It's been a good pandemic for me': Working with coaching and psychotherapy clients, with a focus on clients with a diagnosis of pure obsessive compulsive disorder

Many of the coaching clients are high achievers and in most of the prepandemic sessions presented as confident, in control and professional. Their reasons for coaching were often focused on their desire to move to the next level, which called for them to identify their strengths and perceived weaknesses and take action to address the identified gaps in their skills and knowledge through the coaching or through further training. This chapter offers a 'good enough' experience for clients and so, during the pandemic, moved reluctantly to working via online platforms or telephone sessions, depending on the client's preference. During the pandemic it is encouraged to build in the time to take walks before and after online sessions and, when it became possible to do so, to start taking that coffee time again rather than going straight from an online psychotherapy session to online business. The client with a pure obsessive compulsive disorder (POCD) diagnosis also saw benefits to their being-in-the-world from the pandemic. POCD often manifests as intrusive, inappropriate and shameful thoughts on which the person will ruminate. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Immune System Development Processes with Special Emphasis on Relationship to Potential Mechanisms of MIS-C

Development of the mammalian immune system requires the intersection of myriad internal and external signals, from the migration of pluripotent stem cells to interactions with the vaginal microbiome during partuition to environmental factors that shape immune processes throughout life. Because the sequence of immune developmental events is fairly transcripted across time, multiple windows of susceptibility exist that can lead to immune dysfunction when these developmental events are perturbed. Additionally, early-life immune dysfunction can persist, leading to increased disease risk across the lifespan. Immune dysfunction can present functionally as suppression, hyperresponsivity, or inappropriate inflammation and molecularly, may involve multiple cells and signaling pathways. Thus, scenarios that lead to multisystem inflammatory syndrome in children (MIS-C) can be complex and multifaceted. This presentation will consider windows of susceptibility as well as external factors that may increase the risk of MIS-C.

Information technology & media sociology in a (still) pandemic world

The current period of disruptive social change is inextricably bound up with new means and modes of communication, information, and media streams. The Communication, Information Technologies & Media Sociology section of the American Sociological Association (CITAMS) locates these factors at the center of our collective interests, investigating them through a plethora of methods, theories, and empirical cases. Each year, CITAMS runs a special issue in ICS showcasing select works presented at the previous year's American Sociological Association conference and the affiliated Media Sociology preconference. Papers in the 2022 CITAMS Special Issue reflect a social context defined by a prolonged global pandemic and wrought by democratic uncertainty. Across these social circumstances, technology and media loom large. Simultaneously, everyday life continues and classic CITAMS scholarship sustains relevance for the ways people interact, construct identity, consume, and mobilize. All of this and more are contained in the pages of this year's Special Issue, from which readers can get a sense of what CITAMS has to offer and consider how their own work may fit within the broad CITAMS umbrella. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Don't let corona become our only story

This chapter is about, what impact can the corona crisis have on our mental health? Besides the relational tensions that can arise from living on top of each other, many of us are also stuck in one negative story. The chapter is about the importance making room for stories that are not about corona. It discusses about work that consisting of broadening people's horizon by letting participants discover that they consist of multiple stories. This will have an enormous impact on the mental well-being of a large part of the population, which will have lots of consequences. That is why it is important to actively make room for other stories right now, in the middle of the pandemic. Memories from the past and dreams for the future. This is a responsibility one has to take towards one's own mental health (and resilience), just as we have to do for others. Sharing other stories and making sure people don't get stuck in that one difficult story is just as much part of caring about each other and will help us get through this crisis healthier. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Isopp 2023

The proceedings contain 109 papers. The topics discussed include: dose intensity of palbociclib and initial body weight dosage: implications on progression free survival in 220 patients with ER+/HER2-negative metastatic breast cancer;characteristics of Nirmatrelvir/Ritonavir (Paxlovid) recipients and clinical interventions by oncology pharmacists at a tertiary outpatient cancer center;safe handling of non-carcinogenic drugs in the Ghent University Hospital: development, implementation and communication of hospital-specific guidelines;case series: use of olaparib in uncommon locations in patients with impaired homologous recombination;real-world data evaluation of medicines used in special situations in oncohematology: a retrospective study from a comprehensive cancer institution;Dostarlimab in the treatment of recurrent endometrial cancer: real life experience;medication-related osteonecrosis of the jaws and CDK4/6 inhibitors in breast cancer;and efficacy and safety outcomes of generic imatinib in adults with chronic myeloid leukemia (CML) following the switch from branded imatinib.

