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This paper presents a unique time-varying parameter vector autoregression (TVP-VAR) based extended joint connectedness approach to quantify the connectedness and transmission mechanism of shocks of nine commodities futures returns (namely;Gold and Silver from the category of precious metals;Copper, Lead, Zinc, Nickel and Aluminium from the category of base or industry metals;Natural Gas and Brent Crude Oil from energy sector) obtained from Multi Commodity Exchange of India Limited (MCX) from January 1, 2018 to December 31, 2021. This paper employs Balcilar et al. (2021)'s TVP-VAR extended joint connectedness approach, which combines the TVP-VAR connectedness approach of Antonakakis et al. (2020) with the joint spillover approach of Lastrapes and Wiesen (2021), to investigate the dynamic connectedness among the select commodity futures of interest. Our findings show that system-wide dynamic connectedness varies over time and is driven by economic events. The pandemic shocks appear to have an impact on system-wide dynamic connectedness, which peaks during the COVID-19 pandemic. Crude oil and zinc are the primary net shock transmitters, whereas gold and silver are the primary net shock receivers. We also discovered that the role of aluminum in shock transmitters and shock receivers changed during the course of the investigation. Pairwise connectivity, on the other hand, shows that Zinc, Copper, Nickel, and Crude oil are the key drivers of gold price changes, explaining the network's high degree of interconnectivity. During the study period, it was also discovered that silver has a significant influence on gold. Furthermore, in comparison to natural gas, gold's spillover activity is still relatively modest (on a scale), indicating that gold is less sensitive to market innovations. © 2023 Elsevier Ltd
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Background. In the Guatemala AGricultural workers and Respiratory Impact (AGRI) study, we evaluated the clinical and socioeconomic burdens of respiratory disease in a cohort of Guatemalan banana farm workers. Methods. All eligible workers were offered enrollment from June 15-December 30, 2020, and annually, then followed for influenza-like illnesses (ILI) through: 1) selfreporting to study nurses, 2) sentinel surveillance at health posts, and 3) absenteeism. Workers with ILI submitted nasopharyngeal swabs for influenza, RSV, and SARS-CoV-2 testing, then completed surveys at days 0, 7, and 28. Enrollment and acute-illness serum samples were tested for anti-SARS-CoV-2 nucleocapsid IgG (anti-N, Roche Elecsys ), and neutralizing antibodies (NAb) were tested in a subset using a lentivirus-based pseudovirion assay. Results. Through October 10, 2021, 1,833 workers were enrolled. The majority were male (84%), young (mean 31 years), and healthy (< 13% had comorbidity). Through October 10, 2021, 1,833 workers developed 169 ILIs (12.0/100 person-years) and 43 (25.4%) of these ILIs were laboratory-confirmed SARS-CoV-2 (3.1/100 person-years). Workers with SARS-CoV-2-positive ILI reported more anosmia (p< 0.01), dysgeusia (p< 0.01), difficulty concentrating (p=0.01), and irritability (p=0.01), and greater clinical and well-being severity scores (Flu-iiQ) than testnegative ILIs (Fig 1);they also had greater absenteeism (p< 0.01) and lost income (median US$127.1, p< 0.01). Among 1334 workers enrolled in 2020, 616 (46.2%) had anti-N IgG suggestive of prior SARS-CoV-2 infection. COVID-19 incidence density for IgG-seropositive workers was 0.4/100 Person Years (PY), lower than those who were seronegative (2.3/100 PY) (Fig 2). At enrollment, anti-N IgG titers in serum correlated with neutralizing antibody titers (R2 =0.26, p< 0.0001). Notably, in < 6 months from enrollment, most workers with follow-up NAb testing (65/77, 84%) exhibited a 95% decrease in neutralizing antibody titers. Conclusion. Guatemalan farm workers suffered a significant burden of COVID-19, including more severe clinical and economic outcomes than other respiratory illnesses. Ongoing vaccination programs and longitudinal serology will provide additional insight into long-term immunity.
