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1.
Environ Sci Pollut Res Int ; 2022 May 30.
Article in English | MEDLINE | ID: covidwho-1872662

ABSTRACT

Lianhuaqingwen (LH), one traditional Chinese medicine (TCM), has been used to treat the coronavirus disease 2019 (COVID-19), but its ecotoxicity with potential human health security has not been well investigated. To overcome such adverse effects and improve its medication efficacy, an intelligent multi-method integrated dietary scheme, screening, and performance evaluation approach was developed. Thirteen LH compounds were selected, and the main protease (Mpro) was used as the potential drug target. Resulted information showed that the more compounds of LH added, the higher medication efficacy obtained using multi-method integrated screening system, expert consultation method, and molecular dynamics simulation. Pharmacodynamic mechanism analysis showed that low total energy and polar surface area of LH active compound (i.e., ß-sitosterol) will contribute to the best therapeutic effect on COVID-19 using quantitative structure-activity relationships (QSAR) and sensitivity models. Additionally, when mild COVID-19 patients take LH with the optimum dietary scheme (i.e., ß-lactoglobulin, α-lactalbumin, vitamin A, vitamin B, vitamin C, carotene, and vitamin E), the medication efficacy were significantly improved (23.58%). Pharmacokinetics and toxicokinetics results showed that LH had certain human health risks and ecotoxicity. This study revealed the multi-compound interaction mechanism of LH treatment on COVID-19, and provided theoretical guidance for improving therapeutic effect, evaluating TCM safety, and preventing human health risk.

2.
Frontiers in public health ; 10, 2022.
Article in English | EuropePMC | ID: covidwho-1872003

ABSTRACT

Background With promotion of COVID-19 vaccinations, there has been a corresponding vaccine hesitancy, of which older adolescents and young adults represent groups of particular concern. In this report, we investigated the prevalence and reasons for vaccine hesitancy, as well as potential risk factors, within older adolescents and young adults in China. Methods To assess these issues, an online survey was administered over the period from March 14 to April 15, 2021. Older adolescents (16–17 years old) and young adults (18–21 years old) were recruited nationwide from Wechat groups and results from a total of 2,414 respondents were analyzed. Socio-demographic variables, vaccine hesitancy, psychological distress, abnormal illness behavior, global well-being and social support were analyzed in this report. Results Compared to young adults (n = 1,405), older adolescents (n = 1,009) showed higher prevalence rates of COVID-19 vaccine hesitancy (16.5 vs. 7.9%, p < 0.001). History of physical diseases (p = 0.007) and abnormal illness behavior (p = 0.001) were risk factors for vaccine hesitancy among older adolescents, while only a good self-reported health status (p = 0.048) was a risk factor for young adults. Concerns over COVID-19 vaccine side effects (67.1%) and beliefs of invulnerability regarding infection risk (41.9%) were the most prevalent reasons for vaccine hesitancy. Providing evidence on the vaccine reduction of COVID-19 infection risk (67.5%), ensuring vaccine safety (56.7%) and the low risk of side effects (52.7%) were the most effective persuasions for promoting vaccinations. Conclusion In China, older adolescents showed a higher prevalence for vaccine hesitancy than that of young adults. Abnormal illness behavior and history of physical diseases were risk factors for vaccine hesitancy among these older adolescents, while social support represents an important factor which could help to alleviate this hesitancy.

3.
Biomed Res Int ; 2022: 4284146, 2022.
Article in English | MEDLINE | ID: covidwho-1807688

ABSTRACT

Background: It is of vital importance to determine the safety of drugs. Pregnant women, as a special group, need to evaluate the effects of drugs on pregnant women as well as the fetus. The use of drugs during pregnancy may be subject to fetal toxicity, thus affecting the development of the fetus or even leading to stillbirth. The U.S. Food and Drug Administration (FDA) issued a toxicity rating for drugs used during pregnancy in 1979. These toxicity ratings are denoted by the letters A, B, C, D, and X. However, the query of drug pregnancy category has yet to be well established as electronic service. Results: Here, we presented PregTox, a publicly accessible resource for pregnancy category information of 1114 drugs. The PregTox database also included chemical structures, important physico-chemical properties, protein targets, and relevant signaling pathways. An advantage of the database is multiple search options which allow systematic analyses. In a case study, we demonstrated that a set of chemical descriptors could effectively discriminate high-risk drugs from others (area under ROC curve reached 0.81). Conclusions: PregTox can serve as a unique drug safety data source for drug development and pharmacological research.


