and need for mechanical ventilator support (OR=3.76, 95%CI: 2.08-6.82, P<0.001) compared to patients with lower FIB-4 index. Conclusion. This meta-analysis indicated that high FIB-4 index score was associated with the severity and mortality in COVID-19 infected patients.Copyright © 2022 by the Association of Clinical Scientists, Inc.
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Vaccines are crucial for controlling deadly diseases, and how to persuade people to get vaccinated has become a hot topic in enhancing public health benefits. One way to increase the vaccination rate is to raise public awareness of the importance of vaccines through advertising. As an effective and cost-friendly approach, goal framing has been widely used in vaccine advertising. However, the literature has mixed findings about whether positive or negative goal framing is more effective in persuading people to get vaccinated. The present study aims to investigate how temporal distance (present vs. future) interacts with different types of goal framing (positive vs. negative) in persuading people to get the COVID-19 vaccine. We hypothesized that negative goal framing is more persuasive when the advertising focuses on present outcomes, while positive goal framing is more effective when combined with future- focused outcomes. We further hypothesized that the inner mechanism is the intertemporal asymmetry of approach and avoidance motivation. More specifically, the avoidance motivation induced by a negative frame is stronger in the present, while the approach motivation induced by a positive frame is stronger in the future. The perceived risk of COVID-19 moderated this effect. Four studies were conducted to examine our hypotheses. Study 1 was conducted to preliminarily investigate how goal framing and temporal distance jointly influence willingness to get the COVID-19 vaccine. The aim of Study 2 was to verify the mediating effect of approach and avoidance motivation in a different advertising setting, as well as to rule out the potential mediators of the construal level and positive/ negative emotions. In Study 3, we further tested the mediators by manipulating participants' approach and avoidance motivation. Study 4 was a quasi-experiment in which we recruited participants from areas with different levels of COVID-19 risk to test how perceived risk moderated the interaction effect of goal framing and temporal distance. The results showed that a negative goal frame was more persuasive when combined with present-focused advertising, while a positive goal frame was more effective when combined with future- focused advertising (Study 1, N = 363). Avoidance motivation mediated the relationship between the goal frame and vaccine uptake in the present context, while approach motivation mediated the relationship between the goal frame and vaccine uptake in the future context (Study 2, N = 292). The results in Study 3 ( N = 347) revealed that approach motivation priming increases the persuasiveness of the present-positive frame, while avoidance motivation priming increases the persuasiveness of the future- negative frame. COVID-19 risk also had an impact on the relationship between goal framing and temporal distance on vaccine uptake. When the COVID-19 risk was high, the difference in vaccine uptake between present-positive and present-negative conditions disappeared, while the future-positive frame was still more persuasive than the future- negative frame (Study 4, N = 423). In conclusion, the present study found an interactive effect of goal framing and temporal distance in persuading people to get the COVID-19 vaccine. Avoidance/approach motivation mediates the relationship between goal framing and vaccine uptake in the present/future temporal context. The perceived COVID risk further moderated the interaction effect. The present study contributes to both the framing and approachavoidance motivation literature and sheds light on future practices in persuading people to get the COVID vaccine and promoting the uptake of other vaccines.
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Introduction: The annual National Diabetes Inpatient Audit (NaDIA and NaDIA-Harms) in the UK continues to show significant problems with patient care. During the COVID pandemic patient care has been even more difficult. New initiatives are urgently required to improve inpatient safety for people with diabetes. Method: The Joint British Diabetes Societies for Inpatient Care (JBDS-IP) organised the seventh national Rowan Hillson In-patient Safety Award on the theme of "the best interventions: redesigning, rebuilding and maintaining safe inpatient diabetes care during COVID". Result: The winner was the DEKODE team, led by Dr Punith Kempegowda from University Hospitals Birmingham NHS Foundation Trust, for their innovative quality improvement project across hospitals during COVID to improve diabetes-related ketoacidosis (DKA) management and study DKA in people with COVID. Adherence to national guidance improved in some hospitals, with falls in hypoglycaemia, and overall there was a significant improvement in awareness about DKA amongst junior doctors. The King's College NHS Foundation Trust team, led by Adrian Li and colleagues, received the highly commended award for their innovative project of remote blood glucose (BG) monitoring across healthcare boundaries. This improved diabetes control and tackled health inequalities. Summary and conclusion: These and similar schemes need to be developed, promoted and shared to improve safety for people with diabetes admitted in hospital during COVID times.
