Telehealth utilization and patient satisfaction in an ambulatory movement disorders center during the COVID-19 pandemic.

INTRODUCTION: Studies suggest that patients are satisfied with telehealth in ambulatory settings. However, tele-neurology satisfaction data are limited by a small sample size and COVID-19-era data is not specific to movement disorders clinics. In this prospective observational study, telehealth utilization during the COVID-19 pandemic was assessed, and patient satisfaction was compared between telehealth and in-person visits in an outpatient movement disorders center. METHODS: Patients ≥18 years who completed an appointment at Northwestern's Movement Disorders Clinic were invited to complete a post-visit Medallia survey. The primary outcomes of the survey were likelihood to recommend (LTR) provider, LTR location, and 'spent enough time,' on a 0-10 scale. Responses were categorized into in-person vs. telehealth groups. RESULTS: Telehealth utilization significantly increased from a pre-COVID timeframe rate of 0.3% (Nov 2019 to Feb 2020) to 39.5% during the COVID-19 pandemic (March 2020 through April 2021) (p-value < 0.001). During the COVID-19 pandemic, 621 patients responded to the post-visit Medallia survey (response rate = 30%), including 365 in-person and 256 telehealth visits. No significant differences were observed between in-person and telehealth encounters in LTR provider (p = 0.892), LTR location (p = 0.659), and time spent (p = 0.395). Additional subgroup multivariable analysis did not support differences in satisfaction between different age groups. DISCUSSION: With its large sample size, our study demonstrates that in the setting of increased TH utilization in movement disorders clinic during the COVID-19 pandemic, patients reported similar satisfaction with telehealth compared to in-person visits. This study supports the utility of telehealth to provide specialized neurologic clinic care.

Comparing the severity of chronic rhinosinusitis symptoms before versus during the COVID-19 pandemic.

Background: COVID-19 measures such as masking, social distancing, and staying indoors may mitigate chronic rhinosinusitis (CRS) symptoms. We evaluate whether these measures correlated with improved symptoms in patients with CRS. Methods: This retrospective study compared SNOT-22 survey data from the Northwestern CRS Registry at the time of enrollment and at years 1-5 of follow-up. The final sample consisted of 1826 SNOT-22 surveys for 598 patients. April 10, 2020 to December 31, 2021 was considered "during the pandemic" and prior to March 11, 2020 was considered "pre-pandemic." Wilcoxon test was used to compare SNOT22 at enrollment pre-pandemic versus during pandemic. Separate linear mixed models were performed to estimate SNOT22 at 1 to 5 years after enrollment pre-pandemic versus during pandemic. Results: Subjects enrolled during the pandemic had worse SNOT22 scores than those enrolled pre-pandemic (53 vs. 42, p = .0024). Total SNOT-22 scores were improved during the pandemic than before the pandemic at 1 year follow-up (18.17 vs. 12.22, p = .001). This effect persists when evaluating the nasal (7.33 vs. 5.13, p = .003), sleep (2.63 vs. 1.39, p = .008), function (1.40 vs. 0.72, p = .015), and emotion (0.77 vs. 0.17, p < .001) domains individually. There was no statistically significant difference in total SNOT-22 score at Years 2-5 of follow-up. Conclusions: Patients with CRS experience a greater reduction in symptom severity in their first year of treatment during the pandemic than before the pandemic, plausibly from measures such as masking and staying indoors. Level of Evidence: 4.

The natural tannins oligomeric proanthocyanidins and punicalagin are potent inhibitors of infection by SARS-CoV-2 in vitro (preprint)

The COVID-19 pandemic continues to infect people worldwide. While the vaccinated population has been increasing, the rising breakthrough infection persists in the vaccinated population. For living with the virus, the dietary guidelines to prevent virus infection are worthy of and timely to develop further. Tannic acid has been demonstrated to be an effective inhibitor of coronavirus and is under clinical trial. Here we found that two other members of the tannins family, oligomeric proanthocyanidins (OPCs) and punicalagin, are also potent inhibitors against SARS-CoV-2 infection with different mechanisms. OPCs and punicalagin showed inhibitory activity against omicron variants of SARS-CoV-2 infection. The water extractant of the grape seed was rich in OPCs and also exhibited the strongest inhibitory activities for viral entry of wild-type and other variants in vitro. Moreover, we evaluated the inhibitory activity of grape seed extractants (GSE) supplementation against SARS-CoV-2 viral entry in vivo and observed that serum samples from the healthy human subjects had suppressive activity against different variants of SARS-CoV-2 vpp infection after taking GSE capsules. Our results suggest that natural tannins acted as potent inhibitors against SARS-CoV-2 infection, and GSE supplementation could serve as healthy food for infection prevention.

