Impact of providing at-home medical device kits on remote monitoring of individuals with cystic fibrosis

Background: Cystic fibrosis (CF) is a chronic, multi-system disease that can greatly affect quality of life, so it is important for people with CF to be closely evaluated. Routine care includes measurement of basic vital signs, which allows providers to assess respiratory, cardiovascular, and nutritional status, all of which are aspects people with CF at high risk of decompensation because of the disease's pathophysiology [1]. Providing patients with home devices can improve access to vital sign monitoring, which in turn can expand the scope of telehealth and bring attention to daily changes in a patient's overall health [2]. We predict that providing patients with medical devices to monitor vitals will benefit their overall health and wellbeing. Method(s): Medical device kits were offered to patients coming for their routine in-person visits at VCU Health Mayland Medical Center. Each kit contained a tape measure, pulse oximeter, thermometer, blood pressure apparatus, and weight scale. Before receiving the kit, patients who agreed to participate in the study filled out a pre-distribution survey that was modeled after the Centers for Disease Control and Prevention Health- Related Quality of Life-14. If patients did not know how to use a device, health care staff instructed them on its use. Twoweeks after they received the kit, patients were emailed a post-distribution survey that assessed the usefulness of each medical device. Result(s): Seventeen of 18 patients (94.4%) agreed to participate in the study. From the pre-distribution survey, 11.8% of patients frequently monitored their vitals;94.1% of those believed that using the devices would help improve the maintenance of their health, and 82.3% were aware of normal values for blood pressure, pulse, oxygen level, and body temperature and how to measure height and weight. All six of the 17 (35.3%) patients who responded to the post-distribution survey stated that the devices had worked as intended and that they did not find the devices too time consuming. Of the five devices that patients received, most patients found the pulse oximeter and blood pressure apparatus to be useful (100%), followed by the weight machine (75%), thermometer (50%), and tape measure (0%). Conclusion(s): Although most patients agreed that monitoring their vital signs at home would help maintain or enhance their health (94.1%), before this study, only two (11.8%) indicated that they regularly self-measured their vital signs. Overall, patients received being provided home devices was overall positively, with the pulse oximeter and blood pressure apparatus being the most popular. Reasons included ease of access and ability to self-triage and determine the urgency of seeing a health care provider if feeling unwell. The results of this study highlight not only patient desires to be more involved with their health, but also the importance of continuing to find ways to optimize remote monitoring during this COVID era.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

CORD-19: The COVID-19 open research dataset

The COVID-19 Open Research Dataset (CORD-19) is a growing resource of scientific papers on COVID-19 and related historical coronavirus research. CORD-19 is designed to facilitate the development of text mining and information retrieval systems over its rich collection of metadata and structured full text papers. Since its release, CORD-19 has been downloaded over 200K times and has served as the basis of many COVID-19 text mining and discovery systems. In this article, we describe the mechanics of dataset construction, highlighting challenges and key design decisions, provide an overview of how CORD-19 has been used, and describe several shared tasks built around the dataset. We hope this resource will continue to bring together the computing community, biomedical experts, and policy makers in the search for effective treatments and management policies for COVID-19. © ACL 2020.All right reserved.

Is There a Relationship Between Pilot Stress and Short- and Long- Haul Flights?

Past studies have been conducted to identify whether short-haul (SH) or long-haul (LH) pilots experience a higher level of stress during a single flight. An extensive literature review revealed high stress levels in both groups (i.e., LH pilots were more stressed than SH pilots, and vice versa). To investigate these mixed results, quantitative and qualitative survey data were collected from 49 international commercial airline pilots from various countries in the Asia-Pacific, Europe and in North America. The General Health Questionnaire–12 (GHQ-12) was used to measure the stress levels of pilots during the pandemic. The study found that there was no significant difference between the stress levels of SH pilots compared to the stress levels of medium-, long-, and ultra long-haul pilots. To further investigate stress levels, pilots’ qualitative responses indicated that 75.5% of pilots were impacted by factors related to the COVID-19 pandemic, including increased stress associated with the uncertain future of the aviation industry, and income instability. In summary, this study aims to raise the attention of industry stakeholders such as aviation authorities and airlines of the need for targeted initiatives to support pilots who are most vulnerable to high-stress levelsas. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Global STEM Education through e-Service Learning in the Time of COVID-19: A Case Study

