Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 9 de 9
Filter
1.
Cityscape ; 23(3):335-344, 2021.
Article in English | ProQuest Central | ID: covidwho-1848667

ABSTRACT

This paper examines the current use of panelized components in homebuilding in the Oklahoma City (OKC) and Dallas-Fort Worth (DFW) areas. Panelization is a type of prefabrication in which certain framing components are built off site and then transported to the site for assembly. This technique has been reported to make homebuilding more efficient and affordable. Further, panelization may be one strategy to cope with the growing labor shortage. However, adoption in the United States varies and is relatively limited. To better understand the benefits and challenges of panelization, semi-structured interviews were conducted with 10 production homebuilders from the OKC and DFW metropolitan areas. Although most of the benefits (faster, more consistent, and less waste) and challenges (cost, logistics, and labor issues) were consistent with previous research, new benefits related to warranties and new challenges relating to transportation and delivery were identified. In addition, the study concludes that national and regional production builders differ in their priorities and perceptions of panelization: national builders are trying to increase their use of panelization, whereas regional builders are moving away from it.

2.
Rev Cardiovasc Med ; 23(2): 50, 2022 02 08.
Article in English | MEDLINE | ID: covidwho-1716431

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) has significantly the delivery of healthcare all around the world. In part, an abnormal and unexplained high non-COVID-related cardiovascular mortality rate was reported during the outbreak. We assess the correlation between anxiety level and decision to seek medical care (DSMC) during the COVID-19 pandemic. MATERIALS AND METHODS: We recruited patients with cardiovascular complaints admitted to the emergency department in a single institute in Israel between February and September 2020. Anxiety level was measured using available questionnaires. DSMC was assessed with a newly designed questionnaire (DM-19). RESULTS: Two-hundreds seventy patients were included in the study. The mean age was 52.6 ± 14.9 (females represent 36.2%). 23.6% of the patients had at least moderate cardiovascular risk. High anxiety levels were (HAL) reported in nearly half of the patients (57.1% and 49.8% for General Anxiety Disorder Assessment [GAD-7] and Beck Anxiety Inventory [BAI], respectively). It was more prevalent in old, married, and unemployed patients (significant p-value for all in both questionnaires). Age was an independent factor (χ2 = 6.33, p < 0.001, odds-ratio: 4.8) and had a positive correlation on anxiety level (r = 0.81, p < 0.001 and r = 0.62, p < 0.001, for GAD-7 and BAI, respectively). The DM-19 revealed a strong and positive correlation of seeking medical care with anxiety level (R2 linear = 0.44, r = 0.70, p < 0.001 and R2 linear = 0.30, r = 0.58, p < 0.001 for GAD-7 and BAI, respectively) and results in deferring medical care for several days than patient with low anxiety level (p = 0.02). CONCLUSIONS: We observed an abnormal prevalence of a high level of anxiety among non-COVID patients with cardiovascular complaints, which affected the patient's likelihood to seek medical care and resulted in an unreasonable postponement of medical treatment. Our results may explain cardiovascular mortality trends during the outbreak and should be considered in health crisis management. Future studies will involve multi-institutional efforts to address reproducibility of our findings across geographic regions in the state of the global impact. Additionally, it is imperative to understand the effects of the coronavirus vaccine on patient consideration to seek medical care.


Subject(s)
COVID-19 , Pandemics , Adult , Aged , Anxiety/diagnosis , Anxiety/epidemiology , COVID-19/epidemiology , COVID-19 Vaccines , Depression/epidemiology , Disease Outbreaks , Female , Humans , Israel/epidemiology , Middle Aged , Reproducibility of Results , SARS-CoV-2
3.
Can J Kidney Health Dis ; 8: 20543581211027759, 2021.
Article in English | MEDLINE | ID: covidwho-1320523

ABSTRACT

BACKGROUND: The incidence of acute kidney injury (AKI) in patients with COVID-19 and its association with mortality and disease severity is understudied in the Canadian population. OBJECTIVE: To determine the incidence of AKI in a cohort of patients with COVID-19 admitted to medicine and intensive care unit (ICU) wards, its association with in-hospital mortality, and disease severity. Our aim was to stratify these outcomes by out-of-hospital AKI and in-hospital AKI. DESIGN: Retrospective cohort study from a registry of patients with COVID-19. SETTING: Three community and 3 academic hospitals. PATIENTS: A total of 815 patients admitted to hospital with COVID-19 between March 4, 2020, and April 23, 2021. MEASUREMENTS: Stage of AKI, ICU admission, mechanical ventilation, and in-hospital mortality. METHODS: We classified AKI by comparing highest to lowest recorded serum creatinine in hospital and staged AKI based on the Kidney Disease: Improving Global Outcomes (KDIGO) system. We calculated the unadjusted and adjusted odds ratio for the stage of AKI and the outcomes of ICU admission, mechanical ventilation, and in-hospital mortality. RESULTS: Of the 815 patients registered, 439 (53.9%) developed AKI, 253 (57.6%) presented with AKI, and 186 (42.4%) developed AKI in-hospital. The odds of ICU admission, mechanical ventilation, and death increased as the AKI stage worsened. Stage 3 AKI that occurred during hospitalization increased the odds of death (odds ratio [OR] = 7.87 [4.35, 14.23]). Stage 3 AKI that occurred prior to hospitalization carried an increased odds of death (OR = 5.28 [2.60, 10.73]). LIMITATIONS: Observational study with small sample size limits precision of estimates. Lack of nonhospitalized patients with COVID-19 and hospitalized patients without COVID-19 as controls limits causal inferences. CONCLUSIONS: Acute kidney injury, whether it occurs prior to or after hospitalization, is associated with a high risk of poor outcomes in patients with COVID-19. Routine assessment of kidney function in patients with COVID-19 may improve risk stratification. TRIAL REGISTRATION: The study was not registered on a publicly accessible registry because it did not involve any health care intervention on human participants.