Subject(s)
Drug-Related Side Effects and Adverse Reactions , Female , Fetus , Humans , Pharmaceutical Preparations , Pregnancy , Prenatal Care , Stillbirth
4.
J Evid Based Med ; 15(1): 30-38, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1784678

ABSTRACT

OBJECTIVE: To evaluate the effectiveness and safety of Qingjin Yiqi granules (QJYQ) on post-COVID-19 condition (PCC). METHOD: Patients who met the inclusion criteria were randomly assigned to two groups, the QJYQ group received QJYQ combined with standard rehabilitation treatments (SRTs) and the control group only received SRTs. The treatment course was 14 days. The primary outcomes were modified Medical Research Council (mMRC) scale and Borg scale, while the secondary outcomes included symptoms score and 6-minute walking distance (6MWD). The safety outcome was the incidence of adverse events. RESULTS: A total of 388 patients with PCC were enrolled and randomly assigned to the QJYQ group (n = 194) and the control group (n = 194). Compared to the controls, the mMRC scale was improved in the QJYQ group, which was better than that of the control group [ß (95%CI): -0.626 (-1.101, -0.151), p = 0.010]. A significant improvement in Borg scale was also observed in the QJYQ group compared to the control group [ß (95%CI): -0.395(-0.744, -0.046), p = 0.026]. There was no statistically significant difference in symptoms score and 6MWD between the two groups (p = 0.293, p = 0.724). No treatment-related adverse events were observed in either group. CONCLUSIONS: QJYQ can bring benefits to patients with PCC, mainly in the improvement of breathlessness and fatigue.


Subject(s)
COVID-19 , COVID-19/drug therapy , Humans , Treatment Outcome
5.
Atmospheric Chemistry and Physics ; 22(7):4853-4866, 2022.
Article in English | ProQuest Central | ID: covidwho-1786221

ABSTRACT

The outbreak of COVID-19 promoted strict restrictions to human activities in China, which led to a dramatic decrease in most air pollutant concentrations (e.g., PM2.5, PM10, NOx, SO2 and CO). However, an obvious increase in ozone (O3) concentrations was found during the lockdown period in most urban areas of China. In this study, we conducted field measurements targeting ozone and its key precursors by utilizing a novel proton transfer reaction time-of-flight mass spectrometer (PTR-TOF-MS) in Changzhou, which is representative of the Yangtze River Delta (YRD) city cluster of China. We further applied the integrated methodology including machine learning, an observation-based model (OBM) and sensitivity analysis to obtain insights into the reasons causing the obvious increase in ozone. Major findings include the following: (1) by deweathered calculation, we found changes in precursor emissions contributed 1.46 ppbv to the increase in the observed O3 during the full-lockdown period in 2020, while meteorology constrained 3.0 ppbv of O3 in the full-lockdown period of 2019. (2) By using an OBM, we found that although a significant reduction in O3 precursors was observed during the full-lockdown period, the photochemical formation of O3 was stronger than that during the pre-lockdown period. (3) The NOx/VOC ratio dropped dramatically from 1.84 during the pre-lockdown to 0.79 in the full-lockdown period, which switched O3 formation from a VOC-limited regime to the boundary of a NOx- and VOC-limited regime. Additionally, box model results suggested that the decrease in the NOx/VOC ratio during the full-lockdown period could increase the mean O3 by 2.4 ppbv. Results of this study give insights into the relationship between O3 and its precursors in urban area and demonstrate reasons for the obvious increase in O3 in most urban areas of China during the COVID-19 lockdown period. This study also underlines the necessity of controlling anthropogenic oxygenated volatile organic compounds (OVOCs), alkenes and aromatics in the sustained campaign of reducing O3 pollution in China.

