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1.
mBio ; : e0175122, 2022.
Article in English | MEDLINE | ID: covidwho-2038241

ABSTRACT

COVID-19 convalescent plasma (CCP) was an early and widely adopted putative therapy for severe COVID-19. Results from randomized control trials and observational studies have failed to demonstrate a clear therapeutic role for CCP for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Underlying these inconclusive findings is a broad heterogeneity in the concentrations of neutralizing antibodies (nAbs) between different CCP donors. We conducted this study to evaluate the effectiveness and safety of nAb titer-defined CCP in adults admitted to an academic referral hospital. Patients positive by a SARS-CoV-2 nucleic acid amplification test and with symptoms for <10 days were eligible. Participants received either CCP with nAb titers of >1:640 (high-titer group) or >=1:160 to 1:640 (standard-titer group) in addition to standard of care treatments. The primary clinical outcome was time to hospital discharge, with mortality and respiratory support evaluated as secondary outcomes. Adverse events were contrasted by CCP titer. Between 28 August and 4 December 2020, 316 participants were screened, and 55 received CCP, with 14 and 41 receiving high- versus standard-titer CCP, respectively. Time to hospital discharge was shorter among participants receiving high- versus standard-titer CCP, accounting for death as a competing event (hazard ratio, 1.94;95% confidence interval [CI], 1.05 to 3.58;Gray's P = 0.02). Severe adverse events (SAEs) (>=grade 3) occurred in 4 (29%) and 23 (56%) of participants receiving the high versus standard titer, respectively, by day 28 (risk ratio, 0.51;95% CI, 0.21 to 1.22;Fisher's P = 0.12). There were no observed treatment-related AEs. (This study has been registered at ClinicalTrials.gov under registration no. NCT04524507). IMPORTANCE In this study, in a high-risk population of patients admitted for COVID-19, we found an earlier time to hospital discharge among participants receiving CCP with nAb titers of >1:640 compared with participants receiving CCP with a lower nAb titer and no CCP-related AEs. The significance of our research is in identifying a dose response of CCP and clinical outcomes based on nAb titer. Although limited by a small study size, these findings support further study of high-nAb-titer CCP defined as >1:640 in the treatment of COVID-19.

2.
Osong Public Health & Research Perspectives ; 13(4):263-272, 2022.
Article in English | MEDLINE | ID: covidwho-2030557

ABSTRACT

OBJECTIVES: It is crucial to establish the characteristics of coronavirus disease 2019 (COVID-19) outbreaks at army training centers to develop preventive measures. Therefore, this study aimed to determine the COVID-19 transmission patterns and risk factors in a sequence of outbreaks at an army training center from June to August 2021. METHODS: This study included 1,324 trainees at an army training center where outbreaks occurred from June to August 2021. The outbreak was qualitatively analyzed according to the period, attack rate, demographic characteristics, vaccination history, and living areas. An aerodynamic experiment was performed to evaluate aerosol transmission in living areas. RESULTS: Three outbreaks occurred at the army training center from June to August 2021. The first, second, and third outbreaks lasted for 32, 17, and 24 days, and the attack rates were 12.8%, 18.1%, and 8.9%, respectively. Confirmed cases were distributed in all age groups. Recruits and the unvaccinated were at higher risk for COVID-19. The aerodynamic experiment verified the possibility of aerosol transmission within the same living area. CONCLUSION: COVID-19 transmission at army training centers should be minimized through quarantine and post-admission testing during the latency period as part of integrated measures that include facility ventilation, vaccination, indoor mask-wearing, and social distancing.

