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1.
Annals of Emergency Medicine ; 78(4):S138-S139, 2021.
Article in English | EMBASE | ID: covidwho-1748241

ABSTRACT

Study Objectives: COVID-19 dramatically changed weekly academic conferences with virtual presentations replacing in-person didactics. Through group chat functions, modern communication platforms provide the opportunity for synchronous online discussions to occur in parallel with didactic presentations. We sought to qualitatively characterize the content, nature, and educational uses of synchronous online discussions occurring during weekly academic conferences and to assess the attitudes of lecturers and audience members towards these discussions. Methods: Transcripts of synchronous online discussions occurring from 7/1/20 to 12/31/20 were qualitatively analyzed using a grounded theory approach. Initial themes were identified by the primary author. Following a preliminary coding by the study authors, the themes were iteratively refined to arrive at a final coding strategy. Each month’s transcripts were coded by 2 study authors. When there was disagreement between coders, the primary author made a final coding determination. Following the study period, a survey distributed to residents and faculty assessed attitudes towards the synchronous online discussions. Results: The qualitative analysis of the transcripts identified 2352 coded messages. The final coding schema can be seen in Figure 1. Of 1720 identified content codes, the most commonly identified themes were cultural communications (40.8%) and knowledge sharing (39.0%). Within the broader theme of knowledge sharing, participants were most likely to share individual practice experience (366/671 codes). Statements with uncited data/evidence (113 codes) occurred in similar frequency to sharing of academic resources (137 codes). Questions directed towards other members of the audience (48.8% of questions) were only slightly less common than questions directed to the lecturer (51.2% of questions). There were 56 respondents to the survey (30 residents, 25 faculty, 1 fellow). Of the 44 respondents that had presented didactics, 54.5% (24/44) identified that it was challenging to keep up with the synchronous online discussion. From the perspective of the audience, 82.1% (46/56) felt it was easy to keep up with the discussion. Presenters of didactics felt identifying a member of the audience as a surrogate was the easiest means to keep up with the discussion (75%, 33/44 presenters). Audience members agreed that they were much more likely to ask a question in a synchronous online discussion as opposed to speaking out loud (71.4%, 40/56). Conclusions: Weekly academic conferences are a critical component of residency education, enabling not only the acquisition of knowledge but also the social sharing of knowledge/experiences developing of robust communities of practice. Our qualitative analysis found that cultural communication occurred with near equal frequency to knowledge sharing and that sharing of individual practice experiences was more common than sharing of academic resources. These synchronous online discussions may make it more likely for audience members to ask questions of each other or the lecturer but keeping up with the discussion was challenging for lecturers. [Formula presented]

2.
Open Forum Infectious Diseases ; 8(SUPPL 1):S806-S807, 2021.
Article in English | EMBASE | ID: covidwho-1746277

ABSTRACT

Background. Remdesivir (RDV) is a potent nucleotide prodrug inhibitor of the SARS-CoV-2 RNA-dependent RNA polymerase that has demonstrated efficacy in the treatment of patients hospitalized with moderate to severe COVID-19. This Phase 3 (GS-US-540-9012) double-blind, placebo-controlled study compared the efficacy and safety of 3 days of RDV to standard of care in non-hospitalized, high-risk participants with confirmed COVID-19. Methods. Participants were randomly assigned 1:1 to receive intravenous (IV) RDV (200 mg on day 1, 100 mg on days 2 to 3) or placebo. The primary efficacy endpoint was composite COVID-19 hospitalization or all-cause death by day 28 and compared using Cox proportional hazards model with baseline stratification factors as covariates. The primary safety endpoint was proportion of participants with treatment-emergent adverse events. Study enrollment was terminated early for administrative reasons in light of the evolving pandemic. Results. 562 patients underwent randomization and started their assigned treatment (279, RDV;283, placebo). Baseline demographics and characteristics were balanced across arms. Overall, 52% were male, 44% were Hispanic/Latino ethnicity and 30% were ≥ 60 years old. The most common comorbidities were diabetes mellitus (62%), obesity (56%;median BMI, 30.7), and hypertension (48%). Median baseline SARS-CoV-2 RNA nasopharyngeal viral load was 6.2 log10 copies/mL. Treatment with RDV significantly reduced COVID-19 hospitalization or all-cause death by day 28 (HR, 0.13;95% CI, 0.03 - 0.59;p = 0.008;Table 1) compared to placebo. Participants receiving RDV also had significantly lower risk for COVID-19-related medically attended visits or all-cause death by day 28 compared to placebo (HR, 0.19;95% CI, 0.07 - 0.56;p = 0.002;Table 1). No deaths occurred in either arm by day 28. There was no difference between arms in time-weighted average change in nasopharyngeal viral loads from baseline up to day 7. The proportion of patients with AEs was similar between arms (Table 1);the most common AEs in the RDV arm were nausea (11%), headache (6%), and diarrhea (4%). Conclusion. A 3-day course of IV RDV was safe, well tolerated and highly effective at preventing COVID-19 related hospitalization or death in high-risk non-hospitalized COVID-19 patients.

