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Introduction: Disseminated histoplasmosis (DH) presents as primarily lung manifestations with extrapulmonary involvement in immunocompromised hosts. Granulomatous hepatitis as first presentation of DH in an immunocompetent host is uncommon. Case Description/Methods: 25-year-old female presented with one month of fever, fatigue, myalgias, 30-pound weight loss, cough, nausea, vomiting, and epigastric pain. She has lived in the Midwest and southwestern US. Presenting labs: TB 1.9 mg/dL, AP 161 U/L, AST 172 U/L, ALT 463 U/L. Workup was negative for COVID, viral/autoimmune hepatitis, sarcoidosis, tuberculosis, and HIV. CT scan showed suspected gallstones and 9 mm left lower lobe noncalcified nodule. EUS showed a normal common bile duct, gallbladder sludge and enlarged porta hepatis lymph nodes which underwent fine needle aspiration (FNA). She was diagnosed with biliary colic and underwent cholecystectomy, with white plaques noted on the liver surface (A). Liver biopsy/FNA showed necrotizing granulomas (B) and fungal yeast on GMS stain (C). Although histoplasmosis urine and blood antigens were negative, histoplasmosis complement fixation was >1:256. She could not tolerate itraconazole for DH, requiring amphotericin B. She then transitioned to voriconazole, discontinued after 5 weeks due to increasing AP. However, her symptoms resolved with normal transaminases. At one year follow up, she is asymptomatic with normal liver function tests. Discussion(s): DH is a systemic granulomatous disease caused by Histoplasma capsulatum endemic to Ohio, Mississippi River Valley, and southeastern US. DH more commonly affects immunocompromised hosts with AIDS, immunosuppressants, and organ transplant. Gastrointestinal involvement is common in DH (70-90%) with liver involvement in 90%. However, granulomatous hepatitis as primary manifestation of DH is rare (4% of liver biopsies). Hepatic granulomas are seen in < 20%. Patients may present with nonspecific systemic symptoms. Serum/urine antigens may be negative. Gold standard for diagnosis is identifying yeast on tissue stains. Recommended treatment is amphotericin B followed by 1 year of itraconazole. However, shorter treatment duration may be effective in immunocompetent hosts. This case is unique in that granulomatous hepatitis was the first presentation of DH in our immunocompetent patient diagnosed on EUS FNA and liver biopsy. Clinicians must have a high degree of suspicion for DH in patients with fever of unknown origin especially in endemic areas regardless of immunologic status. (Table Presented).
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Purpose: This study examines a phygital approach to rural cultural heritage tourism, adopted by a rural community in Sapphaya, Chai Nat Province, Thailand, in response to the Covid-19 crisis. Specifically, it investigates a community's initiatives to amalgamate its physical and digital marketing communications in order to engage with consumers as a strategy for destination recovery and resilience. Design/methodology/approach: This is a qualitative exploratory study involving three stages of action, applying two research approaches: (1) participatory action research (PAR) with Sapphaya's tourism stakeholders, and (2) social media research utilising netnographic analysis of Sapphaya's tourism social enterprise social media pages. Findings: The findings indicate that a phygital rural cultural heritage strategy can facilitate the interconnectivity between a destination's physical and digital dimensions of its cultural heritage tourism product, thereby enhancing its intrinsic value, meaning and experiential perceptions. Specifically, it recommends that a successful community-based phygitalisation strategy requires grassroot engagement across all stages of planning, development, implementation and management of the rural cultural heritage tourism product. Practical Implications: The paper focusses on the cultural heritage tourism strategy adopted by a rural community across the physical-digital-phygital spectrum to augment its sustainable tourism development during a time of crisis. A framework for phygital rural cultural heritage as a strategy for destination resilience and recovery is also proposed. Originality/value: This study adopts a local engagement approach to develop a cooperative community heritage management strategy, based upon local rural capacity building towards digitalisation and empowering innovative partnerships amongst its stakeholders.
