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1.
International Journal of Molecular Sciences ; 24(1):721, 2023.
Article in English | Academic Search Complete | ID: covidwho-2200291

ABSTRACT

Chronic opioid use disorder patients often also use other substances such as amphetamines. The gene-based analysis method was applied in the genomic database obtained from our previous study with 343 methadone maintenance treatment (MMT) patients. We found that the gene encoding gamma-aminobutyric acid type A receptors (GABA-A receptor) delta subunit isoforms (GABRD) was associated with amphetamine use in heroin dependent patients under MMT in Taiwan. A total of 15% of the 343 MMT patients tested positive for amphetamine in the urine toxicology test. Two genetic variants in the GABRD, rs2889475 and rs2376805, were found to be associated with the positive urine amphetamine test. They are located in the exon 1 of the splice variant and altered amino acid compositions (T126I, C/T, for rs2889475, and R252Q, G/A, for rs2376805). The CC genotype carriers of rs2889475 showed a four times higher risk of amphetamine use than those with TT genotype. The GG genotype carriers of rs2376805 showed a three times higher risk of amphetamine use than the AA genotype carriers. To our knowledge, this is the first report that demonstrated an association of the delta splice variant isoform in the GABA-A receptor with an increased risk of amphetamine use in MMT patients. Our results suggest that rs2889475 and rs2376805 may be indicators for the functional role and risk of amphetamine use in MMT patients. [ FROM AUTHOR]

3.
Health Place ; 76: 102811, 2022 07.
Article in English | MEDLINE | ID: covidwho-1851142

ABSTRACT

During the COVID-19 pandemic in 2020, the Supplemental Nutrition Assistance Program (SNAP) Online Purchasing Pilot (OPP) was rapidly expanded across the US. This program, enabling direct-to-home grocery delivery, could be a transformative step towards improving fresh-food access. However, lack of information on which areas are serviced by SNAP OPP hinders the identification of potential demographic and regional disparities in access. Lessons from the initial implementation period are critical for understanding continuing inequities and informing the implementation of future programs. In California, SNAP OPP expanded food access for 85.9% of the state's SNAP households in 2020-21. Coverage was significantly greater in urban areas, covering 87.2% of CalFresh households in urban limited food access areas as compared with 29.9% of CalFresh households in rural limited food access areas. County-level COVID-19 rates did not have a meaningful association with SNAP OPP coverage.


Subject(s)
COVID-19 , Food Assistance , COVID-19/epidemiology , Family Characteristics , Food Supply , Humans , Pandemics , Poverty
4.
Mol Ther ; 30(9): 2998-3016, 2022 09 07.
Article in English | MEDLINE | ID: covidwho-1821532

ABSTRACT

We established a split nanoluciferase complementation assay to rapidly screen for inhibitors that interfere with binding of the receptor binding domain (RBD) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike glycoprotein with its target receptor, angiotensin-converting enzyme 2 (ACE2). After a screen of 1,200 US Food and Drug Administration (FDA)-approved compounds, we identified bifonazole, an imidazole-based antifungal agent, as a competitive inhibitor of RBD-ACE2 binding. Mechanistically, bifonazole binds ACE2 around residue K353, which prevents association with the RBD, affecting entry and replication of spike-pseudotyped viruses as well as native SARS-CoV-2 and its variants of concern (VOCs). Intranasal administration of bifonazole reduces lethality in K18-hACE2 mice challenged with vesicular stomatitis virus (VSV)-spike by 40%, with a similar benefit after live SARS-CoV-2 challenge. Our screen identified an antiviral agent that is effective against SARS-CoV-2 and VOCs such as Omicron that employ the same receptor to infect cells and therefore has high potential to be repurposed to control, treat, or prevent coronavirus disease 2019 (COVID-19).


