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1.
Microorganisms ; 10(4):690, 2022.
Article in English | ProQuest Central | ID: covidwho-1810029

ABSTRACT

In Germany, tick-borne encephalitis (TBE) infections mainly occur in southern regions. Despite recent increases in incidence, TBE vaccination coverage remains low, necessitating additional preventive strategies against TBE. Our case-control study in Southern Germany from 2018 to 2020 mapped knowledge/application of tick-protective strategies and identified TBE risk factors. We calculated odds ratios (OR), with 95% confidence intervals (CI). We interviewed 581 cases and 975 matched controls. Most participants recalled lifetime tick bites, mainly while walking, gardening, or hiking. However, only 45% of cases noticed ticks during exposure time;another 12% reported unpasteurized milk intake. While tick-protection knowledge was satisfactory, application lagged behind. Risk factors included dog ownership (OR = 2.45, 95% CI: 1.85–3.24), walks ≥ 4×/week (OR = 2.11, 95% CI: 1.42–3.12), gardening ≥ 4×/week (OR = 1.83, 95% CI: 1.11–3.02), and garden proximity < 250 m of forests (OR = 2.54, 95% CI: 1.82–3.56). Applying ≥2 tick-protective strategies (OR = 0.52, 95% CI: 0.40–0.68) and keeping lawns mowed (OR = 0.63, 95% CI: 0.43–0.91) were inversely associated with TBE. In 2020 (likely pandemic-related), cases reported significantly more walks than previously, potentially explaining the record high case numbers. Our findings provide guidance on targets for TBE prevention. Persons with gardens near forests, frequent outdoor activities, or dogs could particularly benefit from targeted information, including on vaccination and preventing tick bites.

2.
Journal of the American Academy of Physician Assistants ; 35(4):29-33, 2022.
Article in English | Scopus | ID: covidwho-1806587

ABSTRACT

Acute respiratory distress syndrome (ARDS) is a severe, often fatal, lung condition frequently seen in patients in the ICU. ARDS is triggered by an inciting event such as pneumonia or sepsis, which is followed by an inappropriate host inflammatory response that results in pulmonary edema and impaired gas exchange, and may progress to fibrosis. With the increased spotlight and discussion focused on ARDS during the COVID-19 pandemic, healthcare providers must be able to identify and manage symptoms based on evidence-based research. © 2022 American Academy of Physician Associates.

3.
Journal of Medical Devices-Transactions of the Asme ; 16(1):7, 2022.
Article in English | Web of Science | ID: covidwho-1779288

ABSTRACT

Critical care patients who experience acute respiratory distress syndrome are commonly placed on mechanical ventilators to improve oxygen delivery and overall gas exchange of the pulmonary system. With the pulmonary inflammation accompanying acute respiratory distress syndrome (ARDS), patients experience significant alterations in ventilation-perfusion (V/Q) ratios resulting in lower blood oxygenation. In severe cases, patients are typically rotated into a prone position to facilitate improved blood flow to portions of the lung that were not previously participating in the gas exchange process. However, proning a patient increases the risk of complications, requires up to seven hospital staff members to carry out, and does not guarantee an improvement in the patient's condition. The low-cost V/Q vest presented here was designed to reproduce the effects of proning while also requiring less hospital staff than the proning process. Additionally, the V/Q Vest helps hospital staff predict whether patients would respond well to a proning treatment. A pilot study was conducted on nine patients with ARDS from coronavirus disease 2019 (COVID-19). The average increase in oxygenation with the V/Q Vest treatment for all patients was 19.7 +/- 38.1%. Six of the nine patients responded positively to the V/Q Vest treatment, exhibiting increased oxygenation. The V/Q Vest also helped hospital staff predict that three of the five patients that were proned would experience an increase in oxygenation. An increase in oxygenation resulting from V/Q Vest treatment exceeded that of the proning treatment in two of these five proned patients.

4.
Europa XXI ; 41, 2021.
Article in English | Scopus | ID: covidwho-1703602

ABSTRACT

One of the social groups particularly hard hit by the COVID-19 pandemic is people experiencing homelessness, as they are especially vulnerable to infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Still, the pandemic also drastically affected their livelihoods, as parts of municipal emergency assistance services have broken away. This article aims to highlight emergency responses of the Berlin Senate to people experiencing homelessness regarding COVID-19. The Senate is responding to the issue, among other things, by expanding and refiguring the existing contingent of shelters run by municipal emergency assistance services, preventing transmission of COVID-19 and treating those infected, and establishing mechanisms of tenant protection. The paper discusses to what extent Senate measures and interventions at the onset of the pandemic can address the emergent need for homeless assistance services in Berlin. © 2021, Insitute of Geography and Spatial Organization Polish Academy of Sciences. All rights reserved.