COVID-19 has brought about a lot of disruption, and education was one of the areas that was very significantly impacted. In many places in the world, students and teachers were forced to learn or teach online, oftentimes with very little preparation, in other places, schools shut down altogether and students' learning was interrupted. In this paper, we describe a case study that attempts to alleviate some of these challenges through an online STEM workshop series. Focus group studies were used to inform the design of the workshops, which were run as part of a service-learning program, incorporated student-directed, tangible learning, virtual experiential learning alongside theoretical content delivery to complement the formal curriculum. We present evaluation information as well as lessons learned for future similar endeavours.

Fact or fiction: Verifying scientific claims

We introduce scientific claim verification, a new task to select abstracts from the research literature containing evidence that SUPPORTS or REFUTES a given scientific claim, and to identify rationales justifying each decision. To study this task, we construct SCIFACT, a dataset of 1.4K expert-written scientific claims paired with evidence-containing abstracts annotated with labels and rationales. We develop baseline models for SCIFACT, and demonstrate that simple domain adaptation techniques substantially improve performance compared to models trained on Wikipedia or political news. We show that our system is able to verify claims related to COVID-19 by identifying evidence from the CORD-19 corpus. Our experiments indicate that SCIFACT will provide a challenging testbed for the development of new systems designed to retrieve and reason over corpora containing specialized domain knowledge. Data and code for this new task are publicly available at https://github.com/allenai/scifact. A leader-board and COVID-19 fact-checking demo are available at https://scifact.apps.allenai.org. © 2020 Association for Computational Linguistics.

IMPACT OF MAIL-IN SPUTUM CULTURES IN DELIVERY OF CYSTIC FIBROSIS CARE VIA TELEHEALTH

TOPIC: Education, Research, and Quality Improvement TYPE: Original Investigations PURPOSE: Cystic fibrosis (CF) is a multi-organ disease due to a mutation in the cystic fibrosis transmembrane conductance regulator gene. The mutation causes viscous mucus to accumulate in vital organs including the lungs. The thick mucus layers serve as sites of infection which are a significant cause of morbidity and mortality in CF patients. Sputum samples assess the types of pathogens that colonize CF patients’ lungs and can be used to guide treatment. Prior to the COVID-19 pandemic, sputum cultures were almost exclusively collected in the clinical setting. The purpose of this study was to examine the effectiveness of at-home collection of sputum samples. Specifically, we aimed to see if mail-in sputum samples can replace samples collected in clinic, thereby increasing accessibility of remote CF care. METHODS: Adult and pediatric patients were provided a mail-in sputum kit from the clinic along with instructions on collecting and shipping samples. Kits were completed by 7 adult and 32 pediatric patients from March 2020 to April 2021. The samples were shipped via FedEx to the microbiology lab for processing. The results were then compared with those of the patients’ previous hospital cultures from 2017-2020 for pediatrics and 2019-2020 for adults for reliability. The mail-in cultures were considered reliable if the patients’ previous in-clinic sputum samples had grown at least 50% of the same pathogens grown from the mail-in sample. RESULTS: Mail-in samples were reliable for 85.7% of the adult patients and 92.9% of the pediatric patients. Four pediatric patients were excluded from the study because they had not completed an in-hospital sputum sample. CONCLUSIONS: Given that the pathogens between adult and pediatric cultures were reliable 85.7% and 92.9% of the time respectively, mail-in sputum cultures appear to be an effective form of remote maintenance care in CF patients. Implementing mail-in culture protocols can expand the efficacy of telehealth in routine CF patient care. CLINICAL IMPLICATIONS: Future studies should look at optimizing patient education on mail-in sputum collection to facilitate ease of access. The usage of mail-in cultures can minimize the need for CF patients to come into the hospital for testing and in-clinic visits. DISCLOSURES: No relevant relationships by Madihah Alam, source=Web Response No relevant relationships by Sarah Barrett, source=Web Response Advisory Committee Member relationship with PARI Please note: 2019 Added 04/14/2021 by Nauman Chaudary, source=Web Response, value=Honoraria Moderator relationship with PARI Please note: 2021 Added 04/14/2021 by Nauman Chaudary, source=Web Response, value=Consulting fee Advisory Committee Member relationship with DYMEDSO Please note: 2021 Added 04/14/2021 by Nauman Chaudary, source=Web Response, value=Consulting fee No relevant relationships by Karen Lo, source=Web Response