6.
Frontiers in cellular and infection microbiology ; 12, 2022.
Article in English | EuropePMC | ID: covidwho-1762433

ABSTRACT

Objective To evaluate the necessity of Covid-19 vaccination in children aged < 12 y by comparing the clinical characteristics between unvaccinated children aged < 12 y and vaccinated patients aged ≥ 12y during the Delta surge (B.1.617.2) in Putian, Fujian, China. Methods A total of 226 patients with SARS-Cov-2 Delta variant (B.1.167.2;confirmed by Real-time PCR positivity and sequencing) were enrolled from Sep 10th to Oct 20th, 2021, including 77 unvaccinated children (aged < 12y) and 149 people aged ≥ 12y, mostly vaccinated. The transmission route was explored and the clinical data of two groups were compared;The effect factors for the time of the nucleic acid negativization (NAN) were examined by R statistical analysis. Results The Delta surge in Putian spread from children in schools to factories, mostly through family contact. Compared with those aged ≥ 12y, patients aged < 12y accounted for 34.07% of the total and showed milder fever, less cough and fatigue;they reported higher peripheral blood lymphocyte counts [1.84 (1.32, 2.71)×10

7.
J Telemed Telecare ; : 1357633X221086447, 2022 Mar 16.
Article in English | MEDLINE | ID: covidwho-1745575

ABSTRACT

INTRODUCTION: We examined the coronavirus disease 2019 (COVID-19) pandemic impact on weekly trends in the billing of virtual and in-person physician visits in Ontario, Canada. METHODS: In this retrospective cohort study, physician billing records from Ontario were aggregated on a weekly basis for in-person and virtual visits from 3 January 2016 to 27 March 2021. For each type of visit, a segmented negative binomial regression analysis was performed to estimate the weekly pre-pandemic trend in billing volume per thousand adults (3 January 2016 to 14 March 2020), the immediate change in mean volume at the start of the pandemic, and additional change in weekly volume in the pandemic era (15 March 2020 to 27 March 2021). RESULTS: Before the start of the pandemic, the weekly volume of virtual visits per thousand adults was low with a 0.5% increase per week (rate ratio [RR]: 1.0053, 95% confidence interval [CI]: 1.0050-1.0056). A dramatic 65% reduction in in-person visits (RR: 0.35, 95% CI: 0.32-0.39) occurred at the start of the pandemic while virtual visits grew by 21-fold (RR: 21.3, 95% CI: 19.6-23.0). In the pandemic era, in-person visits rose by 1.4% per week (RR: 1.014, 95% CI: 1.011-1.017) but no change was observed for virtual visits (p-value = 0.31). Overall, we noted a 57.6% increase in total weekly physician visits volume after the start of the pandemic. DISCUSSION: These results are meaningful for virtual care reimbursement models. Future study needs to assess the quality of care and whether the increase in virtual care volume is cost-effective to society.

8.
Curr Oncol ; 29(3): 1877-1889, 2022 03 10.
Article in English | MEDLINE | ID: covidwho-1742359

ABSTRACT

Emergency department (ED) use is a concern for surgery patients, physicians and health administrators particularly during a pandemic. The objective of this study was to assess the impact of the pandemic on ED use following cancer-directed surgeries. This is a retrospective cohort study of patients undergoing cancer-directed surgeries comparing ED use from 7 January 2018 to 14 March 2020 (pre-pandemic) and 15 March 2020 to 27 June 2020 (pandemic) in Ontario, Canada. Logistic regression models were used to (1) determine the association between pandemic vs. pre-pandemic periods and the odds of an ED visit within 30 days after discharge from hospital for surgery and (2) to assess the odds of an ED visit being of high acuity (level 1 and 2 as per the Canadian Triage and Acuity Scale). Of our cohort of 499,008 cancer-directed surgeries, 468,879 occurred during the pre-pandemic period and 30,129 occurred during the pandemic period. Even though there was a substantial decrease in the general population ED rates, after covariate adjustment, there was no significant decrease in ED use among surgical patients (OR 1.002, 95% CI 0.957-1.048). However, the adjusted odds of an ED visit being of high acuity was 23% higher among surgeries occurring during the pandemic (OR 1.23, 95% CI 1.14-1.33). Although ED visits in the general population decreased substantially during the pandemic, the rate of ED visits did not decrease among those receiving cancer-directed surgery. Moreover, those presenting in the ED post-operatively during the pandemic had significantly higher levels of acuity.


