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1.
American Journal of Otolaryngology ; 44(2):103718, 2023.
Article in English | ScienceDirect | ID: covidwho-2129841

ABSTRACT

Background Multiple reports have linked COVID-19 infection with sudden sensorineural hearing loss (SSNHL), although other studies have failed to demonstrate this association. The current study was conceived to examine the rates of SSNHL across a large, principally national, population by characterizing the rate of transtympanic injections for SSNHL during the pandemic. Methods Retrospective review of all patients that underwent transtympanic injection from 2019 to 2020. Results Covering a unique beneficiary population of 9.6 million individuals of all ages in the United States, a statistically significant decrease in transtympanic injections for SSNHL was performed from 2019 to 2020 (p = 0.04, IRR = 0.91, 95 % CI = 0.84–0.99). No patient receiving a transtympanic injection also had a COVID-19 diagnosis. Conclusions These findings support the idea that COVID-19 infections do not clinically significantly increase patients' risk of developing SSNHL. In fact, the decreased exposure through social isolation to other common viruses implicated in causing SSNHL may have actually led to a lower rate of SSNHL during the pandemic.

2.
Cancers (Basel) ; 14(19)2022 Sep 23.
Article in English | MEDLINE | ID: covidwho-2109946

ABSTRACT

(1) Background: the SARS-CoV-2 (COVID-19) pandemic continues, and patients actively receiving chemotherapy are known to be at enhanced risk for developing symptomatic disease with poorer outcomes. Our study evaluated the prevalence of COVID-19 among patients and providers of our community-facing county health system during the B1.1.529 ("Omicron") COVID-19 variant wave. (2) Methods: We retrospectively analyzed patients that received care and clinical providers whom worked at the Jackson Memorial Hospital Hematology/Oncology clinic in Miami, Florida, USA, from 1 December 2021 through 30 April 2022. We assessed demographic variables and quality outcomes among patients. (3) Results: 1031 patients and 18 providers were retrospectively analyzed. 90 patients tested positive for COVID-19 (8.73%), while 6 providers tested positive (33.3%) (p = 0.038). There were 4 (10.3%) COVID-19-related deaths (and another outside our study timeframe) and 39 non-COVID-19-related deaths (89.7%) in the patient population (p = 0.77). COVID-19 accounted for 4.44% of our clinic's total mortality, and delayed care in 64.4% of patients. (4) Conclusions: The prevalence of COVID-19 positivity in our patient cohort mirrored local, state, and national trends, however a statistically significant greater proportion of our providers tested positive. Almost two-thirds of patients experienced a cancer treatment delay, significantly impacting oncologic care.

4.
Energy Economics ; : 106348, 2022.
Article in English | ScienceDirect | ID: covidwho-2061099

ABSTRACT

The surmounted environmental and energy challenges have motivated this study to explore the connectedness nexus between oil/renewable energy and stock markets for oil-exporting (importing) countries. We utilize the dynamic conditional correlation (DCC-GARCH) connectedness framework to compare the connectedness of oil/renewable energy with stock markets. Our results showcase higher total connectedness between renewable energy and stock markets. We find increased connectedness during three major pandemics (Swine Flu, EBOLA, and COVID-19). We performed a regression analysis that highlighted the impact of economic and financial uncertainties on connectedness as an additional analysis. The addition of dummy variables for three major pandemics indicates that COVID-19 significantly impacted the connectedness between oil/renewable energy and stock markets. For the robustness of our results, we employed time-varying vector autoregressions (TVP-VAR) connectedness framework to showcase that our results remain qualitatively similar and robust to different specifications. We draw useful implications for oil exporting and oil importing countries in particular, and we draft ramifications for investors, portfolio managers, policymakers, and macroprudential bodies in general.

5.
medrxiv; 2022.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2022.09.22.22280247

