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1.
iPSCs for Studying Infectious Diseases ; : 31-46, 2021.
Article in English | Scopus | ID: covidwho-1803274

ABSTRACT

Intracranial inoculation of susceptible strains of mice with the neuroadapted JHM strain of mouse hepatitis virus (JHMV, a member of the Coronaviridae family of viruses) results in an acute encephalomyelitis characterized by widespread growth of virus in astrocytes, microglia, and oligodendrocytes with relative sparing of neurons. Virus-specific CD4+ and CD8+ T cells infiltrate into the central nervous system in response to infection and control viral replication through secretion of interferon gamma as well as cytolytic activity. Nonetheless, virus persists in white matter tracts, and animals develop an immune-mediated demyelinating disease in which both T cells and macrophages amplify white matter damage. For the past decade, we have explored the therapeutic potential of human neural progenitor cells derived from pluripotent stem cells in promoting clinical recovery associated with remyelination of demyelinated axons following intraspinal transplantation. This chapter highlights recent studies from our laboratories demonstrating that tissue repair is associated with the emergence of regulatory T cells in response to transplantation of NPCs. © 2021 Elsevier Inc. All rights reserved.

2.
American Journal of Obstetrics and Gynecology ; 226(3, Supplement):S1342-S1343, 2022.
Article in English | ScienceDirect | ID: covidwho-1705586
3.
Journal of Comparative Social Work ; 16(2):113-140, 2021.
Article in English | Scopus | ID: covidwho-1702744

ABSTRACT

The COVID-19 pandemic has significantly affected all aspects of social work education, including field education. The Transforming the Field Education Landscape (TFEL) partnership conducted two national online surveys to determine the impacts of the pandemic on social work field education. The first survey explored the perspectives of students and received responses from 367 Bachelor of Social Work (BSW) and Master of Social Work (MSW) students. The second survey was designed to gather the perspectives of field instructors, with 73 field instructors completing the survey. The article examines the impacts of the pandemic on social work practice, field supervision, practicum flexibility and accommodations in placement, the shift to remote learning, perceptions of future career prospects and the effects on wellness and mental health. This article contributes to an increased understanding of the strengths and challenges facing social work field education, and informs field planning and responses in a pandemic. The findings will be of interest to social work field education programmes, field education coordinators and directors, field instructors, field agencies and undergraduate and graduate social work students. Recommendations for social work field education are offered. © 2021. All Rights Reserved.

4.
Obesity ; 29(SUPPL 2):195, 2021.
Article in English | EMBASE | ID: covidwho-1616060

ABSTRACT

Background: Delays from the COVID-19 pandemic led to increased surgical wait times. With ongoing bed pressures, we must safely maximize surgical volumes. We prospectively evaluated the feasibility and safety of bariatric surgery without inpatient hospital admission. Methods: We identified patients whose elective bariatric surgery we felt could be safely scheduled without inpatient admission to a surgical ward. Patients recovered in an 'overnight stay' perioperative area. Selection criteria excluded patients with revisional surgery, BMI≥55, insulin-dependent diabetes, or therapeutic anticoagulation. Data were collected on consecutive patients scheduled without admission between April and June 2021. Seven-day emergency department (ED) visits and readmissions were used to establish the safety of this intervention. Results: Of 47 patients scheduled for surgery without admission, 42 (89.4%) underwent Roux-en- Y gastric bypasses and 5 (10.6%) sleeve gastrectomies. Patients stayed between 16 and 23 hours, with a mean and median of just over 20 hours. Only 2 (4.3%) patients required admission to the surgical ward, but both were discharged on postoperative day 1 (POD1). Only 2(4.3%) patients had ED visits within 7 days postoperatively, and neither required admission. There were no complications, reoperations, or deaths. A control group of bariatric surgery patients with planned hospital admission per usual care is being analyzed for comparison. Conclusions: We demonstrated that bariatric surgery can be performed without inpatient hospital admission in select patients. We anticipate our controls will further confirm the safety of this endeavor. Optimizing resource utilization is crucial now, as hospitals recover from the pandemic and prepare for potential future waves.