3.
Obesity ; 29(SUPPL 2):189-190, 2021.
Article in English | EMBASE | ID: covidwho-1616053

ABSTRACT

Background: Individuals living in rural areas have higher obesity and obesity related co-morbidities than their urban counterparts. Understanding rural-urban differences associated with weight management may inform the development of effective weight management interventions for adults living in rural areas. Methods: The International Weight Control Registry (IWCR) is an online registry designed to assess factors contributing to successes and challenges with weight loss and weight loss maintenance across the world. We examined demographics, weight history and weight management strategies in a sample of urban and rural residents in the Midwestern U.S. (IA, IL, IN, KS, MI, MN, MO, ND, NE, OH, SD, WI). Participants were classified as rural or urban by the Rural-Urban Commuting Area Code. Analyses included Chi-square tests for proportions and independent t-test and Wilcoxon rank sum test for continuous variables. Results: The sample was 45% rural (n = 78 of a total N = 174) with a mean age of 50.3 years. Rural residents were more likely to be white, non-college graduates, and have lower family income compared with urban areas (p < 0.05). Rural and urban residents reported similar weight histories and strategies for weight management. Work-related physical activity was higher and weekday sitting time was lower in rural compared to urban residents (p < 0.01). These data could potentially be impacted by the relative number of residents working from home during COVID-19 (Urban: 59% vs. Rural: 37%, p < 0.05). Rural residents were more likely to report a lack of neighborhood walkability (p < 0.01) and healthy food availability (p < 0.05) compared with urban residents. Conclusions: These data suggest rural-urban differences in demographic characteristics, opportunity for leisure time physical activity, and the availability of heathy foods should be considered in the development of weight management interventions. The consistency of the observed findings will be evaluated at the regional, national and international levels as the size of the available sample in the IWCR increases.

4.
Journal of Eating Disorders ; 9(SUPPL 1):1, 2021.
Article in English | Web of Science | ID: covidwho-1576255
5.
Journal of Aging Science ; 9(Suppl 7), 2021.
Article in English | MEDLINE | ID: covidwho-1513649

ABSTRACT

Multiple lines of evidence currently indicate that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) gains entry into human host cells via a high-affinity interaction with the angiotensin-converting enzyme 2 (ACE2) transmembrane receptor. Research has further shown the widespread expression of the ACE2 receptor on the surface of many different immune, non-immune and neural host cell types, and that SARS-CoV-2 has the remarkable capability to attack many different types of human-host cells simultaneously. One principal neuroanatomical region for high ACE2 expression patterns occurs in the brainstem, an area of the brain containing regulatory centers for respiration, and this may in part explain the predisposition of many COVID-19 patients to respiratory distress. Early studies also indicated extensive ACE2 expression in the whole eye and the brain's visual circuitry in aged humans. In this study we analyzed ACE2 receptor expression at the mRNA and protein level in multiple cell types involved in human vision, including cell types of the external eye and several deep brain regions known to be involved in the processing of visual signals. Here we provide evidence: (i) that many different optical and neural cell types of the human visual system provide receptors essential for SARS-CoV-2 invasion;(ii) of the remarkable ubiquity of ACE2 presence in cells of the eye and anatomical regions of the brain involved in visual signal processing;(iii) that ACE2 receptor expression in different ocular cell types and visual processing centers of the brain provide multiple compartments for SARS-CoV-2 infiltration;and (iv) of a gradient of increasing ACE2 expression from the anterior surface of the eye to the visual signal processing areas of the occipital lobe and the primary visual neocortex. A gradient of ACE2 expression from the eye surface to the occipital lobe may provide the SARS-CoV-2 virus a novel pathway from the outer eye into deeper anatomical regions of the brain involved in vision. These findings may explain, in part, the many recently reported neuro-ophthalmic manifestations of SARS-CoV-2 infection in COVID-19 affected patients.