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Rhinovirus (RV) is one of the pathogens causing acute and chronic respiratory illnesses worldwide in paediatric patients. Compulsory mask-wearing and high stringency of social distancing were executed in Hong Kong since the SARSCoV-2 outbreak. While other common respiratory viruses vanished in routine surveillance programme, two sudden upsurges of RV associated upper respiratory tract infections were observed from Oct. to Nov. 2020 after schools reopening, and Apr. to Aug. 2021. We aimed to investigate if these RVs have a prominent role in transmission by analysing the RV genotype composition, assessing their replication competence, and the clinical features of paediatric patients. RV specimens collected from the hospitalised patients were genotyped, with clinical features of the patient documented and compared to those obtained in the pre-COVID-19 period. The replication competence of the RVs was examined in the well-differentiated human nasopharyngeal epithelial cells (HNPEC), and the stability of the RVs on different materials was tested. We identified the monopoly of minor group RV in each of the study duration, namely RV-A47 (80%) and RV-A49 (51%), respectively. In contrast to a diversified RV genotype composition in 2018-19. Without prior in vitro adaptation, the two minor-group RVs replicated in the HNPECs effectively to a comparable level as in the laboratory strain RVA16. The rise of minor-group RVs and dominance of single RV genotype under strict social distancing and hand hygiene is remarkable. Further investigation of the viral determinant, with an assessment of transmissibility in an animal model, will be needed to validate the specific role of these RVs.
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This chapter critically examines both the types and networks of disinformation produced in Sinophone and English languages by a variety of "Chinese" actors and institutions, most notably: state representatives and state-affiliated media of the People's Republic of China;Chinese diasporic media publication, The Epoch Times;and the broader media network associated with Guo Wengui, including GNews. It starts by highlighting two key theories that emerged around Covid-19 in the People's Republic of China (namely the United States military transmission theory and the Fort Detrick lab-leak theory), before showing how this information was spread through multimedia video content. Through interview data, the chapter also highlights how these theories influenced people's perception of Covid-19 in the People's Republic of China, both online and offline. The second section examines how actors and institutions involved in a variety of contradictory political projects attempt to influence how Covid-19 is imagined outside of the People's Republic of China, particularly among the American right and the Chinese diaspora. The chapter highlights how a more nuanced understanding of "China" and "Chineseness" is necessary to properly contextualize these sources of information;how the flattening of China and Chineseness can contribute to disinformation and misinformation;and, how the study of Covid-19 disinformation and misinformation illuminates the contours of ongoing geopolitical rivalries. © 2023 selection and editorial matter, Michael Butter and Peter Knight;individual chapters, the contributors.
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The recurring outbreak of COVID-19 has witnessed community group purchasing return to the mainstay of national consumption. The paper conducted a questionnaire survey on consumer groups with experience in community group purchasing to explore the influencing factors of customer satisfaction in developing community group purchasing. The evaluation index system was determined based on the CCSI model, and the entropy weighting method was used to determine the index weights. Multidimensional regression analysis was used to verify the influencing factors of consumer satisfaction and their magnitude. The results show that expected satisfaction, perceived value, perceived quality, and platform image all have a positive influence on consumer satisfaction, and there is a meaningful relationship between consumer satisfaction and consumer loyalty. Multidimensional enhancement of consumer satisfaction can drive the sustainable development of community group purchasing. © 2022 ACM.
