Opinion and Sentiment Analysis of Palliative Care in the Era of COVID-19.

During the COVID-19 pandemic, the value of palliative care has become more evident than ever. The current study quantitatively investigated the perceptions of palliative care emerging from the pandemic experience by analyzing a total of 26,494 English Tweets collected between 1 January 2020 and 1 January 2022. Such an investigation was considered invaluable in the era of more people sharing and seeking healthcare information on social media, as well as the emerging roles of palliative care. Using a web scraping method, we reviewed 6000 randomly selected Tweets and identified four themes in the extracted Tweets: (1) Negative Impact of the Pandemic on Palliative Care; (2) Positive Impact of the Pandemic on Palliative Care; (3) Recognized Benefits of Palliative Care; (4) Myth of Palliative Care. Although a large volume of Tweets focused on the negative impact of COVID-19 on palliative care as expected, we found almost the same volume of Tweets that were focused on the positive impact of COVID-19 on palliative care. We also found a smaller volume of Tweets associated with myths about palliative care. Using these manually classified Tweets, we trained machine learning (ML) algorithms to automatically classify the remaining tweets. The automatic classification of Tweets was found to be effective in classifying the negative impact of the COVID-19.

Determinants of voluntary compliance: COVID-19 mitigation.

During the pre-vaccine period, the success of containing the spread of COVID-19 depends upon how communities respond to non-pharmaceutical mitigation policies such as social distancing, wearing of masks, retail and dining constraints, crowd limitation, and shelter-in-place orders. Of these policies, shelter-in-place and social distancing are of central importance. By using county-level mobility data as a measure of a community's voluntary compliance with social distancing policies, this study found that counties who received strong state social distancing policy directives and who had a high pro-social character showed lower mobility on retail and recreation mobility and grocery and pharmacy mobility (better social distancing) after states reopened from shelter-in-place orders. Counties that experienced a longer duration of shelter-in-place orders showed higher mobility (less social distancing), implying that the duration of the shelter-in-place order deteriorated social distancing response after reopening. This may be because reopening sent a "safe" signal to these counties or resulted in a response to the pent-up demand inducing higher mobility. The results indicate that implementing shelter-in-place and social distancing policies to slow down the transmission of COVID-19 were not necessarily effective in motivating a county to reduce mobility voluntarily. A county's pro-social character and the duration of shelter-in-place order should be considered when designing COVID-19 mitigation policies.

The Impact of the COVID-19 Pandemic on Kidney Transplant Candidate Waitlist Status across Demographic and Geographic Groups: A National Analysis of UNOS STAR Data.

The primary goal of this retrospective study is to understand how the COVID-19 pandemic differentially impacted transplant status across race, sex, age, primary insurance, and geographic regions by examining which candidates: (i) remained on the waitlist, (ii) received transplants, or (iii) were removed from the waitlist due to severe sickness or death on a national level. Methods: The trend analysis aggregated by monthly transplant data from 1 December 2019 to 31 May 2021 (18 months) at the transplant center level. Ten variables about every transplant candidate were extracted from UNOS standard transplant analysis and research (STAR) data and analyzed. Characteristics of demographical groups were analyzed bivariately using t-test or Mann-Whitney U test for continuous variables and using Chi-sq/Fishers exact tests for categorical variables. Results: The trend analysis with the study period of 18 months included 31,336 transplants across 327 transplant centers. Patients experienced a longer waiting time when their registration centers in a county where high numbers of COVID-19 deaths were observed (SHR < 0.9999, p < 0.01). White candidates had a more significant transplant rate reduction than minority candidates (-32.19% vs. -20.15%) while minority candidates were found to have a higher waitlist removal rate than White candidates (9.23% vs. 9.45%). Compared to minority patients, White candidates' sub-distribution hazard ratio of the transplant waiting time was reduced by 55% during the pandemic period. Candidates in the Northwest United States had a more significant reduction in the transplant rate and a greater increase in the removal rate during the pandemic period. Conclusions: Based on this study, waitlist status and disposition varied significantly based on patient sociodemographic factors. During the pandemic period, minority patients, those with public insurance, older patients, and those in counties with high numbers of COVID-19 deaths experienced longer wait times. In contrast, older, White, male, Medicare, and high CPRA patients had a statistically significant higher risk of waitlist removal due to severe sickness or death. The results of this study should be considered carefully as we approach a reopening world post-COVID-19, and further studies should be conducted to elucidate the relationship between transplant candidate sociodemographic status and medical outcomes during this era.

Regional poverty and infection disease: early exploratory evidence from the COVID-19 pandemic.

This paper examines the role of regional poverty on the COVID-19 pandemic in the USA. It also explores how the effects differ with the concentration of ethnic minorities. We find that poverty is a significant and consistent determinant of higher COVID-19 infections and fatalities. Prevalent poverty areas experienced higher infections due to economic structure that require hypermobility (high mobility and interpersonal interaction)-more physical human to human contact resulting in higher deaths from limited access to health services. These are also regions where minority groups are concentrated. Disproportionate infections and fatalities occurred within the black, Hispanic, and Asian population. Our evidence is robust to state fixed effects that capture local COVID-19 mitigation policies, multi-level hierarchical modeling, spatial autoregressive assessment, and large sets of county-level health, social, and economic factors. This paper contributes to the literature on health and economic disparities and their resulting consequences for infectious diseases.