5.
Pakistan Journal of Medical and Health Sciences ; 16(1):256-258, 2022.
Article in English | EMBASE | ID: covidwho-1677849

ABSTRACT

Objective: To compare the patient outcome in severe COVID-19 pneumonia between the non-invasive ventilation and invasive mechanical ventilation. Study design: Prospective, observational study Study Setting and Duration: Department of Pulmonology, Bahawal Victoria Hospital, Bahawalpur from January 2021 to June 2021. Methodology: We analyzed 660 patients of severe covid pneumonia. Conscious proning was done in those requiring ≥ 21 L oxygen and oxygen saturation < 90%. We defined typical ARDS according to Berlin criteria. Atypical ARDS did not fulfill set criteria. We divided ARDS into 2 types i-e H and L type. We managed ARDS with either NIV, invasive mechanical ventilation or both. We used multiple regression analysis to predict ICU stay. Results: Out of 660 patients, 285 (43.18%) developed biPAP failure and were subsequently intubated. We observed 273 (41.4%) overall mortality, 175 (64.1%) in IMV and 98 (35.9%) in the NIV group (p<0.0001). invasive mechanical ventilation had statistically significant correlation with mortality and also predicted ICU stay. (p=< 0.001, OR 3.2, p=0.001). Conclusion: NIV therapy is superior to invasive mechanical ventilation in terms of ICU stay and outcome.

6.
Architectural Design ; 92(1):112-119, 2022.
Article in English | Web of Science | ID: covidwho-1620095

ABSTRACT

Theorists of Half-Earth Socialism Troy Vettese, Drew Pendergrass and Filip Mesko explain their global societal vision and explore how eco-socialist planning can create a just and sustainable society. They argue that the problem of land scarcity is an opportunity to erode the separation of city and country, while vast swathes of the world could be rewilded.

7.
Powder Diffraction ; 36(4):291-296, 2021.
Article in English | ProQuest Central | ID: covidwho-1594455

ABSTRACT

Materials Identification Quantitative Phase Analysis Advanced PDF Modelling EDS Detectors Sample Preparation of XRF Basic XRF Trace Analysis Layered Structures Intermediate to Advanced XRD Imaging Micro XRF Non-ambient XRD Quantitative Analysis of XRF Handheld XRF III. New Developments in XRD and XRF Instrumentation Quantitative Phase Analysis Advanced Total Scattering Methods for Complex Material Studies Quantitative Analysis of XRF Trace Analysis including TXRF Machine Learning Techniques in X-ray Analysis General XRD Imaging Stress Analysis Functional Materials General XRF Non-ambient Analysis X-ray Absorption Spectroscopy Industrial Applications of XRD and XRF Cultural Heritage V. POSTER SESSIONS Both XRD and XRF Posters were available on the first day of the conference. Residual Stress and Microstructural Analysis of Laser Powder Bed Fusion Processed Ti-5Al-5V-5Mo-3Cr Alloy Using Synchrotron X-ray Diffraction C. XRF best poster award M. Sunder*, M.A. Zaitz, IBM, USA, for their work: Andrés Servando Aguirre Sánchez, Instituto Tecnológico y de Estudios Superiores de Monterrey, Mexico Adam Corrao, Stony Brook University, USA Hannah Cross, Keele University, United Kingdom Samantha Davies, Cranfield University, United Kingdom Benedikt Eger, Bonn-Rhein-Sieg University of Applied Sciences, Germany Gesa Goetzke, TU Berlin, Germany Sarah Gosling, Cranfield University, United Kingdom Sven Hampel, Clausthal University of Technology, Germany Benjamin Hulbert, University of Illinois at Urbana-Champaign, USA Rahul Lalge, University of Minnesota, USA Marcelo Augusto Malagutti, Universidade Federal de Santa Catarina, Brazil Otavio Jovino Marques, Illinois Institute of Technology, USA Ana Cecilia Murrieta Muñoz, Tecnológico de Monterrey, Mexico Steffen Staeck, TU Berlin, Germany VIII.