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Extracellular vesicles (EVs) are phospholipid bilayer vesicles actively secreted by cells, that contain a variety of functional nucleic acids, proteins, and lipids, and are important mediums of intercellular communication. Based on their natural properties, EVs can not only retain the pharmacological effects of their source cells but also serve as natural delivery carriers. Among them, plant-derived nanovesicles (PNVs) are characterized as natural disease therapeutics with many advantages such as simplicity, safety, eco-friendliness, low cost, and low toxicity due to their abundant resources, large yield, and low risk of immunogenicity in vivo. This review systematically introduces the biogenesis, isolation methods, physical characterization, and components of PNVs, and describes their administration and cellular uptake as therapeutic agents. We highlight the therapeutic potential of PNVs as therapeutic agents and drug delivery carriers, including anti-inflammatory, anticancer, wound healing, regeneration, and antiaging properties as well as their potential use in the treatment of liver disease and COVID-19. Finally, the toxicity and immunogenicity, the current clinical application, and the possible challenges in the future development of PNVs were analyzed. We expect the functions of PNVs to be further explored to promote clinical translation, thereby facilitating the development of a new framework for the treatment of human diseases.Copyright © 2023 Chinese Pharmaceutical Association and Institute of Materia Medica, Chinese Academy of Medical Sciences
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COVID-19 is an acute respiratory infectious disease caused by 2019-nCoV, which has become a major global public health event and a serious threat to human health. So far, specific antiviral drugs, safe and effective vaccines for 2019-nCoV are still under development, so there is an urgent need to find alternative strategies for the treatment of COVID-19. Convalescent plasma(CP) contains high titer neutralizing antibodies from patients recovering from infectious diseases, which has been used in the treatment of major infectious diseases such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), and achieved satisfactory clinical results. Therefore, CP from COVID-19 patient is a meaningful choice for the treatment of severe or life-threatening COVID-19 patients, but its potential risks need to be studied. This review focuses on the clinical mechanism, collection points, clinical application and potential benefits and risks of clinical treatment of CP from COVID-19 patients, which will provide reference for the clinical application of CP from COVID-19 patients.Copyright © 2021 Chinese Medical Association
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COVID-19 is an acute respiratory infectious disease caused by 2019-nCoV, which has become a major global public health event and a serious threat to human health. So far, specific antiviral drugs, safe and effective vaccines for 2019-nCoV are still under development, so there is an urgent need to find alternative strategies for the treatment of COVID-19. Convalescent plasma(CP) contains high titer neutralizing antibodies from patients recovering from infectious diseases, which has been used in the treatment of major infectious diseases such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), and achieved satisfactory clinical results. Therefore, CP from COVID-19 patient is a meaningful choice for the treatment of severe or life-threatening COVID-19 patients, but its potential risks need to be studied. This review focuses on the clinical mechanism, collection points, clinical application and potential benefits and risks of clinical treatment of CP from COVID-19 patients, which will provide reference for the clinical application of CP from COVID-19 patients.Copyright © 2021 Chinese Medical Association
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COVID-19 is an acute respiratory infectious disease caused by 2019-nCoV, which has become a major global public health event and a serious threat to human health. So far, specific antiviral drugs, safe and effective vaccines for 2019-nCoV are still under development, so there is an urgent need to find alternative strategies for the treatment of COVID-19. Convalescent plasma(CP) contains high titer neutralizing antibodies from patients recovering from infectious diseases, which has been used in the treatment of major infectious diseases such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), and achieved satisfactory clinical results. Therefore, CP from COVID-19 patient is a meaningful choice for the treatment of severe or life-threatening COVID-19 patients, but its potential risks need to be studied. This review focuses on the clinical mechanism, collection points, clinical application and potential benefits and risks of clinical treatment of CP from COVID-19 patients, which will provide reference for the clinical application of CP from COVID-19 patients.Copyright © 2021 Chinese Medical Association
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Cidofovir is well described as an effective antiviral agent. It is reported to treat viral warts successfully in immunocompetent and immunocompromised individuals. Unfortunately, its use may be limited by the high cost and pain of treatment. We here report the successful treatment of multiple palmoplantar warts in an 8-year old male undergoing chemotherapy for relapsed acute lymphoblastic leukaemia. His most significant lesion was a 3 x 3 x 1.5 cm tumorous lesion on the central plantar forefoot that interfered with weight bearing. It had been resistant to over-the-counter treatments, cryotherapy, silver nitrate cautery, curettage and cautery, cantharadin and topical 5-fluorouracil. He was developing multiple satellite lesions and they had spread to the toes, the other foot and both hands, totalling more than 30 lesions. The first treatment session was during sedation for intrathecal chemotherapy. One millilitre of cidofovir (diluted to 15 mg mL-1) was instilled to the largest lesion (although solution was seen visibly escaping from the surface). The remainder of the vial was compounded to topical cidofovir 1% in Eucerin, which he applied once daily to remaining lesions. His postprocedure recovery was unremarkable, with no analgesia requirements or other complications. By the time of review 4 weeks later, the verruca that had received one session of intralesional treatment had completely resolved. Some of the smaller warts had shrunk in size. Despite reports of pain associated with intralesional cidofovir injections, our patient was keen for a repeated treatment to more lesions without sedation/anaesthetic. He tolerated the treatment of a number of remaining lesions without the need for topical or local anaesthesia. Treatments continued at 4-weekly intervals (to coincide with his chemotherapy regimen) with good response and no side-effects. After three treatment sessions most lesions had resolved with only some smaller lesions remaining. Unfortunately, his next treatments were suspended as he contracted COVID-19. In summary, we report the successful eradication of significant and widespread viral warts in an immunocompromised paediatric patient. Reports in patients under 10 years of age are scarce. We also confirm excellent tolerance of the procedure. Although the high cost of cidofovir may seem prohibitive, given that one vial could generate around 25 mL solution and 0.2-1 mL is needed per lesion, we would argue that it may be more costeffective than multiple sessions of other less/ineffective modalities. Furthermore, its antiviral mechanism of action is particularly beneficial in immunocompromised patients in comparison with other modalities, which require an efficient immune response in order to be successful.
