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1.
Int Urogynecol J ; 2022.
Article in English | Web of Science | ID: covidwho-2014092

ABSTRACT

INTRODUCTION AND HYPOTHESIS: During the COVID-19 pandemic, guidance was issued in the United Kingdom advising a delay in routine pessary reviews. The impact of this has not been fully explored. The null hypothesis for this study is that delayed routine pessary reviews during the COVID-19 pandemic did not result in a statistically significant increase in complication rate. METHODS: A retrospective comparative cohort study was conducted in NHS Tayside, Scotland, involving 150 patients pre-pandemic and 150 patients during the COVID-19 pandemic (before exclusions). Their notes were reviewed identifying age, care provider, pessary type, length of pessary usage, review date, time elapsed since the previous review, bleeding/infection/ulceration, removal issues, pessary replacement and outcome. Patients excluded were those with no pessary in situ at review, reviews at </=4 months and >8 months (pre-pandemic) and reviews at </=8 months (COVID-19 pandemic). RESULTS: The pre-pandemic group (n=106) had average review times of 10.1,6.2 and 6.2 months for cubes, rings and all others. Overall rates of bleeding/infection/ulceration;reported removal issues;and pessary subsequently not replaced were 9.4%, 11.3% and 5.7% respectively. The COVID-19 pandemic group (n=125) had average review times of 14.7, 10.8 and 11.4 months for cubes, rings and all others. Overall rates of bleeding/infection/ulceration;reported removal issues;and pessary subsequently not replaced were 21.6%, 16.0%, and 12.0% respectively. CONCLUSIONS: Overall, there was a significant increase in rates of bleeding/ulceration/infection (p=0.01). When individual pessaries were considered, this only remained true for rings (p=0.02). Our data would suggest that routine ring pessary reviews should not be extended beyond 6 months or risk bleeding/ulceration/infection.

2.
Non-conventional in English | NTIS, Grey literature | ID: grc-754611

ABSTRACT

Currently scheduled for liftoff in 2024, Gateway will be an outpost orbiting the moon for astronauts headed to and from the lunar surface and will serve as a staging point for deep space exploration. In January 2020, NASA Headquarters contacted Goddard Space Flight Center (GSFC) with a request that they provide a Heliophysics instrumentation package for Gateway. This package would later become known as the Heliophysics Environmental & Radiation Measurement Experiment Suite (HERMES). HERMES consists of four high-heritage instruments – a Miniaturized Electron pRoton Telescope (MERIT), an Electron Electrostatic Analyzer (EEA), a Solar Probe Analyzer-Ions (SPAN-I), and Noise Eliminating Magnetometer Instrument in a Small Integrated System (NEMISIS), which consists of one fluxgate and two magneto-inductive magnetometers. Launching HERMES with Gateway would provide an opportunity to conduct early science experiments on Gateway, but the plan to develop HERMES concurrently with Gateway and launch with the co-manifested vehicle brought numerous technical challenges for the pathfinder payload. HERMES was intended to be a low-cost, tailored Class-D mission, and maintaining that programmatic position proved difficult as the technical challenges grew. The effects of Coronavirus Disease 2019 (COVID-19) were not factored in from the beginning and also created programmatic challenges. This paper will discuss what’s being done to overcome the technical and programmatic challenges to put HERMES on track for a 2024 Launch Readiness Date (LRD).

