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1.
Journal of General Internal Medicine ; 37:S295, 2022.
Article in Spanish | EMBASE | ID: covidwho-1995614

ABSTRACT

BACKGROUND: Safety net health care systems (which disproportionately serve racial/ethnic minority, low-income, and/or Limited English Proficient (LEP) populations) care for patients who face a multilevel “digital divide.” The transition to telemedicine prompted by the Coronavirus-19 disease (COVID- 19) pandemic facilitated continuity of care in some settings. However, most safety net health systems were left ill-prepared to address challenges to digital uptake among their patients, individuals who already face language and literacy barriers that negatively impact health access and health outcomes. Because there is little evidence on telemedicine implementation strategies in safety nets, we examined perspectives from leadership and frontline healthcare workers in the Los Angeles County Department of Health Services (LAC DHS), the second largest safety net in the United States, regarding facilitators and barriers for effective and patient-centered telemedicine implementation in a safety net setting. METHODS: We conducted 20 in-depth interviews with LAC DHS physicians, nurses, medical/nursing directors, and administrative leadership between October 2020 and December 2020. Interview scripts included questions about telemedicine experiences, technology, staff resources, needs, and facilitators for their implementation, (focusing on video visits). Qualitative analyses involved a deductive approach, with thematic summaries of transcript content using Atlas.ti software. RESULTS: Each of the 5 major LAC DHS centers (encompassing diverse health settings across all of Los Angeles county) were represented among the participants. Based on these interviews, a process map was developedoutlining the numerous staff and patient steps needed to achieve a single LAC DHS telemedicine video visit, alongside identified facilitators and barriers. Themes surrounding telemedicine implementation were identified at the patient, clinic/provider, health system levels with accompanying exemplar quotations. These included: preparedness for digital access and utilization (patient), staff empowerment to implement visits (clinic/provider), telemedicine technology infrastructure (system), among others. CONCLUSIONS: Telemedicine implementation in the safety net setting will require a team-based approach, and patient, clinic, and health system level themes must be considered when disseminating telemedicine services across safety net settings. In particular, participants emphasized prioritizing “hightouch” efforts to enroll patients in their health portal as an entry to digital health engagement/education, and facilitating access to telemedicine visits. Participants also highlighted robust workflows, having defined staff telemedicine “champions,” and multidisciplinary teams that could focus on telemedicine access for patients. Future research will also need to focus on safety net patients' experiences with telemedicine access and quality.

2.
5.
Clinical Neurosurgery ; 67(SUPPL 1):44, 2020.
Article in English | EMBASE | ID: covidwho-1816178

ABSTRACT

INTRODUCTION: During the Sars-CoV-2 pandemic, Endoscopic Endonasal Surgery (EES) is feared to be a high-risk procedure for transmission of the COVID-19 virus. Nonetheless, data are lacking regarding the management of EES during this pandemic. METHODS: A web-based survey of skull base surgeons worldwide was conducted.Different practices by geographical regions and COVID-19 prevalence were analyzed. RESULTS: 135 unique responses were collected. Regarding the use of personal protection equipment (PPE), North America reported using more powered air-purifying respirators (PAPR) and Asia/Europe using more standard precautions. North America and Europe resorted more to reverse transcriptase polymerase chain reaction (RT-PCR) for screening asymptomatic patients. High prevalence countries showed a higher use of PAPR. The medium prevalence group reported lower RT-PCR testing for symptomatic cases and the high prevalence group used it significantly more in asymptomatic cases. 19 respondents reported healthcare personnel transmission of COVID-19 from EES, with a higher rate of transmission among countries classified as having a medium prevalence of COVID-19. These specific respondents (medium prevalence) also reported a lower use of airborne PPE. In the cases of healthcare transmission, the patient was reportedly asymptomatic 32% of the time. CONCLUSION: This survey gives an overview of EES practices during the Sars-CoV-2 pandemic. Intensified preoperative screening, even in asymptomatic patients, RT-PCR for all symptomatic cases, and an increased use of airborne PPE is associated with decreased reports of COVID-19 transmission during EES.

