ABSTRACT
Most people in the United States began to alter their decisions and actions beginning in March 2020 due to the Covid-19 pandemic, when the closures and 'pause' on most work were established. Studying the transforming urban conditions in New York City specifically presents a lens through which to understand how we quickly adapted to new spatial conditions as measures were put in place for keeping people healthy and encouraging businesses to stay open and approachable. Immediately, the need for social distancing asked us to consider how to navigate exposure as we moved beyond the home. Necessities for businesses to survive became a priority for the city and coalesced with people's desire for seeking ways to do things outdoors. A focus on using city streets as urban public spaces resulted. Policies such as Open Restaurants and Open Streets were developed by the Department of Transportation to mitigate pandemic circumstances and to stir dynamic and optimistic possibilities for street use. Open Restaurants called for food/drink establishments to quickly reimagine their adjacent pavement or available street space. Open Streets initiated new ways for creating pedestrian zones in previously trafficked areas. This article highlights fieldwork documentation comparing a Cluster and Line of food/drink establishments with a newly pedestrian Avenue, in connected Brooklyn neighbourhoods. Diagrams, photographs and maps document the ingenious street constructions and the observed and felt psychological or phenomenal transformations taking place. An urban interiorism grew out of the imposed formalisation of rules for movement patterns and compact constructions, while the ad hoc or serendipitous conditions allowed for other intimate conditions. Notions of 'village cafes' or 'urban beaches' evolved through myriad forms and materials inviting unusual seating configurations and interactions. Speculations on what these internal/external spatial experiences, changing identities and continued urban freedoms are teaching us are also explored through a multidisciplinary set of voices.
ABSTRACT
Purpose: Post-acute sequelae of SARS-CoV-2 infection (PASC) is an increasingly recognized phenomenon manifested by long lasting cognitive, mental, and physical symptoms. We aimed to estimate the prevalence of PASC symptoms in solid organ transplant recipients (SOTRs) in the short (1- 6 months) and long-term (> 6 months) periods after SARS-CoV-2 infection. We also compared the prevalence of these symptoms between those with SARS-CoV-2 infection requiring hospitalization and those not requiring hospitalization. Method(s): We surveyed 111 SOTRs with self-reported SARS-CoV-2 infection diagnosed more than 4 weeks prior to survey administration. The survey consisted of 7 validated questionnaires ("Quick Dementia Rating System (QDRS)", "Patient Health Questionnaire (PHQ9)", "Generalized Anxiety Disorder 7 (GAD-7)", "Impact of Events Scale (IES-6)", "EuroQol- 5 Dimension (EQ-5D)", "PROMIS global physical health scale (GHS) "and "Breathlessness, Cough and Sputum Scale (BCSS)"). Result(s): Of the 111 survey participants, 32 (33%) had been hospitalized and 35 (36%) had SARS-CoV-2 infection >6 months ago. Median (IQR) age was 58 years (46, 65). Median time from SARS-CoV-2 diagnosis was 167 days (138, 221). Cognitive impairment, anxiety, depression, insomnia, feeling of trauma, fatigue, pain, breathing problems, cough, abnormal smell, abnormal taste, and diarrhea were reported by 40%, 23%, 36%, 55%, 53%, 41%, 19%, 33%, 33%, 21%, 22%, and 32% of patients respectively. Hospitalized patients had poorer scores in cognition (QDRS survey score of 2 versus 0.75, p=0.048) (Figure 1), quality of life (EQ-5D survey score of 2 versus 1, p=0.043), physical health (PROMIS GHS survey score of 10 versus 11, p=0.013), respiratory status (BCSS survey score of 1 versus 0, p=0.056), and pain (Pain score of 3 versus 0, p 0.006). Among patients who had SARS-CoV-2 infection >6 months ago, abnormal breathing, cough, abnormal smell, abnormal taste, and diarrhea continued to be reported by 31%, 31%, 29%, 32%, and 32% of patients respectively. Conclusion(s): After SARS-CoV-2 infection, SOTRs had a high prevalence of PASC symptoms. Some of the symptoms are more severe in patients who had required hospitalization and persist beyond 6 months. Further studies are needed to understand the long term sequalae of SARS-CoV-2 infection in SOTRs and to develop an evidence-based multidisciplinary approach for caring for these patients beyond the acute phase. (Table Presented).
ABSTRACT
Purpose : The incidence of herpes zoster ophthalmicus (HZO) may be increasing, however the impact of the SARS-CoV2 pandemic (COVID) on HZO epidemiology is unclear. This study seeks to determine the variation in the incidence of HZO over the past 6 years with a special focus on its correlation with overall systemic herpes zoster (SHZ) incidence and HZO monthly and seasonal changes before and after the onset of COVID. Methods : This is a hospital-based epidemiology study of patients attending Duke University Hospital System (DUHS) between 01/2016 and 10/2021 via Duke Enterprise Data Unified Content Explorer (DEDUCE) data with corresponding ICD codes for HZO and SHZ diagnosis. The analysis calculated monthly incidence of novel consults of HZO and SHZ with emphasis on demographics, seasonal variation, and the changes in rates with the COVID pandemic (estimated to impact DUHS population starting in 03/2020). Results : 24896 patients presented with SHZ at DUHS in the study period, of whom 2921 (11.7%) suffered from HZO. The mean age at the incident episode of HZO was 62.8±15.6 years. Most patients were white (78%), female (63.5%), above 50 years old (79.5%) and non-smokers (61.5%). Over the study period SHZ experienced an overall decline in its incidence, however HZO incident cases have been slightly increasing with a mean of 37/month in 2016, 47/month in 2019, and 50/month in 2021. The ratio of monthly incidence HZO/SHZ demonstrates a steady increase from an annual 9% in 2016 to 13.4% in 2019 and 15.5% in 2021. Interestingly, HZO annual peak incidence steadily emerged in the months of November and February throughout all the years. Since COVID onset, the mean monthly incidence of SHZ decreased significantly (373.1 +/- 35 vs 312.1 ± 28, p<0.0001). However, the mean monthly incidence of HZO exhibited a statistically significant increase (39.5 ± 10 vs 46.7 ± 16;p=0.025). Likewise, the trendlines of HZO/SHZ exhibited a significant increase since COVID (10.6% ± 4.6 to 15.1% ± 2.7;p<0.0001). Conclusions : These study findings point that HZO incidence may be increasing, despite an overall lower SHZ incidence, which may suggest a distinct mechanism for HZO appearance despite vaccination efforts. A specific seasonal variation with winter peaks was observed, which should guide physicians towards early recognition of HZO. COVID, directly or indirectly, may have accelerated the already increasing HZO incidence.