3.
Annals of Laboratory Medicine ; 43(1):120-123, 2023.
Article in English | MEDLINE | ID: covidwho-2022635
4.
Transfusion ; 2022.
Article in English | PubMed | ID: covidwho-2019640

ABSTRACT

BACKGROUND: Due to the coronavirus disease 2019 (COVID-19) pandemic, the transfusion medicine community has experienced unprecedented blood supply shortages since March 2020. As such, numerous changes to everyday practice have occurred with a specific emphasis on blood conservation. We sought to determine the strategies used to mitigate blood shortages and promote blood conservation during the pandemic. METHODS: An anonymous, 37-question survey was developed using Research Electronic Data Capture and distributed via e-mail to transfusion medicine specialists across the US obtained via publicly available databases. RESULTS: Amongst surveyed [41.1% response rate (51/124 institutions)], 98.0% experienced a product shortage, with the greatest number reporting red blood cell (RBC) shortages (90.2%). This led to 35.3% of institutions altering the composition and/or number of blood product suppliers, including a 100% increase in the number of institutions acquiring blood from organizations that connect hospital transfusion services with blood collection centers (e.g., Blood Buy) compared to before March 2020. Prospective triaging of blood products was the most common blood conservation strategy (68.1%), though 35.4% altered their RBC exchange or transfusion program for patients receiving chronic RBC transfusion/exchange. As a result of these changes, 78.6% of institutions reported that these changes resulted in a reduction in blood product usage, and 38.1% reported a decrease in product wastage. CONCLUSIONS: Most hospitals experienced the effects of the supply shortage, and many of them implemented blood conserving measures. Conservation strategies were associated with decreased blood utilization and waste, and future studies could evaluate whether these changes persist. This article is protected by copyright. All rights reserved.

5.
19th International Conference on Ubiquitous Robots, UR 2022 ; : 243-247, 2022.
Article in English | Scopus | ID: covidwho-2019017

ABSTRACT

With the COVID-19 outbreak, people with disabilities have faced difficulties in managing their health owing to restrictions on medical access and use. Therefore, this study aimed to develop an Internet of Things-based health information-sharing mobile app for the disabled and their caregivers and evaluate its usability in maintaining access to health care services. As a first step, 19 user needs were evaluated through the Daily Health app 1.0, developed for the disabled by the National Rehabilitation Center. Based on these needs, the study participants proceeded with mind maps and personas to derive the User Interface. Subsequently, the Daily Health 2.0 program was designed, and heuristic and usability evaluations were conducted by experts. The Daily Health app 2.0 beta version was developed by modifying the detailed functions and design of the app based on the results of experts' opinions. Finally, a usability evaluation was conducted for app users. The app developed in this study will contribute to the efficient health management of people with disabilities in non-face-to-face situations. When combined with robot technology, it is expected that more effective health management will be possible by replacing physical functions that are difficult for people with disabilities. © 2022 IEEE.

6.
Sustainable Environment ; 8(1), 2022.
Article in English | Web of Science | ID: covidwho-2017559

ABSTRACT

Eight to ten percent of total global greenhouse gas emissions are associated with food loss and waste. Tackling the challenges of food loss and sustainable food waste management is key to fulfilling the Paris Agreement. However, among the Nationally Determined Contributions to the Paris Agreement, very few countries make references to food loss and waste. In this work, we reviewed the problem of food loss and waste from a global viewpoint and highlighted the opportunities of managing food loss and waste towards carbon mitigation and beyond. The importance of developing a coherent collaboration among all associated stakeholders was implied. Some recent policy developments and the impacts of COVID-19 pandemic are discussed followed by the summarization of potential solutions to tackling the fool loss and waste challenge.

