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The need for change in India's agrarian sector came into sharp focus with the COVID-19 pandemic. This paper traces the imperatives that have shaped the trajectory of the development of the rural economy in post-independence India including the social, cultural and political matrix within which the processes and activities of the rural economy are carried out. It also explores the possibilities of social, cultural and political change based on a perspective that seeks to reconcile the imperatives of unity and social justice with a practical reading of the ground reality in India's villages. The paper suggests reform in social, cultural and political structures and practices at the village level along with economic prescriptions such as increasing the marketability of agricultural produce and creating jobs in the manufacturing sector to absorb workers displaced from the agricultural sector. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.
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Purpose: The present study aims to test the Quadratic Programming model for Optimal Portfolio selection empirically. Need for the Study: All the investors who buy financial products are motivated to obtain higher profits or, in other words, to maximise their returns. However, the high returns are often accompanied by higher risks, and avoiding such risks has become the primary concern for all investors. There is a great need for such a model to maximise profits and minimise risk, which can help design an investment portfolio with minimum risk and maximum return. The Quadratic Programming model is one such model which can be applied for selected shares to build an optimised portfolio. Methodology: This study optimises the stock samples using a two-level screening of correlation coefficient and coefficient of variation. The monthly closing prices of the NSE-listed Indian pharmaceutical stocks from December 2019 to January 2022 have been used as sample data. The Lagrange Multiplier method is used to apply the model to achieve the optimal portfolio solution. Based on the market reality, the transaction costs have also been considered. The Quadratic programming model is further optimised to achieve the optimal portfolio for the select stocks. Findings: The traditional portfolio theory and the modified quadratic model gives similar and consistent results. In other words, the modified quadratic model asserts the accuracy of the conventional portfolio model. The portfolio constructed in the present study gives a return much higher than the return of the benchmark portfolio of Nifty Fifty, indicating the usefulness of applying the Quadratic Programming model. Practical Implications: The construction of an optimal portfolio using the traditional or modified Quadratic model can help investors make rational investment decisions for better returns with lower risks. © 2023 by Chetna and Dhiraj Sharma.
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Aim: The presentation shares traditional Native American knowledge about wellbeing and caring for a person's body, heart, connection to the Creator, ancestors, and the land Methods: Drawing upon community narratives and traditional ancestral knowledge themes pertinent to the topic will be presented. Narrative Review Results: Ancestral knowledge is essential to access and practice in? community care and healing. This knowledge is sacred to the lives wellbeing, and continuation of traditional ways for Confederated Tribes of Warm Springs (CTWS) people. CTWS young people play an important role in these practices for their community and elders. The practice of taking CTWS children from families was a pivotal moment that pushed forward the concept of mental health for the CTWS. The threat of climate change, and the COVID-19 pandemic's activation of memories of imposed isolation between our people and from traditional ways continues to impact our young people. The process of healing from historical and present-day traumas includes grieving those losses and healing from addictions, as well as physical and sexual abuse Conclusion(s): Rebuilding and strengthening connections to the land Chuush (water in Sahaptin language), food gathering, and being with each other, is central to our young people's, and community's, healing The path of returning to our traditional understanding of the knowledge of what the Creator has provided for the CTWS people will be shared. This knowledge is useful for the care of young people Native and non-Native alike.