6.
Blood ; 138(SUPPL 1):1284, 2021.
Article in English | EMBASE | ID: covidwho-1770222

ABSTRACT

BACKGROUND: BPDCN is a rare, aggressive hematologic malignancy characterized by historically poor overall survival and limited therapeutic options. Despite the recent approval of tagraxofusp-erzs for BPDCN, outcomes remain suboptimal for many patients. Additionally, patients with BPDCN are older and often have co-morbidities at baseline, preventing them from receiving tagraxofusp-erzs. Therefore, novel therapies are needed in the frontline setting for patients with BPDCN. Overexpression of CD123 (IL-3Rα) is present in all BPDCN cases, thereby establishing this surface marker as a target for therapeutic intervention. IMGN632 is a CD123-targeting ADC, comprised of a high-affinity anti-CD123 antibody coupled to a DNA-alkylating payload of the novel IGN (indolinobenzodiazepine pseudodimer) class. IMGN632 has demonstrated favorable safety and promising clinical activity in relapsed/refractory (R/R) BPDCN [Blood (2020) 136 (Supplement 1): 11-13], leading to the FDA granting IMGN632 Breakthrough Therapy Designation (BTD) for R/R BPDCN (Oct 2020). Following BTD and alignment with FDA, a pivotal cohort in frontline (no prior systemic treatment) BPDCN patients was initiated in addition to a continuing cohort of patients with R/R disease, where we have enrolled 33 patients to date. Here we report the initial experience of three frontline patients who are not part of the pivotal cohort. METHODS: IMGN632 was administered IV at a dose of 0.045 mg/kg on day 1 of a 21-day cycle to all patients. Efficacy was assessed using modified Severity Weighted Assessment Tool (for skin lesions), PET/CT, and blast percentage in bone marrow aspirates. The response criteria were adapted from established BPDCN criteria (Pemmaraju NEJM 2019). RESULTS: Three patients with frontline BPDCN (no prior systemic therapy) received IMGN632. All three of these frontline patients achieved a clinical complete remission (CRc). Patient 1 was a 79yo woman who presented with skin, nodal, and extensive bone marrow disease (80% involvement). After one dose of IMGN632, she cleared her bone marrow (0%), and after 3 cycles, her nodal lesions and skin lesions resolved to achieve a CRc. Upon complete response, treatment was held due to patient co-morbidities. With just 3 cycles of IMGN632, this patient achieved duration of response (DOR) of 10.7 months without further therapy. Patient 2 was a 67yo man who had extensive skin disease covering >20% of the body;over several cycles, he achieved a PR then a CRc and bridged to an allogeneic stem cell transplant (SCT). The patient achieved a DOR of 13.5 months, with no evidence of disease relapse when he died from graft versus host disease. Patient 3 was a 66yo woman who presented with extensive skin and nodal lesions. After improvement over 4 cycles, she achieved a CRc with clearing of most of her skin lesions and all nodal lesions. Unfortunately, while still in CRc, the patient died of COVID-19 pneumonia, with a DOR of 3.7 months. CONCLUSION: Administration of IMGN632 to frontline BPDCN patients resulted in clinical complete remission in the initial three patients with durable responses in the two non-COVID impacted patients. None of these patients progressed while on therapy, and one patient successfully bridged to SCT. Enrollment continues in the pivotal frontline and R/R cohorts. (BPDCNtrial.com;NCT03386513).

7.
MEDLINE; 2022.
Preprint in English | MEDLINE | ID: ppcovidwho-329703

ABSTRACT

Understanding immune memory to Common Cold Coronaviruses (CCCs) is relevant for assessing its potential impact on the outcomes of SARS-CoV-2 infection, and for the prospects of pan-corona vaccines development. We performed a longitudinal analysis, of pre-pandemic samples collected from 2016-2019. CD4+ T cells and antibody responses specific for CCC and to other respiratory viruses, and chronic or ubiquitous pathogens were assessed. CCC-specific memory CD4+ T cells were detected in most subjects, and their frequencies were comparable to those for other common antigens. Notably, responses to CCC and other antigens such as influenza and Tetanus Toxoid (TT) were sustained over time. CCC-specific CD4+ T cell responses were also associated with low numbers of HLA-DR+CD38+ cells and their magnitude did not correlate with yearly changes in the prevalence of CCC infections. Similarly, spike RBD-specific IgG responses for CCC were stable throughout the sampling period. Finally, high CD4+ T cell reactivity to CCC, but not antibody responses, was associated with high pre-existing SARS-CoV-2 immunity. Overall, these results suggest that the steady and sustained CCC responses observed in the study cohort are likely due to a relatively stable pool of CCC-specific memory CD4+ T cells instead of fast decaying responses and frequent reinfections.

8.
PubMed; 2022.
Preprint in English | PubMed | ID: ppcovidwho-329605

ABSTRACT

Microglia, the innate immune cells of the brain, are exquisitely sensitive to dynamic changes in the neural environment. Using single cell RNA sequencing of the postnatal somatosensory cortex during topographic remapping, we identified a type I interferon (IFN-I) responsive microglia population that expanded with this developmental stressor. Using the marker gene IFITM3 we found that IFN-I responsive microglia were engulfing whole neurons. Loss of IFN-I signaling ( Ifnar1 -/- ) resulted in dysmorphic 'bubble' microglia with enlarged phagolysosomal compartments. We also observed a reduction in dead cells and an accumulation of neurons with double strand DNA breaks, a marker of cell stress. Conversely, IFN-I gain of function in zebrafish was sufficient to drive microglial engulfment of whole neurons. We identified IFITM3+ microglia in two murine disease models: SARS-CoV-2 infection and the 5xFAD model of Alzheimer's disease. These data reveal a novel role for IFN-I signaling in regulating efficient neuronal clearance by microglia.