3.
Neurology ; 98(18 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1925319

ABSTRACT

Objective: We aimed to analyze gender authorship of accepted AAN s in the year prior to and during the pandemic. Background: The COVID-19 pandemic has led to deleterious effects on productivity of female scientists. The AAN changed the review guidelines to blind reviewers to author names and affiliations in 2021. We analyzed the trends of gender authorship over two years given the pandemic and blinding. Design/Methods: s were reviewed manually (n=3211 in 2020;n=2188 in 2021). Data were collected regarding gender of first and senior authors, types of research (case report, series, or trial), subspecialty, and origin of research (USA, international, or corporate-affiliated). We compared the percentages of female first and senior authors in the two years using Z-test for two independent proportions. Results: The percentages of female first and senior authors did not significantly change from the 2020 to 2021 AAN meetings. The analysis of subspecialties with more than 100 s showed the lowest percentages of female senior authors were cerebrovascular disease (29%) and headache (29%) in 2020. Cerebrovascular disease continued to have the lowest percentage (29%) in 2021. For case reports and case series, the percentages of female first and senior authors were 51%, 37% in 2020 and 52%, 36% in 2021. For clinical trials, the percentages were 33%, 25% in 2020 and 28%, 20% in 2021. In analysis of the origin of research, corporate-affiliated had the lowest percentages of female first (34%, 36%) and senior authors (23%, 30%). Conclusions: Our study did not show significant changes of female authorship in accepted AAN s during the pandemic. This may be due to positive changes instituted by the AAN such as increasing awareness of disparity, blinding of s, and increased female leadership. Nevertheless, clinical trials and corporate-affiliated research still had significantly low proportions of female authors.

4.
Neurology ; 98(18 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1925285

ABSTRACT

Objective: Determine neuromuscular manifestation incidence in COVID-19 patients from the longitudinal electronic health record database Optum. Background: Both central and peripheral nervous system (PNS) manifestations of COVID-19 have been reported. A Chinese retrospective case series, on 214 hospitalized COVID-19 patients, found that 8.9% presented with peripheral nerve disease and 7% had muscular injuries. Other studies looking at the prevalence of PNS manifestations are limited and have significantly lower numbers. Design/Methods: The COVID-19 data is sourced from more than 700 hospitals and 7000 clinics in the US. Patients with numerous neuromuscular diagnoses were identified based on ICD-10 coding. Examples include carpal tunnel syndrome, radial nerve lesion, sciatic nerve lesion, myasthenia gravis, acute transverse myelitis, Bell's palsy, and trigeminal neuralgia. Results: We reviewed a total of 598,847 patients with positive COVID-19 PCR and/or diagnosis coding. Neuromuscular complications must have been within 45 days of diagnosis to be included. Incidence of similar neuromuscular complaints was evaluated in 3,001,153 controls without COVID-19. Critical illness neuropathy was found in 35,782 COVID-positive patients and 6,281 of those without. Retrospective study limitations include temporal relationship to COVID-19 does not necessarily indicate causality and inability to confirm the coding by record review or EMG/NCS. Conclusions: Incidence of neuromuscular disorders is generally lower or equivalent in COVID19 patients than in the general population, except for critical illness neuropathy and myopathy. This finding may be explained by more COVID-19 patients being in the intensive care unit and bedbound for longer periods. It is worth noting that a small case series of COVID-related critical illness neuropathy and myopathy patients showed no histopathological or clinical differences compared to non-COVID patients. To our knowledge, this report includes an analysis of neuromuscular manifestations in one of the largest cohorts of COVID-19 patients. This can assist with risk-benefit discussions regarding treatment initiation, etiology of diagnoses, and counseling for COVID-19 questions.

5.
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY ; 129:209-210, 2022.
Article in English | Web of Science | ID: covidwho-1905000
6.
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY ; 129:142-142, 2022.
Article in English | Web of Science | ID: covidwho-1904490
7.
Radical Teacher ; 122:42-51, 2022.
Article in English | Scopus | ID: covidwho-1879591
8.
Annals of Surgical Oncology ; 29(SUPPL 1):225-226, 2022.
Article in English | Web of Science | ID: covidwho-1812665
9.
International Journal of Performance Arts and Digital Media ; 18(1):1-6, 2022.
Article in English | Web of Science | ID: covidwho-1795471
10.
Critical Care ; 26(SUPPL 1), 2022.
Article in English | EMBASE | ID: covidwho-1793890