ABSTRACT

Background: We investigated whether abatacept, a selective costimulation modulator, provides additional benefit when added to standard-of-care for patients hospitalized with Covid-19. Methods: We conducted a master protocol to investigate immunomodulators for potential benefit treating patients hospitalized with Covid-19 and report results for abatacept. Intravenous abatacept (one-time dose 10 mg/kg, maximum dose 1000 mg) plus standard of care (SOC) was compared with shared placebo plus SOC. Primary outcome was time-to-recovery by day 28. Key secondary endpoints included 28-day mortality. Results: Between October 16, 2020 and December 31, 2021, a total of 1019 participants received study treatment (509 abatacept; 510 shared placebo), constituting the modified intention-to-treat cohort. Participants had a mean age 54.8 (SD 14.6) years, 60.5% were male, 44.2% Hispanic/Latino and 13.7% Black. No statistically significant difference for the primary endpoint of time-to-recovery was found with a recovery-rate-ratio of 1.14 (95% CI 1.00-1.29; p=0.057) compared with placebo. We observed a substantial improvement in 28-day all-cause mortality with abatacept versus placebo (11.0% vs. 15.1%; odds ratio [OR] 0.62 [95% CI 0.41-0.94]), leading to 38% lower odds of dying. Improvement in mortality occurred for participants requiring oxygen/noninvasive ventilation at randomization. Subgroup analysis identified the strongest effect in those with baseline C-reactive protein >75mg/L. We found no statistically significant differences in adverse events, with safety composite index slightly favoring abatacept. Rates of secondary infections were similar (16.1% for abatacept; 14.3% for placebo). Conclusions: Addition of single-dose intravenous abatacept to standard-of-care demonstrated no statistically significant change in time-to-recovery, but improved 28-day mortality. Trial registration: ClinicalTrials.gov (NCT04593940).


Subject(s)
COVID-19
6.
medrxiv; 2022.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2022.09.22.22280245

ABSTRACT

BackgroundImmune dysregulation contributes to poorer outcomes in severe Covid-19. Immunomodulators targeting various pathways have improved outcomes. We investigated whether infliximab provides benefit over standard of care. MethodsWe conducted a master protocol investigating immunomodulators for potential benefit in treatment of participants hospitalized with Covid-19 pneumonia. We report results for infliximab (single dose infusion) versus shared placebo both with standard of care. Primary outcome was time to recovery by day 29 (28 days after randomization). Key secondary endpoints included 14-day clinical status and 28-day mortality. ResultsA total of 1033 participants received study drug (517 infliximab, 516 placebo). Mean age was 54.8 years, 60.3% were male, 48.6% Hispanic or Latino, and 14% Black. No statistically significant difference in the primary endpoint was seen with infliximab compared with placebo (recovery rate ratio 1.13, 95% CI 0.99-1.29; p=0.063). Median (IQR) time to recovery was 8 days (7, 9) for infliximab and 9 days (8, 10) for placebo. Participants assigned to infliximab were more likely to have an improved clinical status at day 14 (OR 1.32, 95% CI 1.05-1.66). Twenty-eight-day mortality was 10.1% with infliximab versus 14.5% with placebo, with 41% lower odds of dying in those receiving infliximab (OR 0.59, 95% CI 0.39-0.90). No differences in risk of serious adverse events including secondary infections. ConclusionsInfliximab did not demonstrate statistically significant improvement in time to recovery. It was associated with improved 14-day clinical status and substantial reduction in 28- day mortality compared with standard of care. Trial registrationClinicalTrials.gov (NCT04593940).


Subject(s)
Pneumonia , COVID-19
7.
Nucleic Acids Res ; 50(14): 8168-8192, 2022 08 12.
Article in English | MEDLINE | ID: covidwho-1961119

ABSTRACT

Nucleocapsid protein (N-protein) is required for multiple steps in betacoronaviruses replication. SARS-CoV-2-N-protein condenses with specific viral RNAs at particular temperatures making it a powerful model for deciphering RNA sequence specificity in condensates. We identify two separate and distinct double-stranded, RNA motifs (dsRNA stickers) that promote N-protein condensation. These dsRNA stickers are separately recognized by N-protein's two RNA binding domains (RBDs). RBD1 prefers structured RNA with sequences like the transcription-regulatory sequence (TRS). RBD2 prefers long stretches of dsRNA, independent of sequence. Thus, the two N-protein RBDs interact with distinct dsRNA stickers, and these interactions impart specific droplet physical properties that could support varied viral functions. Specifically, we find that addition of dsRNA lowers the condensation temperature dependent on RBD2 interactions and tunes translational repression. In contrast RBD1 sites are sequences critical for sub-genomic (sg) RNA generation and promote gRNA compression. The density of RBD1 binding motifs in proximity to TRS-L/B sequences is associated with levels of sub-genomic RNA generation. The switch to packaging is likely mediated by RBD1 interactions which generate particles that recapitulate the packaging unit of the virion. Thus, SARS-CoV-2 can achieve biochemical complexity, performing multiple functions in the same cytoplasm, with minimal protein components based on utilizing multiple distinct RNA motifs that control N-protein interactions.