Quantifying the spatial spillover effects of non-pharmaceutical interventions on pandemic risk.

BACKGROUND: Non-pharmaceutical interventions (NPIs) implemented in one place can affect neighboring regions by influencing people's behavior. However, existing epidemic models for NPIs evaluation rarely consider such spatial spillover effects, which may lead to a biased assessment of policy effects. METHODS: Using the US state-level mobility and policy data from January 6 to August 2, 2020, we develop a quantitative framework that includes both a panel spatial econometric model and an S-SEIR (Spillover-Susceptible-Exposed-Infected-Recovered) model to quantify the spatial spillover effects of NPIs on human mobility and COVID-19 transmission. RESULTS: The spatial spillover effects of NPIs explain [Formula: see text] [[Formula: see text] credible interval: 52.8-[Formula: see text]] of national cumulative confirmed cases, suggesting that the presence of the spillover effect significantly enhances the NPI influence. Simulations based on the S-SEIR model further show that increasing interventions in only a few states with larger intrastate human mobility intensity significantly reduce the cases nationwide. These region-based interventions also can carry over to interstate lockdowns. CONCLUSIONS: Our study provides a framework for evaluating and comparing the effectiveness of different intervention strategies conditional on NPI spillovers, and calls for collaboration from different regions.

A Pathology-based Case Series of Influenza- and COVID-19-associated Pulmonary Aspergillosis: The Proof Is in the Tissue.

RATIONALE: Invasive pulmonary aspergillosis has emerged as a frequent coinfection in severe COVID-19, similarly to influenza; yet the clinical invasiveness is more debated. OBJECTIVES: We investigated the invasive nature of pulmonary aspergillosis in histology specimens of influenza and COVID-19 intensive care unit (ICU) fatalities in a tertiary care center. METHODS: In this monocentric, descriptive, retrospective case series we included adult ICU patients with PCR-proven influenza/COVID-19 respiratory failure that underwent postmortem examination and/or tracheobronchial biopsy during ICU admission from September 2009 until June 2021. Diagnosis of probable/proven viral-associated pulmonary aspergillosis (VAPA) was made based on the ICM-IAPA and ECMM/ISHAM-CAPA consensus criteria. All respiratory tissues were independently reviewed by two experienced pathologists. MEASUREMENTS AND MAIN RESULTS: In the 44 patients of the autopsy-verified cohort, 6 proven influenza-associated and 6 proven COVID-19-associated pulmonary aspergillosis diagnoses were identified. Fungal disease was identified as missed-diagnosis upon autopsy in 8% of proven cases (n=1/12), yet most frequently found as confirmation of probable antemortem diagnosis (n=11/21, 52%) despite receiving antifungal treatment. Bronchoalveolar lavage galactomannan testing showed highest sensitivity for VAPA diagnosis. Among both viral entities, an impeded fungal growth was the predominant histologic pattern of pulmonary aspergillosis. Fungal tracheobronchitis was histologically indistinguishable in influenza (n=3) and COVID-19 (n=3) cases, yet macroscopically more extensive at bronchoscopy in influenza setting. CONCLUSIONS: Proven invasive pulmonary aspergillosis diagnosis was found regularly and with a similar histological pattern in influenza and in COVID-19 ICU case-fatalities. Our findings highlight an important need for VAPA awareness with an emphasis on mycological bronchoscopic work-up. This article is open access and distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).

Mild SARS-CoV-2 infection results in long-lasting microbiota instability.