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Objective: The prognosis value of fibrosis-4 score (FIB-4) in COVID-19 is controversial. Hence, we conducted a systematic review and meta-analysis to investigate the association between the FIB-4 index and COVID-19 disease progression. Methods: We performed meta-analysis using the PubMed, Embase, and Cochrane databases. A fixed- or random-effects model was used for evaluating heterogeneity. Results: Thirteen studies were included. The meta-analysis of unadjusted results showed that compared to lower FIB-4 index, patients with higher FIB-4 index had increased odds of mortality (OR=5.1, 95%CI 3.67-7.09;P < 0.001), ICU admission (OR=2.32, 95%CI: 1.65-3.25, P < 0.00001) and need for mechanical ventilator support (OR=3.51, 95%CI: 2.1-5.85, P < 0.001). In addition, the meta-analysis of adjusted results showed patients with higher FIB-4 index was associated with increased risk of mortality (OR=3.01, 95%CI: 2.21-4.09, P < 0.001) and need for mechanical ventilator support (OR=3.76, 95%CI: 2.08-6.82, P < 0.001) compared to patients with lower FIB-4 index. Conclusions: This meta-analysis indicated that high FIB-4 index score was associated with the severity and mortality in COVID-19 infected patients.
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Inevitably, consumers will be exposed to death-related information in their daily lives. For example, they are informed about deaths and injuries caused by accidents, terrorism and disasters on social media. They may also encounter the experiences of deceased friends and relatives or the news of unfortunate strangers. Especially in the context of the COVID-19 pandemic, consumers are more frequently exposed to death cues. Researches have shown that consumers' decision-makings and purchasing behaviors shift when dealing with death threats. Compared to material consumption, experiential consumption delivers greater and persistent well-being and it is emerging as an extremely important consumption pattern. It is unclear, however, whether these mortality cues will exert positive or negative effects on consumers' preference for experiential purchases. Based on the meaning maintenance model, 4 studies were conducted to examine how mortality salience influences consumers' preference for experiential purchases. In Study 1a and Study 1b, we experimentally manipulated mortality salience and examined its effect on consumers' preference for experiential purchases. Study 1a (N = 140) was a single factor (mortality salience) between-subjects design, participants were randomly assigned to different groups to imagine about incurable infectious disease or dental surgery. Participants in Study 1b (N = 252) were instructed to write about death or dental pain. Study 2 (N =219) was designed to test the mediating role of meaning in life. Participants were required to read a news report concerning traffic accident or dental surgery, and then finish the Meaning in Life Questionnaire. Study 3 (N = 166) was a 2 (mortality salience vs. control condition) × 2 (social support: high level vs. low level) between-subjects design. Participants were provided a news report pertaining to the global fatalities under the COVID-19 pandemic in mortality salience condition, and pertaining to global tourism during the pandemic period in the control condition. Social support was manipulated by writing in detail a difficult situation "in which your family or friends accompanied you", or "in which you had to face all by yourself". Additionally, we used a single-paper meta-analysis (SPM) to document a robust effect across all studies. The main results of this study are as follows: (1) Exposed to mortality salience will lead to stronger preference for experiential purchases. (2) The effects seem to be driven by meaning in life, whereby exposure to mortality salience undermines consumers' meaning in life, and consumers will gravitate towards experiential consumption to enhance their impaired meaning. (3) Social support moderates the effect of mortality salience on meaning in life. Only when consumers received low level of social support, will mortality salience reduce their meaning in life. (4) Social support moderates the mediating effect of meaning in life on mortality salience and preference for experiential purchases. Specifically, meaning in life mediates the effect of mortality salience on preference for experiential purchases only when consumers received low social support. To enhance the overall validity, we performed a single-paper meta-analysis (SPM) on the four studies. The SPM showed that consumers had greater preference of experiential purchase when exposed to mortality salience (Estimate β = 0.30, SE = 0.07, z = 4.178, p < 0.001), which strengthened the robustness of our general conclusion. This research yields practical implications by demonstrating that mortality salience exerts positive effect on consumers' preference for experiential purchases, which enables us to identify the changes in consumption patterns and mindset under the pandemic, providing references for marketing and promotion strategies. © Science Press.