9.
Journal of Investigative Medicine ; 70(2):677-678, 2022.
Article in English | EMBASE | ID: covidwho-1708167

ABSTRACT

Purpose of Study Despite the tremendous success of SARSCoV- 2 vaccines, breakthrough infections occur and are being recognized with increasing frequency. It is unclear whether breakthrough infections are the result of host and/or viral factors. We examined clinical and viral genomic data from patients with SARS-CoV-2 infection after vaccination to elucidate factors contributing to breakthrough. Methods Used This study was conducted in the Emory Healthcare (EHC) System. Patients with vaccine breakthrough infection, defined as a positive PCR test ≥14 days after the final dose of an FDA approved vaccine, were identified by both routine surveillance and notification by treating clinicians. Vaccination status was obtained from the Georgia Registry of Immunization Transactions and Services records by the Georgia Emerging Infections Program. Clinical information was derived from electronic medical records and was compared to data from 2-3 matched controls per case. Residual SARS-CoV-2 positive nasopharyngeal (NP) samples were collected and underwent RNA extraction. SARSCoV- 2 genome sequencing was performed using random-primer cDNA synthesis, Nextera XT library preparation, and Illumina sequencing. Summary of Results Forty vaccine breakthrough cases were identified between March 22 and July 16, 2021. The median time from final vaccine dose to positive COVID-19 test was 91 days (range 15-163). Compared to 94 controls, vaccine breakthrough cases were significantly older (median 57.5 years vs 42.0 years, p<.0001). Individuals over 60 accounted for half of all breakthrough cases, and individuals over 40 accounted for 80%. Immunosuppressed individuals represented 37.5% of breakthrough cases compared to 25% of unvaccinated controls. Rates of symptomatic infection and severe disease leading to hospitalization were similar between cases and controls. There was no difference in SARS-CoV-2 RT-PCR cycle threshold (Ct) between cases (n=32, median Ct=20.7, interquartile range (IQR)- 10.3) and controls (n=94, median Ct=24.0, IQR= 7.0;p=0.34). SARS-CoV-2 genome sequences from 24 cases were compared to 116 baseline surveillance sequences from unvaccinated EHC patients. There was no distinct phylogenetic clustering of vaccine breakthrough cases, and their sequences belonged to the predominant lineage of the time. From March 22-June 19, B.1.1.7 (alpha) accounted for 78% of breakthrough infections and 77% of surveillance sequences. From June 20-July 16, B.1.617.2 (delta) accounted for 86% of breakthrough infections and 72% of surveillance sequences. No spike mutations or deletions were associated with vaccine breakthrough infections. Conclusions Overall, our findings suggest that host factors, such as older age and immunosuppression, play a more important role than viral factors in SARS-CoV-2 vaccine breakthrough infections. Further studies are needed to understand the potential impacts of waning immunity or poor immunogenicity in individuals who experience vaccine breakthrough infections.

10.
Embase;
Preprint in English | EMBASE | ID: ppcovidwho-326837

ABSTRACT

SARS-CoV-2 infection and COVID-19 vaccines elicit memory T cell responses. Here, we report the development of two new pools of Experimentally-defined T cell epitopes derived from the non-spike Remainder of the SARS-CoV-2 proteome (CD4RE and CD8RE). The combination of T cell responses to these new pools and Spike (S) were used to discriminate four groups of subjects with different SARS-CoV-2 infection and COVID-19 vaccine status: non-infected, non-vaccinated (I-V-);infected and non-vaccinated (I+V-);infected and then vaccinated (I+V+);and non-infected and vaccinated (I-V+). The overall classification accuracy based on 30 subjects/group was 89.2% in the original cohort and 88.5% in a validation cohort of 96 subjects. The T cell classification scheme was applicable to different mRNA vaccines, and different lengths of time post-infection/post-vaccination. T cell responses from breakthrough infections (infected vaccinees, V+I+) were also effectively segregated from the responses of vaccinated subjects using the same classification tool system. When all five groups where combined, for a total of 239 different subjects, the classification scheme performance was 86.6%. We anticipate that a T cell-based immunodiagnostic scheme able to classify subjects based on their vaccination and natural infection history will be an important tool for longitudinal monitoring of vaccination and aid in establishing SARS-CoV-2 correlates of protection.