Subject(s)
COVID-19 , Neoplasms , COVID-19/epidemiology , Emergency Service, Hospital , Humans , Neoplasms/epidemiology , Neoplasms/surgery , Ontario/epidemiology , Pandemics , Retrospective Studies
10.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324246

ABSTRACT

COVID-19 emerged as the most lethal pandemic in the last century. Although it can affect persons with any age, patients with advanced age represent a significantly higher fraction of severe disease. The molecular and cellular mechanisms that render patients with advanced age susceptible to severe disease remains unknown. Here we revealed that older subjects (>=30 years) had significantly elevated levels of anti-inflammatory cytokine IL-10, but no change in any of the pro-inflammatory cytokines. While an expansion of NKT cell fraction was observed in older patients, a decrease in CD8+ T cell fraction was observed in these patients. In addition, older subjects had a delayed humoral response measured as IgM and IgG levels. Overall, these patients had significantly elevated viral load compared to young subjects. These data demonstrate altered early inflammatory and antiviral responses contributing to the age-related susceptibility to COVID-19.Funding Statement: This study was supported by funding from Beijing Nova Program Interdisciplinary Cooperation Project (DC;No. Z191100001119021), Chinese PLA General Hospital Youth Project (DC;No.QNF19074) and China 13th Five-year National Key Grant (LXX;No.2018ZX09201013). Declaration of Interests: The authors declare that there are no competing interests.Ethics Approval Statement: This study was approved by the ethics committee of Guangzhou Eighth People’s Hospital, with a waiver of informed consent.

11.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-318920

ABSTRACT

Background: Moderate cases account for the majority in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and can also progress to severe/critical condition. Here, we investigated the clinical course and management of hospitalized moderate SARS-CoV-2 patients. Methods: : The medical records and follow-up data were analyzed from the SARS-CoV-2 patients outside Wuhan. Results: : A total of 73 moderate patients (38 men, 35 women) were included, with median age of 47.0 (38.5-57.5) years. Among them, only one patient (1.4%) died using active treatment to improve symptoms. The median duration of the four main symptoms cough, fever, chest tightness, and fatigue were about 1-2 weeks;the median duration of the positive nucleic acid test (NAT) results for SARS-CoV-2 was slightly more than 2 weeks;the median hospitalization time was almost four weeks in 72 moderate survivors. The duration of cough and fever was positively correlated with the duration of the positive NAT results. On admission, 50% had lymphopenia;less than 30% had abnormal blood biochemistry findings involving hyperglycemia, liver function and myocardial enzymes. At discharge, the laboratory indexes were substantially improved. Two weeks after discharge, 5.6% survivors experienced a recurrence of the positive NAT results. Conclusions: : Moderate SARS-CoV-2 patients have a good prognosis by the active treatment. After discharge, it is necessary that moderate survivors undergo at least a 2-week collective medical observation in quarantine places, which can identify and treat a proportion of patients with re-positive NAT results and to prevent the spread of the potential sources of infection.

12.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-317972

ABSTRACT

Background: An outbreak of novel coronavirus disease 2019 (COVID-19) is a newly discovered contagious disease, which first broke out in China.Based on the psychological state, maintenance hemodialysis (MHD) patients might bear psychological problemsunder the COVID-19epidemic situation.To evaluate the psychological health of MHDpatients and explore the corresponding intervention strategies. Methods: Acluster sampling approach was employed to obtain a sample of 206 MHD patients from two hospitals in Yunnan province: a COVID-19-designated hospital and a non-COVID-19-designated hospital. Post-traumatic stress disorder (PTSD) checklistwas used to assess the psychological status,while Kidney Diseaseand Quality of Life --Short Form(KDQOL-SF)was applied to assess the quality of life(QOL). The factorsinfluencing thepsychological status in MHD patients were employed by binary logistic regression. Results: Among MHD participants (age 53.4 ± 15.3 years), 61 cases showed mild to moderate positive PTSD, and 72 casespresented severe positive PTSD.The level of education, capital income, hospital, depressive tendency, and QOL were the influence factors for the occurrence of PTSD. Moreover, the PTSD was negatively correlated with QOL and positively correlated with COVID-19-designated hospital and the depressive tendency. Conclusion: During the COVID-19 epidemic, MHD patients, especially in COVID-19-designated hospitals, with low QOL and depressive tendency had a high incidence of positive PTSD, which requires prompt psychological counseling and effective measures from medical staff to ensure timely treatment of patients.