5.
Journal of Money Credit and Banking ; : 43, 2021.
Article in English | Web of Science | ID: covidwho-1597331

ABSTRACT

We employ a new Keynesian model with random search in the labor market and endogenous selection among heterogeneous workers to investigate the impact of a pandemic-induced recession on the distribution of unemployment across workers. In such a recession, workers whose unemployment spells in normal times are inefficiently frequent and long are disproportionately affected. This remains true even when the pandemic initially causes mass layoffs that affect workers broadly or if many separations represent temporary layoffs. Monetary policy that responds to labor market variables affects unemployment for all workers but does relatively little for the distribution of unemployment across workers types.

6.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-297060

ABSTRACT

Human organs are complex, three-dimensional and multiscale systems. Spatially mapping the human body down through its hierarchy, from entire organs to their individual functional units and specialised cells, is a major obstacle to fully understanding health and disease. To meet this challenge, we developed hierarchical phase-contrast tomography (HiP-CT), an X-ray phase propagation technique utilising the European Synchrotron Radiation Facility's Extremely Brilliant Source: the world's first high-energy 4 th generation X-ray source. HiP-CT enabled three-dimensional and non-destructive imaging at near-micron resolution in soft tissues at one hundred thousand times the voxel size whilst maintaining the organ's structure. We applied HiP-CT to image five intact human parenchymal organs: brain, lung, heart, kidney and spleen. These were hierarchically assessed with HiP-CT, providing a structural overview of the whole organ alongside detail of the organ's individual functional units and cells. The potential applications of HiP-CT were demonstrated through quantification and morphometry of glomeruli in an intact human kidney, and identification of regional changes to the architecture of the air-tissue interface and alveolar morphology in the lung of a deceased COVID-19 patient. Overall, we show that HiP-CT is a powerful tool which can provide a comprehensive picture of structural information for whole intact human organs, encompassing precise details on functional units and their constituent cells to better understand human health and disease.

7.
PUBMED; 2021.
Preprint in English | PUBMED | ID: ppcovidwho-293161

ABSTRACT

Human organs are complex, three-dimensional and multiscale systems. Spatially mapping the human body down through its hierarchy, from entire organs to their individual functional units and specialised cells, is a major obstacle to fully understanding health and disease. To meet this challenge, we developed hierarchical phase-contrast tomography (HiP-CT), an X-ray phase propagation technique utilising the European Synchrotron Radiation Facility's Extremely Brilliant Source: the world's first high-energy 4 th generation X-ray source. HiP-CT enabled three-dimensional and non-destructive imaging at near-micron resolution in soft tissues at one hundred thousand times the voxel size whilst maintaining the organ's structure. We applied HiP-CT to image five intact human parenchymal organs: brain, lung, heart, kidney and spleen. These were hierarchically assessed with HiP-CT, providing a structural overview of the whole organ alongside detail of the organ's individual functional units and cells. The potential applications of HiP-CT were demonstrated through quantification and morphometry of glomeruli in an intact human kidney, and identification of regional changes to the architecture of the air-tissue interface and alveolar morphology in the lung of a deceased COVID-19 patient. Overall, we show that HiP-CT is a powerful tool which can provide a comprehensive picture of structural information for whole intact human organs, encompassing precise details on functional units and their constituent cells to better understand human health and disease.