4.
Mol Med ; 26(1): 98, 2020 10 30.
Article in English | MEDLINE | ID: covidwho-894987

ABSTRACT

BACKGROUND: Mechanical ventilation, in combination with supraphysiological concentrations of oxygen (i.e., hyperoxia), is routinely used to treat patients with respiratory distress, such as COVID-19. However, prolonged exposure to hyperoxia compromises the clearance of invading pathogens by impairing macrophage phagocytosis. Previously, we have shown that the exposure of mice to hyperoxia induces the release of the nuclear protein high mobility group box-1 (HMGB1) into the pulmonary airways. Furthermore, extracellular HMGB1 impairs macrophage phagocytosis and increases the mortality of mice infected with Pseudomonas aeruginosa (PA). The aim of this study was to determine whether GTS-21 (3-(2,4-dimethoxybenzylidene) anabaseine), an α7 nicotinic acetylcholine receptor (α7nAChR) agonist, could (1) inhibit hyperoxia-induced HMGB1 release into the airways; (2) enhance macrophage phagocytosis and (3) increase bacterial clearance from the lungs in a mouse model of ventilator-associated pneumonia. METHOD: GTS-21 (0.04, 0.4, and 4 mg/kg) or saline were administered by intraperitoneal injection to mice that were exposed to hyperoxia (≥ 99% O2) and subsequently challenged with PA. RESULTS: The systemic administration of 4 mg/kg i.p. of GTS-21 significantly increased bacterial clearance, decreased acute lung injury and decreased accumulation of airway HMGB1 compared to the saline control. To determine the mechanism of action of GTS-21, RAW 264.7 cells, a macrophage-like cell line, were incubated with different concentrations of GTS-21 in the presence of 95% O2. The phagocytic activity of macrophages was significantly increased by GTS-21 in a dose-dependent manner. In addition, GTS-21 significantly inhibited the cytoplasmic translocation and release of HMGB1 from RAW 264.7 cells and attenuated hyperoxia-induced NF-κB activation in macrophages and mouse lungs exposed to hyperoxia and infected with PA. CONCLUSIONS: Our results indicate that GTS-21 is efficacious in improving bacterial clearance and reducing acute lung injury via enhancing macrophage function by inhibiting the release of nuclear HMGB1. Therefore, the α7nAChR represents a possible pharmacological target to improve the clinical outcome of patients on ventilators by augmenting host defense against bacterial infections.


Subject(s)
Benzylidene Compounds/pharmacology , Hyperoxia/immunology , Macrophages, Alveolar/drug effects , Pseudomonas Infections/drug therapy , Pyridines/pharmacology , Ventilator-Induced Lung Injury/drug therapy , alpha7 Nicotinic Acetylcholine Receptor/antagonists & inhibitors , Animals , Disease Models, Animal , HMGB1 Protein/metabolism , Hyperoxia/diet therapy , Macrophages, Alveolar/immunology , Macrophages, Alveolar/metabolism , Male , Mice , Mice, Inbred C57BL , Phagocytosis/drug effects , Pseudomonas aeruginosa , RAW 264.7 Cells
5.
Cureus ; 12(9): e10302, 2020 Sep 07.
Article in English | MEDLINE | ID: covidwho-782460

ABSTRACT

Pulmonary imaging findings in e-cigarette and vaping use associated lung injury (EVALI) and coronavirus disease 2019 (COVID-19) may be similar. One such pulmonary radiographic finding is ground glass opacities (GGOs). These GGOs present a wide differential that is narrowed down through diagnostic testing, deliberation of past medical history as well as medication use, and social history. This case presents GGOs observed in a COVID rule-out admission clinically correlated with EVALI.

