Multiple Group Membership, Optimistic Bias, and Infection Risk in the Context of Emerging Infectious Diseases

Background: Understanding psychosocial factors which impact responses to emerging infectious diseases (EIDs) is vital in managing epidemics and pandemics. Two under-researched areas in this field are the interactive roles of optimistic bias (underestimation of the likelihood of negative events occurring to the self, relative to others) and group membership (a factor observed to be psychologically protective, but infection risk enhancing). Aims: The current study aimed to test the relationships between optimistic bias and membership of multiple groups upon EID-related emotional and psychological responses and behavioral intentions. Methods: Participants from the UK and US (N = 360) rated how they would evaluate and respond to a fictitious EID immediately before the 2020 COVID-19 lockdowns in a correlational study. Results: Negative relationships were observed between optimistic bias and perceived infection vulnerability, infection prevention strategies, and perceived EID severity. Multiple group membership correlated negatively with germ avoidance, but positively with emotional responses such as disgust and increased perceived vulnerability to infection - factors linked to avoiding infection. Multiple group memberships and optimistic bias were unrelated. Limitations: The study focussed on a fictitious disease and relies on cross-sectional data and behavioral intentions. Conclusions: These findings build upon the small evidence base on the role of optimistic bias in EID management and suggest that multiple group membership is unlikely to increase optimistic bias. The theoretical and practical implications of the findings for EID management are discussed. © 2023 Hogrefe Publishing.

Limitations of High Flow Nasal Cannula at End of Life

Rationale Many patient with end-stage fibrotic lung disease die in the hospital due to dependence on High Flow Nasal Cannula (HFNC), not available at home. Despite available technical maturity, HFNC is not sufficiently available due to size and portability, energy requirement and oxygen (O2) capacity. This has become particularly problematic during the current Covid-19 pandemic, when many had to die alone in hospital due to these constraints. ObjectiveThe objective of this investigation was to appreciate the number of patients who die in hospital on comfort care, who could benefit from HFNC at home to support person-centered care (self-determination, family involvement, comforts of home) at end of life (EOL). MethodsWe collected data from a convenience sampling of patients who received care at a 449-bed acute-care community hospital in Southern California between June 2020 and June 2021. Data from this retrospective review of the electronic health record included demographics (age, gender, BMI and ethnicity). Other variables collected were length of stay (LOS), Covid status (+/-), comfort care orders, and HFNC requirement. Data were analyzed for frequencies, means and percentages. Chi square (categorical) and t- tests (continuous) were performed to determine statistical significance and Pearson r (categorical) and eta (continuous) were performed to test strength of association.ResultsOf the sample (n = 91), mean age was 78 years (+/- 10.6) and mostly female (38.8%, n = 42). Mean LOS was 13.7 days (+/- 12.1). Most (71.4%) patients in the sample were Hispanic (n = 65). 63 patients had orders for comfort care (69.2%), and 61 patients were Covid positive (67%). There was a statistically significant difference in mean flow rate (p = 0.022, η = 0.564) and fi02 (p < 0.001, η = 0.688) for patients discharged to hospice vs. those who died in hospital. For patients who died in hospital, mean fi02 was 0.94 (12.2) and mean flow rate (in liters) was 48.6 (16.4). ConclusionsThe pandemic has highlighted many healthcare disparities in the United States, and made apparent the needs of persons with fibrotic lung disease at EOL. This investigation revealed that most patients in hospital opting for comfort care died in hospital as their needs for increased flow rates and fi02 far exceeds what is currently available for outpatient use of HFNC. Investments should be made into developing technologies to support these individuals with the benefits of decreased need for hospitalization and promoting self-determination at EOL.

Employing Mozilla Hubs as an Alternative Tool for Student Outreach: A Design Challenge Use Case

Due to the 2020 COVID-19 pandemic, online virtual gathering platforms have risen at all levels as alternatives to traditional videoconferencing. The implementation of physical distancing and limited capacity implemented to reduce the spread of COVID-19 changed how academic activities are conducted. For example, student outreach presents students with experiential learning opportunities and teamwork on campus. While video conferencing tools have thrived over the pandemic, these lack immersion and presence, lead to fatigue, and lack engagement. In this paper, we present the development and hosting of a Design Challenge employing the open-source virtual reality (VR) platform, Hubs by Mozilla. Usability perceptions from five out of ten participants were gathered and analyzed employing a simplified version of the System Usability Scale questionnaire. The process of developing the Mozilla Hubs environment allowed us to identify technical issues associated with performance and audio quality. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Centralized remote and risk-based monitoring in the influenza vaccine to effectively stop cardiothoracic events and decompensated heart failure trial: A cost-effective and easy-to-implement approach