8.
Int J Crit Illn Inj Sci ; 11(2): 51-55, 2021.
Article in English | MEDLINE | ID: covidwho-1311415

ABSTRACT

BACKGROUND: The association between commonly monitored respiratory parameters, including compliance and oxygenation and clinical outcomes in acute respiratory distress syndrome (ARDS) from coronavirus disease 2019 (COVID-19) remains unclear, limiting prognostication and the delivery of targeted treatments. Our project aim was to identify if any such associations exist between clinical outcomes and respiratory parameters. METHODS: We performed a retrospective observational cohort study of confirmed COVID-19 positive patients admitted to a single dedicated intensive care unit at a university hospital from March 27 to April 26, 2020. We collected information on baseline clinical and demographic characteristics and initial respiratory parameters. Our primary outcome was in-hospital mortality. RESULTS: A total of 22 patients met criteria for ARDS and were included in our study. Nine of the 22 (40.9%) patients with ARDS died during hospitalization. The initial static respiratory system compliance of survivors was 39 (interquartile range [IQR] 34, 55) and nonsurvivors was 27 (IQR 24, 33, P < 0.01). A lower respiratory system compliance was associated with an increased adjusted odd of in-hospital mortality (odds ratio 1.2, 95% confidence interval 1.01, 1.45 P = 0.04). CONCLUSION: In our cohort of 22 patients mechanically ventilated with ARDS from COVID-19, having lower respiratory system compliance after intubation was associated with an increased risk of in-hospital mortality, consistent with ARDS from non-COVID etiologies.

9.
Crit Care Explor ; 3(6): e0451, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1274517

ABSTRACT

Accurate identification of acute respiratory distress syndrome is essential for understanding its epidemiology, patterns of care, and outcomes. We aimed to design a computable phenotyping strategy to detect acute respiratory distress syndrome in electronic health records of critically ill patients. DESIGN: This is a retrospective cohort study. Using a near real-time copy of the electronic health record, we developed a computable phenotyping strategy to detect acute respiratory distress syndrome based on the Berlin definition. SETTING: Twenty multidisciplinary ICUs in Mayo Clinic Health System. SUBJECTS: The phenotyping strategy was applied to 196,487 consecutive admissions from year 2009 to 2019. INTERVENTIONS: The acute respiratory distress syndrome cohort generated by this novel strategy was compared with the acute respiratory distress syndrome cohort documented by clinicians during the same period. The sensitivity and specificity of the phenotyping strategy were calculated in randomly selected patient cohort (50 patients) using the results from manual medical record review as gold standard. MEASUREMENTS AND MAIN RESULTS: Among the patients who did not have acute respiratory distress syndrome documented, the computable phenotyping strategy identified 3,169 adult patients who met the Berlin definition, 676 patients (21.3%) were classified to have severe acute respiratory distress syndrome (Pao2/Fio2 ratio ≤ 100), 1,535 patients (48.4%) had moderate acute respiratory distress syndrome (100 < Pao2/Fio2 ratio ≤ 200), and 958 patients (30.2%) had mild acute respiratory distress syndrome (200 < Pao2/Fio2 ratio ≤ 300). The phenotyping strategy achieved a sensitivity of 94.4%, specificity of 96.9%, positive predictive value of 94.4%, and negative predictive value of 96.9% in a randomly selected patient cohort. The clinicians documented acute respiratory distress syndrome in 1,257 adult patients during the study period. The clinician documentation rate of acute respiratory distress syndrome was 28.4%. Compared with the clinicians' documentation, the phenotyping strategy identified a cohort that had higher acuity and complexity of illness suggested by higher Sequential Organ Failure Assessment score (9 vs 7; p < 0.0001), higher Acute Physiology and Chronic Health Evaluation score (76 vs 63; p < 0.0001), higher rate of requiring invasive mechanical ventilation (99.1% vs 71.8%; p < 0.0001), higher ICU mortality (20.6% vs 16.8%; p < 0.0001), and longer ICU length of stay (5.1 vs 4.2 d; p < 0.0001). CONCLUSIONS: Our rule-based computable phenotyping strategy can accurately detect acute respiratory distress syndrome in critically ill patients in the setting of high clinical complexity. This strategy can be applied to enhance early recognition of acute respiratory distress syndrome and to facilitate best-care delivery and clinical research in acute respiratory distress syndrome.