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Introduction: Lung cancer is the leading cause of cancer-related death in the US with an estimated 236,740 new cases and 130,180 deaths expected in 2022. While early detection with low-dose computed tomography reduces lung cancer mortality by at least 20%, there has been a low uptake of lung cancer screening (LCS) use in the US. The COVID-19 pandemic caused significant disruption in cancer screening. Yet, little is known about how COVID-19 impacted already low use of LCS. This study aims to estimate LCS use before (2019) and during (2020 and 2021) the COVID-19 pandemic among LCS-eligible population in the US. Method(s): We used population-based, nationally representative, cross-section data from the 2019 (n=4,484), 2020 (n=1,239) and 2021 (n=1,673) Behavioral Risk Factor Surveillance System, Lung Cancer Screening module. The outcome was self-reported LCS use among eligible adults in the past 12 months. For 2019 and 2020, the eligibility was defined based on US Preventive Services Task Force (USPSTF) initial criteria-adults aged 55 to 80 years old, who were current and former smokers (had quit within the past 15 years) with at least 30 pack years of smoking history. For 2021, we used the USPSTF updated criteria- adults aged 50 to 80 years, current and former smokers (who had quit within the past 15 years) with at least 20 pack years of smoking history. We applied sampling weights to account for the complex survey design to generate population estimates and conducted weighted descriptive statistics and logistic regression models. Result(s): Overall, there were an estimated 1,559,137 LCS-eligible respondents from 16 US states in 2019 (AZ, ID, KY, ME, MN, MS, MT, NC, ND, PA, RI, SC, UT, VT, WV, WI), 200,301 LCS-eligible respondents from five states in 2020 (DE, ME, NJ, ND, SD), and 668,359 LCS-eligible respondents from four states in 2021 (ME, MI, NJ, RI). Among 2,427,797 LCS-eligible adults, 254,890;38,875;and 122,240 individuals reported receiving LCS in 2019, 2020 and 2021, respectively. Overall, 16.4% (95% CI 14.4-18.5), 19.4% (95% CI 15.3-24.3), and 18.3% (95% CI 15.6-21.3) received LCS during 2019, 2020, and 2021, respectively. In all years, the proportion of LCS use was higher among adults aged 65-74, insured, those with fair and poor health, lung disease and history of cancer (other than lung cancer). In 2020, a higher proportion of adults living in urban areas reported receiving LCS compared to those living in rural areas (20.36% vs. 12.7%, p=0.01). Compared to non-Hispanic White adults, the odds of receiving LCS was lower among Hispanic adults and higher among Non-Hispanic American Indian/Alaskan Native adults in 2020 and 2021, respectively. Conclusion(s): LCS uptake remains low in the US. An estimated 2,011,792 adults at high-risk for developing lung cancer did not receive LCS during 2019, 2020 and 2021. Efforts should be focused to increase LCS awareness and uptake across the US to reduce lung cancer burden.
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The COVID-19 ‘new normal' has forced organisations to reinvent business practices including rewards in order to retain and motivate employees. This article reviewed the published literature to identify the changing Total Rewards strategies adopted by firms in India as they navigated the various phases of this unprecedented pandemic. The review of academic papers as well as practitioner articles or news articles on relevant themes published in the period of 2020–2021 was followed by semi-structured interviews with 12 human resource practitioners working in the Compensation and Benefits or Total Rewards function across various organisations in India to arrive at the findings of the study. The study revealed that most firms have adopted a compassionate approach while reformulating their Total Rewards strategy. Agility, fairness and hyper-personalisation form the cornerstones for relooking at the Total Rewards dimensions such as pay, benefits, learning and development, and work environment. Spurred by the pandemic, the article highlights the endeavour of Indian firms to imbibe compassion into their Total Rewards strategies by being agile, fair and hyper-personalised. Further, it also lists potential challenges that Indian reward leaders might need to address to successfully implement and sustain a compassionate Total Rewards culture in their organisations.
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How does the Indian movie industry recoup, rebuild and rejuvenate post-COVID-19? Are there new pathways opening up? Is digitization one of them? These are the hot topics that are being discussed by practitioners in the Indian movie industry, since the global pandemic, COVID-19, reduced India as a nation from a thriving movie industry to a struggling movie industry. They are illustrative of entrepreneurial failure in the Indian movie industry, exposed by COVID-19. There is an urgent need to develop alternate pathways for revenue generation to protect the Indian movie industry from further decline. With close to 2000 movies being released each year, the movie industry was one of the largest employment-generating industries in India, bringing both income and joy to people's lives in a nation beset by vast differences in wealth. However, it has been based on theatrical exhibition rather than digitization, with a lukewarm response to digital providers, to its detriment. During the pandemic, lack of digital innovation flipped from `might do' to `must do' in order to ensure the many family businesses in the Indian movie industry survive and monetize developed content. Though India's poor lost out on their share of entertainment due to screen closures, digitization ensured that the growing middle class could be catered to. However, the business model is rapidly changing and the role of the producer as an entrepreneur is diminishing because artists and technicians are directly striking deals and developing content with funding from digital providers.
