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1.
BMJ Open ; 12(4), 2022.
Article in English | EMBASE | ID: covidwho-1822070

ABSTRACT

Introduction Treatment-resistant schizophrenia (TRS) is associated with significant impairment of functioning and high treatment costs. Identification of patients at high risk of TRS at the time of their initial diagnosis may significantly improve clinical outcomes and minimise social and functional disability. We aim to develop a prognostic model for predicting the risk of developing TRS in patients with first-episode schizophrenia and to examine its potential utility and acceptability as a clinical decision tool. Methods and analysis We will use two well-characterised longitudinal UK-based first-episode psychosis cohorts: Aetiology and Ethnicity in Schizophrenia and Other Psychoses and Genetics and Psychosis for which data have been collected on sociodemographic and clinical characteristics. We will identify candidate predictors for the model based on current literature and stakeholder consultation. Model development will use all data, with the number of candidate predictors restricted according to available sample size and event rate. A model for predicting risk of TRS will be developed based on penalised regression, with missing data handled using multiple imputation. Internal validation will be undertaken via bootstrapping, obtaining optimism-adjusted estimates of the model's performance. The clinical utility of the model in terms of clinically relevant risk thresholds will be evaluated using net benefit and decision curves (comparative to competing strategies). Consultation with patients and clinical stakeholders will determine potential thresholds of risk for treatment decision-making. The acceptability of embedding the model as a clinical tool will be explored using qualitative focus groups with up to 20 clinicians in total from early intervention services. Clinicians will be recruited from services in Stafford and London with the focus groups being held via an online platform. Ethics and dissemination The development of the prognostic model will be based on anonymised data from existing cohorts, for which ethical approval is in place. Ethical approval has been obtained from Keele University for the qualitative focus groups within early intervention in psychosis services (ref: MH-210174). Suitable processes are in place to obtain informed consent for National Health Service staff taking part in interviews or focus groups. A study information sheet with cover letter and consent form have been prepared and approved by the local Research Ethics Committee. Findings will be shared through peer-reviewed publications, conference presentations and social media. A lay summary will be published on collaborator websites.

2.
Influenza and other Respiratory Viruses ; 2022.
Article in English | EMBASE | ID: covidwho-1822050

ABSTRACT

Based on our national outpatient sentinel surveillance, we have developed a novel approach to determine respiratory syncytial virus (RSV) epidemic seasons in Germany by using RSV positivity rate and its lower limit of 95% confidence interval. This method was evaluated retrospectively on nine RSV seasons, and it is also well-suited to describe off-season circulation of RSV in near real time as observed for seasons 2020/21 and 2021/22 during the COVID-19 pandemic. Prospective application is of crucial importance to enable timely actions for health service delivery and prevention.

4.
Current Orthopaedic Practice ; 2022.
Article in English | EMBASE | ID: covidwho-1821984

ABSTRACT

Background: The COVID-19 pandemic has forced many medical education institutions to switch from in-person to online learning environments. There is an existing gap in knowledge about the effectiveness of virtual learning for medical students. Objective: The purpose of the study was to determine if virtual orthopaedic surgery away rotations (VOSAR) benefit medical students and programs. Methods: Virtual rotations were created at two large residency programs for fourth-year medical students. From October 12, 2020 through December 28, 2020, satisfaction and quality were assessed using a 22-question survey, residency interview, rank, and match data. Forty-two fourth-year medical students participated, 38 of whom responded to the survey. Results: Most students stated course objectives were clear and consistent with coursework. Most were pleased with the variety of cases and presentations and were able to meaningfully interact with faculty and residents. Most stated they would participate again and suggest the rotation to others. Twenty-five of 42 participants were ranked by at least one program;39 were accepted into residency positions, 21 of which were in orthopaedic surgery. Conclusions: The results indicate that the VOSAR benefits students and programs. Based on the success of the VOSAR, both programs continued to offer the curriculum for 2021. Level of Evidence: Level IV.