7.
Bioengineering and Translational Medicine ; 2022.
Article in English | Scopus | ID: covidwho-2013376

ABSTRACT

The respiratory tract represents the key target for antiviral delivery in early interventions to prevent severe COVID-19. While neutralizing monoclonal antibodies (mAb) possess considerable efficacy, their current reliance on parenteral dosing necessitates very large doses and places a substantial burden on the healthcare system. In contrast, direct inhaled delivery of mAb therapeutics offers the convenience of self-dosing at home, as well as much more efficient mAb delivery to the respiratory tract. Here, building on our previous discovery of Fc-mucin interactions crosslinking viruses to mucins, we showed that regdanvimab, a potent neutralizing mAb already approved for COVID-19 in several countries, can effectively trap SARS-CoV-2 virus-like particles in fresh human airway mucus. IN-006, a reformulation of regdanvimab, was stably nebulized across a wide range of concentrations, with no loss of activity and no formation of aggregates. Finally, nebulized delivery of IN-006 resulted in 100-fold greater mAb levels in the lungs of rats compared to serum, in marked contrast to intravenously dosed mAbs. These results not only support our current efforts to evaluate the safety and efficacy of IN-006 in clinical trials, but more broadly substantiate nebulized delivery of human antiviral mAbs as a new paradigm in treating SARS-CoV-2 and other respiratory pathologies. © 2022 Inhalon Biopharma. Bioengineering & Translational Medicine published by Wiley Periodicals LLC on behalf of American Institute of Chemical Engineers.

9.
Financial Liberalization and Economic Development in Korea, 1980-2020 ; : 1-316, 2022.
Article in English | Scopus | ID: covidwho-2012249

ABSTRACT

Since the early 1980s, Korea’s financial development has been a tale of liberalization and opening. After the 1997 financial crisis, great strides were made in building a market-oriented financial system through sweeping reforms for deregulation and the opening of financial markets. However, the new system failed to steer the country away from a credit card boom and bust in 2003, a liquidity crisis in 2008, and a run on its savings banks in 2011, and has been severely tested again by the ongoing COVID-19 pandemic crisis. Financial liberalization, clearly, has been no panacea. This study analyzes the deepening of and structural changes in Korea’s financial system since the early 1980s and presents the empirical results of the effects of financial development on economic growth, stability, and the distribution of income. It finds that, contrary to conventional wisdom, financial liberalization has contributed little to fostering the growth and stability of the Korean economy and has exacerbated income distribution problems. Are there any merits in financial liberalization? The authors answer this query through empirical examinations of the theories of finance and growth. They point to a clear need to further improve the efficiency, soundness, and stability of Korean financial institutions and markets. © 2021 by The President and Fellows of Harvard College.

11.
J Gen Intern Med ; 2022.
Article in English | PubMed | ID: covidwho-2000087

ABSTRACT

BACKGROUND: The first surge of the COVID-19 pandemic entirely altered healthcare delivery. Whether this also altered the receipt of high- and low-value care is unknown. OBJECTIVE: To test the association between the April through June 2020 surge of COVID-19 and various high- and low-value care measures to determine how the delivery of care changed. DESIGN: Difference in differences analysis, examining the difference in quality measures between the April through June 2020 surge quarter and the January through March 2020 quarter with the same 2 quarters' difference the year prior. PARTICIPANTS: Adults in the MarketScan® Commercial Database and Medicare Supplemental Database. MAIN MEASURES: Fifteen low-value and 16 high-value quality measures aggregated into 8 clinical quality composites (4 of these low-value). KEY RESULTS: We analyzed 9,352,569 adults. Mean age was 44 years (SD, 15.03), 52% were female, and 75% were employed. Receipt of nearly every type of low-value care decreased during the surge. For example, low-value cancer screening decreased 0.86% (95% CI, -1.03 to -0.69). Use of opioid medications for back and neck pain (DiD +0.94 [95% CI, +0.82 to +1.07]) and use of opioid medications for headache (DiD +0.38 [95% CI, 0.07 to 0.69]) were the only two measures to increase. Nearly all high-value care measures also decreased. For example, high-value diabetes care decreased 9.75% (95% CI, -10.79 to -8.71). CONCLUSIONS: The first COVID-19 surge was associated with receipt of less low-value care and substantially less high-value care for most measures, with the notable exception of increases in low-value opioid use.