Ultrasound combined with glial cell line-derived neurotrophic factor-loaded microbubbles for the targeted treatment of drug addiction.

Drug addiction is a serious problem globally, recently exacerbated by the COVID-19 pandemic. Glial cell-derived neurotrophic factor (GDNF) is considered a potentially effective strategy for the treatment of addiction. Previous animal experiments have proven that GDNF has a good therapeutic effect on drug addiction, but its clinical application is limited due to its poor blood-brain barrier (BBB) permeability. Low-frequency focused ultrasound, combined with microbubbles, is a non-invasive and reversible technique for locally-targeted BBB opening. In the present study, magnetic resonance imaging-guided low-frequency focused ultrasound, combined with GDNF microbubbles, was used to target BBB opening in the ventral tegmental area (VTA) region. The effects of GDNF on morphine-induced conditioned place preference (CPP) and acute withdrawal symptoms in rats after a partially opened BBB were evaluated by behavioral observation. Western blot was used to detect changes in tyrosine hydroxylase (TH) expression levels in the VTA region after different treatments, and high performance liquid chromatography was used to detect the changes in monoamine neurotransmitter content. The results showed that ultrasound combined with GDNF microbubbles targeted and opened the BBB in the VTA region, and significantly increased GDNF content, destroyed morphine-induced CPP, and reduced the withdrawal symptoms of morphine addiction in rats. Furthermore, the up-regulation of TH expression and the increase of norepinephrine and dopamine content induced by morphine were significantly reversed, and the increase of 5-hydroxytryptamine content was partially reversed. Therefore, ultrasound combined with GDNF microbubbles to target and open the BBB can effectively increase the content of central GDNF, thus playing a therapeutic role in morphine addiction. Our study provides a new approach to locally open the BBB and target delivery of neurotrophic factors, such as GDNF, to treat brain diseases like addiction.

Implementing a Personalized Music Intervention for Persons Living With Dementia in Nursing Facilities

The Mason Music & Memory Initiative (M3I) team has implemented a personalized music intervention in nursing facilities across Virginia aiming to improve behavioral and psychological symptoms of persons living with dementia. This person-centered intervention uses a unique music playlist comprising songs, artists, and preferred musical genres. The preliminary findings from a randomized controlled trial will be reported, the purpose of which was to examine the intervention impact on nursing home residents’ mood and behavior. Based on the findings from 16 facilities with 158 residents who have completed the study, both quantitative and qualitative data indicate the positive effects on residents, including improved sleep and mood, as well as reduced agitation. The challenges in implementing intervention research in nursing facilities during the COVID-19 pandemic and the principles of telehealth and virtual support for facilities that were used to address those challenges will also be discussed.

Analysis of Symptomology, Infectiveness, and Reinfections between Male and Female COVID-19 Patients: Evidence from Japanese Registry Data

Background: Hokkaido was the first Japanese prefecture to be affected by COVID-19. Since the beginning of the pandemic, the Japanese government has been publishing the information of each individual who was tested positive for the virus. Method: The current study analyzed the 1269 SARS-CoV-2 cases confirmed in Hokkaido in order to examine sex-based differences in symptomology and infectiveness, as well as the status of reinfections and the viral transmission networks. Results: The majority of asymptomatic patients were females and older. Females were 1.3-fold more likely to be asymptomatic (p <0.001) while a decade of difference in age increased the likelihood of being asymptomatic by 1% (p <0.001). The data contained information up to quaternary viral transmission. The transmission network revealed that, although asymptomatic patients are more likely to transmit the virus, the individuals infected by asymptomatic cases are likely to be asymptomatic (p <0.001). Four distinct co-occurrences of symptoms were observed, including (i) fever/fatigue, (ii) pharyngitis/rhinitis, (iii) ageusia/anosmia, and (iv) nausea/vomiting/diarrhea. The presences of diarrhea (p = 0.05) as well as nausea/vomiting (p <0.001) were predictive of developing dyspnea, i.e., severe disease. About 1% of the patients experienced reinfection. Conclusions: Sex and symptomatology appear to play important roles in determining the levels of viral transmission as well as disease severity.

Symptom and Age Homophilies in SARS-CoV-2 Transmission Networks during the Early Phase of the Pandemic in Japan.

Kanagawa and Hokkaido were affected by COVID-19 in the early stage of the pandemic. Japan's initial response included contact tracing and PCR analysis on anyone who was suspected of having been exposed to SARS-CoV-2. In this retrospective study, we analyzed publicly available COVID-19 registry data from Kanagawa and Hokkaido (n = 4392). Exponential random graph model (ERGM) network analysis was performed to examine demographic and symptomological homophilies. Age, symptomatic, and asymptomatic status homophilies were seen in both prefectures. Symptom homophilies suggest that nuanced genetic differences in the virus may affect its epithelial cell type range and can result in the diversity of symptoms seen in individuals infected by SARS-CoV-2. Environmental variables such as temperature and humidity may also play a role in the overall pathogenesis of the virus. A higher level of asymptomatic transmission was observed in Kanagawa. Moreover, patients who contracted the virus through secondary or tertiary contacts were shown to be asymptomatic more frequently than those who contracted it from primary cases. Additionally, most of the transmissions stopped at the primary and secondary levels. As expected, significant viral transmission was seen in healthcare settings.