Feed outlook: special article: ethanol markets in 2020

U.S. Ethanol Market Faced Shock in 2020: The US. ethanol market faced pandemic-related shocks in 2020, as COVID-19 reduced driving miles and demand for transportation fuel. These shocks ultimately impacted U.S. feed-grains markets, particularly corn. Since the creation of the Renewable Fuel Standard (RFS) in 2005, and the subsequent passage of RFSZ in 2007, the use of corn for ethanol fuel has created a link between US. feed grain markets and transportation fuel use. As a result of this linkage, the sudden change in social and economic behaviors caused by COVID-19 led to changes in US. com markets. The following is a broad summary of the pre-pandemic state of the ethanol market, the 2020 ethanol market, and the identification of certain market factors that are expected to be important for the outlook of the US. ethanol market. Ethanol Market Trends and Conditions Prior to COVID-19: For the 4 years spanning 2016-2019, the US. motor gasoline product supplied was quite stable. According to US. Energy Information Administration data (EIA), monthly gasoline product supplied averaged about 11.9 billion gallons between 2016-2019. Deviations generally followed seasonal patterns. Gasoline supply levels began 2020 up slightly from their 2016-2019 averages: 11.4 billion gallons in January, compared to an average January-supply level of 11.3 billion gallons and 10.9 billion gallons in February, compared to an average of 10.7 billion gallons.

Effect of the COVID-19 Pandemic on Sports-Related Injuries Evaluated in US Emergency Departments.

BACKGROUND: Organized athletics are undergoing a gradual resumption after a prolonged hiatus in 2020 because of the coronavirus disease 2019 (COVID-19) pandemic. PURPOSE/HYPOTHESIS: The purpose of this study was to evaluate the effect of the 2020 COVID-19 period on emergency department (ED) visits for sports-related injuries in the United States. It was hypothesized that such visits decreased in response to the pandemic conditions. STUDY DESIGN: Descriptive epidemiology study. METHODS: A selection of sports (baseball, basketball, softball, soccer, American football, weightlifting, track and field, martial arts, boxing, golf, personal fitness, cycling, tennis, and ice hockey) were classified as being an organized team, organized individual, or nonorganized sport. The National Electronic Injury Surveillance System database was then queried for ED visits for sports-related injuries between January 1, 2018, and December 31, 2020, and we compared weighted national injury estimates and injury characteristics from athletes presenting to EDs in 2018 and 2019 versus those from the 2020 COVID-19 pandemic period and between March 1 and May 31, 2020 (government-imposed lockdown period). Bivariate comparisons between variables were conducted using chi-square analysis, with strength of association assessed using odds ratios. RESULTS: The 164,151 unweighted cases obtained from the query resulted in a weighted national estimate of 5,664,795 sports-related injuries during the study period. Overall, there was a 34.6% decrease in sports-related ED visits in 2020 compared with the yearly average between 2018 and 2019 (baseline). The number of ED visits in 2020 decreased by 53.9% versus baseline for injuries incurred by participation in an organized team sport and by 34.9% for injuries incurred by participation in an organized individual sport. The number of ED visits during the 2020 lockdown period decreased by 76.9% versus baseline for injuries incurred by participation in an organized team sport and by 65.8% for injuries incurred by participation in an organized individual sport. Injuries sustained while participating in a nonorganized sport remained relatively unaffected and decreased by only 8.1% in 2020. CONCLUSION: ED visits in the United States for injuries sustained while participating in an organized team or individual sport underwent a decrease after the beginning of the COVID-19 pandemic in 2020, especially during the lockdown period.

Treatment and prevention of community-acquired bacterial meningitis

Bacterial meningitis is a serious infection that requires immediate treatment. Recommended empiric antimicrobial therapy is based upon the most likely pathogen, according to a patient’s age and immune status. Antimicrobial therapy should be modified after identification of the causative microorganism and results of susceptibility tests. Preventive measures include the use of vaccines that target Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae, as well as the use of chemoprophylaxis in selected situations. Pharmacists are in a key position to recommend appropriate antimicrobial therapy for the treatment and prophylaxis of bacterial meningitis and to ensure that patients are receiving recommended vaccinations.

Disparity in telehealth and emergency department use among Medicaid and commercially insured patients receiving systemic therapy for cancer in Washington State following the COVID-19 Pandemic