ABSTRACT

Introduction: The aim of this study was to improve treatment of corticosteroid induced hyperglycaemia in patients critically unwell with COVID-19. Management with high dose steroids reduces mortality and has become standard practice. However, high dose glucocorticoid therapy impairs glucose metabolism in patients already at risk of insulin resistance and impaired insulin production, resulting in increased incidence of hyperglycaemia [1]. Methods: A retrospective audit was undertaken, collecting data on steroid use, glycaemic control, and insulin treatment in 100 patients admitted to the Royal Cornwall Hospital Intensive Care Unit with COVID-19. A standard operating procedure (SOP) for the treatment of steroid induced hyperglycaemia was created, based on guidelines from the National Inpatient Diabetes COVID-19 Response Group [1]. Results: Of 100 patients, 91 received high dose steroids. The majority (64.8%) experienced glycaemic control issues, defined as one episode of blood sugar > 12 mmol/l. Of the patients treated with 6 mg dexamethasone 52% experienced hyperglycaemia, compared to 71% of those treated with higher steroid doses. There was no significant difference in the highest blood sugar level of either cohort (t54 = - 0.450, p = 0.654). The average time between first episode of hyperglycaemia and commensal of insulin was 76 h. There was a lack of consensus in management of steroid-induced hyperglycaemia-no treatment was administered in 37% of patients. In those who were treated, 19 different combinations of insulin were given. Sliding scale insulin was administered in most patients who experienced no further hyperglycaemia. Conclusions: These results highlight a necessity for consensus management of steroid induced hyperglycaemia. In line with these findings, the devised SOP recommends initial therapy with rapid acting insulin and administration of a sliding scale if hyperglycaemia persists.

11.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-332306

ABSTRACT

In contrast to the increasing levels of high avidity S antibody measured by the Roche assay in the first 6 months following natural infection, marked waning is seen post 2 or 3 doses of vaccine. Although the kinetics differ between those with vaccine-induced immunity compared to those infected prior to vaccination (hybrid immunity), waning rates appear to be similar following 2 or 3 doses of vaccine. These data should allow countries to optimise the timing of future doses of vaccine.

12.
Journal of the American College of Cardiology ; 79(9):2512, 2022.
Article in English | EMBASE | ID: covidwho-1768643

ABSTRACT

Background: Complete heart block (CHB) is a cardiac conduction disorder commonly due to age-related degeneration of the conduction system. Other etiologies include hypothyroidism, Lyme disease or COVID-19, infiltrative cardiomyopathy, myocarditis, and atrioventricular (AV) nodal blocking agents. Hyperthyroidism is an extremely rare cause of CHB. Case: We present the case of a 40-year-old previously healthy male who presented after two syncopal episodes. He denied any home medications, recreational drug use, or prior syncopal episodes. He did endorse worsening palpitations, heat intolerance, anxiety, insomnia and diarrhea for one month. Initial EKG was normal. Labs revealed an undetectable thyroid stimulating hormone (TSH), and high T4 of 3.26 ng/dL. Potassium was 3.1 mMol/L which was replaced to normal levels. In the emergency department, he had another syncopal episode. Telemetry showed a 20 second episode of CHB. Patient was admitted and started on methimazole. Decision-making: Labs showed positive TSH receptor antibodies and thyroid stimulating immunoglobulins, confirming a diagnosis of Graves’ disease. COVID-19 IgG antibodies were positive with negative COVID-19 PCR, indicative of remote COVID 19 infection. Cardiac MRI did not show any myocarditis or infiltrative disease, and otherwise revealed a structurally normal heart. Lyme disease antibodies were negative. Toxicology screen was negative. Thyroid ultrasound showed diffuse heterogeneity of the gland. 72 hour telemetry monitoring revealed no further conduction abnormalities. At this point, CHB wes attributed to hyperthyroidism. As this was reversible, and CHB resolved after initiation of methimazole, a permanent pacemaker was not placed. He was discharged with a 30-day event monitor which did not show any conduction abnormalities. Conclusion: This case highlights a rare sequela of hyperthyroidism induced CHB. Although the pathophysiology is not well understood, a proposed mechanism is the direct toxic effect of T3 leading to focal inflammation of the AV node. Further studies are needed to evaluate the pathophysiology and chronicity of this process, which will assist in the decision to implant a permanent pacemaker.