Viruses targeting mammalian cells can indirectly alter the gut microbiota, potentially compounding their phenotypic effects. Multiple studies have observed a disrupted gut microbiota in severe cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection that require hospitalization. Yet, despite demographic shifts in disease severity resulting in a large and continuing burden of non-hospitalized infections, we still know very little about the impact of mild SARS-CoV-2 infection on the gut microbiota in the outpatient setting. To address this knowledge gap, we longitudinally sampled 14 SARS-CoV-2-positive subjects who remained outpatient and 4 household controls. SARS-CoV-2 cases exhibited a significantly less stable gut microbiota relative to controls. These results were confirmed and extended in the K18-humanized angiotensin-converting enzyme 2 mouse model, which is susceptible to SARS-CoV-2 infection. All of the tested SARS-CoV-2 variants significantly disrupted the mouse gut microbiota, including USA-WA1/2020 (the original variant detected in the USA), Delta, and Omicron. Surprisingly, despite the fact that the Omicron variant caused the least severe symptoms in mice, it destabilized the gut microbiota and led to a significant depletion in Akkermansia muciniphila. Furthermore, exposure of wild-type C57BL/6J mice to SARS-CoV-2 disrupted the gut microbiota in the absence of severe lung pathology.IMPORTANCETaken together, our results demonstrate that even mild cases of SARS-CoV-2 can disrupt gut microbial ecology. Our findings in non-hospitalized individuals are consistent with studies of hospitalized patients, in that reproducible shifts in gut microbial taxonomic abundance in response to SARS-CoV-2 have been difficult to identify. Instead, we report a long-lasting instability in the gut microbiota. Surprisingly, our mouse experiments revealed an impact of the Omicron variant, despite producing the least severe symptoms in genetically susceptible mice, suggesting that despite the continued evolution of SARS-CoV-2, it has retained its ability to perturb the intestinal mucosa. These results will hopefully renew efforts to study the mechanisms through which Omicron and future SARS-CoV-2 variants alter gastrointestinal physiology, while also considering the potentially broad consequences of SARS-CoV-2-induced microbiota instability for host health and disease.

Analysis of Japanese consumers' attitudes toward the digital transformation of OTC medicine purchase behavior and eHealth literacy: an online survey for digital experience design.

Introduction: Since the enactment of the revised Pharmaceutical Affairs Act in Japan in 2009, self-medication practices have increased in the country. However, studies report that consumers pay little attention to the medication facts and risks indicated on the packages of over-the-counter (OTC) medicines, which could be a potential risk. Since the COVID-19 pandemic, the digital transformation of purchasing OTC medicines has progressed. As an appropriate design for the digital transformation is likely to improve consumers' literacy and them obtaining medical information, this study systematically examines Japanese consumers' attitudes toward the digital transformation of OTC medicine purchase behavior and its correlation to eHealth literacy, exploring an appropriate digital experience design in purchasing OTC medicine. Methods: Participants from the Greater Tokyo Area of Japan participated in an online survey. Consumers' current behavior and preferences in accessing OTC medicine, receiving medication guidance, and obtaining medical information were examined. eHealth literacy was assessed using the J-eHEALS. Descriptive statistics, text mining, and thematic analysis were conducted to answer research questions. Results: Over 89% of the respondents who had experience in purchasing OTC medicines preferred local pharmacies or stores rather than online purchasing, p < 0.001. Obtaining medicine guidance in pharmacies or stores was the main preference over other approaches, p < 0.001. Furthermore, most of the participants accepted selecting medicine on shelves and digital screens in-store. However, they were accustomed to using smartphones to obtain additional information at the pharmacy or drug store, p < 0.001; this behavior was positively correlated with eHealth literacy, p < 0.001. Conclusions: Japanese consumers are seeking a combination of conventional and digital behaviors for purchasing OTC medicine rather than opting for a particular method. Most consumers prefer purchasing and receiving instructions in-store while searching for additional decision-making information online. eHealth literacy is positively associated with digital behaviors of OTC medicine information acquisition but less associated with medicine purchases and selections. The hybrid digital experience design may enhance the OTC medicine purchase experience and reduce potential risks by providing appropriate information.