13.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-308148

ABSTRACT

Purpose: To assess the psychological effects of the novel coronavirus disease (COVID-19) on medical staff and the general public. Methods: : During the outbreak of COVID-19, an internet-based questionnaire included The Self-rating Depression Scale (SDS), Perceived Stress Scale (PSS-10), and Impact of Event Scale-Revised (IES-R) was used to assess the impact of the epidemic situation on the mental health of medical staff and general population in Wuhan and its surrounding areas. Results: : The results suggest that the outbreak of COVID-19 has affected individuals significantly, the degree of which is related to age, sex, occupation and mental illness. There was a significant difference in PSS-10 and IES-R scores between the medical staff and the general population. The medical staff showed higher PSS-10 scores (16.813 ± 4.87) and IES-R scores (22.40 ± 12.12) compared to members of the general population PSS-10 (14.80 ± 5.60) and IES-R scores (17.89 ± 13.08). However, there was no statistically significant difference between the SDS scores of medical staff (44.52 ± 12.36) and the general public (43.08 ± 11.42). In terms of the need for psychological assistance, 50.97% of interviewees responded that they needed psychological counseling, of which medical staff accounted for 65.87% and non-medical staff accounted for 45.10%. Conclusion: During the ongoing COVID-19 outbreak, great attention should be paid to the mental health of the population, especially medical staff, and measures such as psychological intervention should be actively carried out for reducing the psychosocial effects.

14.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324848

ABSTRACT

The prolonged lockdown imposed to contain the COVID-19 pandemic prevented many people from direct contact with nature and greenspaces, raising alarms for a possible worsening of mental health. This study investigates the effectiveness of a simple and affordable remedy for improving psychological well-being, based on audio-visual stimuli brought by a short computer video showing forest environments, with an urban video as a control. Randomly selected participants were assigned the forest or urban video, to look at and listen early in the morning, and filled questionnaires. In particular, the State-Trait Anxiety Inventory (STAI) Form Y, collected in baseline condition and at the end of the study, and the Part II of the Sheehan Patient Rated Anxiety Scale (SPRAS), collected every day immediately before and after watching the video. The virtual exposure to forest environments showed effective to reduce perceived anxiety levels in in people forced by lockdown in limited spaces and environmental deprivation. Although significant, the effects were observed only in the short term, highlighting the limitation of the virtual experiences. The reported effects might also represent a benchmark to disentangle the determinants of health effects due to real forest experiences, for example, the inhalation of biogenic volatile organic compounds (BVOC).

15.
J Natl Compr Canc Netw ; : 1-9, 2022 02 01.
Article in English | MEDLINE | ID: covidwho-1662814

ABSTRACT

BACKGROUND: Resource restrictions were established in many jurisdictions to maintain health system capacity during the COVID-19 pandemic. Disrupted healthcare access likely impacted early cancer detection. The objective of this study was to assess the impact of the pandemic on weekly reported cancer incidence. PATIENTS AND METHODS: This was a population-based study involving individuals diagnosed with cancer from September 25, 2016, to September 26, 2020, in Ontario, Canada. Weekly cancer incidence counts were examined using segmented negative binomial regression models. The weekly estimated backlog during the pandemic was calculated by subtracting the observed volume from the projected/expected volume in that week. RESULTS: The cohort consisted of 358,487 adult patients with cancer. At the start of the pandemic, there was an immediate 34.3% decline in the estimated mean cancer incidence volume (relative rate, 0.66; 95% CI, 0.57-0.75), followed by a 1% increase in cancer incidence volume in each subsequent week (relative rate, 1.009; 95% CI, 1.001-1.017). Similar trends were found for both screening and nonscreening cancers. The largest immediate declines were seen for melanoma and cervical, endocrinologic, and prostate cancers. For hepatobiliary and lung cancers, there continued to be a weekly decline in incidence during the COVID-19 period. Between March 15 and September 26, 2020, 12,601 fewer individuals were diagnosed with cancer, with an estimated weekly backlog of 450. CONCLUSIONS: We estimate that there is a large volume of undetected cancer cases related to the COVID-19 pandemic. Incidence rates have not yet returned to prepandemic levels.