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This study aimed to determine the effects of a 16-week COVID-19 lockdown on body composition and vertical jump performance. Thirteen martial artists participated in this study. Participants were tested at: 1) pre-lockdown (pre), 2) post-lockdown (post), 3) two-weeks-post-lockdown (post+2), and 4) four-weeks-post-lockdown (post+4). Repeated-measures-ANOVAs were conducted with post-hoc analyses. Differences were observed in vertical jump height (VJH) (10.33%), peak velocity (PV) (3.10%), reactive-strength-index-modified (RSImod) (13.8%), and peak-propulsive-power (PPP) (6.00%) from pre-to-post. There as an increase from post-to-post+2 in VJ (13.06%), PV (4.12%), RSImod (14.0%), and PPP (4.66%). There was an increase from post to post+2 in VJH (10.8%), PV (3.1%), RSImod (14.0%), and PPP (3.0%). Fat mass (FM) and BF% increased from pre to post (13% and 11%, respectively) and decreased from post to post+4 (8% and 11%, respectively);fat-free mass (FFM) decreased from pre-to-post (11%) and decreased from post-to-post+4 (8%). There were moderate associations (rmc = 0.42-0.47) between FFM and VJH, FMM and PPP, FFM and PV, BF% and PV, and FM and PV. While the lockdown resulted in a significant decrease in vertical jump performance and increases in BF and FM, participant's performance returned to pre-lockdown levels after only 2-4 weeks of post-lockdown training by decreasing BF, FM, and increasing FFM. © Faculty of Education. University of Alicante.
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As cardiovascular diseases are still a major cause of death in most countries, it is still relevant to look into treatment of such diseases. Dyslipidemia is one of the important identified risk factors for cardiovascular diseases. As this is largely driven by lifestyle and diet, it may be difficult to control it with lifestyle modifications alone. Currently, Statins remains to be the mainstay therapy for dyslipidemia but this is also met by problems within certain patient population. The drug may be contraindicated in certain patient groups;some patients tend to not respond to Statins;while certain patients may not tolerate the adverse events. This study looked into available literature on studies done on dyslipidemia using plant-based formulations using randomized clinical trial. Based on the review conducted, there are several plant-based formations with potential to be similar in efficacy to Statins. Some of the plants used are abundant or may be easily sourced. With the increasing popularity of food supplements or nutraceuticals, exploration on the potential of plant-based products is attractive. Despite the promising results of some studies, these will need further investigations and targeting a larger population size. Formulation options may need to be explored also focused on its stability. © RJPT All right reserved.
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Face masks have become a necessary thing that people need to wear daily. Even though some people might already be vaccinated, there is still a chance that the Covid-19 virus could still infect them. Hence, this paper presents a device developed to help determine the quality of face masks crucial in preventing the spread of the virus. These devices can calculate the temperature outside the face mask at a maximum distance of three meters. The way this device works is by measuring the temperature released out of the face mask. Here, the developments of the device with the ability to help determine the quality of face masks are explained and discussed. In the end, the device is perfectly functioning and definitely would assist in verifying the quality of the face masks being worn by someone. Two types of faces are used as test materials: the KN95 type face mask and the 3ply facemask used in Malaysia. Each facemask collected data from 30 minutes to 300 minutes for ten subjects over ten days. Studies that have been conducted show that the thermal value of the KN95 facemask increased to 30.27°C after 5 hours of use. At the same time, the 3ply type facemask offers a thermal value of up to 34.58°C after 5 hours of use. This shows a thermal value difference of up to 4.31°C for both facemasks after 5 hours of use. © 2021 Institute of Physics Publishing. All rights reserved.
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COVID19 chest X-ray has been used as supplementary tools to support COVID19 severity level diagnosis. However, there are challenges that required to face by researchers around the world in order to implement these chest X-ray samples to be very helpful to detect the disease. Here, this paper presents a review of COVID19 chest X-ray classification using deep learning approach. This study is conducted to discuss the source of images and deep learning models as well as its performances. At the end of this paper, the challenges and future work on COVID19 chest X-ray are discussed and proposed. © 2021 Institute of Physics Publishing. All rights reserved.