Subject(s)
Coronavirus Nucleocapsid Proteins , RNA, Double-Stranded , SARS-CoV-2 , Binding Sites , Coronavirus Nucleocapsid Proteins/chemistry , Phosphoproteins/chemistry , RNA, Double-Stranded/genetics , RNA, Viral/genetics , RNA-Binding Proteins/metabolism , SARS-CoV-2/genetics , Temperature
8.
Vaccine ; 40(33): 4726-4731, 2022 08 05.
Article in English | MEDLINE | ID: covidwho-1907850

ABSTRACT

INTRODUCTION: The COVID-19 vaccine is essential to reduce the global impact of the pandemic. Understanding its acceptance is key to Nigeria's national COVID-19 control strategies. METHODS: Between the 6th and 22nd of January 2021, we conducted a non-probability convenience sampling of 3076 respondents using online and in-person interviews to assess the prevalence and predictors of the COVID-19 vaccine acceptance in Nigeria. FINDINGS: Of the 3076 recruited participants, 74.7% (n = 2300/3076) had tertiary education. The median age group was 30-39 years (35.1%, n = 1097/3076) whereas 31% (n = 952/3076) of all respondents had a monthly income<30,000 Naira (65 USD). The survey results indicated that a wide range of the respondents were in government employment (34.1%, n = 1050/3076). The majority of our study participants (92.2%, n = 2835/3076) believe that COVID-19 is real and not a hoax. Only 27.9% (n = 858/3076) of the study participants have been tested for COVID-19 and 17.8 % (n = 152/858) of the tested respondents were COVID-19 positive by PCR. Half (50.7%; n = 1560/3076) of the study participants were willing to take the vaccine once available. The majority of the respondents (81.1%, n = 2496/3076) were not willing to pay for the vaccine. Only 15.9% (n = 483/3076) of the respondents rated the government's handling of the pandemic above average. The potential acceptance of the COVID-19 vaccine was significantly affected by the age and the monthly income of the respondents. Respondents older than 60 years old (OR: 3.02, 95% CI: 1.69,5.41; p < 0.001) and those that earn between 250,000-500,000 Naira monthly (OR: 1.38; 95% CI: 1.11,1.70; p < 0.001) were more likely to accept the COVID-19 vaccine respectively. In addition, the respondents' perception of the existence of the disease (OR: 1.45; 95% CI: 0.99,2.18; p > 0.05), the need for a COVID-19 vaccine (OR: 16; 95% CI: 11.63,22.10; p < 0.001), the willingness to pay (OR: 1.68; 95% CI: 1.39,2.01; p < 0.001) and the rating of the government handling of the pandemic (OR: 2.25; 95% CI: 1.57,3.23; p < 0.001) were critical to the acceptance of the COVID-19 vaccine. INTERPRETATION: With 50.7% vaccine acceptance, Nigeria's public health policymakers must prioritize and develop strategies that will effectively increase COVID-19 vaccine acceptance across the country with emphasis on trust, transparency and strong leadership.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Humans , Middle Aged , Nigeria/epidemiology , Patient Acceptance of Health Care , Surveys and Questionnaires
9.
J Educ Perioper Med ; 24(1): E683, 2022.
Article in English | MEDLINE | ID: covidwho-1904238

ABSTRACT

Background: The shift to virtual interviews during the COVID-19 pandemic has elevated the vital role of Accreditation Council for Graduate Medical Education residency program websites in conveying information to applicants. The purpose of our study was to assess the recruitment, education, and diversity and inclusion content on websites for anesthesiology residency programs. Second, we aimed to test the hypothesis that the content scores of websites are higher in programs with more National Institutes of Health funding, in programs that are university-based versus community-based, and in larger programs, as measured by number of residents. Methods: Two independent reviewers evaluated the websites of the 159 anesthesiology residency programs accredited by the Accreditation Council for Graduate Medical Education for the presence (yes/no) of 12 recruitment, 6 education, and 8 diversity and inclusion criteria. Multiple linear regression was used to determine which program factors were most associated with total website content score. Results: Anesthesiology residency program websites contained a mean of 12.9 (SD = 3.4; range, 3-21) of the 26 study-defined criteria. The most common recruitment, education, and diversity and inclusion criteria were, respectively, program description, rotation information, and community demographics. Controlling for program factors, a university-based affiliation (P = .016) was associated with higher website content scores. Conclusions: There is large variation in the recruitment, education, and diversity and inclusion content on anesthesiology residency program websites nationally. Since program websites averaged only half of criteria, this may provide an impetus for programs to modify their websites, which may inform applicant decisions about which programs align with their training and career goals.