8.
American Journal of Gastroenterology ; 116(SUPPL):S596, 2021.
Article in English | EMBASE | ID: covidwho-1534735

ABSTRACT

Introduction: The Coronavirus 2019 pandemic prompted Gastroenterology (GI) practices to rapidly implement telehealth-based care in order to improve resource allocation, protect patient and staff wellbeing, and comply with public health measures. In 2020, we surveyed nearly 1,500 patients showing a satisfaction rate with telehealth services of over 80%. This current descriptive, survey-based study aims to assess patient satisfaction with telehealth services in comparison to in-person office visits and to portray the factors impacting the patient experience. Methods: An online survey was distributed to patients of eight community-based GI practices across the United States between January and April, 2021. Responses were recorded on a five-point Likert scale. The net promoter score (NPS), a metric for customer loyalty and satisfaction, was calculated to better assess the patient experience. A score between 0-30 denotes good quality of service with room for growth and improvement. Results: A total of 2928 patients had at least one telehealth visit (68.1% female, 87.1% White, mean age 64.5 years). Reason for visit was most often related to inflammatory bowel disease (18.4%), procedure preparation or follow-up (15.2%), or heartburn/reflux (13.4%). Most patients (54.7%) were likely to continue using telehealth services after the pandemic mainly due to shorter wait and travel times (41.1%), flexibility with personal schedule (30.7%), and ease of scheduling appointments on desired date (26.0%). Approximately 73% of respondents indicated that they received a similar quality of care through telehealth as compared to in-person visits and 61.1% stated that patient-physician interaction was also similar. Overall, the NPS for telehealth services among the participating GI practices was 25. Conclusion: Telehealth has become a valuable component of the healthcare system. Our results add to the existing literature regarding the high rate of patient satisfaction with telehealth and display the fact that the quality of virtual care can be perceived similar to that of in-person care. Furthermore, the calculated NPS confirms this level of satisfaction while signaling the need for continued growth and development of virtual care delivery. Further studies are needed to assess the impact of telehealth services on patient and population health outcomes and evaluate underrepresented..

9.
Nat Methods ; 18(12): 1532-1541, 2021 12.
Article in English | MEDLINE | ID: covidwho-1504972

ABSTRACT

Imaging intact human organs from the organ to the cellular scale in three dimensions is a goal of biomedical imaging. To meet this challenge, we developed hierarchical phase-contrast tomography (HiP-CT), an X-ray phase propagation technique using the European Synchrotron Radiation Facility (ESRF)'s Extremely Brilliant Source (EBS). The spatial coherence of the ESRF-EBS combined with our beamline equipment, sample preparation and scanning developments enabled us to perform non-destructive, three-dimensional (3D) scans with hierarchically increasing resolution at any location in whole human organs. We applied HiP-CT to image five intact human organ types: brain, lung, heart, kidney and spleen. HiP-CT provided a structural overview of each whole organ followed by multiple higher-resolution volumes of interest, capturing organotypic functional units and certain individual specialized cells within intact human organs. We demonstrate the potential applications of HiP-CT through quantification and morphometry of glomeruli in an intact human kidney and identification of regional changes in the tissue architecture in a lung from a deceased donor with coronavirus disease 2019 (COVID-19).


Subject(s)
COVID-19/pathology , Image Processing, Computer-Assisted/methods , Imaging, Three-Dimensional/methods , Lung/pathology , SARS-CoV-2 , Tomography, X-Ray Computed/methods , Humans , Kidney/anatomy & histology , Synchrotrons
10.
Journal of Minimally Invasive Gynecology ; 28(11, Supplement):S101-S102, 2021.
Article in English | ScienceDirect | ID: covidwho-1466637

ABSTRACT

Study Objective The purpose of this study was to evaluate the effect of the COVID-19 pandemic on the ectopic pregnancy surgical volume, both ruptured and stable cases, at a New York City high-volume, tertiary-care center. Design A retrospective chart review of 2 years of ectopic pregnancy surgical case volume. The time period evaluated included March 2019-February 2020 prior to the COVID-19 pandemic in New York City followed by March 2020-February 2021 when hospital services shifted to care of such patients. Setting N/A. Patients or Participants All patients who underwent emergent gynecological surgery for ectopic pregnancies were reviewed by weekly and monthly volume over a 2-year period. Further review of ruptured as compared to unruptured cases was performed, with particular interest regarding hemoperitoneum at time of abdominal entry. Interventions N/A. Measurements and Main Results There was no significant difference (t(21) = 0.52, p = 0.612) between the pre-pandemic year March 2019 – February 2020 with a total of 33 ectopic cases (mean monthly volume 2.75, SD = 1.42) as compared to March 2020 – February 2021 total of 37 ectopic cases (mean monthly volume 3.08, SD = 1.73). There was no significant difference (t(22) = 0.56, p = 0.583) regarding ruptured ectopic case volume between 2019-2020 and 2020-2021 (total of 23 and 27, mean monthly volume 1.92 and 2.25 respectively). Finally, for ruptured ectopic cases, the mean estimated hemoperitoneum encountered upon entry into the abdomen (excluding subsequent operative blood loss) was 184.29 cc pre-pandemic and 244.8 cc during the pandemic with no significant difference between the years (t (44) = 1.18, p = 0.244). Conclusion There were no significant differences in ectopic case volume prior and after the COVID-19 pandemic and no significant differences in hemoperitoneum upon abdominal entry, suggesting that the fear of the pandemic was not a deterrent to care for patients needing emergent ectopic surgery.

