ABSTRACT
The emergence of the XBB.1.16 Omicron subvariant of COVID-19 has been a cause for concern for the WHO and health authorities globally. This subvariant, which originated from a hybrid of two BA.2 progeny pedigree, has two amino acid mutations in its spike protein and shares a genetic makeup similar to the XBB.1.5 variant. The WHO initially labeled it as a variant under monitoring before elevating it to a variant of interest after it was found to have caused a surge of COVID-19 cases in India for seven months. The XBB.1.16 subvariant has a proliferative edge and can evade the immune system. It has been spreading rapidly on a global scale and has been linked with a higher effective reproductive number than other subvariants. As such, a concerted international effort to prevent and contain its transmission has been recommended. Health authorities must strengthen their health systems, surveillance, and data collection systems to enable them to detect, track, and respond to emerging and reemerging strains of the virus in a timely and effective manner. Research into the XBB.1.16 subvariant is crucial for alerting and preparing the global populace for a potential outbreak, developing treatment options, and potential vaccines. Implementing the One Health approach can promote greater collaboration between diverse disciplines and societal levels to build a more resilient and sustainable future for all.
ABSTRACT
Vaccines are one of the most successful tools for protecting the public's health. However, widespread vaccine hesitancy in the Southern United States is preventing effective mitigation of the current COVID-19 pandemic. The purpose of this study was to assess COVID-19 vaccine acceptance among adults living in a largely rural Southern state. This cross-sectional study collected data from 1,164 Arkansas residents between October 3 and October 17, 2020 using random digit dialing. The primary outcome was a multidimensional COVID-19 vaccine acceptance measure with scores between -3 to +3. The full COVID-19 vaccine acceptance scale was measured along with perceived vaccine safety, effectiveness, acceptance, value, and legitimacy subscales. Statistical analyses were conducted using multivariable linear regression. Results indicated Black participants had the lowest overall vaccine acceptance (0.5) compared to White participants (1.2). Hispanic participants had the highest scores (1.4). In adjusted models, Black participants had 0.81 points lower acceptance than White participants, and Hispanic participants had 0.35 points higher acceptance. Hispanic participants had the highest scores for all five vaccine acceptance subscales, relatively equivalent to White participants. Black participants had consistently lower scores, especially perceived vaccine safety (mean -0.2, SD 0.1). In conclusion, the lowest vaccine acceptance rates were among Black participants particularly on perceived vaccine safety. While Black participants had the lowest acceptance scores, Hispanic participants had the highest. This variability shows the value of a multidimensional vaccine acceptance measure to inform COVID-19 vaccination campaign strategies.
Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , Humans , Arkansas/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Pandemics , Race Factors , VaccinationABSTRACT
It has been three years since SARS-CoV-2 emerged and the world plunged into a \"once in a century\" pandemic. Since then, multiple waves of infection have swept through the human population, led by variants that were able to evade any acquired immunity. The co-evolution of SARS-CoV-2 variants with human immunity provides an excellent opportunity to study the interaction between viral pathogens and their human hosts. The heavily N-glycosylated spike-protein of SARS-CoV-2 plays a pivotal role in initiating infection and is the target for host immune response, both of which are impacted by host-installed N-glycans. We compared the N-glycan landscape of recombinantly expressed, stabilized, soluble spike-protein trimers representing seven of the most prominent SARS-CoV-2 variants and found that N-glycan processing is conserved at most sites. However, in multiple variants, processing of N-glycans from high mannose- to complex-type is reduced at sites N165, N343 and N616, implicated in spike-protein function.
ABSTRACT
Intravenous (IV) drugs are administered through infusion pumps and IV administration sets for patients who are seen in healthcare settings. There are multiple areas of the medication administration process that can influence the amount of a drug a patient receives. For example, IV administration sets that deliver a drug from an infusion bag to a patient vary in terms of length and bore. In addition, fluid manufacturers report that the total acceptable volume range for a 250 mL bag of normal saline can be anywhere from 265 to 285 mL. At the institution chosen for our study, each 50 mg vial of eravacycline is reconstituted using 5 mL of diluent, and the total dose is administered as a 250 mL admixture. This single-center, retrospective, quasi-experimental study evaluated the residual medication volume after the completion of an IV eravacycline infusion in patients admitted during the pre-intervention study period compared to those in the post-intervention study period. The primary outcome of the study was to compare the residual antibiotic volume remaining in the bags following IV infusions of eravacycline before and after the implementation of interventions. The secondary outcomes included the following: comparing the amount of the drug lost in the pre- and post-intervention periods, determining whether the amount of residual volume was affected by nursing shifts (day versus night), and lastly assessing the cost of facility drug waste. On average, approximately 15% of the total bag volume was not infused during the pre-intervention period, which was reduced to less than 5% in the post-intervention period. Clinically, the average estimated amount of eravacycline discarded decreased from 13.5 mg to 4.7 mg in the pre- and post-intervention periods, respectively. Following the statistically significant results of this study, the interventions were expanded at this facility to include all admixed antimicrobials. Further studies are needed to determine the potential clinical impact when patients do not receive complete antibiotic infusions.