16.
Pharmacol Res ; 177: 106092, 2022 03.
Article in English | MEDLINE | ID: covidwho-1639171

ABSTRACT

Kinsenoside (KD) exhibits anti-inflammatory and immunosuppressive effects. Dendritic cells (DCs) are critical regulators of the pathologic inflammatory milieu in liver fibrosis (LF). Herein, we explored whether and how KD repressed development of LF via DC regulation and verified the pathway involved in the process. Given our analysis, both KD and adoptive transfer of KD-conditioned DCs conspicuously reduced hepatic histopathological damage, proinflammatory cytokine release and extracellular matrix deposition in CCl4-induced LF mice. Of note, KD restrained the LF-driven rise in CD86, MHC-II, and CCR7 levels and, simultaneously, upregulated PD-L1 expression on DCs specifically, which blocked CD8+T cell activation. Additionally, KD reduced DC glycolysis, maintained DCs immature, accompanied by IL-12 decrease in DCs. Inhibiting DC function by KD disturbed the communication of DCs and HSCs with the expression or secretion of α-SMA and Col-I declined in the liver. Mechanistically, KD suppressed the phosphorylation of PI3K-AKT driven by LF or PI3K agonist, followed by enhanced nuclear transport of FoxO1 and upregulated interaction of FoxO1 with the PD-L1 promoter in DCs. PI3K inhibitor or si-IL-12 acting on DC could relieve LF, HSC activation and diminish the effect of KD. In conclusion, KD suppressed DC maturation with promoted PD-L1 expression via PI3K-AKT-FoxO1 and decreased IL-12 secretion, which blocked activation of CD8+T cells and HSCs, thereby alleviating liver injury and fibro-inflammation in LF.


Subject(s)
Hepatitis , Phosphatidylinositol 3-Kinases , 4-Butyrolactone/analogs & derivatives , Animals , B7-H1 Antigen , Dendritic Cells/metabolism , Forkhead Box Protein O1 , Inflammation/drug therapy , Interleukin-12 , Mice , Monosaccharides , Phosphatidylinositol 3-Kinases/metabolism , Proto-Oncogene Proteins c-akt/metabolism
18.
BMJ ; 375: e066588, 2021 12 08.
Article in English | MEDLINE | ID: covidwho-1560914

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of remote proactive management of toxicities during chemotherapy for early stage breast cancer. DESIGN: Pragmatic, cluster randomised trial. SETTING: 20 cancer centres in Ontario, Canada, allocated by covariate constrained randomisation to remote management of toxicities or routine care. PARTICIPANTS: All patients starting adjuvant or neoadjuvant chemotherapy for early stage breast cancer at each centre. 25 patients from each centre completed patient reported outcome questionnaires. INTERVENTIONS: Proactive, standardised, nurse led telephone management of common toxicities at two time points after each chemotherapy cycle. MAIN OUTCOME MEASURES: The primary outcome, cluster level mean number of visits to the emergency department or admissions to hospital per patient during the whole course of chemotherapy treatment, was evaluated with routinely available administrative healthcare data. Secondary patient reported outcomes included toxicity, self-efficacy, and quality of life. RESULTS: Baseline characteristics of participants were similar in the intervention (n=944) and control arms (n=1214); 22% were older than 65 years. Penetration (that is, the percentage of patients who received the intervention at each centre) was 50-86%. Mean number of visits to the emergency department or admissions to hospital per patient was 0.91 (standard deviation 0.28) in the intervention arm and 0.94 (0.40) in the control arm (P=0.94); 47% (1014 of 2158 patients) had at least one visit to the emergency department or a hospital admission during chemotherapy. Among 580 participants who completed the patient reported outcome questionnaires, at least one grade 3 toxicity was reported by 48% (134 of 278 patients) in the intervention arm and by 58% (163 of 283) in the control arm. No differences in self-efficacy, anxiety, or depression were found. Compared with baseline, the functional assessment of cancer therapy trial outcome index decreased by 6.1 and 9.0 points in the intervention and control participants, respectively. CONCLUSIONS: Proactive, telephone based management of toxicities during chemotherapy did not result in fewer visits to the emergency department or hospital admissions. With the rapid rise in remote care because of the covid-19 pandemic, identifying scalable strategies for remote management of patients during cancer treatment is particularly relevant. TRIAL REGISTRATION: ClinicalTrials.gov NCT02485678.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Breast Neoplasms/drug therapy , Monitoring, Ambulatory/methods , Outpatients , Telemedicine , Telephone , Adult , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Breast Neoplasms/psychology , COVID-19 , Chemotherapy, Adjuvant/adverse effects , Drug-Related Side Effects and Adverse Reactions , Emergency Service, Hospital/statistics & numerical data , Female , Humans , Middle Aged , Ontario , Pandemics , Quality of Life , SARS-CoV-2 , Surveys and Questionnaires , Treatment Outcome
19.
Front Public Health ; 9: 779720, 2021.
Article in English | MEDLINE | ID: covidwho-1528877