13.
Genetics in Medicine ; 24(3):S150, 2022.
Article in English | EMBASE | ID: covidwho-1768091

ABSTRACT

Introduction: The global pandemic required healthcare institutions and clinical research programs to adapt quickly to non-traditional care models. TeleKidSeq is a pilot study that emerged from the NYCKidSeq program, an NIH-funded Clinical Sequencing Evidence-Generating (CSER) Consortium site focused on incorporating genomic medicine into the care of diverse New York City children with suspected genetic disorders. Embracing the opportunity to study the use of telehealth in delivering genomic results, TeleKidSeq will examine the impact of innovative remote genetic counseling modalities in medically underserved populations. Studies focusing on the use of telehealth performed before the COVID-19 pandemic have shown that patients prefer in-person visits to virtual visits;however, with the increased familiarity and widespread use of virtual platforms, we anticipate an increase in the preference for telehealth visits. TeleKidSeq aims to fill the gaps in current knowledge on the impact of visual aids in telehealth in diverse urban patient populations. Methods: TeleKidSeq will recruit 496 pediatric participants (aged 0-21 years) with neurologic, immunologic, or cardiac conditions suspected to have an underlying genetic cause who receive care predominantly within two large health systems in the New York metropolitan area. The Mount Sinai Genomics Stakeholder Board, consisting of diverse stakeholders and key community advisors, provided guidance about our study design and materials. Participants will be English- or Spanish-speaking, and based on prior enrollment data from NYCKidSeq study, we expect more than 65% will be from populations underrepresented in medical research. Prior to enrollment, participants will be randomized to receive their genomic results from a genetic counselor via telehealth either with screen sharing (ScrS) or without screen sharing (NScrS). All participants will receive genome sequencing (GS) from a clinically validated laboratory. Additionally, we will use GUÍA, a web-based application designed to enhance the delivery of genomic test results, in both the ScrC and NScrS arms to facilitate delivery of individualized genomic results and clinical information in a personalized, highly visual, and narrative manner. Surveys administered at baseline, after results disclosure, and 6-months post-results disclosure will be used to evaluate study outcomes. The primary outcome of the TeleKidSeq study will be participants’ perceived understanding of their GS results with a comparison between the results disclosed via videoconferencing with ScrS and NScrS arms. Secondary outcomes will include: objective understanding of GS results;understanding of medical follow-up recommendations and the actionability of genome sequencing results;adherence to medical follow-up recommendations made based on genomic results;and satisfaction with and ease of use of the telehealth experience, compared across the two arms. Diagnostic yield, clinical utility and cost of GS will also be assessed. Results: Not applicable. Conclusion: Overall, the TeleKidSeq pilot study will contribute to innovations in communicating genomic test results to diverse populations through telehealth technology. In conjunction with NYCKidSeq, this work will inform best practices for the implementation of genomic medicine in diverse, English- and Spanish-speaking populations.