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The current outbreak of COVID-19 is caused by the SARS-CoV-2 virus that has affected > 210 countries. Various steps are taken by different countries to tackle the current war-like health situation. In India, the Ministry of AYUSH released a self-care advisory for immunomodulation measures during the COVID-19 and this review article discusses the detailed scientific rationale associated with this advisory. Authors have spotted and presented in-depth insight of advisory in terms of immunomodulatory, antiviral, antibacterial, co-morbidity associated actions, and their probable mechanism of action. Immunomodulatory actions of advised herbs with no significant adverse drug reaction/toxicity strongly support the extension of advisory for COVID-19 prevention, prophylaxis, mitigations, and rehabilitation capacities. This advisory also emphasized Dhyana (meditation) and Yogasanas as a holistic approach in enhancing immunity, mental health, and quality of life. The present review may open-up new meadows for research and can provide better conceptual leads for future researches in immunomodulation, antiviral-development, psychoneuroimmunology, especially for COVID-19.Copyright © 2021, Institute of Korean Medicine, Kyung Hee University.
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The purpose of this study is to identify and analyse the impact of digital innovations to manage business operations during COVID-19 lockdown. Due to COVID-19, a nation-wide lockdown affected the Indian economy severely as both service and manufacturing organizations were closed for a long duration. Thus, to manage with these challenges and address the expectations of their employees, organizations identified various artificial intelligence (AI) and cloud-based digital innovations to continue their business operations during lockdown. The study used a systematic review of literature and document analysis to unravel such innovations that have been initiated and implemented in Indian organizations during COVID-19 lockdown. The study finds that digital innovations and strategies are useful for coping with unseen challenges and also can transform the organizations into smarter ones. The study proposes a conceptual framework on the basis of findings, which will be used for futuristic studies.
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Functional beverages originate primarily from fruits and vegetables sources, but also include those from other plants such as tea, coffee, cocoa, soybean as well as animal products like milk and dairy-based and alcoholic drinks. They have definite medical or health benefits which include prevention or delaying the progress of diseases. Indian gooseberry is a very rich source of vitamin C and phenolics, two potent antioxidant compounds. Similarly curcumin in turmeric, piperine in black pepper and gingerol in ginger have proven antioxidant and anti-inflammatory properties. Incidence of covid-19 pandemic has raised awareness among people the importance of maintaining higher levels of immunity. A study was undertaken at Kerala Agricultural University during 2020–21 to develop an herbal functional drink from Indian gooseberry fruit juice incorporated with turmeric and black pepper powders, ginger juice extract and juice of acid lime fruits. The herbal drink formulated with these ingredients was homogenized at an operating pressure of 175 Bar with a speed of 235 SPM and was subsequently pasteurized at 100 0 C for 10 minutes in glass bottles, followed by storage under refrigerated conditions at 5 ± 2 0 C for 3 months. The initial ascorbic acid, total phenolics, total flavonoids, total carotenoids and total curcumin contents were 61.0 mg100g− 1, 184.0 mg100g− 1, 153.0 mg100g− 1, 119.98 mg100g− 1 and 31.0 mg100g− 1, respectively. Antioxidant activity of the herbal drink was determined by three assays, viz. ABTS, DDPH and FRAP. The initial IC 50 values of the herbal drink by ABTS, DPPH and FRAP assays were 8.64, 0.212 and 0.368 μgml− 1, respectively. Significant decline in ascorbic acid, total flavonoids, total carotenoids and curcumin content were recorded in the product during storage in contrast to the total phenolics content which showed a significant rise over the storage period. Antioxidant activity of the herbal drink determined by all the three assays also declined significantly throughout the storage period. The results indicate that the product can be promoted as a healthy drink which has to be stored at low temperature in order to retain higher levels of antioxidant compounds and antioxidant activity. Graphical : [Figure not available: see fulltext.] © 2023, The Author(s).
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This paper highlights the changes in the unemployment rate across different age cohorts among young people in India due to the COVID-19 pandemic. The study observes that the youth unemployment rate increased at a much higher rate in urban areas both for male and female youth during the initial phase of pandemic. To understand the severity of the effects of pandemic on unemployment across different age groups among the youth, this study enquires into the nature and causes of unemployment among them. The probit estimates of unemployment function for the youth reveals that the likelihood of youth being unemployed is less in upper age cohorts within the young age range. An inverse relationship is observed between general education and employment among the youth in the Indian youth labour market. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.