Monitoring of clinical trials is crucial for the protection of human subjects, the integrity of the study, validity of the data, and for safeguarding the highest standards in clinical research. It is required by good clinical practice, but the expense of traditional on-site monitoring can be prohibitive. Striking a balance between the level of monitoring needed and meeting the good clinical practice requirements while remaining fiscally viable is a delicate act, but can be successfully achieved with a targeted use of resources. This paper details the use of a cost-effective strategy of using a risk-based remote monitoring model adopted in the INfluenza Vaccine to Effectively Stop cardio Thoracic Events and Decompensated heart failure trial (ClinicalTrials.gov Identifier: NCT02787044), a pragmatic large simple trial, conducted in the United States and Canada. These strategies provide protection to human subjects and ensure the enrollment of eligible patients to the trial, two areas deemed most critical for INfluenza Vaccine to Effectively Stop cardio Thoracic Events and Decompensated heart failure as a pragmatic trial. When combined appropriately strategies common to centralized, remote, and risk-based monitoring ensure the safety of participants, study quality, and allow the study to remain within budgetary constraints. The INfluenza Vaccine to Effectively Stop cardio Thoracic Events and Decompensated heart failure trial is monitored without a single planned on-site visit. The monitors use the electronic trial master file used in the study along with low-tech and easy to implement, yet secure methods to review the informed consent. The monitors also use an electronic data capture system in the study and a secure cloud-based system to access and share protected health information-redacted medical records to verify eligibility of enrolled patients. The key to the successful remote monitoring of the trial is based on the low-tech methodologies that all sites could easily access and implement while still providing a high level of security for the subjects' protected health information. The processes developed for INfluenza Vaccine to Effectively Stop cardio Thoracic Events and Decompensated heart failure allowed for the study teams to react quickly to any issues, while still ensuring highquality monitoring at a much lower cost than on-site monitoring. The strategies for monitoring the INfluenza Vaccine to Effectively Stop cardio Thoracic Events and Decompensated heart failure trial could be feasible for other clinical trials similar in design and risk especially during the COVID-19 pandemic and in the future. The INfluenza Vaccine to Effectively Stop cardio Thoracic Events and Decompensated heart failure trial was supported by the National Heart, Lung, and Blood Institute under cooperative agreements U01HL130163 and U01HL130204 and by Sanofi Pasteur to the INfluenza Vaccine to Effectively Stop cardio Thoracic Events and Decompensated heart failure Clinical Coordinating Center and the INfluenza Vaccine to Effectively Stop cardio Thoracic Events and Decompensated heart failure Data Coordinating Center.

EPIC30M: An Epidemics Corpus of Over 30 Million Relevant Tweets

Since the start of COVID-19, there has been several relevant corpora from various sources that were released to support research in this area. While these corpora are valuable in supporting analysis for this specific pandemic, researchers will benefit from additional benchmark corpora that contain other epidemics for better generalizability and to facilitate cross-epidemic pattern recognition and trend analysis tasks. During our research, we discover little disease related corpora in the literature that are sizable and rich enough to support such cross-epidemic analysis tasks. To address this issue, we present EPIC30M, a large-scale epidemic corpus that contains more than 30 million micro-blog posts, i.e., tweets crawled from Twitter, from year 2006 to 2020. EPIC30M contains a subset of 26.2 million tweets related to three general diseases, namely Ebola, Cholera and Swine Flu, and another subset of 4.7 million tweets of six global epidemic outbreaks, including the 2009 H1N1 Swine Flu, 2010 Haiti Cholera, 2012 Middle-East Respiratory Syndrome (MERS), 2013 West African Ebola, 2016 Yemen Cholera and 2018 Kivu Ebola. Furthermore, we explore and discuss the properties of this corpus with statistics of key terms and hashtags and trends analysis for each subset. Finally, we discuss the potential value and impact that EPIC30M could generate through a discussion of multiple use cases of cross-epidemic research topics that attract growing interest in recent years. These use cases span multiple research areas, such as epidemiological modeling, pattern recognition, natural language understanding and economical modeling. The corpus is publicly available at https://www.github.com/junhua/epic.

Further evidence that far-UVC for disinfection is unlikely to cause erythema or pre-mutagenic DNA lesions in skin

It is well understood that ultraviolet-C (UVC) radiation is effective for the destruction of micro-organisms and drug-resistant bacteria and is being investigated for its effectiveness at destroying the virus responsible for the current Covid-19 global pandemic. Far-UVC (200 - 220 nm) has been proposed as an effective disinfection radiation that is safe to humans. In 2014, Woods et al. undertook a first-in-person study to assess the effect on skin of a 222 nm UVC emitting device (Sterilray disinfectant wand, Healthy Environment Innovations, Dover, NH, USA).