10.
Emerg Infect Dis ; 27(7)2021 07.
Article in English | MEDLINE | ID: covidwho-1278365

ABSTRACT

Within 5 weeks in 2021, B.1.1.7 became the dominant severe acute respiratory syndrome coronavirus 2 lineage at an outpatient testing site in Berlin, Germany. Compared with outpatients with wild-type virus infection, patients with B.1.1.7 had similar cycle threshold values, more frequent sore throat and travel history, and less frequent anosmia/ageusia.


Subject(s)
COVID-19 , SARS-CoV-2 , Berlin , Germany/epidemiology , Humans , Outpatients
11.
Emerg Infect Dis ; 27(8): 2174-2178, 2021 08.
Article in English | MEDLINE | ID: covidwho-1261342

ABSTRACT

We detected delayed and reduced antibody and T-cell responses after BNT162b2 vaccination in 71 elderly persons (median age 81 years) compared with 123 healthcare workers (median age 34 years) in Germany. These data emphasize that nonpharmaceutical interventions for coronavirus disease remain crucial and that additional immunizations for the elderly might become necessary.


Subject(s)
COVID-19 , Adult , Aged , Aged, 80 and over , COVID-19 Vaccines , Germany/epidemiology , Humans , SARS-CoV-2 , T-Lymphocytes , Vaccination
12.
Emerg Infect Dis ; 27(8): 2169-2173, 2021 08.
Article in English | MEDLINE | ID: covidwho-1261341

ABSTRACT

One week after second vaccinations were administered, an outbreak of B.1.1.7 lineage severe acute respiratory syndrome coronavirus 2 infections occurred in a long-term care facility in Berlin, Germany, affecting 16/20 vaccinated and 4/4 unvaccinated residents. Despite considerable viral loads, vaccinated residents experienced mild symptoms and faster time to negative test results.


Subject(s)
COVID-19 , SARS-CoV-2 , Berlin , Disease Outbreaks , Germany/epidemiology , Humans , Long-Term Care , Vaccination
13.
Sci Total Environ ; 764: 142919, 2021 Apr 10.
Article in English | MEDLINE | ID: covidwho-1065580

ABSTRACT

For over 15-years, proponents of the One Health approach have worked to consistently interweave components that should never have been separated and now more than ever need to be re-connected: the health of humans, non-human animals, and ecosystems. We have failed to heed the warning signs. A One Health approach is paramount in directing our future health in this acutely and irrevocably changed world. COVID-19 has shown us the exorbitant cost of inaction. The time to act is now.


Subject(s)
COVID-19 , One Health , Animals , Berlin , Ecosystem , Global Health , Humans , SARS-CoV-2
14.
Emerg Infect Dis ; 27(2): 645-648, 2020 02.
Article in English | MEDLINE | ID: covidwho-953739

ABSTRACT

We report an outbreak of coronavirus disease with 74 cases related to a nightclub in Germany in March 2020. Staff members were particularly affected (attack rate 56%) and likely caused sustained viral transmission after an event at the club. This outbreak illustrates the potential for superspreader events and corroborates current club closures.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Disease Outbreaks/statistics & numerical data , Disease Transmission, Infectious/statistics & numerical data , Food Services , Adolescent , Adult , COVID-19/virology , Child , Child, Preschool , Female , Germany/epidemiology , Humans , Male , Middle Aged , SARS-CoV-2 , Young Adult
15.
Anaesthesist ; 70(5): 420-431, 2021 05.
Article in German | MEDLINE | ID: covidwho-950263

ABSTRACT

BACKGROUND: The COVID-19 pandemic represents an unprecedented severe test for emergency medicine in Germany. In addition to in-hospital emergency medicine, prehospital emergency medicine has the decisive task of fully guaranteeing emergency medical healthcare. In this article the Berlin Fire Brigade shows new ways for emergency medical services to fulfil these increased responsibilities during the pandemic in prehospital emergency medicine in the State of Berlin. METHODS: A systematic presentation of the challenges and conceptional responses of preclinical emergency medicine to the COVID-19 pandemic was carried out using the example of the emergency medical services in the State of Berlin. RESULTS: The Berlin Fire Brigade has a dispatch center that coordinates all requests for assistance in the State of Berlin over the emergency telephone number 112. On average a total of 2565 emergency calls are received every 24 h, from which 1271 missions are generated. During the pandemic there was a striking increase in missions to patients with acute respiratory diseases (ARD). Of the missions 11% were carried out to patients with the suspicion of COVID-19. The duration of the emergency calls was extended on average by 1:36 min due to the additional questions in the pandemic protocol and the duration of the mission by an average of 17 min with the additional alarm keyword acute respiratory disease (ARD). CONCLUSION: The continuing pandemic reveals that tasks and responsibilities of public services in emergency rescue go far beyond the immediate medical prevention of danger to life and limb. In addition to the controller and triage functions in the integrated dispatch center of the Berlin Fire Brigade (112), the emergency and healthcare measures could be ensured. This was accomplished by comprehensive measures for situation control, situation reports and mastering situations despite the lack of alternative outpatient care options, especially in the areas of general practitioner, public health care and medical specialist practices.