6.
Crit. Rev. Phys. Rehabil. Med. ; 2(32): 97-109, 2020.
Article in English | WHO COVID, ELSEVIER | ID: covidwho-727339

ABSTRACT

In all countries, COVID-19 has had a profound impact on society in general and on healthcare systems in particular. Its route of transmission is similar to that of SARS-CoV and MERS-CoV, and it spreads through respiratory droplets and direct physical contact. It displays greater infectivity rates than the two recent viral outbreaks (SARS and MERS), and early epidemiological studies reveal lower fatality rates. Elderly and multimorbid persons are at the highest risk of developing complications and death. Although men and women are thought to be at equal risk for COVID-19, more men than women are dying, presumably due to sex-based immunological differences and lifestyle factors such as smoking. N95 respirators are thought to be more effective in preventing viral transmission than surgical masks, but the evidence is limited and inconsistent. The current clinical management strategy of COVID-19 is the same as acute respiratory distress syndrome (ARDS). Novel treatments and therapies such as the use of plasmapheresis, chloroquine, hydroxychloroquine, and remdesivir have shown promising results in clinical trials for treating COVID-19. The roles of physical rehabilitation and medicine are expected to increase because postrecovery COVID-19 patients are experiencing cardiovascular, neurological, psychological, and cognitive sequalae. Innovative management strategies are needed to limit the spread of disease and to protect vulnerable persons. Significant evidence indicates that the use of telerehabilitation reduces hospitalizations and cardiac events compared to regular care. Actions are needed to prevent deconditioning in rehabilitation patients, and respiratory therapy practices will require close attention to reduce the dispersion of air droplets.

7.
J Am Heart Assoc ; 9(13): e017042, 2020 07 07.
Article in English | MEDLINE | ID: covidwho-617454

ABSTRACT

The coronavirus disease 2019 pandemic, caused by severe acute respiratory syndrome coronavirus-2, represents the third human affliction attributed to the highly pathogenic coronavirus in the current century. Because of its highly contagious nature and unprecedented global spread, its aggressive clinical presentation, and the lack of effective treatment, severe acute respiratory syndrome coronavirus-2 infection is causing the loss of thousands of lives and imparting unparalleled strain on healthcare systems around the world. In the current report, we discuss perioperative considerations for patients undergoing cardiac surgery and provide clinicians with recommendations to effectively triage and plan these procedures during the coronavirus disease 2019 outbreak. This will help reduce the risk of exposure to patients and healthcare workers and allocate resources appropriately to those in greatest need. We include an algorithm for preoperative testing for coronavirus disease 2019, personal protective equipment recommendations, and a classification system to categorize and prioritize common cardiac surgery procedures.


Subject(s)
Cardiac Surgical Procedures/standards , Coronavirus Infections/epidemiology , Disease Transmission, Infectious/prevention & control , Heart Diseases/surgery , Personal Protective Equipment/standards , Pneumonia, Viral/epidemiology , Practice Guidelines as Topic , Triage/standards , Betacoronavirus , COVID-19 , Comorbidity , Coronavirus Infections/complications , Coronavirus Infections/transmission , Heart Diseases/epidemiology , Humans , Pandemics , Perioperative Period , Pneumonia, Viral/complications , Pneumonia, Viral/transmission , SARS-CoV-2
8.
Mol Med ; 26(1): 63, 2020 06 29.
Article in English | MEDLINE | ID: covidwho-617382

ABSTRACT

BACKGROUND: Oxygen therapy, using supraphysiological concentrations of oxygen (hyperoxia), is routinely administered to patients who require respiratory support including mechanical ventilation (MV). However, prolonged exposure to hyperoxia results in acute lung injury (ALI) and accumulation of high mobility group box 1 (HMGB1) in the airways. We previously showed that airway HMGB1 mediates hyperoxia-induced lung injury in a mouse model of ALI. Cholinergic signaling through the α7 nicotinic acetylcholine receptor (α7nAChR) attenuates several inflammatory conditions. The aim of this study was to determine whether 3-(2,4 dimethoxy-benzylidene)-anabaseine dihydrochloride, GTS-21, an α7nAChR partial agonist, inhibits hyperoxia-induced HMGB1 accumulation in the airways and circulation, and consequently attenuates inflammatory lung injury. METHODS: Mice were exposed to hyperoxia (≥99% O2) for 3 days and treated concurrently with GTS-21 (0.04, 0.4 and 4 mg/kg, i.p.) or the control vehicle, saline. RESULTS: The systemic administration of GTS-21 (4 mg/kg) significantly decreased levels of HMGB1 in the airways and the serum. Moreover, GTS-21 (4 mg/kg) significantly reduced hyperoxia-induced acute inflammatory lung injury, as indicated by the decreased total protein content in the airways, reduced infiltration of inflammatory monocytes/macrophages and neutrophils into the lung tissue and airways, and improved lung injury histopathology. CONCLUSIONS: Our results indicate that GTS-21 can attenuate hyperoxia-induced ALI by inhibiting extracellular HMGB1-mediated inflammatory responses. This suggests that the α7nAChR represents a potential pharmacological target for the treatment regimen of oxidative inflammatory lung injury in patients receiving oxygen therapy.


Subject(s)
Acute Lung Injury/etiology , Acute Lung Injury/metabolism , Benzylidene Compounds/pharmacology , HMGB1 Protein/metabolism , Hyperoxia/complications , Nicotinic Agonists/pharmacology , Pyridines/pharmacology , Acute Lung Injury/drug therapy , Acute Lung Injury/pathology , Animals , Biomarkers , Disease Susceptibility , HMGB1 Protein/blood , HMGB1 Protein/genetics , Immunohistochemistry , Male , Mice , Models, Biological
SELECTION OF CITATIONS
SEARCH DETAIL