6.
Proceedings of the ACM on Human-Computer Interaction ; 5(CHIPLAY), 2021.
Article in English | Scopus | ID: covidwho-1480309

ABSTRACT

COVID-19 exposed the need to identify newer tools to understand perception of information, behavioral conformance to instructions and model the effects of individual motivation and decisions on the success of measures being put in place. We approach this challenge through the lens of serious games. Serious games are designed to instruct and inform within the confines of their magic circle. We built a multiplayer serious game, Point of Contact (PoC), to investigate effects of a serious game on perception and behavior. We conducted a study with 23 participants to gauge perceptions of COVID-19 preventive measures and quantify the change after playing PoC. The results show a significant positive change to participants' perceptions towards COVID-19 preventive measures, shifting perceptions towards following guidelines more strictly due to a greater awareness of how the virus spreads. We discuss these implications and the value of a serious game like PoC towards pandemic risk modelling at a microcosm level. © 2021 ACM.

7.
Ground-Based and Airborne Instrumentation for Astronomy VIII 2020 ; 11447, 2020.
Article in English | Scopus | ID: covidwho-1270870

ABSTRACT

Presented here is a review of the status of facility instruments at the Large Binocular Telescope Observatory (LBTO). These include: the prime-focus optical Large Binocular Cameras (LBCs);optical Multi-Object Double Spectrograph (MODS) for imaging and spectroscopy;and the two LBT Utility Camera in the Infrared (LUCIs) for imaging and spectroscopy, which include the commissioning of the Single conjugated adaptive Optics Upgrade for LBT (SOUL). Recently, the Potsdam Echelle Polarietric and Spectroscopic Instrument (PEPSI), a fiber-fed high resollution optical echelle spectrograph with polarimetry capabilities, has transitioned from a Principal Investigator (PI) instrument to a facility instrument. We discuss the”binocular lifestyle” including the unique challenges of using LBT in three ways: Duplex mode, with identical configurations on both sides (effectively an 11.8 meter mirror);Fraternal Twin (same instruments with different configurations) or Mixed mode, (different instruments on each side) which gives observers two 8.4 meter telescopes to use;or 22.65 meters in interferometry (LBTI) mode. We also review recent changes in nighttime operations at the observatory in response to the COVID-19 pandemic and plans for the implementation of the Health and Instrument Performance plan for the Observatory (HIPO), a program to proactively monitor the health and stability of the facility instruments. © 2020 SPIE

8.
Emergency Medicine Journal ; 37(12):847-848, 2020.
Article in English | EMBASE | ID: covidwho-1146590

ABSTRACT

Aims/Objectives/Background Self-harm among adolescents is a major concern both because it gives rise to considerable distress and disruption in young people's lives and it commonly recurs. There are currently wide variations in the care of this group of patients and it is widely reported that their experience in the emergency department is poor. Young people who have self-harmed may differ from others attending the ED and we need to know more about these differences to inform ED care and potential improvements. The aim of this study was to establish the needs and expectations among children and young people in the ED and to increase the understanding of the specific needs of adolescents who self-harm through comparison with another patient group in the ED. Methods/Design We undertook a case-control study with adolescents attending for suspected fractures serving as the control group. Adolescents and their guardians were each given a questionnaire pack on arrival in ED, and again at least 2 hours later, thus capturing their expectations and pre-existing characteristics, and their experience. Trained research assistants were present in the ED seven days a week and covered 10 am till 10 pm. The study commenced in July 2019 and terminated early in March 2020 at the onset of the COVID 19 pandemic. Results/Conclusions Young people who had self-harmed had significantly higher mean dissatisfaction scores than those with suspected fractures. They also had higher mean levels of emotional and interpersonal difficulties and these were associated with higher dissatisfaction scores. This is the first case-control study to show that dissatisfaction with the ED is at least partly a function of the particular mental health problems suffered by adolescents who self-harm. This in turn provides initial clues to the particular needs of this group of patients in whom the current management is widely reported as inadequate.

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