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BACKGROUND: In response to the COVID-19 pandemic, we scaled up telemedicine and rideshare services for clinic and laboratory visits for pediatric and adolescent patients with HIV. SETTING: HIV subspecialty program for patients aged 0-24 years at Children's National Hospital, Washington, DC. METHODS: Using the χ2 and Wilcoxon rank sum tests, we compared demographics, visit and laboratory data, and rideshare usage among patients who scheduled telemedicine at least once (telemedicine) versus those who never scheduled telemedicine (no-telemedicine) during the pandemic (April-September 2020). We compared the number and proportion of scheduled and completed clinic visits before the pandemic (April-September 2019) with those during the pandemic. RESULTS: We analyzed 178 pediatric and adolescent patients with HIV (median age 17.9 years, 89.3% Black, 48.9% male patients, 78.7% perinatally infected), of whom 70.2% and 28.6% used telemedicine and rideshare, respectively. Telemedicine patients scheduled more visits (236 vs 179, P < 0.0001) and completed a similar proportion of visits (81.8% vs 86.0%, P = 0.3805) compared with no-telemedicine patients. Laboratory testing rates (81.3% versus 98.5%, P = 0.0005) were lower in telemedicine patients compared with no-telemedicine patients. Rideshare usage (12.4% versus 26.5%, P = 0.0068) was lower in telemedicine versus no-telemedicine patients. During the pandemic, most of the patients (81.0%) had HIV RNA <200 copies/mL. The total number of completed visits and the proportion of visits completed were similar before and during the pandemic. CONCLUSION: Most of the pediatric and adolescent patients with HIV used telemedicine and maintained HIV RNA <200 copies/mL during the pandemic. Despite rideshare usage, laboratory testing rates were lower with telemedicine compared with in-person visits.
Subject(s)
COVID-19/epidemiology , HIV Infections/therapy , Health Services Accessibility , Pandemics , Telemedicine , Transportation of Patients , Adolescent , Ambulatory Care , COVID-19/virology , Child , Female , Humans , Male , Patient Satisfaction , Retrospective Studies , SARS-CoV-2/isolation & purificationABSTRACT
OBJECTIVE: To explore the impact of the COVID-19 pandemic on the sleep-wake patterns of preschool children. METHODS: A cohort of preschoolers established before the COVID-19 pandemic was invited to participate in this study. Data including children's demographics, their own and parental sleep-wake patterns, physical activities, and screen time were collected through an online questionnaire from August to September 2020. A comparison was made on the collected data from the same cohort of children before and during the pandemic. RESULTS: The cohort which was established before the pandemic consisted of 3720 preschoolers. For this current study, 642 (17%) participated, and 497 (13%) children who fulfilled the eligibility criteria were included in the final analysis. They showed a delay in their bedtime and wake time on both weekdays and weekends with a 15-30 min increase in nocturnal sleep duration. However, with a reduction in nap time, the average daily sleep duration was shortened by 16.3 ± 64.3 min (p < 0.001) and 27.5 ± 72.9 min (p < 0.001) during weekdays and weekends, respectively. Screen time was increased while outdoor activity duration was decreased. Parental sleep/wake times were also delayed with an increase in sleep duration. Children's sleep habits were associated with screen time and parental sleep/wake patterns. CONCLUSION: Despite school suspension during the COVID-19 pandemic, preschoolers were not sleeping longer. Screen time and parental sleep/wake patterns were the major factors driving the preschoolers' sleep habits. Health education is required to control screen time in children and to promote sleep hygiene among all family members.