11.
Blood ; 138:369, 2021.
Article in English | EMBASE | ID: covidwho-1582289

ABSTRACT

Background: Acute myeloid leukemia (AML) is driven by aberrant leukemic stem cells (LSCs) that initiate and sustain malignancy. To circumvent resistance to therapy, combination therapies with additive mechanisms of action are needed. CD70, a tumor necrosis factor receptor ligand, and its receptor CD27 are expressed on LSCs and AML blasts, but not on hematopoietic stem cells. Cusatuzumab, a high-affinity humanized monoclonal anti-CD70 antibody, kills CD70-expressing cells by Fc domain-mediated effector functions and is a potent inhibitor of CD70-CD27 signaling. Here we report initial results of a study of cusatuzumab in combination with the current standard of care therapy, venetoclax plus azacitidine (CVA), in patients with untreated AML (de novo or secondary) ineligible for intensive chemotherapy due to age ≥75 years or medical comorbidities. Methods: The primary objective of this open label, multicenter, phase 1b study was to assess safety and tolerability of CVA. Key secondary objectives included response rate per ELN 2017 criteria and time to response. Patients received cusatuzumab 10 or 20 mg/kg IV on Day 3 and Day 17, a 3-day ramp-up of venetoclax (100, 200, and 400 mg PO) followed by 400 mg daily dosing, and azacitidine 75 mg/m 2 SC or IV on Days 1-7 of each 28-day cycle. Results: Based on data through Jul 9, 2021, 44 patients enrolled with median age 75 years (range 32-89), 36.4% had secondary AML, 40.9% had an ECOG performance status of 2, and ELN risk was favorable, intermediate and adverse in 18.2%, 20.5% and 61.4%, respectively. All patients received 20 mg/kg cusatuzumab except for 3 patients who received a starting dose of 10 mg/kg with the option to escalate to 20 mg/kg. Of these 3 patients, 1 escalated to 20 mg/kg. At a median follow-up of 29.1 weeks, the median number of treatment cycles was 4.0 (range 1.0-11.0). Grade 3 or above TEAEs were reported in 97.7% of patients;the most common (reported in ≥10%) were neutropenia (68.2%), thrombocytopenia (65.9%), febrile neutropenia (36.4%), anemia (34.1%), leukopenia (29.5%), sepsis (27.3%), and lymphopenia (15.9%). Treatment-emergent serious adverse events (SAEs) were reported in 75% of patients;the most common (reported in at least ≥5%) were febrile neutropenia (27.3%), sepsis (22.7%), COVID-19 (6.8%), and thrombocytopenia (6.8%). Treatment-emergent SAEs of grade ≥3 were reported in 72.7% of the patients. Infusion-related reactions (IRRs) were reported for 11.4% of patients with 2.3% at grade ≥3. Six (13.6%) patients discontinued treatment due to AEs, and 5 (11.4%) TEAEs resulted in death. The mortality rate within 30 days from start of treatment was 4.5%. Table 1 summarizes best response to study treatment. In the intent-to-treat analysis set (n=44) complete remission (CR) rate was 45.5%, while CR + CR with partial hematologic recovery (CRh) + CR with incomplete hematologic recovery (CRi) was 77.3%;MLFS was observed in 11.4% of patients. Of 34 responders (defined as CR, CRi or CRh), 47% were MRD negative by flow cytometry at or after achievement of response. Median time to first response for patients who achieved CR, CRh or CRi was 4.21 (3.0-25.0) weeks. Best response rates in the post-hoc response evaluable analysis set (n=42) that excluded two patients who died before the first disease evaluation were: CR in 47.6%, CR + CRh + CRi in 81.0% and MLFS in 11.9% of patients (Table 1). The majority (97.1%) of responders experienced at least one cycle delay in administration of CVA post response. Conclusions: Cusatuzumab administered in combination with venetoclax and azacitidine to elderly patients with untreated AML was generally well tolerated and demonstrated a safety profile consistent with that previously reported with venetoclax-azacitidine, with the addition of generally manageable IRRs. Response rates support an additive effect of cusatuzumab to the standard of care with potential for improved clinical outcomes. However, further clinical trials are needed for validation of these initial results. HK and GB contributed equally to this publ cation. [Formula presented] Disclosures: Roboz: AstraZeneca: Consultancy;Janssen: Research Funding;Bristol Myers Squibb: Consultancy;Jasper Therapeutics: Consultancy;Agios: Consultancy;Novartis: Consultancy;Amgen: Consultancy;Blueprint Medicines: Consultancy;Janssen: Consultancy;Helsinn: Consultancy;Daiichi Sankyo: Consultancy;Glaxo SmithKline: Consultancy;Celgene: Consultancy;Jazz: Consultancy;MEI Pharma - IDMC Chair: Consultancy;Mesoblast: Consultancy;Actinium: Consultancy;AbbVie: Consultancy;Astex: Consultancy;Bayer: Consultancy;Astellas: Consultancy;Roche/Genentech: Consultancy;Pfizer: Consultancy;Otsuka: Consultancy. Aribi: Seagen: Consultancy. Brandwein: Astellas: Honoraria;Jazz: Honoraria;Amgen: Honoraria;Taiho: Honoraria;BMS/Celgene: Honoraria;Pfizer: Honoraria;Abbvie: Honoraria;University of Alberta: Current Employment. Döhner: Astellas: Consultancy, Honoraria, Research Funding;AstraZeneca: Consultancy, Honoraria;Berlin-Chemie: Consultancy, Honoraria;Amgen: Consultancy, Honoraria, Research Funding;Abbvie: Consultancy, Honoraria, Research Funding;Agios: Consultancy, Honoraria, Research Funding;Celgene: Consultancy, Honoraria, Research Funding;GEMoaB: Consultancy, Honoraria;Helsinn: Consultancy, Honoraria;Janssen: Consultancy, Honoraria;Jazz: Consultancy, Honoraria, Research Funding;Novartis: Consultancy, Honoraria, Research Funding;Oxford Biomedicals: Consultancy, Honoraria;Pfizer: Research Funding;Roche: Consultancy, Honoraria;Gilead: Consultancy, Honoraria;Bristol Myers Squibb: Consultancy, Honoraria, Research Funding;Astex: Consultancy, Honoraria;Ulm University Hospital: Current Employment. Fiedler: Jazz Pharmaceuticals: Consultancy, Other: support for meeting attendance;Abbvie: Consultancy, Honoraria;Morphosys: Consultancy;Celgene: Consultancy;Pfizer: Consultancy, Research Funding;Novartis: Consultancy;ARIAD/Incyte: Consultancy;Amgen: Consultancy, Other: support for meeting attendance, Patents & Royalties, Research Funding;Servier: Consultancy, Other: support for meeting attendance;Daiichi Sankyo: Consultancy, Other: support for meeting attendance;Stemline: Consultancy. Gandini: argenx: Current Employment, Current equity holder in publicly-traded company, Divested equity in a private or publicly-traded company in the past 24 months. Geddes: University of Calgary: Current Employment;Taiho: Consultancy, Membership on an entity's Board of Directors or advisory committees;Jazz: Consultancy, Membership on an entity's Board of Directors or advisory committees;Pfizer: Consultancy, Membership on an entity's Board of Directors or advisory committees;Novartis: Consultancy;BMS: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau;Celgene: Consultancy, Membership on an entity's Board of Directors or advisory committees;Amgen: Consultancy;Paladin: Consultancy;Janssen: Research Funding;Geron: Research Funding;Abbvie: Membership on an entity's Board of Directors or advisory committees, Research Funding. Hou: University of