IMPACT OF PORTABLE SPIROMETERS IN DELIVERY OF CYSTIC FIBROSIS CARE VIA TELEHEALTH

TOPIC: Education, Research, and Quality Improvement TYPE: Original Investigations PURPOSE: Cystic fibrosis (CF) is a chronic, multi-system disorder with significant morbidity and mortality. Consequently, long-term maintenance of this disease is heavily dependent on regular monitoring and treatments. The delivery of telehealth has become a topic of increasing importance since the onset of the COVID-19 pandemic. As such, portable spirometers have gained popularity in at-home care for CF patients. Forced expiratory volume (FEV1) is important clinical data used to assess the status of a patient’s disease and to guide their treatment plans. The purpose of this study was to examine the reliability of portable FEV1 values in comparison to hospital FEV1 values in order to explore novel approaches for remote CF monitoring during the SARS CoV-2 pandemic. METHODS: Funding from the Cystic Fibrosis Foundation and VCU Adult CF Center was used to provide patients with a ZEPHYRx home spirometry kit. Patients were provided instructional materials and were coached on how to use and maintain the device by dedicated respiratory therapists (RT). FEV1 values were reported through the ZEPHYRx Breathe Easy mobile app and these values were tracked from May 2020 to April 2021. The number of times these values fell at or above 90% of the patients’ best hospital FEV1 in the last 12 months was calculated as a percentage. The ZEYPHRx home spirometry values were deemed reliable if the percentage was ≥ 50%. RESULTS: The ZEPHYRx home spirometry kit provided reliable FEV1 values for 81% of the 48 patients who used the device. Compliance rate of the total 64 patients who received the home spirometry kit was 75%. The non-compliant patients were omitted from the final calculation. CONCLUSIONS: In conclusion, the study was successful in determining the reliability of utilizing ZEPHYRx home spirometry kits. The results of this study will expand the scope and efficacy of telehealth for the care of CF patients. CLINICAL IMPLICATIONS: Future studies can analyze the use of the kits in a longitudinal fashion to normalize their use in CF patient care. Including home spirometry kits as part of routine CF care will minimize patients’ visits to the clinic and therefore exposure to pathogens. DISCLOSURES: No relevant relationships by Madihah Alam, source=Web Response No relevant relationships by Sarah Barrett, source=Web Response Advisory Committee Member relationship with PARI Please note: 2019 Added 04/14/2021 by Nauman Chaudary, source=Web Response, value=Honoraria Moderator relationship with PARI Please note: 2021 Added 04/14/2021 by Nauman Chaudary, source=Web Response, value=Consulting fee Advisory Committee Member relationship with DYMEDSO Please note: 2021 Added 04/14/2021 by Nauman Chaudary, source=Web Response, value=Consulting fee No relevant relationships by Karen Lo, source=Web Response

