Experienced versus inexperienced mobile users: eye tracking fashion consumers' shopping behaviour on smartphones

The impact of COVID-19 on shopping behaviour preferences has resulted in the accelerated adoption of e-commerce and increased traffic of first-time e-commerce shoppers worldwide. This study compared experienced versus inexperienced mobile consumers' shopping experiences on smartphones. A mixed-methods research, combining mobile eye-tracking technology and interviews, was employed. The comparison of experienced and inexperienced users showed significant differences in regards to time spent on various stages of the shopping journey, used elements of the website and problem areas encountered. Inexperienced users have higher expectations towards fashion retailer's website. Mobile consumers' prior experience using retailers' digital shopping platform is a key parameter in user experience research and participants' recruitment. The findings of this research have managerial and methodological implications and can be used in understanding the behaviour differences between current and potential customers, and in developing personalised shopping experiences on smartphones by feeding these into retailers' digital analytics database and marketing strategy.

Feasibility of SARS-CoV-2 Antibody Testing in Remote Outpatient Trials.

Background: During the coronavirus disease 2019 (COVID-19) pandemic, clinical trials necessitated rapid testing to be performed remotely. Dried blood spot (DBS) techniques have enabled remote HIV virologic testing globally, and more recently, antibody testing as well. We evaluated DBS testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody testing in outpatients to assess seropositivity. Methods: In 2020, we conducted 3 internet-based randomized clinical trials and offered serologic testing via self-collected DBS as a voluntary substudy. COVID-19 diagnosis was based on the Centers for Disease Control and Prevention case definition with epidemiological link to cases. A minority reported polymerase chain reaction (PCR) testing at an outside facility. We tested for anti-SARS-CoV-2 immunoglobulin via antibody detection by agglutination-PCR (ADAP) and compared the results with enzyme-linked immunosorbent assay (ELISA). Results: Of 2727 participants in the primary studies, 60% (1648/2727) consented for serology testing; 56% (931/1648) returned a usable DBS sample. Of those who were asymptomatic, 5% (33/707) had positive ADAP serology. Of participants with a positive PCR, 67% (36/54) had positive SARS-CoV-2 antibodies. None of those who were PCR-positive and asymptomatic were seropositive (0/7). Of 77 specimens tested for concordance via ELISA, 83% (64/77) were concordant. The challenges of completing a remote testing program during a pandemic included sourcing and assembling collection kits, delivery and return of the kits, and troubleshooting testing. Self-collection was successful for >95% of participants. Delays in US mail with possible sample degradation and timing of DBS collection complicated the analysis. Conclusions: We found remote antibody testing during a global pandemic feasible although challenging. We identified an association between symptomatic COVID-19 and positive antibody results at a similar prevalence as other outpatient cohorts.

A Single-Administration Microneedle Skin Patch for Multi-Burst Release of Vaccine against SARS-CoV-2.

The necessity for multiple injections and cold-chain storage has contributed to suboptimal vaccine utilization, especially in pandemic situations. Thermally-stable and single-administration vaccines hold a great potential to revolutionize the global immunization process. Here, a new approach to thermally stabilize protein-based antigens is presented and a new high-throughput antigen-loading process is devised to create a single-administration, pulsatile-release microneedle (MN) patch which can deliver a recombinant SARS-CoV-2 S1-RBD protein-a model for the COVID-19 vaccine. Nearly 100% of the protein antigen could be stabilized at temperatures up to 100 °C for at least 1 h and at an average human body temperature (37 °C) for up to 4 months. Arrays of the stabilized S1-RBD formulations can be loaded into the MN shells via a single-alignment assembly step. The fabricated MNs are administered at a single time into the skin of rats and induce antibody response which could neutralize authentic SARS-CoV-2 viruses, providing similar immunogenic effect to that induced by multiple bolus injections of the same antigen stored in conventional cold-chain conditions. The MN system presented herein could offer the key solution to global immunization campaigns by avoiding low patient compliance, the requirement for cold-chain storage, and the need for multiple booster injections.