Subject(s)
Antiviral Agents , COVID-19 , Imidazoles , SARS-CoV-2 , Angiotensin-Converting Enzyme 2/antagonists & inhibitors , Animals , Antiviral Agents/pharmacology , COVID-19/drug therapy , Imidazoles/pharmacology , Mice , Protein Binding , SARS-CoV-2/drug effects , Spike Glycoprotein, Coronavirus/chemistry , United States , United States Food and Drug Administration
5.
Curr Opin Ophthalmol ; 33(2): 67-72, 2022 Mar 01.
Article in English | MEDLINE | ID: covidwho-1621697

ABSTRACT

PURPOSE OF REVIEW: Accurate and precise measurement of intraocular pressure (IOP) is a vitally important component of the ophthalmic examination. There are multiple methods of tonometry, each of which has considerations in light of the ongoing severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic. This review discusses these considerations and compares various tonometer methods with the gold standard of Goldmann applanation tonometry (GAT). RECENT FINDINGS: The SARS-CoV-2 virus may spread via droplets, microaerosols, or direct contact in the ophthalmology clinic. Tonometry poses a high risk of contamination. The accuracy and reliability of various methods of tonometry with single-use disposable equipment has been compared with Goldmann applanation tonometry. SUMMARY: Goldmann applanation tonometry with disposable applanation tips, Tono-pen, and iCare employ single use tips to decrease the risk of cross-contamination of infectious agents. Review of the literature demonstrates good correlation between these devices and GAT, although the published level of agreement between devices varies.


Subject(s)
COVID-19 , Glaucoma , Humans , Intraocular Pressure , Reproducibility of Results , SARS-CoV-2 , Tonometry, Ocular
6.
Vaccine ; 39(48): 7058-7065, 2021 11 26.
Article in English | MEDLINE | ID: covidwho-1525976

ABSTRACT

BACKGROUND: Although influenza vaccines provide protection against influenza viruses, concern has been raised that they may increase susceptibility to non-influenza respiratory viruses. As pandemic lockdowns end, temporal overlap of circulation of seasonal influenza viruses and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is expected. Understanding the impact of influenza vaccination on risk of coronavirus infection is therefore of considerable public health importance. METHODS: We performed a secondary analysis of a randomized trial where children and adolescents in Canadian Hutterite colonies were randomly assigned by colony to receive the 2008-2009 seasonal inactivated trivalent influenza vaccine (TIV) or a control hepatitis A (HepA) vaccine. All 3273 colony members (vaccinated children and nonvaccine recipients) were followed for the primary outcome of RT-PCR confirmed seasonal coronavirus infection. Serum collected pre- and post-vaccination was analyzed for titers of IgG antibodies towards human coronaviruses (HCoV). RESULTS: The incidence of coronavirus infection was 0·18/1000 person-days in the colonies that received TIV vs 0.36/1000 person-days in the control group, hazard ratio (HR) 0.49 [0.21-1.17]. The risk reduction among non-vaccine recipients in the TIV group compared to the control group was HR 0.55 [0.24-1.23]. There was an increase in the geometric mean fold change of HCoV-OC43 antibody titers following TIV compared to HepA vaccine (mean difference 1.2 [0.38-2.06], p = 0.007), and an increase in geometric mean HCoV-NL63 antibody titers post-TIV (262.9 vs 342.9, p = 0.03). CONCLUSION: The influenza vaccine does not increase the risk of a coronavirus infection. Instead, the influenza vaccine may reduce the rate of coronavirus infections by inducing cross-reactive anti-coronavirus IgG antibodies.