ABSTRACT

Introduction: With the approval of COVID-19 vaccinations for children and adolescents in China, parental vaccine hesitancy will emerge as a new challenge with regard to the administration of these vaccines. However, little is known regarding this hesitancy as well as regional differences that may exist between parents from Shandong vs. Zhejiang. Methods: To assess these issues, an online survey was conducted via a Wenjuanxing platform over the period from July 22 to August 14, 2021. Parents from Shandong and Zhejiang were recruited from Wechat groups and results from a total of 917 subjects were analyzed. Factors evaluated in this survey included socio-demographic variables, parental vaccine hesitancy, Parental Attitudes toward Childhood Vaccines (PACV) domains (behavior, safety and efficacy, general attitudes) and social support. Results: Compared with those from Shandong (N = 443), parents from Zhejiang (N = 474) showed significantly higher prevalence rates of COVID-19 vaccine hesitancy (19.4 vs. 11.7%, p = 0.001). Multivariate logistic regression showed that yearly household incomes of ≥120,000 RMB (p = 0.041), medical workers (p = 0.022) and general attitudes of PACV (p = 0.004) were risk factors for vaccine hesitancy among parents from Shandong, while behavior (p = 0.004), safety and efficacy (p < 0.001) and general attitudes of PACV (p = 0.002) were risk factors for parents from Zhejiang. Among parents with vaccine hesitancy (N = 144), concerns over side effects (91.0%) and unknown effects (84.0%) of the COVID-19 vaccine were the most prevalent reasons for hesitancy. Evidence providing proof of vaccine safety (67.4%) and assurance of a low risk of being infected by COVID-19 (60.4%) were the two most effective persuasive factors. Conclusion: Parents from Zhejiang showed a higher prevalence of COVID-19 vaccine hesitancy as compared with those from Shandong. Behavior, safety and efficacy, and general attitudes of PACV were the risk factors associated with this hesitancy in these parents from Zhejiang. Given the identification of the various reasons for parental vaccine hesitancy, different strategies as well as regional adjustments in these strategies will be required for an effective and convincing protocol for childhood vaccinations.


Subject(s)
COVID-19 , Vaccines , Adolescent , COVID-19 Vaccines , Child , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Humans , Parents , Patient Acceptance of Health Care , SARS-CoV-2 , Vaccination , Vaccines/adverse effects
20.
COVID-19 in the Environment ; : 325-344, 2022.
Article in English | ScienceDirect | ID: covidwho-1520582

ABSTRACT

This study investigates the transport of air pollutants around the Yangtze River Delta with an aim to identify if there would be a relationship towards health effects during the COVID-19 lockdown period. It is well-known that due to lockdown, the number of socio-economical activities are reduced and hence there is an observable reduction in air pollution. We would like to investigate if this consequential reduction of air pollution would lead to improvement in health amongst its population. A number of integrated methodologies are utilized, including collection and correlation of statistical data and numerical modeling to correlate the mortality rates difference with and without COVID-19 lockdown. In particular air quality changes during the COVID-19 lockdown period are compared with similar periods of the previous years using Brute Force Method. It is found that in general there is significant reduction in air-pollution related mortality, like stroke, ischemic cardio diseases, obstructive pulmonary disease, lung cancer and acute lower respiratory infection are all reduced as a result of relative improvement in PM2.5 level during the lockdown period. Further investigation of the trajectories suggests that these PM2.5 originate from afar with multiple sources, and do not suggest COVID-19 are transported to the region via long-range transport. Our results demonstrate the need for more stringent policy measure to tackle air pollution as it has strong evidence that it increases mortality rate.

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