COVID-19 and sustainability in textile, apparel and fashion use: An assessment of trends

Apart from the many social and health problems it has caused, the COVID-19 pandemic has had a severe impact on most sectors of the economy worldwide. One of the areas where such impact is noticeable is the textile, apparel, and fashion (TAF) industry. The lockdowns and limited access to retailer outlets resulted in a considerable drop in consumption, creating problems related to the excess of stock, the decrease of sales, and the disposal of non-used items. This paper outlines the implications of the COVID-19 on the TAF sectors and European retailers. It analyzes how the current supply chains exacerbated stock control problems, and it reports on the changes in consumption during the pandemic. The worldwide restrictive measures implemented to cope with the COVID-19 pandemic were responsible for significant profit losses. Also, the decrease in consumption, caused by several geographically wide lockdowns, prompted a subsequent reduction in orders and sales, resulting in a significant number of constraints. The implementation of more environmentally friendly processes, including sustainable circularity as a competitiveness source to keep the TAF sectors in the loop and reduce greenhouse gas emissions, may help address the problems associated with the COVID-19 pandemic in the sustainability context, as reported in this paper. © The Author(s) 2022.

Two cases of challenging cutaneous lymphoid infiltrates presenting in the context of COVID-19 vaccination: a reactive lymphomatoid papulosis-like eruption and a bona fide lymphoma.

COVID-19 infection and vaccination may be associated with a wide variety of cutaneous and immune manifestations. Here, we describe two patients who presented with monoclonal cutaneous T-cell infiltrates that showed cytologic and immunophenotypic features concerning for lymphoma shortly following COVID-19 vaccination. In one case, the eruption completely resolved. The second patient showed initial resolution, but her disease recurred and progressed following a breakthrough SARS-CoV-2 infection. These cases suggest that immune stimulation following exposure to SARS-Cov-2 protein(s) in vaccine or infection may facilitate the development of a lymphoma or lymphoproliferative disorder in susceptible individuals. Moreover, they demonstrate that separating these cases from pseudolymphomatous reactive conditions is often challenging and requires close clinical correlation.

NURSING FACILITY QUALITY, CLOSURES, AND STAFFING

The quality of care provided in nursing facilities has long been a societal concern and an important focus of policy at the federal and state level. The COVID-19 pandemic has drawn increased attention to nursing facilities due to high infection and mortality rates as well as increased media attention on staffing shortages that have occurred in the wake of the pandemic. The Office of the Assistant Secretary for Planning and Evaluation (ASPE) and RTI International have recently completed a series of studies focused on nursing facility quality and staffing. This symposium will present the results of four of those studies. First, we will report the results of a study exploring states' use of value-based payment (VBP) programs as part of their nursing facility Medicaid payment systems. Second, we will present the results of a study examining inappropriate discharges from nursing facilities. Third, we will report findings from a study that examined the factors associated with nursing facility closures. Finally, we will present findings from a study that explored the effect of the pandemic on nursing facility staffing. Together these studies provide important information about the state of nursing facilities in the wake of the COVID-19 pandemic and suggest key areas of focus for policymakers.

POLICY ATTENTION NEEDED TO IMPROVE DIRECT CARE WORKER WAGES AND OTHER CHALLENGES

Direct care workers (DCWs), including nursing assistants, home health aides, and personal care assistants, play an essential role in the health and well-being of over 20 million Americans who receive long-term services and supports (LTSS) at home, in nursing facilities, and other settings. In 2020, nearly 4 million DCWs supported older adults and people with disabilities in completing self-care and other daily tasks. Their efforts require considerable technical and interpersonal skills, but these essential workers receive low pay and rarely receive benefits. The COVID-19 pandemic has increased the attention paid to DCWs in the media and among policymakers. This symposium presents the results of three studies conducted by RTI International and the Office of the Assistant Secretary for Planning and Evaluation (ASPE) focused on DCWs. First, we present the results of a study examining how the wages of DCWs compare to the wages of other entry-level workers across all 50 states and report the effect of state policies aimed at improving DCW wages. Second, we report findings from a study exploring the experiences of home care aides during the pandemic as well as the federal and state policies implemented to assist these DCWs during the pandemic. Finally, we present the results of a study that assessed the effect of the COVID-19 pandemic on DCW staffing in nursing facilities. Together these studies suggest that more policy attention is needed to improve direct care work and attract the millions of additional DCWs that are expected to be needed in coming years.