Noncovalent antibody catenation on a target surface greatly increases the antigen-binding avidity.

Immunoglobulin G (IgG) antibodies are widely used for diagnosis and therapy. Given the unique dimeric structure of IgG, we hypothesized that, by genetically fusing a homodimeric protein (catenator) to the C-terminus of IgG, reversible catenation of antibody molecules could be induced on a surface where target antigen molecules are abundant, and that it could be an effective way to greatly enhance the antigen-binding avidity. A thermodynamic simulation showed that quite low homodimerization affinity of a catenator, e.g. dissociation constant of 100 µM, can enhance nanomolar antigen-binding avidity to a picomolar level, and that the fold enhancement sharply depends on the density of the antigen. In a proof-of-concept experiment where antigen molecules are immobilized on a biosensor tip, the C-terminal fusion of a pair of weakly homodimerizing proteins to three different antibodies enhanced the antigen-binding avidity by at least 110 or 304 folds from the intrinsic binding avidity. Compared with the mother antibody, Obinutuzumab(Y101L) which targets CD20, the same antibody with fused catenators exhibited significantly enhanced binding to SU-DHL5 cells. Together, the homodimerization-induced antibody catenation would be a new powerful approach to improve antibody applications, including the detection of scarce biomarkers and targeted anticancer therapies.

Structure-activity relationships of dihydropyrimidone inhibitors against native and auto-processed human neutrophil elastase.

BACKGROUND: Human neutrophil elastase (HNE) is a key driver of systemic and cardiopulmonary inflammation. Recent studies have established the existence of a pathologically active auto-processed form of HNE with reduced binding affinity against small molecule inhibitors. METHOD: AutoDock Vina v1.2.0 and Cresset Forge v10 software were used to develop a 3D-QSAR model for a series of 47 DHPI inhibitors. Molecular Dynamics (MD) simulations were carried out using AMBER v18 to study the structure and dynamics of sc (single-chain HNE) and tcHNE (two-chain HNE). MMPBSA binding free energies of the previously reported clinical candidate BAY 85-8501 and the highly active BAY-8040 were calculated with sc and tcHNE. RESULTS: The DHPI inhibitors occupy the S1 and S2 subsites of scHNE. The robust 3D-QSAR model showed acceptable predictive and descriptive capability with regression coefficient of r2 = 0.995 and cross-validation regression coefficient q2 = 0.579 for the training set. The key descriptors of shape, hydrophobics and electrostatics were mapped to the inhibitory activity. In auto-processed tcHNE, the S1 subsite undergoes widening and disruption. All the DHPI inhibitors docked with the broadened S1'-S2' subsites of tcHNE with lower AutoDock binding affinities. The MMPBSA binding free energy of BAY-8040 with tcHNE reduced in comparison with scHNE while the clinical candidate BAY 85-8501 dissociated during MD. Thus, BAY-8040 may have lower inhibitory activity against tcHNE whereas the clinical candidate BAY 85-8501 is likely to be inactive. CONCLUSION: SAR insights gained from this study will aid the future development of inhibitors active against both forms of HNE.

Affectionate touch and diurnal oxytocin levels: An ecological momentary assessment study.