12.
Epidemiology and health ; : e2022065, 2022.
Article in English | MEDLINE | ID: covidwho-2002598

ABSTRACT

Objectives: This investigation was conducted to determine the size and pattern, source, and transmission route of the COVID-19 outbreak on the ROK Navy Amphibious Warfare ship. Methods: We investigated the characteristics of all crew members and tracked the medical records of the confirmed cases. Fourteen essential ship operation personnel were interviewed. The study design was a retrospective cohort study, and the Incidence Rate Ratio (IRR) was through a statistical program. Results: The COVID-19 incidence on the ROKN Amphibious Warfare ship was 44.7% (38/85). It was estimated that the main propagation route started from the 1st floor worker, which spread to the same floor, and then to other floors. In the case of the working area, the incidence rate of crew members below the 1st floor without ventilation was higher than those on the 2nd or higher floors with natural ventilation. Conclusion: This case is the first case of a COVID-19 outbreak on the ROKN Amphibious Warfare ship, and it is estimated that the incidence rate is high because of the closed and dense environment. To prevent the spread of various respiratory diseases including COVID-19, unified mitigation such as vaccination, observing personal quarantine rules, periodic ventilation, preemptive testing, and blocking transmission through prompt contact management is necessary.

13.
Social Sciences-Basel ; 11(6):15, 2022.
Article in English | Web of Science | ID: covidwho-1928632

ABSTRACT

The COVID-19 pandemic has left international cooperation and liberalistic values in crisis. As liberalism's downfall is widely discussed, international collaborations like the European Union are criticised for their inability to operate adequately during the pandemic. The four examples in this paper are middle power countries (South Korea, Japan, Taiwan, and Singapore) in terms of economic scale and influence. The purpose of this study was to uncover possibilities for and limitations of these middle powers within international cooperative efforts during and after the pandemic. The unknown factor is the path the post-pandemic world will follow. Will nations focus on independent survival? Or will international cooperation shape the new world? Globalisation already seems to have progressed too far for the national egoism of the great powers to prevail. Even if face-to-face is replaced by virtual and offline meetings move online, the social nature of humans remains unchanged, and international cooperation remains valid. The four middle power countries in Asia, which are included among the most economically successful countries, are important to international society based on their relatively excellent quarantine performance. What is important in the diplomacy of middle power countries is not traditional security and hard power but the soft power of international law, human rights, health security, and international cooperation.

14.
Eur Rev Med Pharmacol Sci ; 26(10): 3760-3770, 2022 05.
Article in English | MEDLINE | ID: covidwho-1876425

ABSTRACT

OBJECTIVE: This meta-analysis aims to assess the susceptibility to and clinical outcomes of COVID-19 in autoimmune inflammatory rheumatic disease (AIRD) and following AIRD drug use. MATERIALS AND METHODS: We included observational and case-controlled studies assessing susceptibility and clinical outcomes of COVID-19 in patients with AIRD as well as the clinical outcomes of COVID-19 with or without use of steroids and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). RESULTS: Meta-analysis including three studies showed that patients with AIRD are not more susceptible to COVID-19 compared to patients without AIRD or the general population (OR: 1.11, 95% CI: 0.58 to 2.14). Incidence of severe outcomes of COVID-19 (OR: 1.34, 95% CI: 0.76 to 2.35) and COVID-19 related death (OR: 1.21, 95% CI: 0.68 to 2.16) also did not show significant difference. The clinical outcomes of COVID-19 among AIRD patients with and without csDMARD or steroid showed that both use of steroid (OR: 1.69, 95% CI: 0.96 to 2.98) or csDMARD (OR: 1.35, 95% CI: 0.63 to 3.08) had no effect on clinical outcomes of COVID-19. CONCLUSIONS: AIRD does not increase susceptibility to COVID-19, not affecting the clinical outcome of COVID-19. Similarly, the use of steroids or csDMARDs for AIRD does not worsen the clinical outcome.