5.
FASEB Journal ; 35(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1821974

ABSTRACT

Symbiotic interaction between the human body and its microbiota is an important issue of modern biomedicine and personalized medicine. However, little is known on molecular mechanisms of that relationship. Bearing in mind the ubiquitous participation of peptides in biomolecular interactions and regulatory processes we attempted direct search of blood peptides originated from microbial proteins. LC-MS/MS analysis was carried out of blood serum and plasma samples taken from 20 healthy donors on Q Exactive HF-X Hybrid Quadrupole-Orbitrap mass-spectrometer. Sample preparation was carried out based on our previously developed method of peptide desorption from the surface of major blood plasma proteins followed by standard chromatographic steps. Mascot and X! Tandem search engines were used for peptide identification. Human protein sequences were taken from UniProt Knowledgebase and sequences of human microbiota proteins-from NIH Human Microbiome Project (HMP). As a result, out of 13625 identified peptides 912 were unique fragments of microbial precursors, which is 6.69% of the total amount of detected bloodstream peptides. In 30 cases peptide identification was confirmed by mass-spectral study of individual synthetic samples. Absolute quantification by the mass-spectrometric method of multiple reaction monitoring (MRM) confirmed the presence of bacterial peptides in plasma and serum in the range of approximately 0.1 nMol/L to 1 mkMol/L, which is comparable to physiologically significant hormone concentrations in human blood in normal conditions. Analysis of the in silico obtained hydrolyzates of microbiotic proteins showed that significant number of the identified peptides are derived from the precursor proteins as a result of hydrolysis with trypsin, chymotrypsin and pepsin, the main proteases of the gastrointestinal system. 60% of the identified “microbial” peptides are derived from the intestine flora, about 20% - from oral microbiota and 20% fall on the remaining microbiotic communities. Most of the precursor proteins refer to intracellular, cytoplasmic proteins. The isolated fraction of peripheral blood mononuclear cells showed increase secretion of proinflammatory cytokines, colony stimulating factors and chemoattractants as the response to the addition of some of the identified microbiotic peptides. The data obtained serve as a basis for the ongoing study of the functional properties of microbiome derived peptides.

6.
FASEB Journal ; 35(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1821961

ABSTRACT

Introduction Traditional medical education has recently seen major challenges due to the coronavirus (COVID-19) pandemic. New pedagogical methods, including augmented reality (AR) and virtual reality (VR), are on the rise as alternatives to traditional teaching methods. While AR enhances real world experiences by overlaying information, VR immerses users in a computerized world rather than enhancing reality. It is crucial to understand the limitations of these learning modalities and that at best these approaches should be used to supplement and not replace traditional medical education. Objectives This study is part of a larger project that investigates the advantages and disadvantages of AR/VR in medical education. This portion of the study focused on the limitations of AR/VR and the parameters that we explored are professional and interpersonal skill development, visual haptic training, problem solving skills, physician-patient relationship, technological limitations, and financial challenges. Methods This study is a part of a systematic review of the literature seeking to identify the strengths and weaknesses associated with application of AR/VR to medical education. In this portion of the larger study we outline the limitations of AR/VR in medical education. Results Our research indicates that AR/VR may not provide the same learning experience with regards to professional and interpersonal skill development. In person anatomy learning provides an immersive visuohaptic training experience, which has been shown to promote better recall results in comparison to visual or haptic training alone. Current VR headsets have struggles with regards to video quality and latency, which can cause a sensory mismatch called cybersickness. With the high cost of medical education, AR/VR may bring additional financial burdens for students. A study showed one simulation session totaled nearly $107,000. Conclusion Virtual and augmented reality are rapidly being adopted in many academic fields, and while it is certain that tools using these modalities will be used in medical programs, it is important to understand the limitations that these learning tools pose. VR and AR learning environments can be incredibly fruitful, but in their still-nascent state these technologies are best used as a supplementation to well-vetted existing educational approaches rather than a replacement.