Subject(s)
COVID-19 , Influenza Vaccines , Influenza, Human , Adolescent , Antibodies, Viral , Canada , Child , Communicable Disease Control , Humans , Influenza, Human/prevention & control , SARS-CoV-2 , Vaccination , Vaccines, Inactivated
7.
Soc Sci Humanit Open ; 4(1): 100212, 2021.
Article in English | MEDLINE | ID: covidwho-1466907

ABSTRACT

Digital contact tracing has been deployed as a public health intervention to help suppress the spread of Covid-19 in many jurisdictions. However, most governments have struggled with low uptake and participation rates, limiting the effectiveness of the tool. This paper characterises a number of systems developed around the world, comparing the uptake rates for systems with different technology, data architectures, and mandates. The paper then introduces the MAST framework (motivation, access, skills, and trust), adapted from the digital inclusion literature, to explore the drivers and barriers that influence people's decisions to participate or not in digital contact tracing systems. Finally, the paper discusses some suggestions for policymakers on how to influence those drivers and barriers in order to improve uptake rates. Examples from existing digital contact tracing systems are presented throughout, although more empirical experimentation is required to support more concrete conclusions on effective interventions.

10.
J Microbiol Immunol Infect ; 54(5): 801-807, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1275504

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) manifests symptoms as common etiologies of respiratory tract infections (RTIs). During the pandemic of COVID-19, identifying the etiologies correctly from patients with RTI symptoms was crucial in not only disease control but preventing healthcare system from collapsing. By applying sensitive PCR-based molecular assays, we detected the etiologic agents and delineated the epidemiologic picture of RTIs in the early phase of COVID-19 pandemic. METHODS: From December 2019 to February 2020, we screened patients presented with RTIs using multiplex PCR-based diagnostic assays. Data from pediatric and adult patients were compared with different months and units in the hospital. RESULTS: Of all 1631 patients including 1445 adult and 186 pediatric patients screened, 8 viruses and 4 bacteria were identified. Positive rates were 25% in December, 37% in January, and 20% in February, with pediatric patients having higher positive rates than adults (Ps < 0.001). In pediatric patients, RhV/EnV was the most commonly detected, followed by parainfluenza viruses. Most Mycoplasma pneumoniae infection occurred in pediatric patients. RhV/EnV was the most commonly detected agent in pediatric patients admitted to intensive care units (ICUs), while influenza accounted for the majority of adult cases with critical illness. Noticeably, seasonal coronavirus ranked second in both adult and pediatric patients with ICU admission. CONCLUSION: While we focused on the pandemic of COVID-19, common etiologies still accounted for the majority of RTIs and lead to severe diseases, including other seasonal coronaviruses.


Subject(s)
COVID-19/epidemiology , Disease Outbreaks , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/etiology , Adult , COVID-19/diagnosis , Child , Humans , Influenza, Human/diagnosis , Influenza, Human/epidemiology , Multiplex Polymerase Chain Reaction , Pandemics , Parainfluenza Virus 1, Human , Parainfluenza Virus 2, Human , Pneumonia, Mycoplasma/diagnosis , Pneumonia, Mycoplasma/epidemiology , Retrospective Studies , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification , Seasons , Taiwan/epidemiology
11.
Acad Radiol ; 28(8): 1151-1158, 2021 08.
Article in English | MEDLINE | ID: covidwho-1240127

ABSTRACT

RATIONALE AND OBJECTIVES: The clinical prognosis of outpatients with coronavirus disease 2019 (COVID-19) remains difficult to predict, with outcomes including asymptomatic, hospitalization, intubation, and death. Here we determined the prognostic value of an outpatient chest radiograph, together with an ensemble of deep learning algorithms predicting comorbidities and airspace disease to identify patients at a higher risk of hospitalization from COVID-19 infection. MATERIALS AND METHODS: This retrospective study included outpatients with COVID-19 confirmed by reverse transcription-polymerase chain reaction testing who received an ambulatory chest radiography between March 17, 2020 and October 24, 2020. In this study, full admission was defined as hospitalization within 14 days of the COVID-19 test for > 2 days with supplemental oxygen. Univariate analysis and machine learning algorithms were used to evaluate the relationship between the deep learning model predictions and hospitalization for > 2 days. RESULTS: The study included 413 patients, 222 men (54%), with a median age of 51 years (interquartile range, 39-62 years). Fifty-one patients (12.3%) required full admission. A boosted decision tree model produced the best prediction. Variables included patient age, frontal chest radiograph predictions of morbid obesity, congestive heart failure and cardiac arrhythmias, and radiographic opacity, with an internally validated area under the curve (AUC) of 0.837 (95% CI: 0.791-0.883) on a test cohort. CONCLUSION: Deep learning analysis of single frontal chest radiographs was used to generate combined comorbidity and pneumonia scores that predict the need for supplemental oxygen and hospitalization for > 2 days in patients with COVID-19 infection with an AUC of 0.837 (95% confidence interval: 0.791-0.883). Comorbidity scoring may prove useful in other clinical scenarios.