ABSTRACT
In the context of the city, we must-especially today-study the types of places cities present as public, free and open. To re-think the notion of the urban public sphere, a focus on interiorism expands and deepens the awareness and perception of how urban forms, materials, and the senses interact, to invite various behaviors. This essay presents a pedagogy that extends interior and architectural design practice and theory, through multidisciplinary and multi-site research. A course created by the author called New Interior Urbanism, included a series of local and global urban interior research scenarios to study how streets, parks, plazas, and markets normally considered urban exteriors, should be understood as interiors. Along with on site and virtual fieldwork, a multi-disciplinary reading list informed student opinions;while, the addition of a COVID-19 pandemicinfluenced Sketch Problem/Charrette asked for contemplating interior-based, forwardthinking attitudes to create hypothetical adaptations for existing global public urban spaces, with social/physical distancing strategies. Planned and unplanned course explorations yielded new realizations about: Distinguishing interiorism within urban public places;pondering how individuals and the collective navigate, experience and witness freedom in public space;and, how to consider designing in this dynamic era, and beyond. © 2021 Universidade do Vale do Rio dos Sinos. All rights reserved.
ABSTRACT
Purpose: Our goal was to review the incidence and outcomes of cholecystostomy tube placement during the COVID pandemic as compared to matched controls. Materials and Methods: Monthly interventional radiology (IR) case volume was evaluated during the COVID pandemic through July 30, 2020, and was compared to monthly IR case volume during the same time period in 2019. A retrospective review of 40 patients who received percutaneous cholecystostomy tubes between March 2020 and July 2020 (first COVID pandemic peak in Boston, MA) was compared in a propensity matched controlled study. 14 COVID-positive patients were matched to 26 control patients who received a cholecystostomy tube. Outcomes such as positive cholecystostomy tube microbiology, pre-procedural ICU status, and death were evaluated. Results: During March to July 30, 2020, cholecystostomy tube placement constituted 0.43%, average 6 (range 2-10) cases/month of 1389 (range 672-1777) cases/month, whereas in the year prior for the same period it constituted 0.28%, 5.8 (range 4-8) cases/month of 2103 (range 1998-2146) cases/month. We find the average age was 66.5 ± 17.7 (SD) for COVID-negative and 66.0 ± 17.7 (SD) years for COVID-positive patients. Pre-procedure 19% (5/26) of COVID-negative patients and 50% (7/14) of COVID-positive patients were intubated at the time of placement, P = 0.04. Post-procedure, 54% (14/26) of COVID-negative patients and 50% (7/14) of COVID-positive patients had positive cholecystostomy tube fluid microbiology cultures, P = 0.82. 38% (10/26) of COVID-negative patients and 57% (8/14) of COVID-positive patients were in the ICU at the time of placement, P = 0.26. 23% (6/26) of the COVID-negative patients and 36% (5/14) of COVID-positive patients died post-procedure, P = 0.41. 15.4% (4/26) COVID-negative and 14.3% (2/14) of COVID-positive patients had any complications reported, P = 0.93. Conclusions: During the COVID-19 pandemic, we observed a relative increase in the number of cholecystostomy tube referrals despite a drop in total IR case volume. There were no significant differences in post-procedure long-term outcomes and the microbial culture results in our matched control review. Our study suggests that this perceived increase in cholecystostomy tube placements is not secondary to unique COVID pathophysiology, but rather a persistent incidence of acalculous cholecystitis in the setting of chronic ICU stays seen during the COVID pandemic. With the continuation of the pandemic, cholecystostomy tube placement incidence may increase with continued COVID patient care and chronic ICU stays for these patients.
ABSTRACT
Clinical clerkships have long been a pillar of veterinary medical education. These experiences provide students a unique opportunity to apply skills learned in pre-clinical training through hands-on practice. However, the emergence of the novel coronavirus, SARS-CoV-2, and the subsequent global pandemic of 2020 forced many clinical instructors to adapt to teaching online. This teaching tip describes the use of backward design to create a three-part online clinical learning environment for the delivery of small animal primary care consisting of synchronous rounds, simulated online appointments, and independent learning activities. Results of a survey of students' perspectives on the experience demonstrate that the majority of students found that the online clinical experience met or exceeded expectations and provided a meaningful learning experience. Recommendations based on student feedback and instructor reflection are provided to guide creation and implementation of future online clinical courses. As the field of telemedicine grows, we view incorporation of such learning environments into veterinary medical education curriculum as essential to preparing students to enter the modern veterinary workplace.