Pittsburgh Medical Center Hillman Cancer Centers: Current Employment;AbbVie: Honoraria;AstraZeneca: Honoraria;Karyopharm: Honoraria;Chinese American Hematology Oncology Network: Membership on an entity's Board of Directors or advisory committees. Howes: Janssen R&D, part of Johnson & Johnson: Current Employment;Johnson & Johnson: Current holder of individual stocks in a privately-held company, Current holder of stock options in a privately-held company. Hultberg: argenx: Current Employment, Patents & Royalties. Huselton: University of Rochester: Current Employment. Jacobs: Argenx BV: Current Employment, Current equity holder in publicly-traded company;University of Antwerp: Ended employment in the past 24 months. Kane: Janssen R&D, part of Johnson & Johnson: Current Employment, Current equity holder in publicly-traded company. Lech-Marańda: Takeda: Membership on an entity's Board of Directors or advisory committees;AbbVie: Membership on an entity's Board of Directors r advisory committees;Novartis: Membership on an entity's Board of Directors or advisory committees;Roche: Membership on an entity's Board of Directors or advisory committees;Janssen-Cilag: Membership on an entity's Board of Directors or advisory committees;Amgen: Membership on an entity's Board of Directors or advisory committees;Sanofi: Membership on an entity's Board of Directors or advisory committees;Gilead: Membership on an entity's Board of Directors or advisory committees, Research Funding. Louwers: argenx: Current Employment, Patents & Royalties: Patents (no royalties). Nottage: Janssen R&D, part of Johnson & Johnson: Current Employment;Johnson & Johnson: Current holder of individual stocks in a privately-held company, Current holder of stock options in a privately-held company. Platzbecker: Novartis: Honoraria;AbbVie: Honoraria;Janssen: Honoraria;Celgene/BMS: Honoraria;Geron: Honoraria;Takeda: Honoraria. Rampal: Pharmaessentia: Consultancy;BMS/Celgene: Consultancy;Abbvie: Consultancy;Sierra Oncology: Consultancy;Incyte: Consultancy, Research Funding;Blueprint: Consultancy;Disc Medicine: Consultancy;Jazz Pharmaceuticals: Consultancy;Constellation: Research Funding;Kartos: Consultancy;Stemline: Consultancy, Research Funding;CTI: Consultancy;Novartis: Consultancy;Memorial Sloan Kettering: Current Employment. Salman: Janssen: Current Employment, Current holder of individual stocks in a privately-held company, Current holder of stock options in a privately-held company. Shah: Janssen R&D, part of Johnson & Johnson: Current Employment. Stuart: Clinical Drug Development Consultants LLC: Current Employment;Argenx: Consultancy;Cleave Therapeutics: Consultancy;Triphase Accelerator Corp: Consultancy;IgM Biosciences: Consultancy;Revolution Medicines: Consultancy;Jiya Corp:Consultancy;Geron Corp: Current holder of individual stocks in a privately-held company. Subklewe: Janssen: Consultancy;Pfizer: Consultancy, Speakers Bureau;Takeda: Speakers Bureau;Klinikum der Universität München: Current Employment;MorphoSys: Research Funding;Novartis: Consultancy, Research Funding, Speakers Bureau;Roche: Research Funding;Seattle Genetics: Consultancy, Research Funding;Miltenyi: Research Funding;Gilead: Consultancy, Research Funding, Speakers Bureau;Amgen: Consultancy, Research Funding, Speakers Bureau;BMS/Celgene: Consultancy, Research Funding, Speakers Bureau. Sumbul: argenx: Current Employment. Wang: Takeda: Consultancy, Honoraria, Other: Advisory board;Jazz Pharmaceuticals: Consultancy, Honoraria, Other: Advisory Board;Astellas: Consultancy, Membership on an entity's Board of Directors or advisory committees;Stemline Therapeutics: Consultancy, Honoraria, Other: Advisory board, Speakers Bureau;AbbVie: Consultancy, Membership on an entity's Board of Directors or advisory committees;Kite Pharmaceuticals: Consultancy, Honoraria, Other: Advisory Board;GlaxoSmithKline: Consultancy, Honoraria, Other: Advisory Board;Genentech: Membership on an entity's Board of Directors or advisory committees;BMS/Celgene: Membership on an entity's Board of Directors or advisory committees;DAVA Oncology: Consultancy, Speakers Bureau;Kura Oncology: Consultancy, Honoraria, Other: Advisory board, steering committee, Speakers Bureau;Novartis: Consultancy, Honoraria, Other: Advisory Board;Mana Therapeutics: Consultancy, Honoraria;Pfizer: Consultancy, Honoraria, Other: Advisory Board, Speakers Bureau;Rafael Pharmaceuticals: Other: Data safety monitoring committee;Gilead: Consultancy, Honoraria, Other: Advisory board;Daiichi Sankyo: Consultancy, Honoraria, Other: Advisory board;PTC Therapeutics: Consultancy, Honoraria, Other: Advisory board;Genentech: Consultancy;MacroGenics: Consultancy. Wierzbowska: Jazz: Research Funding;Pfizer: Honoraria;Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees;Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees;Astellas: Honoraria, Membership on an entity's Board of Directors or advisory comm ttees;Abbvie: Honoraria, Membership on an entity's Board of Directors or advisory committees;BMS: Honoraria. Yao: Statagize LLC: Current Employment;Puma Biotechnology, Inc.: Ended employment in the past 24 months;Argenx: Consultancy. Yee: Astex: Membership on an entity's Board of Directors or advisory committees, Research Funding;Janssen: Research Funding;TaiHo: Membership on an entity's Board of Directors or advisory committees;Otsuka: Membership on an entity's Board of Directors or advisory committees;Onconova: Research Funding;Pfizer: Membership on an entity's Board of Directors or advisory committees;Tolero: Research Funding;Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding;Paladin: Membership on an entity's Board of Directors or advisory committees;MedImmune: Research Funding;AbbVie: Honoraria;Bristol-Myers Squibb/Celgene: Membership on an entity's Board of Directors or advisory committees;Shattuck Labs: Membership on an entity's Board of Directors or advisory committees;Forma Therapeutics: Research Funding;Takeda: Membership on an entity's Board of Directors or advisory committees;Geron: Research Funding;Genentech: Research Funding;F. Hoffmann La Roche: Membership on an entity's Board of Directors or advisory committees, Research Funding;Jazz: Research Funding. Kantarjian: Immunogen: Research Funding;Astra Zeneca: Honoraria;KAHR Medical Ltd: Honoraria;Astellas Health: Honoraria;Pfizer: Honoraria, Research Funding;NOVA Research: Honoraria;Ascentage: Research Funding;Precision Biosciences: Honoraria;Novartis: Honoraria, Research Funding;Aptitude Health: Honoraria;Ipsen Pharmaceuticals: Honoraria;Jazz: Research Funding;Daiichi-Sankyo: Research Funding;BMS: Research Funding;Amgen: Honoraria, Research Funding;AbbVie: Honoraria, Research Funding;Taiho Pharmaceutical Canada: Honoraria. Borthakur: Protagonist: Consultancy;Ryvu: Research Funding;Astex: Research Funding;GSK: Consultancy;Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees;Takeda: Membership on an entity's Board of Directors or advisory committees;University of Texas MD Anderson Cancer Center: Current Employment;ArgenX: Membership on an entity's Board of Directors or advisory committees.