COVID-19 and sustainability in textile, apparel and fashion use: an assessment of trends

Apart from the many social and health problems it has caused, the COVID-19 pandemic has had a severe impact on most sectors of the economy worldwide. One of the areas where such impact is noticeable is the textile, apparel, and fashion (TAF) industry. The lockdowns and limited access to retailer outlets resulted in a considerable drop in consumption, creating problems related to the excess of stock, the decrease of sales, and the disposal of non-used items. This paper outlines the implications of the COVID-19 on the TAF sectors and European retailers. It analyzes how the current supply chains exacerbated stock control problems, and it reports on the changes in consumption during the pandemic. The worldwide restrictive measures implemented to cope with the COVID-19 pandemic were responsible for significant profit losses. Also, the decrease in consumption, caused by several geographically wide lockdowns, prompted a subsequent reduction in orders and sales, resulting in a significant number of constraints. The implementation of more environmentally friendly processes, including sustainable circularity as a competitiveness source to keep the TAF sectors in the loop and reduce greenhouse gas emissions, may help address the problems associated with the COVID-19 pandemic in the sustainability context, as reported in this paper. © The Author(s) 2022.

Risk Factors and Clinical Outcomes of Candidemia Associated With Severe COVID-19

IMPORTANCE: COVID-19 can cause serious illness requiring multimodal treatment and is associated with secondary infections. Studies have suggested an increased risk of fungal infections, including candidemia following severe COVID-19 though understanding of risk factors and clinical outcomes remains unclear. OBJECTIVES: To describe clinical characteristics, outcomes and risk factors of candidemia among patients hospitalized with severe COVID-19. DESIGN, SETTING, AND PARTICIPANTS: A multicenter, case-control study of patients with severe COVID-19 was conducted to evaluate risk factors and clinical outcomes in patients who developed candidemia between August 2020 and August 2021. MAIN OUTCOMES AND MEASURES: Chart review evaluating institutional and patient demographics, clinical and mycological characteristics, concomitant interventions (antibiotics, immunosuppressive agents, parenteral nutrition, degree of oxygen support, mechanical ventilation, surgery), treatment regimens, and outcomes (length of stay and discharge disposition) RESULTS: A total of 275 patients were enrolled in the study, including 91 patients with severe COVID-19 and subsequent candidemia and 184 with severe COVID-19 without candidemia. Most patients received antibiotics prior to candidemia episode (93%), while approximately one-quarter of patients received biologic for COVID-19. In-hospital mortality was significantly higher in the cases compared with the controls (68% vs 40%;p < 0.01). Candida albicans was the most common (53%), followed by C. glabrata (19%). Use of central lines, biologic, and paralytics were independent risk factors for candidemia. CONCLUSIONS AND RELEVANCE: Candidemia following COVID-19 infection is a concern that requires clinical consideration and patient monitoring. Risk factors for the development of candidemia in the setting of COVID-19 infection are largely consistent with traditional risk factors for candidemia in hospitalized patients.

Mass trends of parabens, triclocarban and triclosan in Arizona wastewater collected after the 2017 FDA ban on antimicrobials and during the COVID-19 pandemic.