Background: Affectionate touch, which is vital for mental and physical health, was restricted during the Covid-19 pandemic. This study investigated the association between momentary affectionate touch and subjective well-being, as well as salivary oxytocin and cortisol in everyday life during the pandemic. Methods: In the first step, we measured anxiety and depression symptoms, loneliness and attitudes toward social touch in a large cross-sectional online survey (N = 1050). From this sample, N = 247 participants completed ecological momentary assessments over 2 days with six daily assessments by answering smartphone-based questions on affectionate touch and momentary mental state, and providing concomitant saliva samples for cortisol and oxytocin assessment. Results: Multilevel models showed that on a within-person level, affectionate touch was associated with decreased self-reported anxiety, general burden, stress, and increased oxytocin levels. On a between-person level, affectionate touch was associated with decreased cortisol levels and higher happiness. Moreover, individuals with a positive attitude toward social touch experiencing loneliness reported more mental health problems. Conclusions: Our results suggest that affectionate touch is linked to higher endogenous oxytocin in times of pandemic and lockdown and might buffer stress on a subjective and hormonal level. These findings might have implications for preventing mental burden during social contact restrictions. Funding: The study was funded by the German Research Foundation, the German Psychological Society, and German Academic Exchange Service.

Prolonged T-cell activation and long COVID symptoms independently associate with severe COVID-19 at 3 months.

Coronavirus disease-19 (COVID-19) causes immune perturbations which may persist long term, and patients frequently report ongoing symptoms for months after recovery. We assessed immune activation at 3-12 months post hospital admission in 187 samples from 63 patients with mild, moderate, or severe disease and investigated whether it associates with long COVID. At 3 months, patients with severe disease displayed persistent activation of CD4+ and CD8+ T-cells, based on expression of HLA-DR, CD38, Ki67, and granzyme B, and elevated plasma levels of interleukin-4 (IL-4), IL-7, IL-17, and tumor necrosis factor-alpha (TNF-α) compared to mild and/or moderate patients. Plasma from severe patients at 3 months caused T-cells from healthy donors to upregulate IL-15Rα, suggesting that plasma factors in severe patients may increase T-cell responsiveness to IL-15-driven bystander activation. Patients with severe disease reported a higher number of long COVID symptoms which did not however correlate with cellular immune activation/pro-inflammatory cytokines after adjusting for age, sex, and disease severity. Our data suggests that long COVID and persistent immune activation may correlate independently with severe disease.

Parallel use of human stem cell lung and heart models provide insights for SARS-CoV-2 treatment.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily infects the respiratory tract, but pulmonary and cardiac complications occur in severe coronavirus disease 2019 (COVID-19). To elucidate molecular mechanisms in the lung and heart, we conducted paired experiments in human stem cell-derived lung alveolar type II (AT2) epithelial cell and cardiac cultures infected with SARS-CoV-2. With CRISPR-Cas9-mediated knockout of ACE2, we demonstrated that angiotensin-converting enzyme 2 (ACE2) was essential for SARS-CoV-2 infection of both cell types but that further processing in lung cells required TMPRSS2, while cardiac cells required the endosomal pathway. Host responses were significantly different; transcriptome profiling and phosphoproteomics responses depended strongly on the cell type. We identified several antiviral compounds with distinct antiviral and toxicity profiles in lung AT2 and cardiac cells, highlighting the importance of using several relevant cell types for evaluation of antiviral drugs. Our data provide new insights into rational drug combinations for effective treatment of a virus that affects multiple organ systems.

HPV+ Oropharyngeal Cancer in Waldenström Macroglobulinemia.

We present a case of squamous cell carcinoma (SCC) in the setting of Waldenström macroglobulinemia (WM). A 68-year-old male and daily marijuana smoker with recently diagnosed WM presented via telemedicine in 2020 for a progressively worsening sore throat and unintentional weight loss. Immunotherapy for WM was delayed due to the COVID-19 pandemic. In the clinic, examination revealed an indurated, tender midline mass at the base of the tongue, not limiting tongue mobility. The left level-II and right level-III lymph nodes were enlarged. The oropharyngeal lesion was biopsied, and pathology was consistent with human papillomavirus-positive (HPV+) SCC. Four cycles of concurrent chemotherapy and radiation for SCC were administered without delay, with an initial response. However, on surveillance, metastases to the brain and lungs were detected, and the patient was placed on palliative treatment as he did not meet eligibility for a clinical trial due to his WM. Concurrent WM and HPV+ SCC may have a worse prognosis, due to disease progression and reduced therapeutic options.