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In COVID19 pandemic, new norms have been introduced, including, to leave a record when checking-in to a particular place. This new norm is regulated in order to trace locations that have been visited by someone with positive COVID-19. This paper presents a work on development of check-in location system. The system implemented Near Field Communication (NFC) technology which is mainly utilized two NFC compatible devices where an identification card (IC) is used as a smart object (NFC tag) and the NFC detector as an NFC reader to exchange information. Testing has been conducted in order to observe the system performance, and, the results showed that this system is able to collect information of users who were coming to premise. Also, the information can be checked by authority in order to track someone with positive COVID-19. As conclusion, this system can be an alternative to MySejahtera App. © 2021 Institute of Physics Publishing. All rights reserved.
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Introduction: Patients (pts) with hematological malignancies (HMs) are at increased risk for severe COVID19 infection and death (Grivas, 2021). Currently, vaccination represents the most effective prevention approach. HM pts have been shown to have lower immune responses to COVID19 vaccine, particularly those with lymphoid malignancies (LMs) (Herishanu, 2021;Thakkar 2021;Tzarfari 2021). We conducted an observational cohort study at Moffitt Cancer Center (MCC) to evaluate the immune response following one and two doses of the mRNA1273 (Moderna) vaccine in cancer pts. Here we report the results for pts with LMs and assessed associated factors. Methods: MCC pts who presented for the first mRNA-1273 vaccine dose from 1/12/2021-1/25/2021 and who provided consent were enrolled. Blood samples were collected prior to the 1 st and 2 nd doses (Days 1 and 29) and ~28 days after the 2 nd dose (Day 57). The IgG response against the SARS-CoV-2 spike (S) protein was measured using a two-step ELISA adapted from the Krammer (Icahn School of Medicine at Mount Sinai) protocol. The total 103 LM pts who received both vaccine doses and had samples at all time points were included in analyses. The 214 pts with solid tumors (ST) were included as comparison. Associations of seroconversion (SV) rates with pt characteristics were evaluated using the Fisher exact test or Chi-square test as appropriate. Associations of antibody (Ab) titers with pt characteristics were examined using Kruskal Wallis test. Factors independently associated with SV rates were evaluated using multivariable logistic regression. All analyses were performed using SAS 9.4 and R studio. Results: Baseline characteristics, cancer treatments and SV rates by these factors are listed in Tables 1 and 2. 55 pts had B-cell non-Hodgkin lymphoma (B-NHL), 23 had chronic lymphocytic leukemia (CLL), 15 had T- or NK-cell lymphoma (T/NK lymphoma) and 10 had Hodgkin lymphoma (HL). SV rates were significantly lower for LM pts compared to ST pts (49.5% vs 86.9% after the 1st dose and 68.9% vs 98.1% after the 2 nd dose, respectively, p<0.0001 for both doses). Pts with CLL and B-NHL had the lowest SV rates (21.7% and 43.6% after dose 1 and 65.2% and 58.2% after dose 2, respectively). None of the 11 pts on anti-CD20 monoclonal Ab (mAb) seroconverted after 2 doses. Pts on BTK inhibitors (BTKi) or PI3K inhibitors (PI3Ki) or venetoclax also had low SV rates [4/12 (33.3%) after 2 doses]. Only 1 out of the 8 pts post CAR-T seroconverted, despite the fact that 6 pts had CAR-T >12 months ago and 6 pts were in remission and have not received any cancer treatment after CAR-T. Pts with CLL and B-NHL but not on CD20 mAb/BTKi/PI3Ki/venetoclax or post CAR-T had much higher SV rates (31.3-60.5% after dose 1 and 79.0-81.3% after dose 2, Table 3). Other factors associated with lack of SV after 2 doses included: lymphocyte <1 x 10 9/L, low IgG level and on anticancer treatment within 3 months. Multivariate analyses showed that diagnosis of CLL or B-NHL compared to ST, CAR-T and CD20 mAb/BTKi/PI3Ki/venetoclax were independently associated with decreased SV after 2 doses (Table 4). In the univariate model, Ab titers after 1 and 2 doses were significantly lower in pts with diagnosis of CLL/B-NHL, low lymphocyte count, low