10.
Economic Analysis and Policy ; 2022.
Article in English | ScienceDirect | ID: covidwho-1881921

ABSTRACT

With the continuous boom of FinTech, the similar features of different platforms provide effective solutions for small and medium enterprises. This study examines whether FinTech offers useful business mechanisms for SMEs in selected ASEAN countries. The ASEAN countries included in the study are Indonesia, Malaysia, Philippine, Singapore, and Thailand. The study employed factor analysis and segregated the FinTech-SME nexus into five factors. The responses of 300 SME owners were collected through interview questionnaires and surveys. We find that new FinTech and SMEs ‘collisions’ (our term for new utilization) during COVID-19 are the most important factors in the growth of FinTech and the strength of SMEs. Further, we utilized the Kruskal–Wallis test to validate our results and for ranking the factors alongside the ASEAN countries. We present useful implications for policymakers, regulatory bodies, ASEAN countries, and SMEs for welcoming FinTech solutions to facilitate digital transactions.

11.
Sci Robot ; 7(67): eabn0495, 2022 06.
Article in English | MEDLINE | ID: covidwho-1874493

ABSTRACT

Ultrasensitive multimodal physicochemical sensing for autonomous robotic decision-making has numerous applications in agriculture, security, environmental protection, and public health. Previously reported robotic sensing technologies have primarily focused on monitoring physical parameters such as pressure and temperature. Integrating chemical sensors for autonomous dry-phase analyte detection on a robotic platform is rather extremely challenging and substantially underdeveloped. Here, we introduce an artificial intelligence-powered multimodal robotic sensing system (M-Bot) with an all-printed mass-producible soft electronic skin-based human-machine interface. A scalable inkjet printing technology with custom-developed nanomaterial inks was used to manufacture flexible physicochemical sensor arrays for electrophysiology recording, tactile perception, and robotic sensing of a wide range of hazardous materials including nitroaromatic explosives, pesticides, nerve agents, and infectious pathogens such as SARS-CoV-2. The M-Bot decodes the surface electromyography signals collected from the human body through machine learning algorithms for remote robotic control and can perform in situ threat compound detection in extreme or contaminated environments with user-interactive tactile and threat alarm feedback. The printed electronic skin-based robotic sensing technology can be further generalized and applied to other remote sensing platforms. Such diversity was validated on an intelligent multimodal robotic boat platform that can efficiently track the source of trace amounts of hazardous compounds through autonomous and intelligent decision-making algorithms. This fully printed human-machine interactive multimodal sensing technology could play a crucial role in designing future intelligent robotic systems and can be easily reconfigured toward numerous practical wearable and robotic applications.


Subject(s)
COVID-19 , Robotic Surgical Procedures , Wearable Electronic Devices , Artificial Intelligence , Humans , SARS-CoV-2
12.
Value Health ; 25(6): 890-896, 2022 06.
Article in English | MEDLINE | ID: covidwho-1864607

ABSTRACT

OBJECTIVES: Since 2020, COVID-19 has infected tens of millions and caused hundreds of thousands of fatalities in the United States. Infection waves lead to increased emergency department utilization and critical care admission for patients with respiratory distress. Although many individuals develop symptoms necessitating a ventilator, some patients with COVID-19 can remain at home to mitigate hospital overcrowding. Remote pulse-oximetry (pulse-ox) monitoring of moderately ill patients with COVID-19 can be used to monitor symptom escalation and trigger hospital visits, as needed. METHODS: We analyzed the cost-utility of remote pulse-ox monitoring using a Markov model with a 3-week time horizon and daily cycles from a US health sector perspective. Costs (US dollar 2020) and outcomes were derived from the University Hospitals' real-world evidence and published literature. Costs and quality-adjusted life-years (QALYs) were used to determine the incremental cost-effectiveness ratio at a cost-effectiveness threshold of $100 000 per QALY. We assessed model uncertainty using univariate and probabilistic sensitivity analyses. RESULTS: Model results demonstrated that remote monitoring dominates current standard care, by reducing costs ($11 472 saved) and improving outcomes (0.013 QALYs gained). There were 87% fewer hospitalizations and 77% fewer deaths among patients with access to remote pulse-ox monitoring. The incremental cost-effectiveness ratio was not sensitive to uncertainty ranges in the model. CONCLUSIONS: Patient with COVID-19 remote pulse-ox monitoring increases the specificity of those requiring follow-up care for escalating symptoms. We recommend remote monitoring adoption across health systems to economically manage COVID-19 volume surges, maintain patients' comfort, reduce community infection spread, and carefully monitor needs of multiple individuals from one location by trained experts.