Comparative Analysis of Antimicrobial Antibodies between Mild and Severe COVID-19.

Patients with 2019 coronavirus disease (COVID-19) exhibit a broad spectrum of clinical presentations. A person's antimicrobial antibody profile, as partially shaped by past infection or vaccination, can reflect the immune system health that is critical to control and resolve the infection. We performed an explorative immunoproteomics study using microbial protein arrays displaying 318 full-length antigens from 77 viruses and 3 bacteria. We compared antimicrobial antibody profiles between 135 patients with mild COVID-19 disease and 215 patients with severe disease in 3 independent cohorts from Mexico and Italy. Severe disease patients were older with higher prevalence of comorbidities. We confirmed that severe disease patients elicited a stronger anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) response. We showed that antibodies against HCoV-229E and HcoV-NL63 but not against HcoV-HKU1 and HcoV-OC43 were also higher in those who had severe disease. We revealed that for a set of IgG and IgA antibodies targeting coronaviruses, herpesviruses, and other respiratory viruses, a subgroup of patients with the highest reactivity levels had a greater incidence of severe disease compared to those with mild disease across all three cohorts. On the contrary, fewer antibodies showed consistent greater prevalence in mild disease in all 3 cohorts. IMPORTANCE The clinical presentations of COVID-19 range from asymptomatic to critical illness that may lead to intensive care or even death. The health of the immune system, as partially shaped by past infections or vaccinations, is critical to control and resolve the infection. Using an innovative protein array platform, we surveyed antibodies against hundreds of full-length microbial antigens from 80 different viruses and bacteria in COVID-19 patients from different geographic regions with mild or severe disease. We not only confirmed the association of severe COVID-19 disease with higher reactivity of antibody responses to SARS-CoV-2 but also uncovered known and novel associations with antibody responses against herpesviruses and other respiratory viruses. Our study represents a significant step forward in understanding the factors contributing to COVID-19 disease severity. We also demonstrate the power of comprehensive antimicrobial antibody profiling in deciphering risk factors for severe COVID-19. We anticipate that our approach will have broad applications in infectious diseases.

A Contribution to Sustainable Human Resource Development in the Era of the COVID-19 Pandemic.

This examines the six drivers and twelve detailed practices of sustainable human resource development (S-HRD) before and during the COVID-19 pandemic across different organizations in Poland. The empirical strategy is based on explorative research conducted using surveys in Poland between 2020 and 2021. The results confirm that the surveyed organizations implemented S-HRD practices driven mainly by the expectations of external stakeholders. They neglected the areas of caring for employees' well-being and developing environmental awareness before the COVID-19 pandemic. During the pandemic, most companies maintained their approach to S-HRD. This research is unique because it adds to the body of literature advocating the significance of S-HRD for organizational resilience before, during, and after extreme events. Generalizing the results is challenging because the snowball sample has significant restrictions. However, future research may overcome these shortcomings by using larger samples based on probability or random sampling techniques.

Expression profile of HERVs and inflammatory mediators detected in nasal mucosa as a predictive biomarker of COVID-19 severity.

Introduction: Our research group and others demonstrated the implication of the human endogenous retroviruses (HERVs) in SARS-CoV-2 infection and their association with disease progression, suggesting HERVs as contributing factors in COVID-19 immunopathology. To identify early predictive biomarkers of the COVID-19 severity, we analyzed the expression of HERVs and inflammatory mediators in SARS-CoV-2-positive and -negative nasopharyngeal/oropharyngeal swabs with respect to biochemical parameters and clinical outcome. Methods: Residuals of swab samples (20 SARS-CoV-2-negative and 43 SARS-CoV-2-positive) were collected during the first wave of the pandemic and expression levels of HERVs and inflammatory mediators were analyzed by qRT-Real time PCR. Results: The results obtained show that infection with SARS-CoV-2 resulted in a general increase in the expression of HERVs and mediators of the immune response. In particular, SARS-CoV-2 infection is associated with increased expression of HERV-K and HERV-W, IL-1ß, IL-6, IL-17, TNF-α, MCP-1, INF-γ, TLR-3, and TLR-7, while lower levels of IL-10, IFN-α, IFN-ß, and TLR-4 were found in individuals who underwent hospitalization. Moreover, higher expression of HERV-W, IL-1ß, IL-6, IFN-α, and IFN-ß reflected the respiratory outcome of patients during hospitalization. Interestingly, a machine learning model was able to classify hospitalized vs not hospitalized patients with good accuracy based on the expression levels of HERV-K, HERV-W, IL-6, TNF-a, TLR-3, TLR-7, and the N gene of SARS-CoV-2. These latest biomarkers also correlated with parameters of coagulation and inflammation. Discussion: Overall, the present results suggest HERVs as contributing elements in COVID-19 and early genomic biomarkers to predict COVID-19 severity and disease outcome.