7.
FASEB Journal ; 35(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1821960

ABSTRACT

Introduction and Objectives Novel SARS-CoV-2 virus has been implicated in prompting a bold immune response that leads to severe Coronavirus disease 2019 (COVID-19). Recent studies have shown that SARSCoV-2-infected monocytes and macrophages are stimulated to produce an overabundance of pro-inflammatory cytokines and chemokines to generate a cytokine storm. Cytokines in excess can contribute to local tissue inflammation and the pathogenesis of COVID-19. However, the mechanism by which SARS-CoV-2 signal macrophage-derived inflammatory response remains unclear. In the present study, we used RAW 264.7 cells, a wellcharacterized macrophage model, to study the in vitro effects of SARS-CoV-2 on reactive oxygen species (ROS) production and its potential role in the signal transduction of cytokine production. Methods The effect of SARS-CoV-2 on ROS and cytokine generation in macrophages was assessed by treating RAW 264.7 cells with SARS-CoV-2 heat inactivated virus (0-20 million viral particles) or recombinant proteins for 24 hours. 2',7'-Dichlorodihydrofluorescein (2',7'-DCF) fluorescence analysis was utilized to quantify ROS generation within the RAW 264.7 macrophage cell line. Cell culture medium was sampled to quantify the levels of tumor necrosis factor (TNF) using enzyme-linked immunosorbent assay (ELISA). To assess the effects of SARS-CoV-2 on mitochondrial function, cells were treated with SARS-CoV-2 heat inactivated virus (0-20 million viral particles) for 24 hrs. Mitochondria-derived superoxide was measured using the MitoSOX™ red mitochondrial superoxide indicator. Results Treatment of RAW 264.7 cells with inactivated SARS-CoV-2 viral particles or recombinant proteins stimulated ROS production. Mitochondria-derived superoxide and hydrogen peroxide production were increased in response to inactivated SARS-CoV-2 viral particles and recombinant protein exposure. The increased ROS generation is linked to macrophage activation induced by SARS-CoV-2 exposures. Along with the ROS generation, increased TNF production was observed. Conclusions The results of this study suggest that both SARS-CoV-2 viral proteins and heat-inactivated viral particle exposures cause significant generation of ROS and cytokines by RAW 264.7 cells. ROS generation and the subsequent cytokine release apparently play a significant role in the pathogenesis associated with the SARS-CoV-2 viral infection. The imbalanced cellular defense system against oxidative stress commonly associated with aging could explain the increased occurrence of more severe SARS-CoV-2 illness in seniors and in patients with underlying health conditions. Based on the results from this study, we propose that antioxidants such as N-acetyl-L-cysteine, resveratrol, or Vitamin E in combination with antiinflammatory drug could be used to control excess ROS and cytokines in patients with severe COVID-19.