12.
American Journal of Obstetrics and Gynecology ; 226(1):S67, 2022.
Article in English | EMBASE | ID: covidwho-1588502

ABSTRACT

Objective: During the COVID-19 pandemic, institutions turned to telehealth as the primary method of postpartum care delivery. We aimed to determine the impact of telehealth on the completion of postpartum care goals. Study Design: We compared a 14-week period, March-June 2019, before implementation of telehealth to the same calendar months post-implementation during 2020. Patients with a postpartum visit (PPV) scheduled at our institution during the study period were included. Our primary outcome was attendance to the PPV. Secondary outcomes included completion of postpartum depression (PPD) screening, contraception selection, breastfeeding status at PPV, completion of postpartum 2-hour glucose tolerance test (GTT) for women with gestational diabetes, and cardiology follow-up when recommended. Multivariable logistic regression with backward elimination was used to control for confounders. Results: Of the 1,579 patients meeting inclusion criteria, 780 were in the pre-telehealth group and 799 were in the post-telehealth group. Subjects in the post-telehealth group were 90% more likely to attend a PPV compared to those in the pre-telehealth group, even when controlling for race, prenatal care provider, parity, gestational age at delivery, and insurance status (82.9% vs. 72.4%, p < 0.001;aOR 1.90, 95% CI [1.47-2.46]). Patients in the post-telehealth group were also more likely to get screened for PPD (86.3% vs. 65.1%, p < 0.001). While subjects were as likely to choose a contraceptive method at the PPV, those in the post-telehealth group were less likely to choose long-acting reversible contraception (LARC) or permanent sterilization (26.2% vs. 33.2%, p=0.03). There was no difference in breastfeeding status at the PPV, completion rate of postpartum 2-hour GTT, or attendance to cardiology follow-up appointments between groups. Conclusion: Availability of telehealth during the COVID-19 pandemic is associated with increased PPV attendance and PPD screening. However, the availability of telehealth was also associated with a decrease in the utilization of LARC or permanent sterilization. [Formula presented]