Subject(s)
COVID-19 , COVID-19/epidemiology , Cost-Benefit Analysis , Humans , Monitoring, Physiologic , Oximetry , Quality-Adjusted Life Years , United States
13.
Research in International Business and Finance ; : 101680, 2022.
Article in English | ScienceDirect | ID: covidwho-1852006

ABSTRACT

Using the quantile connectedness approach for the median, lower, and upper quantiles, we examine the return and volatility connectedness between energy and BRIC markets from January 1, 2000, to July 9, 2021. We find that uncertain economic activity and intense periods characterize energy and BRIC market returns and volatility connectedness. A parallel return and volatility connectedness structure for upper and lower quantiles against the average quantile revealed different results. Time-varying features are substantiated between energy and BRIC markets;significant distress events, such as the Global Financial Crisis, European Debt Crisis, Shale Oil Revolution, and COVID-19 pandemic, intensified spillovers. We highlight diversification avenues for energy and BRIC markets given the periods of financial turmoil, with investors’ concerns widely addressed by opt-in investment opportunities with lower risk and greater diversification. Our study has beneficial implications for policymakers, regulators, investors, and financial market constituents to redevelop their existing strategies to avoid financial losses.

14.
Trials ; 23(1): 400, 2022 May 12.
Article in English | MEDLINE | ID: covidwho-1846860

ABSTRACT

BACKGROUND: This update describes changes to the Brief Educational Tool to Enhance Recovery (BETTER) trial in response to the COVID-19 pandemic. METHODS/DESIGN: The original protocol was published in Trials. Due to the COVID-19 pandemic, the BETTER trial converted to remote recruitment in April 2020. All recruitment, consent, enrollment, and randomization now occur by phone within 24 h of the acute care visit. Other changes to the original protocol include an expansion of inclusion criteria and addition of new recruitment sites. To increase recruitment numbers, eligibility criteria were expanded to include individuals with chronic pain, non-daily opioid use within 2 weeks of enrollment, presenting musculoskeletal pain (MSP) symptoms for more than 1 week, hospitalization in past 30 days, and not the first time seeking medical treatment for presenting MSP pain. In addition, recruitment sites were expanded to other emergency departments and an orthopedic urgent care clinic. CONCLUSIONS: Recruiting from an orthopedic urgent care clinic and transitioning to remote operations not only allowed for continued participant enrollment during the pandemic but also resulted in some favorable outcomes, including operational efficiencies, increased enrollment, and broader generalizability. TRIAL REGISTRATION: ClinicalTrials.gov NCT04118595 . Registered on October 8, 2019.


Subject(s)
Acute Pain , COVID-19 , Musculoskeletal Pain , Acute Pain/diagnosis , Acute Pain/therapy , Emergency Service, Hospital , Humans , Musculoskeletal Pain/diagnosis , Musculoskeletal Pain/therapy , Pandemics , Randomized Controlled Trials as Topic , SARS-CoV-2 , Treatment Outcome
15.
Dissertation Abstracts International Section A: Humanities and Social Sciences ; 83(7-A):No Pagination Specified, 2022.
Article in English | APA PsycInfo | ID: covidwho-1837334

ABSTRACT

The purpose of this study was to explore how college and university presidents perceive the Greek social organizations that exist on their campus. Fraternities and sororities, in recent years, have increasingly been placed underneath a microscope. While a variety of research exists in regards to perceptions of Greek social organizations there is a dearth of research analyzing college and university presidents. A phenomenological approach was used in order to allow the participants to share stories, experiences, and perceptions freely and unfiltered. The study focused on the Ohio Valley region of the United States. Sixteen presidents volunteered to participate in the interview which represented 5 states and various institution types. The semi-structured interviews were conducted virtually due to the COVID-19 pandemic and allowed for rich conversation, storytelling, and detail descriptions of the phenomenon. Data explication allowed for the finding of three themes across the sixteen participants. These themes were: Financial Impact, Campus Impact, and Desired Evolution. The participants expressed their approval and excitement for the research as it gave them an opportunity to reflect on their experiences and freely share their thoughts. This study is one of the first to investigate the lived experiences of college and university presidents as it related to Greek social organizations. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