Subject(s)
Antirheumatic Agents , Autoimmune Diseases , COVID-19 , Rheumatic Diseases , Antirheumatic Agents/therapeutic use , COVID-19/drug therapy , Humans , Incidence , Rheumatic Diseases/drug therapy , Rheumatic Diseases/epidemiology
16.
Msystems ; 6(6):52, 2021.
Article in English | Web of Science | ID: covidwho-1849163

ABSTRACT

After emerging in China in late 2019, the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread worldwide, and as of mid-2021, it remains a significant threat globally. Only a few coronaviruses are known to infect humans, and only two cause infections similar in severity to SARS-CoV-2: Severe acute respiratory syndrome-related coronavirus, a species closely related to SARS-CoV-2 that emerged in 2002, and Middle East respiratory syndrome-related coronavirus, which emerged in 2012. Unlike the current pandemic, previous epidemics were controlled rapidly through public health measures, but the body of research investigating severe acute respiratory syndrome and Middle East respiratory syndrome has proven valuable for identifying approaches to treating and preventing novel coronavirus disease 2019 (COVID-19). Building on this research, the medical and scientific communities have responded rapidly to the COVID-19 crisis and identified many candidate therapeutics. The approaches used to identify candidates fall into four main categories: adaptation of clinical approaches to diseases with related pathologies, adaptation based on virological properties, adaptation based on host response, and data-driven identification (ID) of candidates based on physical properties or on pharmacological compendia. To date, a small number of therapeutics have already been authorized by regulatory agencies such as the Food and Drug Administration (FDA), while most remain under investigation. The scale of the COVID-19 crisis offers a rare opportunity to collect data on the effects of candidate therapeutics. This information provides insight not only into the management of coronavirus diseases but also into the relative success of different approaches to identifying candidate therapeutics against an emerging disease. IMPORTANCE The COVID-19 pandemic is a rapidly evolving crisis. With the worldwide scientific community shifting focus onto the SARS-CoV-2 virus and COVID-19, a large number of possible pharmaceutical approaches for treatment and prevention have been proposed. What was known about each of these potential interventions evolved rapidly throughout 2020 and 2021. This fast-paced area of research provides important insight into how the ongoing pandemic can be managed and also demonstrates the power of interdisciplinary collaboration to rapidly understand a virus and match its characteristics with existing or novel pharmaceuticals. As illustrated by the continued threat of viral epidemics during the current millennium, a rapid and strategic response to emerging viral threats can save lives. In this review, we explore how different modes of identifying candidate therapeutics have borne out during COVID-19.

17.
Clinical Cancer Research ; 27(6 SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1816889

ABSTRACT

Coronavirus-19 outbreak caused concern of lowering performance of clinical trials, including delays in initiation, lower enrollment, or more frequent deviations related with visit schedule change. Korea, with the sixth largest number of industry-sponsored interventional drug trials in the world, has been controlling COVID-19 outbreak rather successfully and maintaining daily medical practice in most areas of the country. We investigated performance of oncology clinical trials before and after COVID-19 in Korea. We retrospectively identified and reviewed the files, notes, and source documents of ongoing breast cancer clinical trials during January to May 2019 and January to May 2020 in a single cancer center conducting oncology trials in Korea. Number of enrolled patients, drop-outs, protocol deviations including study visit delay or visit omission were measured. We investigated 77 ongoing studies from January to May 2020, and 67 from the same period in 2019. The numbers of newly initiated trials and new enrollment were not decreased during COVID-19 outbreak period. After outbreak of COVID-19, number of onsite monitoring was decreased, however total number of monitoring was maintained as remote monitoring was increased. Remote monitoring comprised 44% of all monitoring visit in 2020, and found 30%(15/50) of protocol deviations detected by all monitoring visit. Of the 26 study visit related protocol deviations during February to May 2020, 10(38%) cases were COVID-19 related. Thirteen percent(3/24) of study drop out cases were COVID-19 related, from subjects' demand due to fear of visiting hospital. Although monitoring access was limited, vigorous countermeasures successfully maintained performance of oncology clinical trials during COVID-19 outbreak in Korea. Remote monitoring visits successfully complemented restricted onsite monitoring. COVID-19 related protocol deviations and drop-out cases were noted, mostly from subjects' concerns about travel. Future regulations and guidelines should pursue developing alternatives of face-to-face contact visit as needed.