Perceived barriers to cervical cancer screening and motivators for at-home human papillomavirus self-sampling during the COVID-19 pandemic: Results from a telephone survey.

Background: Home-based self-sampling for human papillomavirus (HPV) testing may be an alternative for women not attending clinic-based cervical cancer screening. Methods: We assessed barriers to care and motivators to use at-home HPV self-sampling kits during the COVID-19 pandemic as part of a randomized controlled trial evaluating kit effectiveness. Participants were women aged 30-65 and under-screened for cervical cancer in a safety-net healthcare system. We conducted telephone surveys in English/Spanish among a subgroup of trial participants, assessed differences between groups, and determined statistical significance at p<0.05. Results: Over half of 233 survey participants reported that clinic-based screening (Pap) is uncomfortable (67.8%), embarrassing (52.4%), and discomfort seeing male providers (63.1%). The last two factors were significantly more prevalent among Spanish vs English speakers (66.4% vs 30% (p=0.000) and 69.9 vs 52.2% (p=0.006), respectively). Most women who completed the kit found Pap more embarrassing (69.3%), stressful (55.6%), and less convenient (55.6%) than the kit. The first factor was more prevalent among Spanish vs English speakers (79.6% vs 53.38%, p=0.001) and among patients with elementary education or below. Conclusions: The COVID-19 pandemic influenced most (59.5%) to participate in the trial due to fear of COVID, difficulty making appointments, and ease of using kits. HPV self-sampling kits may reduce barriers among under-screened women in a safety-net system. Funding: This study is supported by a grant from the National Institute for Minority Health and Health Disparitie s (NIMHD, R01MD013715, PI: JR Montealegre). Clinical trial number: NCT03898167.

Perception study of perceived value and social influence of digital health services in Indonesia.

BACKGROUND: Healthtech has become a nascent sector of the internet economy since the emergence of the COVID-19 pandemic in 2020. Telemedicine features are facilitated, such as teleconsultation, e-diagnosis, e-prescribing, and e-pharmacy. However, the intention to use digital health services in Indonesia is still underdeveloped though the sales of other risk-free e-commerce products are high enough. OBJECTIVE: This study aims to assess the human perception of perceived value and social influences regarding the intention to use digital health services. METHODS: Google Forms web link is employed to disseminate a set of 4-Point Likert scale questionnaires. In total, 364 complete responses are collected-back. A descriptive approach is employed to process the data using Microsoft Excel and SPSS software. Validity and reliability are quantified using the item total-correlation method and Cronbach's Alpha coefficient. RESULTS: Only 87 respondents (24%) ever used digital health services, of which Halodoc (92%) is the most preferred application, and teleconsultation became the most popular service to access. Out of four, the average score is 3.16 for perceived value and 2.86 for the social influence dimension. CONCLUSION: Most respondents, not dependent on user experience, perceive more values obtained using digital health services, such as time and money savings, convenience, flexible order time, undiscovered identity, adventurous experience, and enjoyment. Another finding of this research proves that some social influences from family, friends, and mass media also bring effect to amplify the intention to use. A low level of trust is assumed to be the cause of a small number of users.