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Objective: Due to the COVID 19 pandemic healthcare providers all over the world had brought some changes in the management of surgical patients. This study is aimed to estimate the impact of pandemic on surgical practices. Material(s) and Method(s): We conducted a retrospective review of the medical records of all patients admitted to the department of general surgery (both elective & emergency), SCB Medical College and Hospital, Odisha, India from April 1 to July 31, 2020, and 2021 and the records were those of patients who were admitted in the same period in 2019. Data collection includes the number of admissions, the reason for admission, the age & gender of the patients admitted patients and type of management. Result(s): There was a 57.5% reduction in total admission during first COVID in pandemic 2020 and 58.7% reduction during second wave of pandemic in 2021. The proportion of patient presenting to emergency department was more in 2020 and 2021 than 2019. Number of emergency admission decreased by 46.54% in 2020 and 46% in 2021. There was a 79.5% drop in the number of out-patients admission in 2020 and 84% in 2021. Furthermore a 79.8% reduction in elective surgical intervention noticed in 2020 and 80% in 2021. Conservative management was preferred over surgical management during the COVID era. Conclusion(s): COVID-19 has led to a drastic reduction in outpatient and elective surgical practices. Hence creating a major concern for all surgeons about the critical situation.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.
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With the spread of COVID-19 pandemic worldwide, the Government of India had imposed lockdown in the month of March 2020 to curb the spread of the virus furthermore. This shutdown led to closure of various institutions, organizations, and industries, and restriction on public movement was also inflicted which paved way to better air quality due to reduction in various industrial and vehicular emissions. To brace this, the present study was carried out to statistically analyze the changes in air quality from pre-lockdown period to unlock 6.0 in South Indian cities, namely, Bangalore, Chennai, Coimbatore, and Hyderabad, by assessing the variation in concentration of PM2.5, PM10, NO2, and SO2 during pre-lockdown, lockdown, and unlock phases. Pollutant concentration data was obtained for the selected timeframe (01 March 2020-30 November 2020) from CPCB, and line graph was plotted which had shown visible variation in the concentration of pollutants in cities taken into consideration. Analysis of variance (ANOVA) was applied to determine the mean differences in the concentration of pollutants during eleven timeframes, and the results indicated a significant difference (F (10,264) = 3.389, p < 0.001). A significant decrease in the levels of PM2.5, PM10, NO2, and SO2 during the lockdown phases was asserted by Tukey HSD results in Bangalore, Coimbatore, and Hyderabad stations, whereas PM10 and NO2 significantly increased during lockdown period in Chennai station. In order to understand the cause of variation in the concentration of pollutants and to find the association of pollutants with meteorological parameters, the Pearson correlation coefficient was used to study the relationship between PM2.5, PM10, NO2, and SO2 concentrations, temperature, rainfall, and wind speed for a span of 15 months, i.e., from January 2020 to March 2021. At a significant level of 99.9%, 99%, and 95%, a significant correlation among the pollutants, rainfall had a major impact on the pollutant concentration in Bangalore, Coimbatore, Hyderabad, and Chennai followed by wind speed and temperature. No significant influence of temperature on the concentration of pollutants was observed in Bangalore station.