8.
FASEB Journal ; 35(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1821935

ABSTRACT

SARS-COV-2, or COVID-19, is a respiratory virus infecting over 86 million people worldwide. In addition to respiratory infections, SARS-COV-2 has been shown to include cardiovascular (CV) complications, including myocarditis and acute coronary syndrome. Risk of severe complications from SARS-COV-2 in individuals with existing CV and metabolic disease has been shown to be increased. Evidence indicates SARS-COV-2 enters tissues via the angiotensin-converting enzyme 2 (ACE2) receptor and that the virus is primed and activated by transmembrane protease, serine 2 (TMPRSS2). The goal of this study was to determine ACE2 and TMPRSS2 mRNA levels in pre-clinical swine models of heart failure (HF). We hypothesized sex, pressure-overload, and comorbidities would increase ACE2 and TMPRSS2 mRNA levels. A retrospective analysis was conducted in previously completed studies in our lab including: 1) Female, intact Ossabaw swine that were either lean control or western diet-fed aortic-banded (N=4-5/group);2) Female Yucatan mini-swine subject to ovariectomy and/or aortic banding (N=5-8/group);and 3) Sedentary and exercise trained male, intact Yucatan mini-swine that were aortic banded. ACE2 and TMPRSS2 mRNA levels were evaluated in the left ventricle (LV), right ventricle (RV), and coronary vasculature using qRT-PCR. Linear regression analysis was used to determine differences between the following variables: pig species, sex hormones, aortic banding, comorbidities, exercise training, and tissue. Data was log-transformed to meet linear regression assumptions. ACE2 and TMPRSS2 mRNA levels were significantly influenced by sex, comorbidity, and tissue type. TMPRSS2 mRNA levels were also influenced by species and disease status. Specifically, ACE2 mRNA levels decreased 57.1% in the LV and increased 169.9% in the RV of males compared to coronary vessels in intact females. TMPRSS2 mRNA levels increased in the LV and RV of males (1,218.6% and 5,479.8%, respectively) compared to coronary vessels in intact females. ACE2 and TMPRSS2 mRNA levels increased 344% and 453.4%, respectively, in the LV of Ossabaw swine fed a Western Diet compared to coronary vessels from Yucatan and Ossabaw swine without comorbidities. Species differences indicated TMPRSS2 mRNA levels increased 449.2% in the RV and 498.6% in the LV in Yucatan mini-swine compared to coronary vessels in Ossabaw swine. A 107.3% increase in TMPRSS2 mRNA level was observed in male swine without HF compared to female intact swine with HF highlighting the importance of sex and disease state. Exercise training did not impact ACE2 or TMPRSS2 mRNA levels irrespective of tissue. In conclusion, these results suggest differences in RV, LV and coronary mRNA levels of ACE2 and TMPRSS2 are dependent upon sex and comorbidities. TMPRSS2 levels are additionally influenced by pig species and pressureoverload. These results provide insight into how ACE2 and TMPRSS2 mRNA levels may influence the cardiovascular involvement of SARS-COV-2 infection in an experimental setting of pre-clinical HF incorporating different swine species, sex, and comorbidities.

9.
FASEB Journal ; 35(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1821901

ABSTRACT

The physiology of critical care patients is more complex than normally appreciated. Patients arrive at the intensive care unit (ICU) or the pediatric ICU (PICU) with a variety of infections, trauma, organ damage, and dysfunctional immune systems. This population is the prime target for testing and applying new precision medicine tools to decipher the unique biology occurring within each patient. This is particularly important as COVID-19 has made such an impact on the United States healthcare system. Thus, there is a need to develop strategies to find multiple levels of information while minimizing the number of tests performed, shifting the balance of testing to more proactive than reactive. With the collection of ∼2mL of blood (about half a teaspoon), our collaboration between Spectrum Health and Michigan State University has shown the ability to use PAXgene tubes and RNAseq to simultaneously map human gene/transcript signatures, score panels of corresponding risk genes, deconvolute immune cells, detect markers of organ/cell damage, detect RNA from bacteria/viruses/plants/fungi, profile the immune repertoire, address how patients are unique from other samples, and address common/rare genetic mutations. These tools have been applied to three cohorts of patients (and age matched controls) for critical care medicine physiology understanding for nearly all ages: 1) Infants with Respiratory syncytial virus (RSV);2) Kids with multiple organ dysfunction syndrome;and 3) Adults with hospitalized or lethal COVID-19. Our findings from these tools shows the complexity of immune system activation, secondary infections, and under appreciated interactions of the immune cell disorder overlapping COVID-19 pathology. The promise of blood-based transcriptomics to reveal cellular and cell free signatures opens a door for building more detailed physiological mechanisms from precision medicine.