13.
American Journal of Obstetrics and Gynecology ; 226(1):S204, 2022.
Article in English | EMBASE | ID: covidwho-1588484

ABSTRACT

Objective: During the COVID-19 pandemic, institutions turned to telehealth as the primary method of postpartum care delivery. We aimed to understand the patient experience around telehealth for delivery of postpartum care using a qualitative approach. Study Design: We performed individual, semi-structured patient interviews (n=25) within two weeks of a scheduled telehealth postpartum visit (PPV) at our institution. Interviews were performed by phone from 10/1/2020-1/1/2021, more than 6 months into the COVID-19 pandemic. Transcriptions were analyzed using grounded theory and coded with a systematic approach. Results: Overall, participants reported mixed preferences for the modality of the postpartum visit (in-person vs. telehealth). Those in favor of telehealth focused on its convenience and flexibility. When performed via video and audio rather than audio alone, participants felt telehealth well-simulated in-person engagement. Participants also reported similar experiences by modality regarding contraceptive planning. On the other hand, several participants raised concerns about the limitations of telehealth for physical examination, such as providing patient reassurance regarding healing after delivery. Reported facilitators to telehealth were lack of need for childcare or transportation to an in-person encounter, minimized disruption to maternal-newborn routine, and prioritizing safety during the COVID-19 pandemic. Reported barriers also included the need for childcare during the telehealth encounter, as well as difficulty finding a private space for the visit, scheduling and logistic challenges, privacy concerns, and technological difficulties. Conclusion: Telehealth is becoming an increasingly utilized modality of PPVs in the United States. In this qualitative analysis, we characterize patients’ experiences with telehealth postpartum care, and identify areas of patient concern. Future work should determine how best to provide reassurance regarding postpartum healing to further optimize telehealth for postpartum care. [Formula presented]

14.
The Lancet Regional Health - Americas ; 8:100150, 2022.
Article in English | ScienceDirect | ID: covidwho-1587085

ABSTRACT

Summary There is growing support to reverse mass incarceration in the United States, especially in the wake of the COVID-19 pandemic. Little is known about what types and scale of community investments are most effective to support mass decarceration. Using a public health prevention framework, we conducted a scoping review to examine community-based programs that reduced criminal legal involvement. We searched PubMed, Embase and three EBSCO databases from 1990 through September 2019 for all experimental or quasi-experimental studies testing interventions pertaining to education, housing, healthcare, employment, or social support services and how they affected an individual's criminal legal outcomes. Our review identified 53 studies that demonstrated the efficacy of early childhood educational interventions and nurse-family partnership programs, post-secondary education for incarcerated students, navigation programs linking incarcerated people to community resources, and peer support upon release to reduce criminal legal system exposure. In concert with legislative action to end mass incarceration, additional research is needed to test interventions designed to achieve mass decarceration which cross multiple domains, interrogate community-level impacts and ascertain long-term outcomes.

15.
International Business and Management ; 36:189-200, 2021.
Article in English | Scopus | ID: covidwho-1550717
18.
International Journal of Distributed Sensor Networks ; 17(10):14, 2021.
Article in English | Web of Science | ID: covidwho-1511672

ABSTRACT

"Social sensors" refer to those who provide opinions through electronic communication channels such as social networks. There are two major issues in current models of sentiment analysis in social sensor networks. First, most existing models only analyzed the sentiment within the text but did not analyze the users, which led to the experimental results difficult to explain. Second, few studies extract the specific opinions of users. Only analyzing the emotional tendencies or aspect-level emotions of social users brings difficulties to the analysis of the opinion evolution in public emergencies. To resolve these issues, we propose an explainable sentiment prediction model based on the portraits of users sharing representative opinions in social sensors. Our model extracts the specific opinions of the user groups on the topics and fully considers the impacts of their diverse features on sentiment analysis. We conduct experiments on 51,853 tweets about the "COVID-19" collected from 1 May 2020 to 9 July 2020. We build users' portraits from three aspects: attribute features, interest features, and emotional features. Six machine learning algorithms are used to predict emotional tendency based on users' portraits. We analyze the influence of users' features on the sentiment. The prediction accuracy of our model is 64.88%.