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Background. Saliva samples are less invasive but not considered the gold standard for detecting SARS-CoV-2, and they are not validated for the Roche Cobas Liat platform. We aimed to evaluate the performance of a saliva sample compared to nasopharyngeal (NP) swab in the detection of SARS-CoV-2 on the Roche Cobas Liat platform at a research site in rural Guatemala. Methods. Adults in an existing cohort study with influenza-like illness (ILI) provided clinical data and underwent NP swab (Copan) collection by trained nurses. Swabs were immediately placed into universal transport media (UTM), stored at 2-8 degreeC for less than 30 minutes and then tested on the Cobas Liat platform for SARS-CoV-2. Consenting subjects who had not eaten or drank in the last 2 hours were asked to provide a 5-mL saliva sample directly into an RNAse free container. The saliva sample remained at 2-8 degreeC for 24 hours, then diluted 1:2 with 0.85% saline (to reduce viscosity) and run on the same assay. We used descriptive statistics to compare the performance of saliva to NP swabs. Results. Of the 28 subjects screened (1/10/22 - 4/26/22), 23 (82%) were consented and enrolled. The majority of subjects were male (78.3%) with a mean age of 31 years (range: 18-59 years). Of the 23 subjects enrolled, 14 (30.4%) reported fever and cough, 16 (34.8%) reported cough only, 14 (30.4%) reported fever only, and 2 (4.3%) reported cough and nasal congestion. The median symptom duration was 3.0 days (IQR: 1.5-5 days). Of the 23 subjects, 5 (23.7%) tested positive for SARS-CoV-2 in both sample types (NP swab and saliva);3 (13%) were discordant, including 1 (4.3%) saliva-positive only and 2 (8.7%) NP-positive only. Compared to NP swab, preliminary performance of saliva in detection of SARS-CoV-2 included a sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of 71.4%, 93.7%, 87%, 83.3%, and 88.2%, respectively. The Fisher's exact test p-value (0.003) shows concordance between both tests. Conclusion. Our preliminary results show good precision between NP and saliva samples in detection of SARS-CoV-2 on the Roche Cobas Liat platform. Ongoing data collection will provide greater insight on the discordant results, but our findings support the continued use of saliva in the detection of SARS-CoV-2 in this population.
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HEMOCOVID-19 is a multi-center trial aiming to assess the microvascular and endothelial health of severe COVID-19 patients in the intensive care using near-infrared spectroscopy. Here, we present the preliminary results, showing that peripheral microcirculatory alterations are associated with the severity of acute respiratory distress syndrome. © 2022 The Author(s).
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Background: Global Health Partnerships (GHPs) represent collaborative efforts towards training, research, and capacity building. Virtual GHP initiatives (VGHPIs) evolved to ensure GHP continuity during the COVID-19 pandemic, however, the current VGHPI landscape is unknown. This study aimed to increase understanding of the existing GHPs' perspectives on VGHPIs to inform future approaches for re-organization and reprioritization of GH activities. Methods: From 15 October to 30 November 2020, authors conducted an online, international survey using snowball sampling to assess pandemic-related changes in activities and document perceived acceptability and barriers to VGHPIs. Analysis stratified responses by country income classification and GHP type. The authors described categorical and continuous data using descriptive statistics. Chisquare tests were used to analyze categorical variables, with alpha set at 0.05. Results: A total of 128 respondents described 219 GHPs, with 82/128 (64%) responding to >1 GHP. Most GHPs (152/219, 69%) were transnational, of >5 years duration (157/219, 72%) and with bidirectional site visits (127/219, 60%);with HIC partners sending significantly more learners to LMIC partner sites (P = 0.0098). Within GHPs, respondents reported the pandemic was a significant disruptor to communication (122/219, 56%), funding (71/219, 32%), activities (195/219, 89%), and access to professional support (73/219, 33%). While 84/219 (38%) of GHPs described VGHPIs prior to the pandemic, respondents indicated that VGHPIs would be important to the majority (206/219, 94%) of GHPs moving forward. Available resources for VGHPIs were significantly different between LMIC and HIC respondents, as were their preference for VGHPIs, technological capacity, and acceptability of VGHPIs (P < 0.0001). There was no significant difference between groups regarding VGHPIs' perceived barriers. Conclusion: The pandemic disrupted many essential GHP elements, compounding on differences in the resources and preferences for VGHPIs between LMIC and HIC. VGHPIs have the potential to bridge existing gaps and maximize gains, bi-directionality, and equity of GHPs during and after COVID-19.