ABSTRACT
Background: Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is a potential complication in critically ill COVID-19 patients. Corticosteroids are standard of care for hospitalized COVID-19 patients but carry an increased risk of secondary infections including CAPA. The objective of this study was to evaluate if duration of corticosteroid therapy ≤10â days versus >10â days affects the risk of developing CAPA. Methods: This was a retrospective cohort study of adult patients with severe COVID-19 pneumonia requiring mechanical ventilation who received at least 3â days of corticosteroid treatment. Incidence of CAPA and secondary outcomes were compared using appropriate bivariable analyses. Steroid duration was evaluated as an independent predictor in a logistic regression model. Results: A total of 278 patients were included (n = 169 for ≤10â days' steroid duration; n = 109 for >10â days). CAPA developed in 20 of 278 (7.2%) patients. Patients treated with >10â days of corticosteroid therapy had significantly higher incidence of CAPA (11.9% vs 4.1%; P = .0156), and steroid duration >10â days was independently associated with CAPA (odds ratio, 3.17 [95% confidence interval, 1.02-9.83]). Secondary outcomes including inpatient mortality (77.1% vs 43.2%; P < .0001), mechanical ventilation-free days at 28 days (0 vs 1.5; P < .0001), and secondary infections (44.9% vs 28.4% P = .0220) were worse in the >10â days cohort. Conclusions: Corticosteroid treatment >10â days in critically ill COVID-19 patients is associated with an increased risk of CAPA. Patients may require corticosteroids for reasons beyond COVID-19 and clinicians should be cognizant of risk of CAPA with prolonged courses.
ABSTRACT
Is left-wing authoritarianism (LWA) closer to a myth or a reality? Twelve studies test the empirical existence and theoretical relevance of LWA. Study 1 reveals that both conservative and liberal Americans identify a large number of left-wing authoritarians in their lives. In Study 2, participants explicitly rate items from a recently-developed LWA measure as valid measurements of authoritarianism. Studies 3-11 show that persons who score high on this same LWA scale possess the traits associated with models of authoritarianism: LWA is positively related to threat sensitivity across multiple areas, including general ecological threats (Study 3), COVID disease threat (Study 4), Belief in a Dangerous World (Study 5), and Trump threat (Study 6). Further, high-LWA persons show more support for restrictive political correctness norms (Study 7), rate African-Americans and Jews more negatively (Studies 8-9), and show more cognitive rigidity (Studies 10 and 11). These effects hold when controlling for political ideology and when looking only within liberals, and further are similar in magnitude to comparable effects for right-wing authoritarianism. Study 12 uses the World Values Survey to provide cross-cultural evidence of Left-Wing Authoritarianism around the globe. Taken in total, this large array of triangulating evidence from 12 studies comprised of over 8,000 participants from the U.S. and over 66,000 participants world-wide strongly suggests that left-wing authoritarianism is much closer to a reality than a myth.
ABSTRACT
INTRODUCTION: The Philippine CORONA Study was a multicenter, retrospective, cohort study of 10,881 coronavirus disease 2019 (COVID-19) admissions between February and December 2020. METHODS: Subgroup analysis was done on clinical outcomes of mortality, respiratory failure, duration of ventilator dependence, intensive care unit (ICU) admission, length of ICU stay, and length of hospital stay among older persons and persons with dementia. RESULTS: The adjusted hazard ratios for mortality among the mild and severe cases were significantly higher by 3.93, 95% CI [2.81, 5.50] and by 1.81, 95% CI [1.43, 2.93], respectively, in older persons compared to younger adults. The adjusted hazard ratios for respiratory failure in older persons were increased by 2.65, 95% CI [1.92, 3.68] and by 1.27, 95% CI [1.01, 1.59] among the mild and severe cases, respectively. The adjusted hazard ratio for ICU admission in older persons was higher by 1.95, 95% CI [1.47, 2.59] among the mild cases. The adjusted hazard ratios for mortality and ICU admission in persons with dementia were higher by 7.25, 95% CI [2.67, 19.68] and by 4.37, 95% CI [1.08, 17.63], respectively, compared to those without dementia. CONCLUSION: Older age and dementia significantly increased the risk of mortality, respiratory failure, and ICU admission among COVID-19 patients.