11.
Journal of Minimally Invasive Gynecology ; 28(11, Supplement):S20, 2021.
Article in English | ScienceDirect | ID: covidwho-1466635

ABSTRACT

Study Objective This study aims to identify patient characteristics associated with length of delay or not returning for elective benign gynecologic surgical procedures that were canceled due to the COVID-19 pandemic. Design Retrospective review of electronic medical records. Setting Academic, urban, tertiary hospital system. Patients or Participants Between March 15, 2020, and May 15, 2020, all elective surgical procedures were canceled due to resource limitations. Electronic medical records were reviewed through November 15, 2020, to assess whether patients rescheduled or did not come back for surgery within the following six-month period. Interventions N/A. Measurements and Main Results 219 benign gynecologic surgeries were canceled between March 15 and May 15, 2020. 158 (72%) patients returned within the following six months for their procedure, and 61 patients (28%) did not return. Among patients who rescheduled, the length of delay was not correlated with age, race/ethnicity, or route of surgery. There was, however, sufficient data to conclude that length of delay differed by primary indication of surgery (p=.0173). There was an association between not returning for surgery and primary indication of pelvic organ prolapse/ incontinence repair (p=.0203). Conclusion The majority of patients rescheduled their procedure within six months following the peak of the COVID-19 crisis. The primary indication of pelvic organ prolapse and incontinence was associated with a decreased likelihood of returning for surgery within six months.

12.
Journal of Childrens Services ; ahead-of-print(ahead-of-print):14, 2021.
Article in English | Web of Science | ID: covidwho-1379504

ABSTRACT

Purpose This paper aims to report on the findings of a qualitative study that explored the views and experiences of young people leaving care during the first phase of the Covid-19 pandemic in Northern Ireland. Design/methodology/approach A qualitative approach was adopted involving semi-structured interviews with 24 care leavers 18-25 years old from across the region. Interviews were conducted remotely online or by telephone and explored young people's lived experiences during the pandemic including their views on the formal support services and how best to provide ongoing for support care leavers during the pandemic. Findings Study findings highlight how known adversities for care leavers are exacerbated during the pandemic, having a detrimental impact, particularly on their emotional well-being. The response of the state as a corporate parent in mitigating the impact of the pandemic was found to be inadequate;with a need for much clearer communication, transparent and prompt decision-making and targeted specialist mental health services. The account given by the young people also highlighted the importance of participation and relationship-based practice to build on the young people's resilience in the context of high levels of social isolation and limited access to informal support systems. Originality/value This research, based on the views of care experienced young people themselves, is the first study in Northern Ireland to report on the impact of the Covid 19 pandemic on care leaving. As such it makes a contribution to this emerging international field of study and, given the persistence of the pandemic, provides empirical findings and a social justice perspective of ongoing relevance to policy and practice with young people leaving care.

13.
International Journal of Children's Rights ; 29(2):261-285, 2021.
Article in English | Scopus | ID: covidwho-1285134

ABSTRACT

Children have a right to have their views sought and given due weight on all matters affecting them, including at times of emergency and crisis. This article describes the process and findings of the ground-breaking CovidUnder19 survey (“Life Under Coronavirus”) which was co-designed with children for children, capturing the experiences of over 26,000 children in 137 countries as to the realisation of their human rights during the first six months of the Covid-19 pandemic. Key findings are discussed through the lens of the crc’s four general principles, read alongside children’s rights, inter alia, to education, play and to be protected from harm. It argues that governments and public bodies should have sought children’s views – not just because they were under an obligation to do so – but because such engagement, now and in crises to come, provides an early warning system that enables decision-makers to mitigate some of the adverse consequences of their responses for children and their rights. © Laura Lundy et al., 2021

14.
Gastrointestinal Endoscopy ; 93(6):AB327-AB328, 2021.
Article in English | Web of Science | ID: covidwho-1261632
15.
Language and Intercultural Communication ; 2021.
Article in English | Scopus | ID: covidwho-1246618