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Air Pollution , COVID-19 , Communicable Disease Control , India , COVID-19/prevention & control , Particulate Matter/analysis , Nitric Oxide/analysis , Sulfur Dioxide/analysisABSTRACT
BACKGROUND: Coronavirus disease (COVID-19) was a pandemic with many physical, psychological, and socioeconomic effects. COVID-19 caused a global increase in anxiety and depression because of its novelty, high infectivity, varied presentation, and unpredictable mortality. In the face of collapsing healthcare facilities, monetary setbacks, and loneliness because of lockdowns, people were anxious, and this was compounded by media sensationalism. We aimed to study the psychosocial impact of COVID-19 on the adult Indian population. METHODS: An online survey using SurveyMonkey was floated through WhatsApp messages in April 2020, using the 'chain-referral sampling' method. Responses from individuals >18 years were included, and questions included age, sex, occupation, demographics, and socioeconomic conditions. The prevalence of anxiety and depression was assessed using the Generalized Anxiety Disorder (GAD-7) and the Patient Health Questionnaire (PHQ-9) scales. Data was analyzed using IBM SPSS software, and predictors of anxiety and depression were assessed. RESULTS: A total of 2640 responses from individuals between 18 years and 81 years were analyzed, of which 39% were from females and 85% from those <50 years of age. There were students (15.6%), teachers (10.7%), healthcare workers (16.8%), homemakers (9%), and daily wage laborers (4.1%), among others. Nearly 80% lived in cities, 55% had salaried jobs, 37% were working from home, 22% were temporarily unemployed, 10% were feeling work stress, 11% had increased alcohol intake, and 7.5% saw an increase in domestic violence. The income of 50% was adversely affected. Nearly 50% of our respondents had some symptoms of anxiety, and 23% had significant anxiety (GAD ≥5). The presence of anxiety was significantly higher in females, younger adults, city dwellers, healthcare workers, unemployed people, individuals living away from home, those without fixed salaries, those with work stress, and in people whose incomes had been adversely affected by the pandemic. On logistic regression analysis, female sex, younger age, unemployment, lack of salaried jobs, work stress, being a healthcare worker, and media reports were independent predictors of anxiety. About 60% of our respondents had some symptoms of depression, with 26% having significant depression (PHQ-9 ≥5). The presence of depression was significantly higher in females, younger adults, city dwellers, unemployed people, individuals living away from home without fixed salaries, and people with work stress. On logistic regression analysis, younger age, female sex, unemployment, lack of salaried jobs, work stress, and media reports were independent predictors of depression. Among our respondents, 70% used the time during the lockdown to study, 77% caught up with their families, and 56% reconnected with hobbies. Nearly 88% of our respondents had adjusted to their changing circumstances, helped by their religious beliefs and faith, the support of family and friends, good government measures, and the assurance of healthcare. CONCLUSIONS: Significant anxiety and depression were seen in 23% and 26% of respondents, respectively. Being a healthcare worker was an independent predictor of anxiety. Female sex, younger age, unemployment, work stress, and sensational media reports were independent predictors of both anxiety and depression.
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In this paper, the dynamic relationship between the volatilities of both the Indian equity market and six major commodity markets is analyzed during the COVID-19 pandemic. We employ the time-varying parameters vector autoregression model (TVP-VAR) and wavelet coherence approach to assess the market connectedness. The results reveal a significant increase in volatility correlation and spillovers between the Indian equity market and the six major commodity markets after the outbreak of COVID-19. Furthermore, it was found that after the COVID-19 outbreak, the volatility from the commodity markets rapidly spilled over to the Indian equity market. The wavelet coherence also suggests that the Indian equity market and the six major commodity markets may exhibit higher levels of contagion over the medium and long term. This evidence has important implications for financial risk management, macroprudential policy design, and investors who are interested in the volatility linkages between the Indian markets and major commodities.
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The Covid-19 health disaster has created a labour crisis. We examine the impact of the Covid-19 induced state-level direct (such as providing free food, minimum income, and transportation services for the labourers) and indirect (such as skill mapping of the return migrants and allowing extended hour shifts in the factories) risk-reducing labour strategies on urban and rural employment rates in India. These risk-reducing labour strategies secure livelihood and discourage labourers from risking their lives by joining the workplace of high interpersonal human contact during the pandemic. This reduces employment rates. Specifically, direct risk-reducing labour strategies reduce employment in urban and rural areas, while indirect risk-reducing labour strategies lessen employment only in urban areas. The mitigating effect justifies the importance of the Keynesian interventionist resilience techniques that safeguard the labourers and reduce the risks during the disaster.
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Volatility, Uncertainty, Complexity, Ambiguity-in a VUCA world the moment of surprise is everywhere, making things extremely unpredictable and planning and strategizing far more challenging. The healthcare industry is witnessing seismic shifts as medicine becomes more personalised, health data becomes valuable, and data sharing becomes essential, demanding the healthcare sector to re-strategise. This research aims to understand the various innovations and change-management techniques based on technology that have been adopted by healthcare industries in today's VUCA world while exploring the innovations needed to drive the Indian healthcare sector in the years to come. Thus, it examines and highlight the implications of the rising emphasis being placed on innovations in the healthcare industry - helping the sector to re-strategise and face the changes in today's VUCA world with greater clarity. This paper is also designed to call attention to and discuss contemporary perspectives taken by top healthcare organisations in India before and during the COVID-19 pandemic. This research is based on secondary data, including intensive analysis of research papers, media articles and grey literature reports, along with examining the recent innovations undertaken by the top healthcare companies and hospitals in India. The findings suggest that moving away from a supply-driven healthcare system toward a patient-centred system is necessary, and therefore organisations in India have to embrace innovation, agility, and adaptability in unison to brave the VUCA times.