IgG and on cancer treatment (Figures 1-3). HL and T/NK lymphoma had titers comparable to solid tumors (Figure 1). Conclusions: Pts with CLL and B-NHL had low SV rates and Ab titers after receiving the mRNA-1273 vaccine when compared with ST, HL and T/NK-lymphoma. Current or past treatments with CD20 mAb/BTKi/PI3Ki/venetoclax and CAR-T were associated with lower immune response, with pooled SV rates of 16.7% after 2 doses. In general, LM pts had lower SV rates and Ab titers after the 1 st dose vs ST, but responses improved after the 2 nd dose. Further studies are needed to improve immune responses to COVID19 vaccines in LM pts, including the potential role of a 3 rd booster dose. [Formula presented] Disclosures: Gaballa: Adaptive Biotechnologies: Research Funding;Epizyme: Consultancy, Resear h Funding;TG therapeutics: Consultancy, Speakers Bureau;Beigene: Consultancy;ADC Therapeutics: Consultancy. Saeed: Bristol-Myers Squibb Company: Consultancy;sano-aventis U.S.: Consultancy, Membership on an entity's Board of Directors or advisory committees;Janssen Pharmaceutica Products, LP: Consultancy, Other: investigator;Celgene Corporation: Consultancy, Other: investigator;MEI Pharma Inc: Consultancy, Other: investigator;Kite Pharma: Consultancy, Other: investigator;Other-TG therapeutics: Consultancy, Other: investigator;Nektar Therapeutics: Consultancy, Other: research investigator;MorphoSys AG: Consultancy, Membership on an entity's Board of Directors or advisory committees;Other-Epizyme, Inc.: Consultancy;Other-Secura Bio, Inc.: Consultancy;Seattle Genetics, Inc.: Consultancy, Membership on an entity's Board of Directors or advisory committees. Shah: Pharmacyclics/Janssen: Honoraria, Other: Expenses;Pfizer: Consultancy, Other: Expenses;BeiGene: Consultancy, Honoraria;Servier Genetics: Other;Jazz Pharmaceuticals: Research Funding;Precision Biosciences: Consultancy;Amgen: Consultancy;Kite, a Gilead Company: Consultancy, Honoraria, Other: Expenses, Research Funding;Acrotech/Spectrum: Honoraria;Novartis: Consultancy, Other: Expenses;Bristol-Myers Squibb/Celgene: Consultancy, Other: Expenses;Adaptive Biotechnologies: Consultancy;Incyte: Research Funding. Locke: Janssen: Consultancy, Other: Scientific Advisory Role;BMS/Celgene: Consultancy, Other: Scientific Advisory Role;EcoR1: Consultancy;Allogene Therapeutics: Consultancy, Other: Scientific Advisory Role, Research Funding;Calibr: Consultancy, Other: Scientific Advisory Role;Amgen: Consultancy, Other: Scientific Advisory Role;Bluebird Bio: Consultancy, Other: Scientific Advisory Role;Umoja: Consultancy, Other;Cowen: Consultancy;Kite, a Gilead Company: Consultancy, Other: Scientific Advisory Role, Research Funding;Emerging Therapy Solutions: Consultancy;Gerson Lehrman Group: Consultancy;Moffitt Cancer Center: Patents & Royalties: field of cellular immunotherapy;Iovance Biotherapeutics: Consultancy, Other: Scientific Advisory Role;GammaDelta Therapeutics: Consultancy, Other: Scientific Advisory Role;Cellular Biomedicine Group: Consultancy, Other: Scientific Advisory Role;Wugen: Consultancy, Other;Takeda: Consultancy, Other;Novartis: Consultancy, Other, Research Funding;Legend Biotech: Consultancy, Other. Chavez: Abbvie: Consultancy;AstraZeneca: Research Funding;Kite/Gilead: Consultancy;Karyopharm Therapeutics: Consultancy;MorphoSys: Speakers Bureau;Epizyme: Speakers Bureau;Bristol Myers Squibb: Speakers Bureau;Merck: Research Funding;Adaptive: Research Funding;BeiGene: Speakers Bureau;Novartis: Consultancy;ADC Therapeutics: Membership on an entity's Board of Directors or advisory committees, Research Funding. Lancet: AbbVie: Consultancy;ElevateBio Management: Consultancy;Daiichi Sankyo: Consultancy;Celgene/BMS: Consultancy;Millenium Pharma/Takeda: Consultancy;BerGenBio: Consultancy;Agios: Consultancy;Astellas: Consultancy;Jazz: Consultancy. Sokol: Dren Bio: Membership on an entity's Board of Directors or advisory committees;Kyowa-Kirin: Membership on an entity's Board of Directors or advisory committees. Pinilla Ibarz: AbbVie, Janssen, AstraZeneca, Novartis, TG Therapeutics, Takeda: Consultancy, Other: Advisory;Sellas: Other: ), patents/royalties/other intellectual property;MEI, Sunesis: Research Funding;AbbVie, Janssen, AstraZeneca, Takeda: Speakers Bureau. Giuliano: Merck & CO: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding.