16.
J Clin Transl Res ; 7(6): 723-732, 2021 Dec 28.
Article in English | MEDLINE | ID: covidwho-1823845

ABSTRACT

BACKGROUND AND AIM: The COVID-19 pandemic was declared a national emergency in the United States in March 2020. The Centers for Medicare and Medicaid Services subsequently released recommendations that health-care facilities temporarily delay elective surgeries and non-essential medical procedures. Disruptions to medical care significantly impacted cancer patients, with cancer screenings halted and nonurgent cancer surgeries postponed as health-care facilities shifted resources toward the COVID-19 pandemic. Although it has been reported that cancer screening rates decreased dramatically in the United States in 2020, it is unclear whether this trend was driven by factors related to public interest in cancer and/or cancer screening as opposed to other factors such as clinical backlogs, pandemic-related policies, and/or resource limitations. The purpose of this study was to use the Google Trends tool to evaluate public interest in six common malignancies and four common cancer screening methods during the COVID-19 pandemic. METHODS: We used the Google Trends tool to quantify public interest in six different malignancies (Breast Cancer, Colon Cancer, Lung Cancer, Prostate Cancer, Thyroid Cancer, and Cervical Cancer) and four cancer screening methods (Pap Smear, Lung Cancer Screening, Mammogram, and Colonoscopy) in the United States during the COVID-19 pandemic. Welch's t-tests were used to compare monthly search volumes during the COVID-19 pandemic (2020) to the 4 years before the pandemic (2016 - 2019) for all ten search terms included in our study. We used Benjamini-Hochberg to adjust raw p values to account for multiple statistical comparisons. The level of statistical significance was defined by choosing a false discovery rate of 0.05. RESULTS: Our results indicate significantly reduced interest in all malignancies studied at the beginning of the COVID-19 pandemic. Public interest in ['Breast Cancer'], ['Colon Cancer'], ['Lung Cancer'], ['Thyroid Cancer'], and ['Cervical Cancer'] significantly decreased in the months of March, April, May, and June 2020 when compared with public interest in 2016-2019. Public interest in cancer screening methods such as ['Pap Smear'], ['Lung Cancer Screening'], ['Mammogram'], and ['Colonoscopy'] significantly deceased in the months of April and May compared to 2016 - 2019 values. However, decreased public interest in cancer screening methods was temporary, with Google search volumes returning to pre-pandemic levels in June 2020 - December 2020. CONCLUSION: There was significantly reduced public interest in both common malignancies and cancer screening methods at the beginning of the COVID-19 pandemic in the United States. However, after an initial decline, public interest as indicated by Google search volumes quickly returned to pre-pandemic levels in the second half of the calendar year 2020. In addition, trends in public interest in cancer screening as indicated by Google search volumes aligned with cancer screening uptake rates in the United States during the study period. This finding suggests that Google Trends may serve as an effective tool in gauging the public's interest in cancer and/or cancer screenings in the United States, which makes it a valuable resource that can be used to inform decisions aimed at improving cancer screening rates in the future. RELEVANCE FOR PATIENTS: The Google Trends tool can be used to measure public interest in various malignancies and their associated screening methods. Google Trends data may be used to inform measures aimed at improving cancer screening uptake.