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Background: Cardiac screening of youth for prevention of sudden cardiac death in the young (SCDY) has been debated due to the absence of large population-specific screening data with outcomes. Despite years of screening by US public screening groups (PSG), there is minimal coordination of effort and no standardized methods for real-world data collection. Objective(s): To understand the methods, quality, outcomes, and best practices of youth screening, the Cardiac Safety Research Consortium Pediatric Cardiology Working Group, in collaboration with FDA and PSGs, developed and enabled a scalable system to collect a uniform pediatric cardiac screening dataset including digital ECGs and post-screening electronic follow-up data. Method(s): Front end data collection (figure) was developed to include use of a universal unique ID system to align paper/digital collection of health and ECG data. PSGs use secure data transfer portals for digital ECG data upload for conversion to device-agnostic standardized FDA format to store in the national pediatric cardiac screening data warehouse. Follow-up data are obtained at designated post-screening intervals (one week, one and 3 months for pilot study) using initial text message contact followed by electronic consent (REDCap) and answering online health surveys. Result(s): Fourteen PSGs in ten states participated in the pilot study. PSG warehouse data include 33840 retrospective ECG datasets collected from 2010 to 2021 containing limited screened history/symptoms but demographics similar to US census as follows: Age 13-30y, Male/Female 57/43%, Asian 6%, Black 19%, Native American <1%, Pacific Islander <1%, White 68%, Other 4%;Hispanic/Non-Hispanic 27%/79%. Individual PSG site demographics reflected local populations. Prospective data collection since 2021 include >4000 uniform screening datasets (age, sex, race, ethnicity, ht, wt, screening H&P, COVID history, medications, digital ECG with results, screening outcome, and, if applicable, ECHO results). Follow up participation allowing initial cellular contact was high (avg 73%, range 51-91%/screening). Conclusion(s): Establishment of a national pediatric cardiac data warehouse enables large-scale aggregation of pediatric cardiac screening information to address deficits in the understanding and prevention of SCDY. This large real-world dataset will help establish normative data for pediatric ECGs which can facilitate development of new diagnostic tools such as machine learning and support pediatric drug and device development. [Formula presented]Copyright © 2023
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Introduction: Traditional clinical trials that utilize fixed sites often fail to recruit participants that are representative of the intended use population. Participants, particularly those from minority groups, cite geographical constraints, mistrust, miscommunication, and discrimination as barriers to successful recruitment. A decentralized clinical trial enrollment strategy offers reduced cost, reduced time requirements, and circumvents barriers associated with the recent pandemic outbreak. Method(s): After the mt-sRNA test system entered design-lock, a decentralized clinical trial (CRC-PREVENT) was launched through a digital campaign (https://www.colonscreeningstudy.com/;NCT04739722). Online advertisements were published on multiple social media sites, and engagement with materials directed patients to an online screener. Participants who completed the screener were eligible for enrollment if they met CRC-PREVENT inclusion and exclusion criteria and were willing to complete all clinical trial components, including providing a stool sample before an optical colonoscopy. Result(s): After 12 months of active enrollment, 276,400 individuals engaged with digital advertisements and completed pre-screener surveys to determine eligibility for the clinical trial. In total, 14,264 individuals consented to participate in the CRC-PREVENT clinical trial. Of these individuals, 58% were female (42% were male), and 65% were over 50. Regarding race and ethnicity, eligible individuals directly represented the intended use population: 16% were Black or African American, 0.2% were Native Hawaiian, Pacific Islander, American Indian, or Alaskan Native, and 7% were Hispanic or Latinx. Regarding socioeconomic status, the decentralized approach permitted access to individuals with healthcare inequities: 25% of participants had income under $29,999, 5% of participants were from rural areas (defined as a city center , 10,000 people), and 36.7% of participants were on public insurance. Individuals were derived from 7,644 unique zip codes across all 48 continental United States. (Table) Conclusion(s): A decentralized recruitment strategy permits highly successful enrollment in the face of screening burdens heightened by COVID-19 pandemic. This approach also offered a significantly more diverse population and could mitigate selection bias and attrition bias associated with the cohorts observed in traditional clinical studies.