Travel Behavior Changes after COVID-19 Outbreak in Taiwan

Although the coronavirus disease (COVID-19) has been under control in Taiwan, the accumulated number of confirmed patients has reached up to 14,853, where 661 cases were fatal with a fatality rate of 4.45% (since the virus outbreak until July 1, 2021). Globally, the toll of confirmed cases has reached 182,641,391 people, where 3,955,679 cases were fatal with a fatality rate of 2.17% (from the virus outbreak until July 1, 2021). Considering the disease has not been under control yet and IT still significantly influences people's daily travel behavior worldwide, it is urgent to investigate as to what extent it changes people's travel habits. Therefore, we conducted a survey from April 24 to May 2, 2020, to obtain data on Taiwanese people's travel behavior before and after the outbreak of COVID-19. Two models, logistic regression and ordered logit models, were used. As for the models' performance, the estimated thresholds of the ordered logit model are significantly positive, and its coefficient is smaller than that of the logistic model, indicating that the estimated coefficients would be overestimated if the dependent variable is dichotomous. Hence, this study suggests that the influence of COVID-19 on travel behaviors in Taiwan can be explained by the ordered logit models. Several important conclusions are described as follows. First, people might significantly reduce travel activities related to social entertainment during the pandemic outbreak. Second, the total travel activities by private vehicles are significantly reduced, while there is no significant decrease in the use of transit. Finally, the important explanatory variables included the importance of the time to promote government policies (such as implementing the real-name registration system for mask purchases, publishing confirmed cases, and establishing the transit disinfection system), types and number of weekly activities, and storage of various types of consumer goods. The results of our study can serve as an important reference for accommodating similar scales of pandemics occurring in the future. [ FROM AUTHOR] Copyright of Journal of Advanced Transportation is the property of Hindawi Limited and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Sex and Gender Bias in Covid-19 Clinical Case Reports.

Clinical case reports circulate relevant information regarding disease presentation and describe treatment protocols, particularly for novel conditions. In the early months of the Covid-19 pandemic, case reports provided key insights into the pathophysiology and sequelae associated with Covid-19 infection and described treatment mechanisms and outcomes. However, case reports are often subject to selection bias due to their singular nature. To better understand how selection biases may have influenced Covid-19-releated case reports, we conducted a bibliometric analysis of Covid-19-releated case reports published in high impact journals from January 1 to June 1, 2020. Case reports were coded for patient sex, country of institutional affiliation, physiological system, and first and last author gender. Of 494 total case reports, 45% (n = 221) of patients were male, 30% (n = 146) were female, and 25% (n = 124) included both sexes. Ratios of male-only to female-only case reports varied by physiological system. The majority of case reports had male first (61%, n = 302) and last (70%, n = 340) authors. Case reports with male last authors were more likely to describe male patients [X 2 (2, n = 465) = 6.6, p = 0.037], while case reports with female last authors were more likely to include patients of both sexes [OR = 1.918 (95% CI = 1.163-3.16)]. Despite a limited sample size, these data reflect emerging research on sex-differences in the physiological presentation and impact of Covid-19 and parallel large-scale trends in authorship patterns. Ultimately, this work highlights potential biases in the dissemination of clinical information via case reports and underscores the inextricable influences of sex and gender biases within biomedicine.

Unbalanced-Tests to the Improvement of Yield and Quality

An integrated-circuit testing model (DITM) is used to describe various factors that affect test yield during a test process. We used a probability distribution model to evaluate test yield and quality and introduced a threshold test and a guardband test. As a result of the development speed of the semiconductor manufacturing industry in the future being unpredictable, we use electrical properties of existing products and the current manufacturing technology to estimate future product-distribution trends. In the development of very-large-scale integration (VLSI) testing, the progress of testing technology is very slow. To improve product testing yield and quality, we change the test method and propose an unbalanced-test method, leading to improvements in test results. The calculation using our proposed model and data estimated by the product published by the IEEE International Roadmap for Devices and Systems (IRDS, 2017) proves that the proposed unbalanced-test method can greatly improve test yield and quality and achieve the goal of high-quality, near-zero-defect products.