15.
Open Forum Infectious Diseases ; 8(SUPPL 1):S587-S588, 2021.
Article in English | EMBASE | ID: covidwho-1746335

ABSTRACT

Background. The COVID-19 pandemic has brought awareness to the dangers of emerging pathogens to global human health and welfare. Sensitivity and flexibility are important features for methods used to detect emerging pathogens. While PCR testing is rapid and sensitive, a significant advantage next generation sequencing (NGS) approaches have over PCR-based analyses is the ability to detect previously undiscovered pathogens while also providing genomic information that can detect SARS-CoV-2 genome sequence, identify source of co-infection, and the host transcriptional response in a single workflow. The critical component enabling this approach is Jumpcode CRISPRclean technology which removes abundant human and bacterial ribosomal RNA sequences from NGS libraries. CRISPRclean workflow easily integrates into next generation sequencing projects Schematic of the Jumpcode CRISPRclean protocol Methods. CRISPRclean was applied to contrived infected tissue samples including human lung RNA spiked with serially diluted amounts of SARS-CoV-2 RNA and bacterial RNA. NEB RNA libraries were prepared and treated with CRISPRclean protocol, then sequenced on Illumina instruments. Data analysis was performed using Jumpcode proprietary software to measure alignment and depletion rates, the Silva database for rRNA read alignment, and Kraken2 and CosmosID pipelines for k-mer based metagenomic investigation. Fold enrichment of SARS-CoV-2 reads after CRISPRclean depletion of libraries prepared from contrived samples. CRISPRclean treatment of the fully contrived samples increases the fraction of reads that map to the SARS-CoV-2 genome by an average of ~10-fold Results. CRISPRclean treatment of the contrived samples increases ~10 fold of reads that map to the SARS-CoV-2 genome. For the 60 viral copies of SARS-CoV-2 sample, the number of reads mapping to the SARSCoV-2 genome increases from ~10,000 reads to ~70,000 reads. A similar increase in reads occurs for S. aureus. The percentage of SARSCoV-2 genome covered at 1X and 10X also increases. Similar results were achieved even after downsampling the datasets to 5M reads. There is a ~4-fold increase in bacterial species detection in these stool samples after CRISPRclean treatment. Percentage of SARSCoV-2 genome covered at 1X and 10X increases as a result of rRNA depletion. Coverage of the SARS-CoV-2 genome at 50 million reads. Number of reads aligning to the S. aureus and SARS-CoV-2 genomes increases after CRISPRclean depletion. For the sample containing 0.0001% SARS-CoV-2, (60 viral copies), the number of reads mapping to the SARS-CoV-2 genome increases from ~10,000 reads to ~70,000 reads. CosmosID Shotgun Metagenomics Analysis heat map showing read alignments to viral genomes. The yellow color indicates high read counts. The CosmosID shotgun metagenomic analysis software was used to analyze the sequencing data, classify the sequences and generate the heat map. Conclusion. Metatranscriptomics powered by CRISPR-mediated rRNA depletion offers a robust methodology to acquire viral genomic data, microbiome composition, co-infection information, and the transcriptional status of the host immune response in a single workflow. This sequencing-based approach can be available on the first day of the next viral outbreak and should be considered as a first-line test for novel zoonotic virus detection. Bacterial species composition of patient stool samples before and after CRISPRclean depletion. ~4-fold increase in bacterial species detection in these stool samples after CRISPRclean treatment. Sequencing data downsampled to 20 million reads.

16.
2021 ASEE Virtual Annual Conference, ASEE 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1696232

ABSTRACT

Geomatics, with an emphasis on developing students' competencies in Geographic Information Systems, is a technology-intensive course. During the Spring 2020 semester, The Citadel shifted to online continuity of instruction after midterms due to the COVID-19 pandemic. The Geomatics instructor was faced with ensuring academic continuity and quality without remote student access to licensed GIS software. The instructor pivoted to use of QGIS, an open-source software, and a carefully-scaffolded project to equip students with essential GIS skills. Test 3 included two equally-weighted parts: (1) conceptual GIS questions and (2) a new open-ended project, which required students to use GIS to investigate a real-world scenario. Synchronous and asynchronous support was provided to afford students the flexibility needed to manage home commitments and technology challenges. Nevertheless, students' potential for increased (even unmanageable) cognitive load was high, due to the new modality, pedagogy and software. We investigated the impacts of the post-pandemic Geomatics course on students' cognitive load and academic performance through the lens of Cognitive Load Theory, which asserts that cognitive overload can hinder learning. Based on students' NASA Task Load Index scores, Test 3 workload was on par with their face-to-face engineering courses and lower than their online engineering courses. We expect that the cognitive load associated with the project and new software was manageable and not a barrier to learning. Performance on the project was substantially higher than on the closed-ended Test 3 questions, which supports that the project-based approach was integral to helping students achieve GIS competencies. Final exam performance was lower than in previous years, which may suggest that the mid-semester modality shift impacted their ability to fully synthesize material from the semester. Future course offerings will use the project to provide students with authentic engagement with GIS and real-world topics, while QGIS will remain an option for remote instruction. © American Society for Engineering Education, 2021