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Introduction: Patients with myeloid malignancies, including acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS), are at a high risk of severe SARS-CoV-2 infection. It is uncertain whether patients with AML and MDS, who frequently have quantitative or qualitative deficiencies of neutrophils and/or lymphocytes, will develop protective immunity from SARS-CoV-2 vaccines. The primary aim of this analysis was to describe the immune response and safety profile to the mRNA-1273 vaccine amongst a cohort of patients with AML and MDS. Methods: We enrolled AML and MDS patients to a large, single-site observational study of mRNA-1273 vaccination in cancer patients during the period January 12 to January 25, 2021. Blood specimens were collected from patients prior to the first and second vaccine doses (Days 1 and 29) and ~28 days after the second vaccine dose (Day 57) for antibody analyses. Retrospective chart review was done to collect information on baseline characteristics, cancer diagnoses, treatments received, and disease status. To evaluate serostatus, a two-step ELISA was performed, measuring IgG responses. SARS-CoV-2 antibody positivity rates were compared using the Fisher exact test or Chi-square test. The association of SARS-CoV-2 antibody titer and patient characteristics was examined by using Kruskal-Wallis test. Paired t-test was used to analyze the difference of SARS-CoV-2 antibody titers among day 1, after dose 1 and dose 2. Results: A total of 46 patients, 30 patients with AML and 16 patients with MDS, were included in this study. The median age at vaccination for the entire cohort was 68 yrs (range 37-85 yrs). The majority of patients were males (58.7%) and Caucasians (95.7%). Table 1 describes the baseline characteristics of the patients. The median time from diagnosis to the start of vaccination series was 24.3 months (range 4.5-105). One third of the patients (32.6%, n=15) were on active treatment for their disease during the course of vaccination with hypomethylating agents (n=6;13%), erythroid maturation agent i.e. luspatercept (n=2, 4.3%), immunomodulatory drugs i.e. lenalidomide (n=1;2.2%) and targeted therapy (6;13%). Targeted therapy included patients on enasidenib (n=4), midostaurin (n=1) and gilteritinib (n=1). A total of 32 patients (69.6%) were post allogeneic stem cell transplantation for their disease. The median time since allo-SCT for the entire cohort was 17 months (4.9-75.8 mos). The majority of the patients (n=40, 87%) were in remission at the time of vaccination. We found that two patients with AML relapsed post vaccination. Overall, 69.6% patients were seropositive at day 29 (after first vaccine dose) and 95.7% patients were seropositive on day 57 (after 2 vaccine doses). Table 2 describes response to the vaccine in our cohort and the differences in seropositivity rate after one and two doses of vaccine, based upon disease characteristics. Age, gender, race, disease status, time to vaccination from disease diagnosis, number of prior lines of therapy, whether on active treatment, laboratory parameters (including ALC and ANC), whether the patient had undergone allo-SCT, and therapy at time of vaccination did not significantly affect the seropositivity rate. Antibody titer levels were significantly higher after the 2 nd vaccine dose than after 1 st dose (mean 3806.5 vs 