Subject(s)
COVID-19 , Deep Learning , Oxygen/therapeutic use , Adult , COVID-19/diagnostic imaging , COVID-19/therapy , Female , Hospitalization , Humans , Male , Middle Aged , Radiography, Thoracic , Retrospective Studies
12.
Influenza Other Respir Viruses ; 15(4): 478-487, 2021 07.
Article in English | MEDLINE | ID: covidwho-1171118

ABSTRACT

BACKGROUND: Physical distancing and facemask use are worldwide recognized as effective non-pharmaceutical interventions (NPIs) against the coronavirus disease-2019 (COVID-19). Since January 2020, Taiwan has introduced both NPIs but their effectiveness on non-COVID-19 respiratory viruses (NCRVs) remain underexplored. METHODS: This retrospective observational study examined electronic records at a tertiary hospital in northern Taiwan from pre-COVID (January-December 2019) to post-COVID period (January-May 2020). Patients with respiratory syndromes were tested for both enveloped (eg, influenza virus and seasonal coronavirus) and non-enveloped RVs (eg, enterovirus and rhinovirus) using multiplex reverse transcription polymerase chain reaction assays. Monthly positivity rates of NCRVs among adult and pediatric patients were analyzed with comparison between pre- and post-COVID periods. RESULTS: A total of 9693 patients underwent 12 127 multiplex RT-PCR tests. The average positivity rate of NCRVs reduced by 11.2% (25.6% to 14.4%) after nationwide PHIs. Despite the COVID-19 pandemic, the most commonly identified enveloped and non-enveloped viruses were influenza virus and enterovirus/rhinovirus, respectively. Observed reduction in NCRV incidence was predominantly contributed by enveloped NCRVs including influenza viruses. We did not observe epidemiological impacts of NPIs on non-enveloped viruses but an increasing trend in enterovirus/rhinovirus test positivity rate among pediatric patients. Our data were validated using Taiwan's national notification database. CONCLUSIONS: Our frontline investigation suggests that the current NPIs in Taiwan might not effectively control the transmission of non-enveloped respiratory viruses, despite their protective effects against influenza and seasonal coronavirus. Health authorities may consider using hydrogen peroxide or chloride-based disinfectants as additional preventative strategies against non-enveloped respiratory viruses in the post-COVID-19 era.


Subject(s)
Communicable Disease Control/methods , Respiratory Tract Infections/prevention & control , Virus Diseases/prevention & control , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Child , Humans , Masks , Middle Aged , Multiplex Polymerase Chain Reaction , Physical Distancing , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/epidemiology , Retrospective Studies , SARS-CoV-2 , Species Specificity , Taiwan/epidemiology , Tertiary Care Centers , Viral Envelope Proteins/genetics , Viral Envelope Proteins/metabolism , Virus Diseases/diagnosis , Virus Diseases/epidemiology , Viruses/classification , Viruses/genetics , Viruses/isolation & purification
13.
Health Res Policy Syst ; 19(1): 40, 2021 Mar 22.
Article in English | MEDLINE | ID: covidwho-1147268