19.
Otolaryngology - Head and Neck Surgery ; 165(1 SUPPL):P53, 2021.
Article in English | EMBASE | ID: covidwho-1467876

ABSTRACT

Session Description: The current pandemic of the SARSCoV- 2 (COVID-19) virus has led to heightened awareness of clinical spread of virus, particularly during operative procedures involving aerosol generation. Data are limited on extent of spread during various anterior and lateral skull base surgical procedures, particularly those procedures using powered instrumentation (with the resultant increase in aerosolization of viral particles). We will review contagion spread with the help of established clinical spread models and discuss applicability to the current pandemic. Evidence-based practices, highlighted by case-based examples, will be emphasized in both anterior and lateral skull base surgery. Principles for planning for and managing future epidemics and/or pandemics will be discussed. This panel is highly relevant to the practicing otolaryngologist and will provide the attendee with a thorough update on clinical practice patterns, potential spread of contagion, and strategies of spread mitigation. Urgent cranial base operations often continued to be performed during the pandemic, and review of these cases can help to plan for less urgent operations in ongoing and future epidemics. Outcome Objectives: (1) Examine the spread of COVID-19 clinically and review mitigation strategies. (2) Examine and recognize international controversies among providers and institutions in formulating those mitigation strategies and the execution of the strategies. (3) Implement evidencebased practice patterns specific to COVID-19 in skull base surgery.

20.
Chest ; 160(4):A1212-A1213, 2021.
Article in English | EMBASE | ID: covidwho-1466138

ABSTRACT

TOPIC: Diffuse Lung Disease TYPE: Medical Student/Resident Case Reports INTRODUCTION: A 56 year old Hispanic woman with a history of asthma presented with five days of progressive dyspnea and hemoptysis. CASE PRESENTATION: Two months prior, she was treated for COVID-19 complicated by intermittent hemoptysis. Subsequently, her hemoptysis gradually worsened resulting in dyspnea on exertion and hypoxia (SpO2 88%). At presentation, she was febrile (100.8 F), tachycardic (141 bpm), tachypneic (36 breaths/min) and hypoxic (SpO2 85%). Exam was notable for coarse breath sounds and crackles on auscultation. Labs were notable for hemoglobin 6.7 g/dL and a negative SARS-CoV-2 PCR test. Chest CT showed extensive ground-glass and reticular opacities (upper lungs) and a cluster of air cysts (left lower lobe). The imaging findings in conjunction with frank hemoptysis and acute hypoxemic respiratory failure were concerning for diffuse alveolar hemorrhage (DAH). Bronchoscopy showed bloody secretions throughout the airway. Serial lavage aliquots returned progressively bloodier washings confirming DAH. She received empiric antibiotics with subsequent unremarkable infectious workup. She also received pulse dose steroids and underwent an autoimmune workup notable for: positive ANA (1:40), positive p-ANCA (1:1280), and positive MPO IgG (106 AU/mL) concerning for ANCA-associated vasculitis (AAV). Hospital course was complicated by intermittent fevers, hemoptysis, and hypoxia - likely progression of DAH secondary to her vasculitis. She was started on intravenous steroids and cyclophosphamide with resolution of hemoptysis and hypoxia. Post discharge, her rheumatological workup was negative for anti-cardiolipin antibodies, phosphatidylserine autoantibodies, beta-2 glycoprotein I antibodies, and DRVVT screen. DISCUSSION: DAH is a life-threatening condition that commonly presents with fever, cough, and dyspnea while hemoptysis may be absent in a third of patients. Bronchoscopic evaluation reveals progressively bloodier aliquots during lavage as noted in our patient. Treatment warrants addressing the underlying etiology, which may be cessation of the inciting drug, treatment of infection, or glucocorticoids for vasculitides. SARS-CoV-2 infection can directly cause DAH by inciting pulmonary endothelialitis. In contrast, our patient had a positive autoimmune workup for AAV, which was thought to be the immediate cause of her DAH. Without prior systemic manifestations of AAV (rash, arthritis, renal disease), either the patient developed AAV triggered by SARS-CoV-2 infection, or she had asymptomatic AAV that manifested due to the infection. There are multiple reports of COVID-19 predisposing to the development of autoimmune diseases, such as GBS and vasculitides, by triggering chronic inflammation. CONCLUSIONS: We hypothesize that our patient likely developed DAH because the infection led to ANCA-associated vasculitis that manifested as DAH rather than directly damaging her pulmonary blood vessels. REFERENCE #1: Lara AR, Schwarz MI. Diffuse alveolar hemorrhage. Chest. 2010;137(5):1164-1171. doi:10.1378/chest.08-2084 DISCLOSURES: No relevant relationships by Daniel Bouland, source=Web Response No relevant relationships by Elizabeth Epstein, source=Web Response Public Stock holder relationship with Cormedix Please note: 01/2021 Added 04/27/2021 by Vineet Gupta, source=Web Response, value=Purchased stock from market Public Stock holder relationship with Athenix Please note: 02/2021 Added 04/27/2021 by Vineet Gupta, source=Web Response, value=Purchased stock from market Public Stock holder relationship with Kinishka Please note: 02/2021 Added 04/27/2021 by Vineet Gupta, source=Web Response, value=Purchased stock from market Public Stock holder relationship with Novavax Please note: 03/2021 Added 04/27/2021 by Vineet Gupta, source=Web Response, value=Purchased stock from market No relevant relationships by Tonya Lee, source=Web Response No relevant relationships by Priya Sharma, source=Web Response No relevant relationships by Edward Wang, source=Web Re ponse

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