Background: Washington was the first US state to experience the COVID-19 pandemic. Transmission risks and patient fears of visiting oncology practices during its onset resulted in rapid adoption of telehealth services. We hypothesized that the pandemic would widen disparities in oncology practice visits between Medicaid and commercially insured patients, resulting higher rates of emergency department (ED) visits during initial treatment. Methods: Linking Washington State SEER records with Medicaid and commercial insurance enrollment and claims records, we compared adults age <65 with new solid tumor malignancies who received systemic treatment at academic and community oncology practices. Persons starting therapy March - June 2020 (COVID) were compared with those starting therapy March-June 2017-2019 (Pre-COVID). Poisson regressions were used to evaluate differences in oncology practice office visits and telehealth visits. Logistic regressions were used to evaluate the likelihood of at least one ED admission among patients starting systemic therapy pre- and post-COVID. Results: Among patients who met inclusion criteria (652 Commercial, 349 Medicaid), Medicaid enrollees had more advanced disease and more comorbidity versus commercial enrollees. In unadjusted analysis of E&M and telehealth service visit codes, office-based visits fell for both insurance groups (Table) while telehealth service visits (negligible pre-COVID) were higher for commercial versus Medicaid enrollees postCOVID. The proportion of persons with ≥ 1 ED visit during therapy fell for both insurance groups. In Poisson models, Medicaid enrollees had significantly fewer total visits (P=0.001) and fewer telehealth visits (p<0.001) compared commercial enrollees during the COVID period. In the logit models, ED visits trended lower for both groups after COVID (OR 0.53 95% CI 0.279 to 1.008). Among Medicaid enrollees, persons ages 40-49 and breast cancer patients were more likely to visit the ED. Among the commercially insured, persons with 2 or more comorbidities were more likely to visit the ED. The pre-post COVID change in likelihood of an ED visit was not significantly different between insurance groups (p=0.355). Conclusions: In Washington State, the COVID-19 pandemic created a substantial disparity in access to office-based and telehealth care for low-income patients receiving systemic therapy for new cancers. Reduced oncology practice visits among Medicaid patients did not widen existing disparities in utilization of emergency care.

Medicaid patients more likely to die at home without hospice during the pandemic versus before, exacerbating disparities with commercially insured patients

Background: The COVID-19 pandemic dramatically reduced family access to hospitals and created new barriers to home hospice care, raising concerns about how the pandemic has impacted cancer patients' place of death and end of life home hospice support. Hypothesizing that Medicaid-enrolled cancer patients may be at greater risk of disruptions in end-of-life care compared to commercially insured patients, we examined changes in place of death and home hospice support for Medicaid and Commercial enrollees following the pandemic. Methods: We linked WA State cancer registry records with claims from Medicaid and approximately 75% of commercially insured cancer patients in the state. Patients ages 18-64 with solid-tumor malignancies who died March-June 2020 (COVID) were compared to those who died March-June 2017-2019 (Pre-COVID). Place of death was categorized as hospital, home with hospice, and home without hospice;nursing home deaths were excluded. Given our sample size, we examined differences in the likelihood of place of death with Fisher's exact tests and multinomial logistic regressions stratified by payer and by COVID period, controlling for age, gender, race, stage, cancer type, and census tract-level neighborhood deprivation. We report marginal effects. Results: In Fisher's exact analyses, Medicaid but not commercial patients were significantly less like to die in hospital and more likely to die at home without hospice during COVID (Table). In pre-post adjusted analysis of Medicaid patients, the probability of dying in the hospital was 12.3% (p=0.03) percentage points lower during the pandemic versus before, while the probability of dying at home without hospice was 11.1% (p=0.04) greater. Place of death did not change significantly pre-post for commercial patients. In addition, Pre-COVID, the probability of dying in the hospital was 10.7% (p=0.03) greater for Medicaid than commercial patients. During COVID, the probability of dying at home without hospice was 15.8% (p=0.04) greater for Medicaid versus commercial patients but lower for women (ME=20.2%;p=0.01) and colorectal versus breast cancer patients (ME=39.2%;p=0.01). Conclusions: Following COVID, Medicaid patients place of death shifted from hospital to homes, but without an increase in the use of home hospice services. In contrast, place of death and hospice use among commercial patients did not significantly change. This widening disparity in home deaths without hospice services raises concerns that the pandemic disproportionately worsened end of life experience for low income patients with cancer. (Table Presented).

Conducting Virtual Global Health Engagement (GHE) activities in the Midst of the Global COVID-19 Pandemic: Considerations for the Department of Defense GHE Enterprise

The global COVID-19 pandemic resulted in restriction of non-essential travel across the globe, as seen in the Office of the Under Secretary of Defense Memorandum, "Force Health Protection Guidance (Supplement 4): DoD Guidance for Personnel Traveling During the Novel Coronavirus Outbreak" (11 March 2020). This resulted in the suspension of most, if not all, Department of Defense (DoD) security cooperation (SC) programs, including DoD Global Health Engagement (GHE) activities.1 One such program is the African Peacekeeping Rapid Response Partnership (APRRP), which relies heavily on face-to-face interactions with select African Partner Nations (PNs), and which was significantly impacted by the inability to conduct in-person training with key partners. In light of these restrictions and suspended activities, the Uniformed Services University of the Health Sciences' (USU's) Center for Global Health Engagement (CGHE), in support of the US Africa Command (USAFRICOM) Office of the Command Surgeon, explored virtual means to execute DoD GHE activities to continue engaging its APRRP PNs, pending return to in-country activities.