18.
Process Safety and Environmental Protection ; 160:1-12, 2022.
Article in English | Web of Science | ID: covidwho-1805002

ABSTRACT

Owing to the inherent complications in membrane distillation (MD) operations, it has become a challenge to acknowledge swiftly and appropriately to safeguard the quality of effluent, particularly when the processing cost is a prominent concern. Membrane wetting in MD operations is a major concern during longterm performance. In this study, machine learning (ML) methodologies were utilized to overcome the limitations of conventional mechanistic modeling. ML applications have never been explored to investigate how operational factors, such as water flux and salt flux, are affected during long-term MD performance. Furthermore, time-dependent factors were neglected, making it difficult to analyze the relationship between effluent quality and operational factors. Therefore, this study demonstrates a novel ML-based framework designed to enhance the performance of MD. The ML-based framework consists of an autoregressive integrated moving average (ARIMA) and utilizes a unique pathway to explain the impact of time series among operational factors. The accuracy of forecasting has been explored by utilizing 180 h (180 datasets), that was further used and divided into training (165 datasets) and test datasets (15 datasets). Eventually, the ARIMA model demonstrated a highly precise relationship order between the model and experimental data, which can be further used to forecast membrane performance in terms of wetting and fouling. The selected ARIMA model (3,2,1) appears to be an adequate model for water and salt flux data which has been effectively used to capture the course of permeate water and salt flux by producing the smallest forecast RMSE. The RMSE values were observed to be 0.22 and 0.05 for water and salt flux respectively, which can better predict long time series with high frequency. These frameworks can be applied for the early prediction of membrane wetting if ample high-resolution data are available.(c) 2022 Institution of Chemical Engineers. Published by Elsevier Ltd. All rights reserved.

19.
9th International Conference on Robot Intelligence Technology and Applications, RiTA 2021 ; 429 LNNS:191-200, 2022.
Article in English | Scopus | ID: covidwho-1802616

ABSTRACT

As the demand for social distancing increases due to the COVID-19 pandemic, it becomes hard to have close interaction between people in an office. Thus, this research aims to develop a contactless office assistant robot that offers interactive services using user differentiation. Our robot system utilizes various functions such as image recognition, user tracking, voice recognition, voice utterance, and secondary image output to enable natural interaction with human and configures a task manager to operate the functions as one integrated system at the required timing. For system evaluation, a video survey was conducted on the appearance of the robot, the robot’s functions, and the demonstration service scenario in which our robot plays an automated assistive service to people in a department office located on the university campus. As a result 92% (62 people) of the survey participants evaluated the robot positively. And 57% (40 people) of the survey participants rated this system as effective in preventing infectious diseases. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

20.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-333828

ABSTRACT

Escape variants of SARS-CoV-2 are threatening to prolong the COVID-19 pandemic. To address this challenge, we developed multivalent protein-based minibinders as potential prophylactic and therapeutic agents. Homotrimers of single minibinders and fusions of three distinct minibinders were designed to geometrically match the SARS-CoV-2 spike (S) trimer architecture and were optimized by cell-free expression and found to exhibit virtually no measurable dissociation upon binding. Cryo-electron microscopy (cryoEM) showed that these trivalent minibinders engage all three receptor binding domains on a single S trimer. The top candidates neutralize SARS-CoV-2 variants of concern with IC 50 values in the low pM range, resist viral escape, and provide protection in highly vulnerable human ACE2-expressing transgenic mice, both prophylactically and therapeutically. Our integrated workflow promises to accelerate the design of mutationally resilient therapeutics for pandemic preparedness. ONE-SENTENCE SUMMARY: We designed, developed, and characterized potent, trivalent miniprotein binders that provide prophylactic and therapeutic protection against emerging SARS-CoV-2 variants of concern.

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