ABSTRACT

BACKGROUND: This paper critically discusses the use and merits of global indices, in particular, the Global Health Security Index (GHSI; Cameron et al. https://www.ghsindex.org/#l-section--map ) in times of an imminent crisis, such as the current pandemic. This index ranked 195 countries according to their expected preparedness in the case of a pandemic or other biological threat. The coronavirus disease 2019 (Covid-19) pandemic provides the background to compare each country's predicted performance from the GHSI with the actual performance. In general, there is an inverted relation between predicted versus actual performance, i.e. the predicted top performers are among those that are the worst hit. Obviously, this reflects poorly on the potential policy uses of this index in imminent crisis management. METHODS: The paper analyses the GHSI and identifies why it may have struggled to predict actual pandemic preparedness as evidenced by the Covid-19 pandemic. The paper also uses two different data sets, one from the Worldmeter on the spread of the Covid-19 pandemics, and the other from the International Network for Government Science Advice (INGSA) Evidence-to-Policy Tracker, to draw comparisons between the actual introduction of pandemic response policies and the corresponding death rate in 29 selected countries. RESULTS: This paper analyses the reasons for the poor match between prediction and reality in the index, and mentions six general observations applying to global indices in this respect. These observations are based on methodological and conceptual analyses. The level of abstraction in these global indices builds uncertainties upon uncertainties and hides implicit value assumptions, which potentially removes them from the policy needs on the ground. CONCLUSIONS: From the analysis, the question is raised if the policy community might have better tools for decision-making in a pandemic. On the basis of data from the INGSA Evidence-to-Policy Tracker, and with backing in studies from social psychology and philosophy of science, some simple heuristics are suggested, which may be more useful than a global index.


Subject(s)
COVID-19 , Decision Making , Disaster Planning , Global Health , Health Policy , Pandemics , Policy Making , Administrative Personnel , Forecasting , Humans , SARS-CoV-2 , Social Values , Trust , Uncertainty
14.
JAMA Ophthalmol ; 139(4): 456-463, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1116915

ABSTRACT

Importance: The American Academy of Ophthalmology (AAO) indicated that urgent or emergent vitreoretinal surgical procedures should continue during the coronavirus disease 2019 (COVID-19) pandemic. Although decreases in the frequency of critical procedures have been reported outside the field of ophthalmology, analyses are limited by volume, geography, and time. Objective: To evaluate whether the frequency of ophthalmic surgical procedures deemed urgent or emergent by the AAO changed across the United States during the COVID-19 pandemic. Design, Setting, and Participants: Vitreoretinal practices from 17 institutions throughout the US participated in this multicenter cross-sectional study. The frequency of 11 billed vitreoretinal Current Procedural Terminology (CPT) codes across respective weeks was obtained from each practice between January 1, 2019, and May 31, 2020. Data were clustered into intravitreal injections (code 67028), lasers and cryotherapy (codes 67141, 67145, and 67228), retinal detachment (RD) repairs (codes 67107, 67108, 67110, and 67113), and other vitrectomies (codes 67036, 67039, and 67040). Institutions were categorized by region (Northeast, Midwest, South, and West Coast), practice setting (academic [tax-exempt] or private [non-tax-exempt]), and date of respective statewide stay-at-home orders. Main Outcomes and Measures: Nationwide changes in the frequency of billing for urgent or emergent vitreoretinal surgical procedures during the COVID-19 pandemic. Results: A total of 526 536 CPT codes were ascertained: 483 313 injections, 19 257 lasers or cryotherapy, 14 949 RD repairs, and 9017 other vitrectomies. Relative to 2019, a weekly institutional decrease in injections was observed from March 30 to May 2, 2020, with a maximal 38.6% decrease (from a mean [SD] of 437.8 [436.3] to 273.8 [269.0] injections) from April 6 to 12, 2020 (95% CI, -259 to -69 injections; P = .002). A weekly decrease was also identified that spanned a longer interval, at least until study conclusion (March 16 to May 31, 2020), for lasers and cryotherapy, with a maximal 79.6% decrease (from a mean [SD] of 6.6 [7.7] to 1.5 [2.0] procedures) from April 6 to 12, 2020 (95% CI, -6.8 to -3.3 procedures; P < .001), for RD repairs, with a maximal 59.4% decrease (from a mean [SD] of 3.5 [4.0] to 1.6 [2.2] repairs) from April 13 to 19, 2020 (95% CI, -2.7 to -1.4 repairs; P < .001), and for other vitrectomies, with a maximal 84.3% decrease (from a mean [SD] of 3.0 [3.1] to 0.4 [0.8] other vitrectomies) from April 6 to 12, 2020 (95% CI, -3.3 to -1.8 other vitrectomies; P < .001). No differences were identified by region, setting, or state-level stay-at-home order adjustment. Conclusions and Relevance: Although the AAO endorsed the continued performance of urgent or emergent vitreoretinal surgical procedures, the frequency of such procedures throughout the country experienced a substantial decrease that may persist after the COVID-19 pandemic's initial exponential growth phase. This decrease appears independent of region, setting, and state-level stay-at-home orders. It is unknown to what extent vitreoretinal intervention would have decreased without AAO recommendations, and how the decrease is associated with outcomes. Although safety is paramount during the COVID-19 pandemic, practices should consider prioritizing availability for managing high-acuity conditions until underlying reasons for the reduction are fully appreciated.