Antimicrobials like parabens, triclosan (TCS), and triclocarban (TCC) are of public health concern worldwide due to their endocrine-disrupting properties and ability to promote antimicrobial drug resistance in human pathogens. The overall use of antimicrobials presumably has increased during the COVID-19 pandemic, whereas TCS and TCC may have experienced reductions in use due to their recent ban from thousands of over-the-counter (OTC) personal care products by the U.S. Food and Drug Administration (FDA). No quantitative data are available on the use of parabens or the impact the FDA ban had on TCC and TCS. Here, we use wastewater samples (n = 1514) from 10 different communities in Arizona to measure the presence of the six different antimicrobial products (TCS, TCC, and four alkylated parabens [methylparaben (MePb), ethylparaben (EtPb), propylparaben (PrPb), butylparaben (BuPb)]) collected before and during the COVID-19 pandemic using a combination of solid-phase extraction, liquid chromatography/tandem mass spectrometry (LC-MS/MS), and isotope dilution for absolute quantitation. The average mass loadings of all antimicrobials combined (1,431 ± 22 mg/day per 1,000 people) after the onset of the local epidemic (March 2020 - October 2020) were significantly higher (945 ± 62 mg/day per 1,000 people; p < 0.05) than before the pandemic (January 2019 - February 2020). Overall, parabens (∑Pbs = 999 ± 16 mg/day per 1,000 people) were the most used antimicrobials, followed by TCS (117 ± 14 mg/day per 1,000 people) and TCC (117 ± 14 mg/day per 1,000 people). After the 2017 U.S. FDA ban, we found a statistically significant (p < 0.05) reduction in the mass loadings of TCS (-89%) and TCC (-80%) but a rise in paraben use (+72%). Mass flows of 3 of a total of 4 parabens (MePb, EtPb, and PrPb) in wastewater were significantly higher upon the onset of the epidemic locally (p < 0.05). This is the first longitudinal study investigating the use of antimicrobials during the COVID-19 pandemic by employing wastewater-based epidemiology. Whereas an overall increase in the use of antimicrobials was evident from analyzing Arizona wastewater, a notable reduction in the use of TCS and TCC was evident during the pandemic, triggered by the U.S. FDA ban.

Effect of Cloth Masks and N95 Respirators on Maximal Exercise Performance in Collegiate Athletes.

This study compared exercise performance and comfort while wearing an N95 filtering facepiece respirator (N95), cloth mask, or no intervention control for source control during a maximal graded treadmill exercise test (GXT). Twelve Division 1 athletes (50% female, age = 20.1 ± 1.2, BMI = 23.5 ± 1.6) completed GXTs under three randomized conditions (N95, cloth mask, control). GXT duration, heart rate (HR), respiration rate (RR), transcutaneous oxygen saturation (SpO2), transcutaneous carbon dioxide (TcPCO2), rating of perceived exertion (RPE), and perceived comfort were measured. Participants ran significantly longer in control (26.06 min) versus N95 (24.20 min, p = 0.03) or cloth masks (24.06 min, p = 0.04). No differences occurred in the slope of HR or SpO2 across conditions (p > 0.05). TcPCO2 decreased faster in control (B = -0.89) versus N95 (B = 0.14, p = 0.02) or cloth masks (B = -0.26, p = 0.03). RR increased faster in control (B = 8.32) versus cloth masks (B = 6.20, p = 0.04). RPE increased faster in the N95 (B = 1.91) and cloth masks (B = 1.79) versus control (B = 1.59, p < 0.001 and p = 0.05, respectively). Facial irritation/itching/pinching was higher in the N95 versus cloth masks, but sweat/moisture buildup was lower (p < 0.05 for all). Wearing cloth masks or N95s for source control may impact exercise performance, especially at higher intensities. Significant physiological differences were observed between cloth masks and N95s compared to control, while no physiological differences were found between cloth masks and N95s; however, comfort my differ.

Boosting corrects a memory B cell defect in SARS-CoV-2 mRNA-vaccinated patients with inflammatory bowel disease.

Immunosuppressed patients with inflammatory bowel disease (IBD) generate lower amounts of SARS-CoV-2 spike antibodies after mRNA vaccination than healthy controls. We assessed SARS-CoV-2 spike S1 receptor binding domain-specific (S1-RBD-specific) B lymphocytes to identify the underlying cellular defects. Patients with IBD produced fewer anti-S1-RBD antibody-secreting B cells than controls after the first mRNA vaccination and lower amounts of total and neutralizing antibodies after the second. S1-RBD-specific memory B cells were generated to the same degree in IBD and control groups and were numerically stable for 5 months. However, the memory B cells in patients with IBD had a lower S1-RBD-binding capacity than those in controls, which is indicative of a defect in antibody affinity maturation. Administration of a third shot to patients with IBD elevated serum antibodies and generated memory B cells with a normal antigen-binding capacity. These results show that patients with IBD have defects in the formation of antibody-secreting B cells and affinity-matured memory B cells that are corrected by a third vaccination.

A Replication of DiMaggio et al. (2020) in Phoenix, AZ.