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Background. The spread of carbapenemase-producing Enterobacterales (CPE) is global threat. Numerous outbreaks of CPE have been reported during the COVID-19 pandemic. We describe the impact of of the SARS-CoV-2 pandemic on the emergence of CPE in south-central Ontario, Canada. Incidence of clinical isolates of CPE and isolates with different CPE genes in Toronto/Peel region, 2017-2021. The upper panel shows the incidence of patients with clinical isolates of CPE by year and quarter from q4 2007 to q1 2022. The lower panel shows the incidence of patients with clinical isolates with different carbapenemase genes by fiscal year during the same period. Methods. TIBDN has performed population-based surveillance for CPE in Toronto/Peel region (pop 4.5M) from first identified isolate in 2007. All laboratories test/refer all carbapenem non-susceptible Enterobacterial isolates for identification of CPE. Hospital charts are reviewed and patients/physicians interviewed. Population data are obtained from Statistics Canada. Results. From 10/2007 to 3/31/2022, 1367 persons colonized or infected with CPE were identified. Theirmedian age was 68.7yrs (IQR 54-78yrs);761 (56%) weremale. 772 (56%) were colonized when first identified;115 (8.4%) were bacteremic at identification or subsequently developed bacteremia. The most common organisms were E. coli (651, 48%), K. pneumoniae (436, 32%), Enterobacter spp. (146, 11%), Citrobacter spp (62, 5%);the most common genes were NDM+/-OXA-48 (722, 53%), OXA-48-like (341, 25%), KPC (225, 16%), VIM(44, 3%). The incidence of CPE infections increased steadily until 3/2020 then declined by 61%and remained stable until 3/2022 (Figure, upper panel). The declinewas greater for E. coli (56%decrease), K. pneumoniae (62%) than for Enterobacter spp. (30%) and other species (19%). It occurred in all genes in 2020;however, KPC containing organisms increased again in 2021 (Figure, lower panel). Conclusion. The advent of the COVID-19 pandemic was associated with an immediate, substantial decline in the incidence of patients with CPE in our population area. This decline occurred in both isolates with genes usually occurring in cases imported from other countries, and in those usually occurring in cases associated with transmission within Canadian hospitals. Decreased travel and enhanced infection prevention and control in hospitals may both have contributed to reductions in CPE during the pandemic. (Figure Presented).
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Since the 18th National Congress of the Communist Party of China, general secretary Xi Jinping has repeatedly stressed the issue of college students shouldering social responsibilities in the new era. He encourages college students to bear the responsibility of the times and learns to assume social responsibility. Based on the literature analysis, using the methods of data investigation and case analysis, the study explores how colleges and universities reasonably use and actively guide students to correctly understand and then agree to translate into action showing social responsibility. At the same time, according to the investigation of college students' sense of social responsibility, this paper analyzes the existing problems in education, so as to put forward objective and accurate feasible strategies and suggestions. © 2022 The Authors. Published by Elsevier B.V.
ABSTRACT
Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant has demonstrated high transmissibility and possesses several spike protein mutations that allow for evasion of previously established immunity.1 mRNA vaccines against the spike protein of the ancestral strain of the virus have been reported to induce robust T cell immunity against the omicron variant when examined in healthy individuals. 2 However, the effectiveness of the booster vaccine doses in late-stage lung cancer patients undergoing active anti-PD-1/ PD-L1 agent immunotherapy has yet to be investigated.3 Methods To address this question, we assessed both CD8+ and CD4+ T cell responses using a modified activationinduced marker (AIM) assay that was performed on peripheral blood mononuclear cells (PBMCs), which was coupled with high dimension spectral flow cytometry analyses. The PBMCs were obtained using cryopreserved blood samples collected from The COVID-19 Vaccine Study of Infections and Immune REspoNse (SIIREN) trial, and a total of 51 patient samples (20 non-cancer patients and 31 lung cancer patients) were assessed. Results Our observations included that booster vaccines induced CD8+ T cell response in both non-cancer subjects and lung cancer patients against ancestral strain and omicron variant, while only marginal induction or trend was detected for CD4+ T cells in normal subjects. Pertinent results also consisted of identification of distinct subpopulation dynamics involving varying degrees of differentiation of antigen-specific CD8+ and CD4+ T cells in lung cancer patients compared to non-cancer subjects, thus demonstrating evidence of dysfunction. Another noteworthy finding included the observation of sex biased T cell responses with female lung cancer patients demonstrating more efficient antigen-specific T cell responses compared to males. Conclusions We conclude that lung cancer patients in our study cohort have substantial qualitative deviation in their T cell response to mRNA vaccine from the normal individuals. This altered response may be a consequence of altered T cell differentiation states, resulting in the high degree of heterogeneity of AIM+ T cells identified in booster vaccinated individuals. Moreover, the dampened T cell response to omicron in cancer patients could implicate that less protection was established by vaccination for lung cancer patients, especially given that humoral response is also reduced in cancer patients.4 This further highlights the need for heightened protective measures for cancer patients to minimize the risk of breakthrough infection with the omicron and other future variants of SARS-CoV-2.5.