315, p<0.0001), a difference that was observed across the different variables and patient subsets (Figure 1). Mild injection site pain, fatigue, headache and arm swelling were the most common adverse events post vaccination. Conclusion: In this observational study, the largest reported to date amongst AML and MDS patients with serial serologic data following 2 vaccine doses, we found that the vast majority of patients with AML and MDS converted to seropositivity after two doses of the vaccine. Although the overall sample size was relatively small, most clinical and laboratory variables (including neutropenia and lymphopenia) did not affect the seropositivity rate. Antibody titer levels increased dramatically follo ing the 2 nd vaccine dose, indicating the potential utility for serial vaccination (i.e. additional dosing) in poorly-responsive patients. While these findings should be substantiated in a larger cohort, mRNA-273 SARS-CoV-2 vaccine appears to induce a strong humoral response in this population of patients with AML and MDS. [Formula presented] Disclosures: Komrokji: PharmaEssentia: Membership on an entity's Board of Directors or advisory committees;Geron: Consultancy;Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees;Acceleron: Consultancy;Jazz: Consultancy, Speakers Bureau;Taiho Oncology: Membership on an entity's Board of Directors or advisory committees;AbbVie: Consultancy;BMSCelgene: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Sweet: Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees;AROG: Membership on an entity's Board of Directors or advisory committees;Gilead: Membership on an entity's Board of Directors or advisory committees;Astellas: Consultancy, Membership on an entity's Board of Directors or advisory committees;Bristol Meyers Squibb: Honoraria, Membership on an entity's Board of Directors or advisory committees. Sallman: Incyte: Speakers Bureau;AbbVie: Membership on an entity's Board of Directors or advisory committees;Aprea: Membership on an entity's Board of Directors or advisory committees, Research Funding;Bristol-Myers Squibb: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Agios: Membership on an entity's Board of Directors or advisory committees;Intellia: Membership on an entity's Board of Directors or advisory committees;Kite: Membership on an entity's Board of Directors or advisory committees;Magenta: Consultancy;Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees;Syndax: Membership on an entity's Board of Directors or advisory committees;Shattuck Labs: Membership on an entity's Board of Directors or advisory committees;Takeda: Consultancy. Padron: Taiho: Honoraria;Kura: Research Funding;BMS: Research Funding;Blueprint: Honoraria;Incyte: Research Funding;Stemline: Honoraria. Kuykendall: BluePrint Medicines: Honoraria, Speakers Bureau;Abbvie: Honoraria;Celgene/BMS: Honoraria, Speakers Bureau;CTI Biopharma: Honoraria;Incyte: Consultancy;Novartis: Honoraria, Speakers Bureau;Protagonist: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding;Prelude: Research Funding;PharmaEssentia: Honoraria. Giuliano: Merck & CO: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding. Lancet: Daiichi Sankyo: Consultancy;BerGenBio: Consultancy;Celgene/BMS: Consultancy;Millenium Pharma/Takeda: Consultancy;Agios: Consultancy;ElevateBio Management: Consultancy;AbbVie: Consultancy;Astellas: Consultancy;Jazz: Consultancy.