Inhibition of Severe Acute Respiratory Syndrome Coronavirus 2 main protease by tafenoquine in vitro (preprint)

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the current pandemic, coronavirus disease 2019 (COVID-19), has taken a huge toll on human lives and the global economy. Therefore, effective treatments against this disease are urgently needed. Here, we established a fluorescence resonance energy transfer (FRET)-based high-throughput screening platform to screen compound libraries to identify drugs targeting the SARS-CoV-2 main protease (Mpro), in particular those which are FDA-approved, to be used immediately to treat patients with COVID-19. Mpro has been shown to be one of the most important drug targets among SARS-related coronaviruses as impairment of Mpro blocks processing of viral polyproteins which halts viral replication in host cells. Our findings indicate that the anti-malarial drug tafenoquine (TFQ) induces significant conformational change in SARS-CoV-2 Mpro and diminishes its protease activity. Specifically, TFQ reduces the alpha-helical content of Mpro, which converts it into an inactive form. Moreover, TFQ greatly inhibits SARS-CoV-2 infection in cell culture system. Hence, the current study provides a mechanistic insight into the mode of action of TFQ against SARS-CoV-2 Mpro. Moreover, the low clinical toxicity of TFQ and its strong antiviral activity against SARS-CoV-2 should warrant further testing in clinical trials.

Prevalence and characterization of asthma in hospitalized and nonhospitalized patients with COVID-19.

BACKGROUND: The Centers for Disease Control and Prevention advises that patients with moderate to severe asthma belong to a high-risk group that is susceptible to severe coronavirus disease 2019 (COVID-19). However, the association between asthma and COVID-19 has not been well-established. OBJECTIVE: The primary objective was to determine the prevalence of asthma among patients with COVID-19 in a major US health system. We assessed the clinical characteristics and comorbidities in asthmatic and nonasthmatic patients with COVID-19. We also determined the risk of hospitalization associated with asthma and/or inhaled corticosteroid use. METHODS: Medical records of patients with COVID-19 were searched by a computer algorithm (March 1 to April 15, 2020), and chart review was used to validate the diagnosis of asthma and medications prescribed for asthma. All patients had PCR-confirmed COVID-19. Demographic and clinical features were characterized. Regression models were used to assess the associations between asthma and corticosteroid use and the risk of COVID-19-related hospitalization. RESULTS: Of 1526 patients identified with COVID-19, 220 (14%) were classified as having asthma. Asthma was not associated with an increased risk of hospitalization (relative risk, 0.96; 95% CI, 0.77-1.19) after adjusting for age, sex, and comorbidities. The ongoing use of inhaled corticosteroids did not increase the risk of hospitalization in a similar adjusted model (relative risk, 1.39; 95% CI, 0.90-2.15). CONCLUSIONS: Despite a substantial prevalence of asthma in our COVID-19 cohort, asthma was not associated with an increased risk of hospitalization. Similarly, the use of inhaled corticosteroids with or without systemic corticosteroids was not associated with COVID-19-related hospitalization.

Is BMI Higher in Younger Patients with COVID-19? Association Between BMI and COVID-19 Hospitalization by Age.

OBJECTIVE: Obesity has been found to be a risk factor for hospitalization with coronavirus disease (COVID-19). This study investigated whether patients hospitalized with COVID-19 differed in BMI at older versus younger ages and whether trends were independent of diabetes and hypertension. METHODS: A cross-sectional analysis of patients hospitalized with moderate to severe COVID-19 at Northwestern Memorial Hospital from March 19, 2020, until April 4, 2020, was performed. Patients hospitalized with COVID-19 above and below the age of 50 were compared as well as those hospitalized without COVID-19. RESULTS: Patients younger than 50 years of age hospitalized with COVID-19 without diabetes or hypertension had mean BMI greater than those older than 50 years of age, with BMI 43.1 (95% CI: 34.5-51.7) versus 30.1 (95% CI: 27.7-32.5) (P = 0.02). Furthermore, BMI appeared to inversely correlate with increasing age among patients hospitalized with COVID-19. We did not detect the same difference or trend for patients hospitalized without COVID-19. CONCLUSIONS: Younger patients (age < 50 years) with COVID-19 had higher mean BMI than older patients with COVID-19, with and without diabetes and hypertension. This trend did not exist in patients without COVID-19 hospitalized during the same time period.