This research replicates in Phoenix, Arizona a study originally conducted by DiMaggio et al. (2020) that investigated the associations between positive COVID-19 tests and demographic, socioeconomic, and racial characteristics in New York City at the ZIP Code Tabulation Area level. We extend that work through a conceptual replication that introduces covariates appropriate to Phoenix, AZ. Our direct replication, which focuses on that city's first wave of COVID-19 (May 31, 2020 to August 1, 2020), demonstrates that the framework used by DiMaggio et al. can be transferred across cities, but also identifies specification decisions that need careful consideration. Our conceptual replication identifies the proportion of Hispanic residents, rather than that of Black/African American residents, to be a key predictor of positive COVID-19 testing. This finding sheds light on the dynamics of race during the pandemic.

Global Forum of Cancer Surgeons: Cancer Surgery During the COVID-19 Pandemic: Impact and Lessons Learned.

BACKGROUND: The purpose of this article is to summarize the opinions of the surgical oncology leaders from the Global Forum of Cancer Surgeons (GFCS) about the global impact of COVID-19 pandemic on cancer surgery. METHODS: A panel session (virtual) was held at the annual Society of Surgical Oncology 2021 International Conference on Surgical Cancer Care to address the impact of COVID-19 on cancer surgery globally. Following the virtual meeting, a questionnaire was sent to all the leaders to gather additional opinions. The input obtained from all the leaders was collated and analyzed to understand how cancer surgeons from across the world adapted in real-time to the impact of COVID-19 pandemic. RESULTS: The surgical oncology leaders noted that the COVID-19 pandemic led to severe disruptions in surgical cancer care across all domains of clinical care, education, and research. Several new changes/protocols associated with increased costs were implemented to deliver safe care. Leaders also noted that preexisting disparities in care were exacerbated, and the pandemic had a detrimental effect on well-being and financial status. CONCLUSIONS: The COVID-19 pandemic has led to severe disruptions in surgical cancer care globally. Leaders of the GFCS opined that new strategies need to be implemented to prepare for any future catastrophic events based on the lessons learned from the current events. The GFCS will embark on developing such a roadmap to ensure that surgical cancer care is preserved in the future regardless of any catastrophic global events.

Mechanisms of SARS-CoV-2 neutralization by shark variable new antigen receptors elucidated through X-ray crystallography.

Single-domain Variable New Antigen Receptors (VNARs) from the immune system of sharks are the smallest naturally occurring binding domains found in nature. Possessing flexible paratopes that can recognize protein motifs inaccessible to classical antibodies, VNARs have yet to be exploited for the development of SARS-CoV-2 therapeutics. Here, we detail the identification of a series of VNARs from a VNAR phage display library screened against the SARS-CoV-2 receptor binding domain (RBD). The ability of the VNARs to neutralize pseudotype and authentic live SARS-CoV-2 virus rivalled or exceeded that of full-length immunoglobulins and other single-domain antibodies. Crystallographic analysis of two VNARs found that they recognized separate epitopes on the RBD and had distinctly different mechanisms of virus neutralization unique to VNARs. Structural and biochemical data suggest that VNARs would be effective therapeutic agents against emerging SARS-CoV-2 mutants, including the Delta variant, and coronaviruses across multiple phylogenetic lineages. This study highlights the utility of VNARs as effective therapeutics against coronaviruses and may serve as a critical milestone for nearing a paradigm shift of the greater biologic landscape.

Visualizing in deceased COVID-19 patients how SARS-CoV-2 attacks the respiratory and olfactory mucosae but spares the olfactory bulb.

Anosmia, the loss of smell, is a common and often the sole symptom of COVID-19. The onset of the sequence of pathobiological events leading to olfactory dysfunction remains obscure. Here, we have developed a postmortem bedside surgical procedure to harvest endoscopically samples of respiratory and olfactory mucosae and whole olfactory bulbs. Our cohort of 85 cases included COVID-19 patients who died a few days after infection with SARS-CoV-2, enabling us to catch the virus while it was still replicating. We found that sustentacular cells are the major target cell type in the olfactory mucosa. We failed to find evidence for infection of olfactory sensory neurons, and the parenchyma of the olfactory bulb is spared as well. Thus, SARS-CoV-2 does not appear to be a neurotropic virus. We postulate that transient insufficient support from sustentacular cells triggers transient olfactory dysfunction in COVID-19. Olfactory sensory neurons would become affected without getting infected.