ABSTRACT
Background: Liver transplantation (LT) activities during the COVID-19 pandemic have been curtailed in many countries which has led to increased percentage of waitlist deaths. The impact of various policies restricting LT on outcomes of patients on the LT waitlist is unclear. This study aims to model effects of various scenarios and duration of LT disruption on outcomes. Methods: Using nationwide data from Hong Kong and Singapore of 571 patients between January 2016 and May 2020, we utilized a continuous time Markov chains model approach to evaluate the three following outcomes: (a) overall survival, (b) proportion of waitlist dropout in HCC patients, and (c) proportion of patients that developed acuteon-chronic liver failure (ACLF) while on the LT waitlist under the five scenarios. The five scenarios were: (1) no limitation to LT (both deceased donor liver transplant [DDLT] and living donor liver transplant [LDLT]), (2) no limitation to DDLT, only urgent (acute liver failure [ALF] or ACLF) LDLT allowed, (3) only urgent LT (DDLT and LDLT) allowed, (4) only DDLT, no LDLT allowed and (5) complete cessation of LT. For each scenario, varying periods of 1-, 3-, 6- and 12-month duration of disruption were simulated. Results: With complete cessation of LT, the projected 1-year overall survival (OS) decreased by 3.6%, 10.51% and 19.21% for a 1-, 3- and 6-month disruption respectively when compared to no limitation to LT, while 5-year OS decreased by 5.3%, 15.81%, and 31.11% respectively. When only urgent LT was allowed, the projected 1-year OS decreased by a similar proportion: 3.1%, 8.41% and 15.20% respectively. When only DDLT was allowed to take place, the 1-year projected OS decreased by a smaller proportion - 1.9%, 6.30% and 10.79% for a 1-, 3-, 6-month disruption respectively. When DDLT and only urgent LDLT were allowed, 1-year projected OS was similar to when only DDLT was allowed, at 1.2%, 5.1% and 8.85% for a 1-, 3- and 6-month disruption respectively (Figure 1A). Complete cessation of LT activities resulted in an increased projected incidence of ACLF at 1-year by 17.6%, 49.1% and 95.5%, as well as an increase in hepatocellular carcinoma (HCC) dropout resulting in delisting at 1-year by 31.8%, 107.96% and 176.06% for a 1-, 3- and 6- month disruption respectively (Figure 1B). When only urgent LT was allowed, HCC dropout and ACLF incidence were comparable to the rates seen in the scenario of complete LT cessation. Conclusion: A short and wide-ranging disruption to LT results in better outcomes compared with a longer duration of partial restrictions. Findings from our study provide useful guidance for LT units worldwide in navigating the peaks and troughs of COVID-19 surges and highlight the impact of LT disruption on waitlisted patients during this prolonged pandemic. Once the peak of the COVID-19 wave has passed, DDLT at minimum should be resumed as soon as possible.
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Background: The COVID-19 outbreak affects both the physical and mental health of individuals and society. This study investigates the factors related to health anxiety in COVID-19 patients and explores their sociodemographic-, disease-, and treatment-related factors, trait anxiety, and characteristics of secure or insecure attachment. Methods: The sample consisted of 420 individuals aged 18-65 years and diagnosed with COVID-19 between March 15 and May 15, 2020. The participants completed a sociodemographic data form and the Health Anxiety Inventory (HAI), Adult Attachment Scale (AAS), and State-Trait Anxiety Inventory (STAI). Results: Hierarchical regression analysis revealed that female gender, presence of chronic physical diseases, presence of mental health problems, and high AAS insecure attachment scores significantly predicted high HAI scores. Moreover, results indicated that the model explained approximately 21% of variance in HAI scores. Conclusions: Factors such as gender, presence of chronic physical diseases, presence of mental health problems, and attachment style influence health anxiety. Determining the appropriate factors that cause health anxiety can contribute to the implementation of protective measures for mental health and to the application of effective interventions for individuals who develop mental problems.
ABSTRACT
Owning a pet has often been associated with improved mental health among owners, including enhanced quality of life, and decreased levels of depression and loneliness. The aim of this study was to identify whether owning a cat and/or dog was associated with better psychological wellbeing during a strict lockdown period in Victoria, Australia, during the COVID-19 pandemic. Data were analysed from a large-scale mental health study: the COvid-19 and you: mentaL heaLth in AusTralia now survEy (COLLATE). The impact of pet ownership on levels of resilience, loneliness and quality of life were examined in a sample of 138 pet owners and 125 non-pet owners. Hierarchical linear regression analyses indicated that pet ownership was significantly associated with poorer quality of life, but not significantly associated with resilience or loneliness, after accounting for situational factors (e.g. job loss) and mood states. Contrary to expectations, the findings suggest that during a specific situation such as a pandemic, pets may contribute to increased burden among owners and contribute to poorer quality of life.