ABSTRACT
Background: Several comorbidities, including cardiovascular diseases or myocardial injury, are reported to be associated with poor prognosis in patients with Coronavirus disease 2019 (COVID-19). However, detailed prognostic analysis of myocardial injury by various biomarkers in COVID-19 patients is limited. Purpose(s): This study aims to explore the prognostic values of highsensitive Troponin I (hsTnI) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) for COVID-19 patients using Japanese real-world data. Method(s): The COVID-MI study is a retrospective cohort study that enrolls consecutive laboratory-confirmed COVID-19 patients admitted to the hospital from July 2020 to September 2021. We collected clinical data, including cardiac biomarker values, by chart review. If the prespecified biomarkers in concern were not available, we measured them using the institutional serum blood bank, which enrolled patients prospectively from July 2020. Patients with available biomarkers were analyzed according to the values of hsTnI or NT-proBNP, using the clinically relevant thresholds (hsTnI: 5 ng/L and 99th percentile of the upper reference limit [99%ile URL], and NTproBNP: 125 pg/mL and 900 pg/mL). The primary outcome measure was all-cause death. Secondary outcome measures included acute respiratory distress syndrome, myocardial infarction, myocarditis/pericarditis, venous thromboembolism, cerebral infarction, and bleeding events. Result(s): We enrolled 917 patients with COVID-19 confirmed by viral nucleic acid amplification test. The mean age was 61 years, and 591 patients (64%) were men. On admission, the number of patients classified as severe or critical COVID-19 was 515 (56%) and 85 (8.7%), respectively. Among the 544 patients with hsTnI values, 365 (67%) patients had elevated hsTnI of >=5 ng/L, and 134 patients (25%) had TnI of >=99%ile URL. Besides, among 546 patients with NT-proBNP values, 295 patients (54%) had elevated NT-pro-BNP of >=125 pg/mL, and 93 patients (17%) had NT-proBNP of >=900 pg/mL. The median follow-up period was 31 days (interquartile range: 11-90 days). In cumulative incidence analysis, higher levels of hsTnI and NT-proBNP were associated with significantly higher mortality (hsTnI: <5 ng/L group;8.8%, 5 ng/L to 99%ile URL group;19%, and >=99%ile URL group;37%, P<0.001, and NT-proBNP: <125 pg/mL group;7.8%, 125 to 900 pg/mL group;21%, and >=900 pg/mL group;45%, P<0.001). The adjusted risk for all-cause death remained significant for each threshold of cardiac biomarkers (hsTnI >=99%ile URL: Hazard ratio [HR] 1.98, 95% confidence interval [CI] 1.11-3.54, P=0.02, and NT-proBNP >=900 pg/mL: HR 3.60, 95% CI 1.86-6.98, P<0.001). Conclusion(s): Elevation of hsTnI or NT-proBNP was associated with poor prognosis in the current relatively severely ill COVID-19 patients. Measuring hsTnI or NT-proBNP can be an attractive option for risk stratification and deciding appropriate management in patients with COVID-19.
ABSTRACT
In recent years, learning styles involving observation and experimentation have been recommended for schools as a form of active learning. The National Institute of Polar Research is promoting the improvement and increased production of resin-embedded zooplankton specimens for use in marine education. Based on trials and questionnaires completed by current teachers, we created a marine educational workshop kit comprising resin-embedded specimens, observation tools, a booklet, worksheets, introductory videos for participants, and workshop programs. The kit is designed mainly for junior high school students and can be used for remote (online) workshops to facilitate online learning necessitated by the COVID-19 pandemic. We have requested school teachers to try using the kit and identify various applications of the kit. We began loaning out the kits in November 2021. We hope that many teachers who have not had the chance to conduct marine education will start using this kit. © 2022 Plankton Society of Japan. All rights reserved.