17.
PLoS One ; 17(3): e0264260, 2022.
Article in English | MEDLINE | ID: covidwho-1793519

ABSTRACT

BACKGROUND: Reports on medium and long-term sequelae of SARS-CoV-2 infections largely lack quantification of incidence and relative risk. We describe the rationale and methods of the Innovative Support for Patients with SARS-CoV-2 Registry (INSPIRE) that combines patient-reported outcomes with data from digital health records to understand predictors and impacts of SARS-CoV-2 infection. METHODS: INSPIRE is a prospective, multicenter, longitudinal study of individuals with symptoms of SARS-CoV-2 infection in eight regions across the US. Adults are eligible for enrollment if they are fluent in English or Spanish, reported symptoms suggestive of acute SARS-CoV-2 infection, and if they are within 42 days of having a SARS-CoV-2 viral test (i.e., nucleic acid amplification test or antigen test), regardless of test results. Recruitment occurs in-person, by phone or email, and through online advertisement. A secure online platform is used to facilitate the collation of consent-related materials, digital health records, and responses to self-administered surveys. Participants are followed for up to 18 months, with patient-reported outcomes collected every three months via survey and linked to concurrent digital health data; follow-up includes no in-person involvement. Our planned enrollment is 4,800 participants, including 2,400 SARS-CoV-2 positive and 2,400 SARS-CoV-2 negative participants (as a concurrent comparison group). These data will allow assessment of longitudinal outcomes from SARS-CoV-2 infection and comparison of the relative risk of outcomes in individuals with and without infection. Patient-reported outcomes include self-reported health function and status, as well as clinical outcomes including health system encounters and new diagnoses. RESULTS: Participating sites obtained institutional review board approval. Enrollment and follow-up are ongoing. CONCLUSIONS: This study will characterize medium and long-term sequelae of SARS-CoV-2 infection among a diverse population, predictors of sequelae, and their relative risk compared to persons with similar symptomatology but without SARS-CoV-2 infection. These data may inform clinical interventions for individuals with sequelae of SARS-CoV-2 infection.


Subject(s)
COVID-19/complications , COVID-19/therapy , Palliative Care , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/epidemiology , Case-Control Studies , Cohort Studies , Female , Humans , Longitudinal Studies , Male , Middle Aged , Palliative Care/methods , Palliative Care/organization & administration , Patient Reported Outcome Measures , Prognosis , Registries , SARS-CoV-2/physiology , Social Determinants of Health , Therapies, Investigational/methods , Time Factors , Young Adult
18.
Harvard Journal of Law and Public Policy ; 45(1):83-101, 2022.
Article in English | ProQuest Central | ID: covidwho-1790702

ABSTRACT

In a speech delivered at the Federalist Society's Annual Lawyers Convention via the internet, Alito talks about what the Society is, what it is not, and why he has been a member for many years. He also talks about the the COVID-19 crisis.

19.
J Clin Med ; 11(6)2022 Mar 19.
Article in English | MEDLINE | ID: covidwho-1760682

ABSTRACT

Goals of care discussions typically focus on decision maker preference and underemphasize prognosis and outcomes related to frailty, resulting in poorly informed decisions. Our objective was to determine whether navigated care planning with nursing home residents or their decision makers changed care plans during the first wave of the COVID-19 pandemic. The MED-LTC virtual consultation service, led by internal medicine specialists, conducted care planning conversations that balanced information-giving/physician guidance with resident autonomy. Consultation included (1) the assessment of co-morbidities, frailty, health trajectory, and capacity; (2) in-depth discussion with decision makers about health status and expected outcomes; and (3) co-development of a care plan. Non-parametric tests and logistic regression determined the significance and factors associated with a change in care plan. Sixty-three residents received virtual consultations to review care goals. Consultation resulted in less aggressive care decisions for 52 residents (83%), while 10 (16%) remained the same. One resident escalated their care plan after a mistaken diagnosis of dementia was corrected. Pre-consultation, 50 residents would have accepted intubation compared to 9 post-consultation. The de-escalation of care plans was associated with dementia, COVID-19 positive status, and advanced frailty. We conclude that during the COVID-19 pandemic, a specialist-led consultation service for frail nursing home residents significantly influenced decisions towards less aggressive care.

20.
Health Services & Outcomes Research Methodology ; 22(1):1-15, 2022.
Article in English | CINAHL | ID: covidwho-1739371

ABSTRACT

Constructing accurate patient transfer networks between hospitals is critical for understanding the spread of healthcare associated infections through statistical and mathematical modeling, and for determining optimal screening and treatment strategies. The Healthcare Cost & Utilization Project (HCUP) State Inpatient Databases (SID) provide valuable information on patient transfers from publicly obtainable claims databases, yet often give an incomplete picture due to missingness of patient tracking identifiers. We designed a novel imputation algorithm that enabled us to estimate the true number of patient transfers between each pair of hospitals in a state over a specified time period and age group in the presence of these missing identifiers. We then validated the algorithm's performance through a series of simulation experiments using the HCUP SID, and finally tested the algorithm on multiple states' genuine data. Our proposed method significantly reduced the total mean squared error in predicting the true number of transfers amongst hospitals for all simulation experiments, and it also yielded epidemic simulations that more closely approximated those corresponding to the true patient transfer network.

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