Association of Pre-Admission Statin Mortality in COVID-19

Background: Coronavirus disease-19 (COVID-19) infection is associated with an uncontrolled systemic inflammatory response. Statins, given their anti-inflammatory properties, may reduce the associated morbidity and mortality. This study aimed to determine the association between statin use prior to hospitalization and in-hospital mortality in COVID-19 patients. Methods: In this retrospective study, clinical data were collected from the electronic medical records of patients admitted to the hospital with confirmed COVID-19 infection from March 1, 2020 to April 24, 2020. A multivariate regression analysis was performed to study the association of pre-admission statin use with in-hospital mortality. Results: Of 255 patients, 116 (45.5%) patients were on statins prior to admission and 139 (54.5%) were not. The statin group had a higher proportion of end stage renal disease (ESRD) (13.8% vs. 2.9%, p = 0.001), diabetes mellitus (63.8% vs. 35.2%, p<0.001), hypertension (87.9% vs. 61.1%, p < 0.001) and coronary artery disease (CAD) (33.6% vs. 5%, p < 0.001). On multivariate analysis, we found a statistically significant decrease in the odds of in-hospital mortality in patients on statins before admission (OR 0.14, 95% CI 0.03-0.61, p = 0.008). In the subgroup analysis, statins were associated with a decrease in mortality in those with CAD (OR 0.02, 95% CI 0.0003-;0.92 p = 0.045) and those without CAD (OR 0.05, 95% CI 0.005-0.43, p = 0.007). Conclusions: Our study suggests that statins are associated with reduced in-hospital mortality among patients with COVID-19, regardless of CAD status. More comprehensive epidemiological and molecular studies are needed to establish the role of statins in COVID-19.

VENTILATOR MECHANICS AND OUTCOMES IN CRITICALLY ILL PATIENTS WITH COVID-19 INFECTION

SESSION TITLE: Critical Care Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: COVID-19 has affected millions of people all over the world with high mortality. This impact is greater in the low socioeconomic patient population. There has been debate on whether the ARDS due to COVID-19 is typical ARDS or the variant phenotypes L and H. We describe the clinical characteristics, ventilator mechanics, and outcomes in an underserved African American patient population. METHODS: This is a single-center retrospective observational study. We included all adult patients with laboratory-confirmed COVID-19 discharged from our ICU between March 15-April 25, 2020. We collected demographic data, laboratory values, respiratory mechanics and clinical outcomes RESULTS: Sixty-one critical ill adult patients with confirmed SARS-Cov-2 were included in the study. Median age was 70 (IQR 61-77) and 31 patients (51%) were female. 21% of patients had preexisting pulmonary disease and almost half were current or former smokers. Hypertension was present in 85% and Diabetes Mellitus in 62% of the patients. Fifty-one patients (83.6%) had two or more comorbidities. On intubation the median PEEP was 8 cm H2O (IQR 5-10), plateau pressure was 25 cm H2O (IQR22-30) and compliance was 26 ml/cmH2O (IQR 21-33). There was a significantly lower mean PF ratio on admission compared to PF ratios 3 days after (p=0.014). The FiO2 requirements were significantly higher on admission compared to 3 days after (89.62 vs 57.71 p=0.005). Compliance increased from the date of admission to day 3 but was not statistically significant. Mechanical ventilation was required in 82% of patients. Prone positioning was done for 30% of patients and had less mortality of 29.7% vs 36.8% (p=0.763). Overall, the mortality rate was 66%. Withdrawal of care was done in 37.7% of patients. Successful extubation rate was 23%. CONCLUSIONS: Our patients presented with the typical low compliance ARDS. The mortality in critically ill COVID-19 patients is high. Increasing age, African Americans, and patients with multiple comorbid conditions are at increased risk of morbidity and mortality. CLINICAL IMPLICATIONS: N/A DISCLOSURES: No relevant relationships by Zurab Azmaiparashvili, source=Web Response No relevant relationships by Sadia Benzaquen, source=Web Response No relevant relationships by Siddique Chaudhary, source=Web Response No relevant relationships by Kevin Bryan Lo, source=Web Response No relevant relationships by ATUL MATTA, source=Web Response No relevant relationships by Gabriel Patarroyo - Aponte, source=Web Response