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1.
PLoS One ; 18(5): e0284716, 2023.
Article in English | MEDLINE | ID: covidwho-20237945

ABSTRACT

Identifying the spatial patterns of genetic structure of influenza A viruses is a key factor for understanding their spread and evolutionary dynamics. In this study, we used phylogenetic and Bayesian clustering analyses of genetic sequences of the A/H1N1pdm09 virus with district-level locations in mainland China to investigate the spatial genetic structure of the A/H1N1pdm09 virus across human population landscapes. Positive correlation between geographic and genetic distances indicates high degrees of genetic similarity among viruses within small geographic regions but broad-scale genetic differentiation, implying that local viral circulation was a more important driver in the formation of the spatial genetic structure of the A/H1N1pdm09 virus than even, countrywide viral mixing and gene flow. Geographic heterogeneity in the distribution of genetic subpopulations of A/H1N1pdm09 virus in mainland China indicates both local to local transmission as well as broad-range viral migration. This combination of both local and global structure suggests that both small-scale and large-scale population circulation in China is responsible for viral genetic structure. Our study provides implications for understanding the evolution and spread of A/H1N1pdm09 virus across the population landscape of mainland China, which can inform disease control strategies for future pandemics.


Subject(s)
Influenza A Virus, H1N1 Subtype , Influenza, Human , Humans , Influenza, Human/epidemiology , Influenza, Human/genetics , Influenza A Virus, H1N1 Subtype/genetics , Phylogeny , Bayes Theorem , China/epidemiology
2.
Head Neck ; 42(6): 1243-1247, 2020 06.
Article in English | MEDLINE | ID: covidwho-125248

ABSTRACT

The 2019 novel coronavirus (COVID-19) pandemic has created significant challenges to the delivery of care for patients with advanced head and neck cancer requiring multimodality therapy. Performing major head and neck ablative surgery and reconstruction is a particular concern given the extended duration and aerosolizing nature of these cases. In this manuscript, we describe our surgical approach to provide timely reconstructive care and minimize infectious risk to the providers, patients, and families.


Subject(s)
Coronavirus Infections/epidemiology , Disease Transmission, Infectious/prevention & control , Head and Neck Neoplasms/surgery , Outcome Assessment, Health Care , Pandemics/statistics & numerical data , Plastic Surgery Procedures/methods , Pneumonia, Viral/epidemiology , Academic Medical Centers , COVID-19 , Clinical Decision-Making , Coronavirus Infections/prevention & control , Female , Head and Neck Neoplasms/pathology , Humans , Interdisciplinary Communication , Male , Neck Dissection/methods , Occupational Health , Pandemics/prevention & control , Patient Safety , Patient Selection , Pennsylvania , Pneumonia, Viral/prevention & control , Postoperative Care/methods , Preoperative Care/methods , Risk Assessment , Surgical Flaps/transplantation
3.
Head Neck ; 42(6): 1310-1316, 2020 06.
Article in English | MEDLINE | ID: covidwho-116760

ABSTRACT

Multidisciplinary conferences (MDC) are an important component of head and neck oncologic care including diagnosis, treatment, and survivorship. Virtual MDC allows for improved collaboration between providers at distant sites and proper allocation of health care resources in a time of crisis. When approached systematically, a virtual MDC is feasible to design and implement in a large academic medical center with multiple satellite hospitals.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Medical Oncology/organization & administration , Pandemics/prevention & control , Patient Care Team/organization & administration , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Telemedicine/organization & administration , Academic Medical Centers , COVID-19 , Coronavirus Infections/epidemiology , Humans , Pennsylvania , Pneumonia, Viral/epidemiology , SARS-CoV-2
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