ABSTRACT

How are we to think about pedagogy and education in these present times when existence itself is in tension and question? As the pandemics of COVID-19, systemic racism, capitalist greed, and land-based plundering, displacement, and dispossession work together to reconfigure power and, relatedly, formal education, most especially in the Global South, what might it mean to think from and shift our gaze toward the decolonial ‘cracks’? How do these ‘cracks’–understood as the extant and nascent fissures in the dominant order–take form? Who are the ‘crack-makers’ and in what ways, through their ground up theorizing, practice, and praxis, are they giving substance and form to the pedagogical imperatives of resistance, re-existence, hope, and life, imperatives conspicuously absent in the conceptualization and rhetoric of ‘quality education’? And finally, what might a reading and rereading of Paulo Freire offer in this regard?. © 2021 Informa UK Limited, trading as Taylor & Francis Group.

16.
Journal of Investigative Medicine ; 69(2):635, 2021.
Article in English | EMBASE | ID: covidwho-1147452

ABSTRACT

Case Report Wiskott-Aldrich Syndrome (WAS) is a recessive Xlinked syndrome characterized by atopic dermatitis, impaired humoral immunity, thrombocytopenia, and autoimmune disease. We present a case of diffuse alveolar hemorrhage initially thought to be bronchiolitis. A 4-month-old late preterm male with history of congenital thrombocytopenia and eczema presented with respiratory distress, hypoxia, cough, petechiae, and painful rash on day of illness (DOI) 5. He had no fever, congestion, or rhinorrhea. Rapid RSV was positive, but viral PCR including RSV and SARS-CoV-2 was negative. Admission labs were notable for thrombocytopenia (54 K/mm3), and otherwise normal leukocytes (9.8 K/mm3), hemoglobin (11.4 g/dL), and CRP (4.9 mg/L). Chest radiograph showed interstitial changes suggesting chronic lung disease. Hypoxia worsened on DOI 6 requiring critical care admission and escalation of oxygen to high flow nasal cannula. Dermatology diagnosed his rash as eczema with viral exanthem. His clinical course and radiographic finding of interstitial changes were not consistent with bronchiolitis and prompted a chest CT on DOI 8 that demonstrated extensive patchy bilateral ground glass opacities consistent with diffuse alveolar hemorrhage. PT, PTT, D-dimer, and Factor VIII activity were normal. Peripheral smear showed small scant platelets. Immunoglobulins were mildly elevated. Oxygen was weaned off by DOI 23. PJP prophylaxis was started due to mild neutropenia with presumed WAS diagnosis. Genetic testing confirmed the diagnosis of WAS. The WAS gene mutation results in a spectrum of syndromes including Wiskott-Aldrich syndrome, X-linked thrombocytopenia and X-linked neutropenia. WAS includes thrombocytopenia, atopic dermatitis, recurrent infections, and autoimmune diseases which rarely can include pulmonary capillaritis leading to diffuse alveolar hemorrhage. Here the initial diagnosis of RSV bronchiolitis was misleading, but a high index of suspicion with an atypical course lead to diagnosis and appropriate treatment and follow-up for WAS.

17.
Ann R Coll Surg Engl ; 103(3): 151-154, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1110067

ABSTRACT

INTRODUCTION: Owing to the COVID-19 pandemic, there has been significant disruption to all surgical specialties. In the UK, units have cancelled elective surgery and a decrease in aerosol generating procedures (AGPs) was favoured. Centres around the world advocate the use of negative pressure environments for AGPs in reducing the spread of infectious airborne particles. We present an overview of operating theatre ventilation systems and the respective evidence with relation to surgical site infection (SSI) and airborne pathogen transmission in light of COVID-19. METHODS: A literature search was conducted using the PubMed, Cochrane Library and MEDLINE databases. Search terms included "COVID-19", "theatre ventilation", "laminar", "turbulent" and "negative pressure". FINDINGS: Evidence for laminar flow ventilation in reducing the rate of SSI in orthopaedic surgery is widely documented. There is little evidence to support its use in general surgery. Following previous viral outbreaks, some centres have introduced negative pressure ventilation in an attempt to decrease exposure of airborne pathogens to staff and surrounding areas. This has again been suggested during the COVID-19 pandemic. A limited number of studies show some positive results for the use of negative pressure ventilation systems and reduction in spread of pathogens; however, cost, accessibility and duration of conversion remain an unexplored issue. Overall, there is insufficient evidence to advocate large scale conversion at this time. Nevertheless, it may be useful for each centre to have its own negative pressure room available for AGPs and high risk patients.