17.
Embase;
Preprint in English | EMBASE | ID: ppcovidwho-326986

ABSTRACT

While it is now evident that Omicron is rapidly replacing Delta, due to a combination of increased transmissibility and immune escape, it is less clear how the severity of Omicron compares to Delta. In Ontario, we sought to examine hospitalization and death associated with Omicron, as compared to matched cases infected with Delta. We conducted a matched cohort study, considering time to hospitalization or death as the outcome, and analyzed with a Cox proportional hazards model. Cases were matched on age, gender, and onset date, while vaccine doses received and time since vaccination were included as adjustment variables. We identified 6,314 Omicron cases that met eligibility criteria, of which 6,312 could be matched with at least one Delta case (N=8,875) based on age, gender, and onset date. There were 21 (0.3%) hospitalizations and 0 (0%) deaths among matched Omicron cases, compared to 116 (2.2%) hospitalizations and 7 (0.3%) deaths among matched Delta cases. The adjusted risk of hospitalization or death was 54% lower (HR=0.46, 95%CI: 0.27, 0.77) among Omicron cases compared to Delta cases. While severity may be reduced, the absolute number of hospitalizations and impact on the healthcare system could still be significant due to the increased transmissibility of Omicron.

18.
Embase;
Preprint in English | EMBASE | ID: ppcovidwho-326930

ABSTRACT

Introduction Individuals with COVID-19 frequently experience symptoms and impaired quality of life beyond 4-12 weeks, commonly referred to as Long COVID. Whether Long COVID is one or several distinct syndromes is unknown. Establishing the evidence base for appropriate therapies is needed. We aim to evaluate the symptom burden and underlying pathophysiology of Long COVID syndromes in non-hospitalised individuals and evaluate potential therapies. Methods and analysis A cohort of 4000 non-hospitalised individuals with a past COVID-19 diagnosis and 1000 matched controls will be selected from anonymised primary care records from the Clinical Practice Research Datalink (CPRD) and invited by their general practitioners to participate on a digital platform (Atom5TM). Individuals will report symptoms, quality of life, work capability, and patient reported outcome measures. Data will be collected monthly for one year. Statistical clustering methods will be used to identify distinct Long COVID symptom clusters. Individuals from the four most prevalent clusters and two control groups will be invited to participate in the BioWear sub-study which will further phenotype Long COVID symptom clusters by measurement of immunological parameters and actigraphy. We will review existing evidence on interventions for post-viral syndromes and Long COVID to map and prioritise interventions for each newly characterised Long COVID syndrome. Recommendations will be made using the cumulated evidence in an expert consensus workshop. A virtual supportive intervention will be coproduced with patients and health service providers for future evaluation. Individuals with lived experience of Long COVID will be involved throughout this programme through a patient and public involvement group. Ethics and dissemination Ethical approval was obtained from the Solihull Research Ethics Committee, West Midlands (21/WM/0203). The study is registered on the ISRCTN Registry (1567490). Research findings will be presented at international conferences, in peer-reviewed journals, to Long COVID patient support groups and to policymakers.

19.
15th European Conference on Game Based Learning, ECGBL 2021 ; 2021-September:648-655, 2021.
Article in English | Scopus | ID: covidwho-1567001

ABSTRACT

The study describes the problem of the complexity of decision-making. If there is any problem, the person is faced with the question of whether to perform an action or not. Our research focuses on the use of role-playing games to solve debatable situations, that is, where a dilemma appears. Today, covid dilemmas are relevant. Players are offered a brief description of a certain situation with controversial solutions to an urgent problem. This study presents practical cases that relate to vaccination against coronavirus. The participants of the game are divided into teams by roles, discuss and formulate their arguments in favor of a certain decision, depending on the chosen role. Next, each of the participants tries to prove the correctness of their point of view in a reasoned way. If the dilemma is decided by a majority vote, then those players who have convinced those present of their point of view in solving the dilemma win. Thus, the problem situation is considered from different sides and a common compromise solution is reached, taking into account the interests of all players. © The Authors, 2021. All Rights Reserved.

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