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Background. The COVID-19 pandemic has led to changes in clinical practice, including a significant increase in the use of telehealth (TH). We sought to assess the impact of the pandemic on the use and perceptions of TH by pediatric infectious diseases (PID) clinicians. Methods. The PIDS∗ Telehealth Working Group developed a 26-question online survey to assess telehealth practices among PID clinicians. The survey was available via Survey Monkey® from 12/6/2020-2/26/2021 to members of PIDS, PICNIC∗, AAMI and AAP∗. Clinicians in active practice in North America were included in the analysis. Results. The response rate was 10% (n=253) of 2,550 PID clinicians. Physicians accounted for 98.4% of the cohort. The remaining 1.6% were allied health professionals. 81 survey respondents (32%) were in 4 US states (CA, TX, OH and NY) and the province of Quebec. 62.8% of respondents were women, 37% of respondents were 36-45 years old, with 42.7% devoting about 50-99% of their time to direct patient care. TH usage increased during the pandemic with the most gain in provider-patient communications with 65.6% increase for synchronous and 22.1% for asynchronous TH (Figure 1). Gains in provider-provider TH were less than 20%. Respondents reported a 6-fold gain in comfort with TH usage versus pre-pandemic level (Figure 2). Most respondents report being satisfied with their current platform and modality. Once the COVID-19 waivers expire, 70% of respondents plan to continue using TH. The most common TH modality used was an EMR-integrated TH platform (Figure 3). The main perceived barriers to TH adoption were lack of complete physical examination (73.7%), dealing with new technology (21.5%), and insufficient reimbursement (20.8%) (Figure 4). Conclusion. The COVID-19 pandemic has resulted in a significant increase in the use of TH by PID specialists versus pre-pandemic usage. Respondents gained comfort with use of different telehealth modalities during the pandemic. This data can help clinicians and organizations in planning and resource allocation for telehealth programs in a post-pandemic environment.
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Modeling infection spread during pandemics is not new, with models using past data to tune simulation parameters for predictions. These help in understanding of the healthcare burden posed by a pandemic and responding accordingly. However, the problem of how college/university campuses should function during a pandemic is new for the following reasons: (i) social contact in colleges are structured and can be engineered for chosen objectives;(ii) the last pandemic to cause such societal disruption was more than 100 years ago, when higher education was not a critical part of society;(iii) not much was known about causes of pandemics, and hence effective ways of safe operations were not known;and (iv) today with distance learning, remote operation of an academic institution is possible. As one of the first to address this problem, our approach is unique in presenting a flexible simulation system, containing a suite of model libraries, one for each major component. The system integrates agent-based modeling and the stochastic network approach, and models the interactions among individual entities (e.g., students, instructors, classrooms, residences) in great detail. For each decision to be made, the system can be used to predict the impact of various choices, and thus enables the administrator to make informed decisions. Although current approaches are good for infection modeling, they lack accuracy in social contact modeling. Our agent-based modeling approach, combinedwith ideas from Network Science, presents a novel approach to contact modeling. A detailed case study of the University of Minnesota's Sunrise Plan is presented. For each decision made, its impact was assessed, and results were used to get a measure of confidence. We believe that this flexible tool can be a valuable asset for various kinds of organizations to assess their infection risks in pandemic-time operations, including middle and high schools, factories, warehouses, and small/medium-sized businesses.
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We present the HEMOCOVID-19 study spanning four countries and eight hospitals where near-infrared spectroscopy is utilized to evaluate microvascular and endothelial health of severe COVID-19 patients at the intensive care. © 2021 SPIE. All rights reserved.
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Global strategies to halt the dual crises of biodiversity loss and climate change are often formulated separately, even though they are interdependent and risk failure if pursued in isolation. The Global Safety Net maps how expanded nature conservation addresses both overarching threats. We identify 50% of the terrestrial realm that, if conserved, would reverse further biodiversity loss, prevent CO2 emissions from land conversion, and enhance natural carbon removal. This framework shows that, beyond the 15.1% land area currently protected, 35.3% of land area is needed to conserve additional sites of particular importance for biodiversity and stabilize the climate. Fifty ecoregions and 20 countries contribute disproportionately to proposed targets. Indigenous lands overlap extensively with the Global Safety Net. Conserving the Global Safety Net could support public health by reducing the potential for zoonotic diseases like COVID-19 from emerging in the future.