ABSTRACT
In recent years, learning styles involving observation and experimentation have been recommended for schools as a form of active learning. The National Institute of Polar Research is promoting the improvement and increased production of resin-embedded zooplankton specimens for use in marine education. Based on trials and questionnaires completed by current teachers, we created a marine educational workshop kit comprising resin-embedded specimens, observation tools, a booklet, worksheets, introductory videos for participants, and workshop programs. The kit is designed mainly for junior high school students and can be used for remote (online) workshops to facilitate online learning necessitated by the COVID-19 pandemic. We have requested school teachers to try using the kit and identify various applications of the kit. We began loaning out the kits in November 2021. We hope that many teachers who have not had the chance to conduct marine education will start using this kit. © 2022 Plankton Society of Japan. All rights reserved.
ABSTRACT
BACKGROUND: In response to the COVID-19 pandemic, the Alzheimer's Disease Research Center (ADRC) at the Icahn School of Medicine at Mount Sinai began conducting evaluations for the National Alzheimer's Coordinating Center Uniform Data Set (NACC UDS) by telephone in March 2020. The ADRC designed a survey to evaluate participant and research coordinator satisfaction with telephone evaluations. METHOD: Following UDS evaluations, participants rated their satisfaction on 5 items: voice quality on telephone, respect for privacy, degree of comfort using the telephone, and confidence that the information collected was accurate. Coordinators were asked to gauge their satisfaction on similar items. To calculate satisfaction scores, responses were assigned values: "Very" = 3, "Fairly" = 2, and "Not at all" = 1. Maximum satisfaction score was 15 for participants and 18 for coordinators. RESULT: Data was available for 130 participants evaluated by telephone between March 2020 and January 2021. Of these, 68.5% were female, 53.7% were white, with an average age of 76.4 and 16 years of education. 74% of participants had a Global Clinical Dementia Rating (CDR) score of 0;22% CDR 0.5;4% CDR 1. Participants with CDR >1 were evaluated by caregiver interviews without testing, and those with CDR=1 were offered testing at the discretion of their family and examiners. Average total satisfaction rating was 14.2/15 for participants and 16.8/18 for coordinators. 98% of participants felt their privacy was "very" respected (mean 2.98/3). When looking at global CDR scores, 89.6% of participants with CDR=0 and 88.2% with CDR ≥0.5 were "very" confident in the accuracy of the information collected. In contrast, coordinators were "very" confident in the accuracy of their evaluation 84.4% of the time when participants had a CDR=0 and 67.7% of the time when participants had a CDR ≥0.5. CONCLUSION: Overall satisfaction with telephone evaluations was high, but participant and coordinator confidence in the accuracy of assessments varied, with coordinator satisfaction lower for more cognitively impaired participants. Future work will analyze satisfaction with ongoing remote assessments and evaluate the impact of additional demographic and diagnostic variables. © 2021 the Alzheimer's Association.
ABSTRACT
Background: Caregivers of persons with Alzheimer's Disease and Other Dementias are a population in need of support as they are vulnerable to emotional, physical, and mental exhaustion associated with caregiver burnout. While CDC guidelines state that social distancing is the greatest protective factor, it can already exacerbate feelings of isolation and stress. Technology offers the opportunity to maximize socialization and access to healthcare;however, research shows that digital platforms are most underutilized by older and lower socioeconomic patients. Objective: This report describes the transition of a weekly caregiver support group from telephone to video conferencing to improve connectedness during a period of social isolation. Method: In 2020, the caregiver support group met weekly over the phone. At each session, there were increased discussions of moving the telephone support group to a video platform. A focused discussion about technology platforms was held to gain an understanding of caregiver attitudes and thoughts regarding technology in which caregivers worried that a video platform would be intrusive and invasive. In June 2020, unreliable phone service resulted in the group transitioning to video. Results: The caregiver group consisted of 5 active members, 2 African American, 2 Asian, and 1 Caucasian. Initial problems included connectivity issues, needing to switch to multiple devices, and assistance with troubleshooting and utilizing the platform. However, caregivers reported feeling that the transition to video was the most natural next step and assisted with reducing feelings of isolation, anxiety, and fear they reported as a result of social distancing due to COVID-19. Caregivers reported feeling connected and because they knew each other so intimately, no longer felt video was intrusive. Conclusions: For older populations who are not familiar with technology, it is important to take steps before beginning a new platform service. This allows for a natural progression to unfamiliar technology. The video platform provided an opportunity for caregivers to be together while apart, which is important for mental health and decreasing caregiver burden.