Subject(s)
COVID-19/epidemiology , SARS-CoV-2 , Vitreoretinal Surgery/statistics & numerical data , Cross-Sectional Studies , Emergency Medical Services , Humans , Vitrectomy/statistics & numerical data
15.
Comput Struct Biotechnol J ; 19: 1063-1071, 2021.
Article in English | MEDLINE | ID: covidwho-1056515

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which induced mainly the respiratory damage also caused ocular surface symptoms. However, the detailed description of ocular manifestations, severity fluctuations in confirmed COVID-19 adult patients still lacked. We analyzed onset clinical symptoms and duration, ocular symptoms, needs for medication, outcomes in 28 conjunctivitis patients who were extracted from 3198 COVID-19 patients hospitalized in Huoshenshan Hospital and Taikangtongji Hospital, Wuhan, China. The expression levels of ACE2, TMPRSS2, ANPEP, DPP4, NRP1 on fetal and adult ocular surface and mouse lacrimal glands were assessed by single cell seq analysis. Our results indicated that conjunctivitis was a rare and self-limited complication in adults with COVID-19 while the existence of coronavirus receptors on human ocular surface and mouse lacrimal glands indicated the risk of SARS-CoV-2 infection. Our research firstly examined SARS-CoV-2 receptors, including the new discovered one, NRP1, on the fetal ocular surface and in the mouse lacrimal glands.

16.
Sensors (Basel) ; 20(10)2020 May 19.
Article in English | MEDLINE | ID: covidwho-306261

ABSTRACT

Many types of thermometers have been developed to measure body temperature. Infrared thermometers (IRT) are fast, convenient and ease to use. Two types of infrared thermometers are uses to measure body temperature: tympanic and forehead. With the spread of COVID-19 coronavirus, forehead temperature measurement is used widely to screen people for the illness. The performance of this type of device and the criteria for screening are worth studying. This study evaluated the performance of two types of tympanic infrared thermometers and an industrial infrared thermometer. The results showed that these infrared thermometers provide good precision. A fixed offset between tympanic and forehead temperature were found. The measurement values for wrist temperature show significant offsets with the tympanic temperature and cannot be used to screen fevers. The standard operating procedure (SOP) for the measurement of body temperature using an infrared thermometer was proposed. The suggestion threshold for the forehead temperature is 36 °C for screening of fever. The body temperature of a person who is possibly ill is then measured using a tympanic infrared thermometer for the purpose of a double check.


Subject(s)
Body Temperature/physiology , Coronavirus Infections/diagnosis , Fever/diagnosis , Pneumonia, Viral/diagnosis , Thermometers , COVID-19 , Coronavirus Infections/physiopathology , Coronavirus Infections/virology , Fever/physiopathology , Fever/virology , Forehead/physiopathology , Humans , Infrared Rays , Pandemics , Pneumonia, Viral/physiopathology , Pneumonia, Viral/virology
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