Subject(s)
Air Filters , COVID-19/prevention & control , Environment, Controlled , Operating Rooms , Patient Isolators , Surgical Procedures, Operative/methods , Ventilation/methods , COVID-19/transmission , Humans , Orthopedic Procedures , SARS-CoV-2 , Surgical Wound Infection/prevention & control
19.
Journal of Minimally Invasive Gynecology ; 27(7, Supplement):S66, 2020.
Article in English | ScienceDirect | ID: covidwho-872264

ABSTRACT

Study Objective To assess anxiety, satisfaction with interim medical care, and changes in medical status in patients who had benign gynecologic surgery postponed due to COVID. Design Online patient survey. Setting New York City Academic Medical Center. Patients or Participants In Mid-March of 2020 there was a moratorium on elective services due to the COVID-19 pandemic. In our institution, 220 patients were identified who had gynecologic surgery postponed. Of these patients, 150 patients were successfully contacted and invited to participate in the study, and 86 completed the survey. Interventions The research instrument was an online survey, which included a validated anxiety questionnaire. Measurements and Main Results Indications for surgery were fibroids (48%), abnormal bleeding (16%), ovarian mass (16%), endometriosis (12%), incontinence (8%), infertility (7%), prolapse (5%), and dysplasia (2%). On the Zung Self-Rated Anxiety Scale, 92% scored within normal range and 8% scored mild-to-moderate anxiety level. 50% of patients reported feeling more anxious about COVID exposure, 22% were more anxious about waiting for surgery, and 28% were equally anxious about both. Sentiment analysis of an open-ended question about postponement revealed 52% of responses were negative, 27% neutral, and 21% positive. Primary themes within negative responses were “frustrated” or “disappointed” about surgery cancellation. Primary themes within positive responses were “safe” or “relieved.” During the postponement, 60% of patients reported symptoms were the same, 27% worse, and 13% better. 36% of patients reported using alternative therapy while awaiting surgery, the most common being non-opioid pain medication (37%), hormonal therapy (29%), dietary changes (29%), supplements (20%), bladder training exercises (7%), pessary (2%), and pelvic floor physical therapy (2%). 80% reported access to MyChart, and 30% participated in telehealth visits, of which all reported satisfaction with the visit. Conclusion Patients with benign gynecologic surgery postponed due to COVID-19 had a negative impression of this impact on their care.

20.
Journal of Minimally Invasive Gynecology ; 27(7, Supplement):S142, 2020.
Article in English | ScienceDirect | ID: covidwho-872263

ABSTRACT

Study Objective To report on the continuance of gynecologic surgery during the COVID-19 pandemic. Design Case series. Setting New York City Academic Medical Center. Patients or Participants In Mid-March of 2020 there was a moratorium on elective services due to the COVID-19 pandemic. 105 surgeries were completed from March 15-April 30, and those that were emergent and urgent were identified. Essential gynecologic surgical procedures were provided during the COVID-19 pandemic. Interventions Peri-operative data were collected retrospectively. Measurements and Main Results A total of 45 cases were identified that were emergent and urgent gynecologic surgical procedures during the COVID-19 pandemic in New York City. Average age was 34 years (range 24-68). In our health system, there were 23 emergency gynecologic cases, the most common were ectopic (14), torsion (3), retained products of conception causing hemorrhage (3) or sepsis (1), exploratory laparotomy for post-operative small bowel obstruction (1), and vaginal myomectomy for hemorrhage (1). Pre-operative PCR testing for COVID-19 was available March 31, but emergency cases were not delayed to await test results. Of the emergency cases, 21 (91.3%) were performed with general and 2 (8.7%) with neuraxial anesthesia. There were 21 urgent gynecologic surgical procedures. All surgical procedures recovered in the operating room during this time frame. Conclusion Essential gynecologic surgery can feasibly continue during peak pandemic crisis in high prevalence areas, with appropriate safety measures.

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