Subject(s)
COVID-19/diagnosis , Emergency Medical Services/methods , Exercise Test/methods , Berlin , COVID-19/physiopathology , COVID-19/therapy , Emergency Responders , Emergency Service, Hospital , Firefighters , Humans , Pandemics , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/therapy , Triage
16.
Cureus ; 12(5): e8228, 2020 May 21.
Article in English | MEDLINE | ID: covidwho-615144

ABSTRACT

As of April 2020, the coronavirus 2019 (COVID-19) pandemic has resulted in more than 210,000 deaths globally. The most common cause of death from COVID-19 is acute respiratory failure. We report the case of a 78-year-old female with a history of hypertension, cerebrovascular accident (CVA), type 2 diabetes mellitus, and sarcoidosis, who presented to the emergency department with one day of dyspnea. The patient experienced a rapid decline in respiratory function and was intubated in the intensive care unit (ICU), meeting the Berlin criteria for severe acute respiratory distress syndrome (ARDS). Chest radiography revealed diffuse bilateral coalescent opacities, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA swab test was positive for COVID-19. The patient experienced acute kidney injury with uptrending creatinine levels and remained lethargic and unresponsive throughout her ICU stay, suggestive of potential hypoxic brain injury. In light of the patient's poor clinical status, age, and significant comorbidities, prognosis was conveyed about medical futility and patient's family agreed to terminal extubation and the patient expired peacefully, exactly one week from hospital admission. This case report highlights the speed at which severe ARDS can present and contribute to end-organ dysfunction in COVID-19 patients.

17.
Crit Care ; 24(1): 198, 2020 05 06.
Article in English | MEDLINE | ID: covidwho-186729

ABSTRACT

In December 2019, an outbreak of coronavirus disease 2019 (COVID-19) was identified in Wuhan, China. The World Health Organization (WHO) declared this outbreak a significant threat to international health. COVID-19 is highly infectious and can lead to fatal comorbidities especially acute respiratory distress syndrome (ARDS). Thus, fully understanding the characteristics of COVID-19-related ARDS is conducive to early identification and precise treatment. We aimed to describe the characteristics of COVID-19-related ARDS and to elucidate the differences from ARDS caused by other factors. COVID-19 mainly affected the respiratory system with minor damage to other organs. Injury to the alveolar epithelial cells was the main cause of COVID-19-related ARDS, and endothelial cells were less damaged with therefore less exudation. The clinical manifestations were relatively mild in some COVID-19 patients, which was inconsistent with the severity of laboratory and imaging findings. The onset time of COVID-19-related ARDS was 8-12 days, which was inconsistent with ARDS Berlin criteria, which defined a 1-week onset limit. Some of these patients might have a relatively normal lung compliance. The severity was redefined into three stages according to its specificity: mild, mild-moderate, and moderate-severe. HFNO can be safe in COVID-19-related ARDS patients, even in some moderate-severe patients. The more likely cause of death is severe respiratory failure. Thus, the timing of invasive mechanical ventilation is very important. The effects of corticosteroids in COVID-19-related ARDS patients were uncertain. We hope to help improve the prognosis of severe cases and reduce the mortality.


Subject(s)
Acute Lung Injury/diagnostic imaging , Coronavirus Infections/therapy , Pneumonia, Viral/therapy , Respiratory Distress Syndrome/diagnostic imaging , Respiratory Distress Syndrome/therapy , Acute Lung Injury/epidemiology , Acute Lung Injury/therapy , Betacoronavirus , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Creatine Kinase/blood , Female , Humans , L-Lactate Dehydrogenase/blood , Male , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Radiography , Respiration, Artificial , Respiratory Distress Syndrome/classification , Respiratory Distress Syndrome/epidemiology , SARS-CoV-2 , Severity of Illness Index , Time Factors
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