10.
FASEB Journal ; 35(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1821868

ABSTRACT

Colleges and universities across the globe were challenged by the necessity of abruptly transitioning their courses to online or hybrid models to adhere to COVID-19 social distancing guidelines. Second year, Doctor of Physical Therapy (DPT) students were surveyed regarding their learning experiences during an online Foundational Sciences course that included a mix of anatomy, physiology, pathology and pharmacology instruction. The purpose was to gain perceptions into best strategies for online instruction for those content areas that promoted course objective competency with an emphasis on learner engagement. Fifty-four DPT students were surveyed following the completion of an 8-week summer semester Foundational Sciences course at the University of the Incarnate Word, School of Physical Therapy, DPT program. The 7-question anonymous survey addressed content delivered both synchronously (live) and asynchronously (prerecorded or self-regulated) with regard to time, synchronous class size and format (large group vs. breakout room), use of asynchronous voiceovers and video tutorials, and rating of specific activities promoting engagement. Open feedback questions addressed virtual course elements that students identified as most and least supportive of content mastery. Fifty responses were collected (93% response rate). Findings from the survey indicated a preference for synchronous sessions of 1.5 hr (94%) in length with the combination of both large and small group (breakout room) sessions (90%). Sixty percent of respondents preferred having a mix of synchronous classes with the entire cohort of 54 learners and smaller synchronous sessions with half the cohort. While 50% indicated a preference for more asynchronous PowerPoint voiceovers, 46% indicated that they preferred not having asynchronous voiceovers that aligned with every synchronous class. Activities promoting engagement received mixed ratings overall using a 5-point Likert scale ranging from poor to excellent. Activities that received majority satisfactory ratings included Poll Everywhere (44%), Zoom annotation tool (40%), Zoom breakout room activities (44%) and StudyMate flashcards (56%). Activities with roughly equivalent ratings for satisfactory, very good and excellent included asynchronous voiceovers (28-36%) and Kahoot quizzes (26-38%). The inclusion of guest speakers was least favorable (32% combined poor and fair responses) out of all the activities utilized to enhance engagement. Respondent open feedback indicated that accessibility to recorded synchronous sessions and asynchronous voiceovers were most valuable to their learning. Question interruptions during synchronous sessions and discussion-based breakout room sessions with less structure was least helpful to their learning. Respondents consistently identified optimal duration and format of online instructional delivery but varied in their responses related to activities promoting learner engagement. This finding could be attributed to variations in learning styles and merits further study. Knowledge derived from educators' experience during the rapidly evolving and adaptive teaching environment of 2020 can be utilized to transform educational approaches in a post COVID-19 era.

11.
FASEB Journal ; 35(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1821854

ABSTRACT

In March 2020, TTUHSC opened a new 20,000sf Institute of Anatomical Sciences for human gross anatomy. When the COVID-19 pandemic struck and many schools shifted from in person to online teaching, we hypothesized that if safety measures were used, in person cadaveric anatomy could be safely taught without a decrease in student performance. To test this, we reduced onsite attendance to less than 25% of room capacity. Masks were required at all times and students were instructed to social distance. Six students were assigned per cadaver, but only two students dissected at a time. The other four students reviewed and completed dissections and/or reviewed in groups of two at other allotted times. Thus, students dissected only every third lab. Dissection and lab review attendance was mandatory and students were nearly 100% compliant. Teaching assistants recorded dissected prosections reviews, and these videos were uploaded to password protected course files for independent learning. Students were provided iPads in the laboratory and access to three software packages for use on and off site. All students had access to multiple formative quizzes and exams, and three new online practice practical exams were created. To help reduce testing anxiety, a pass/fail system replaced categorical grading. However, all written and practical exams were conducted on site and in person. At TTUHSC, we have developed an exam question database to track historical student performance including a 25-question optional pre-block practice exam used to assess incoming student anatomical aptitude. In 2020, 90% of incoming students (93% in 2019) took the pre-block exam and scored an average of 28% (24% in 2019). In 2020, despite vastly different content delivery approaches (>80% of lectures were on Zoom) and reduced in-person dissection requirements, students modestly outperformed their 2019 counterparts. Overall exam averages were 89% in 2020 compared to 87% in 2019. If a categorical system was in place, 66% of students would have earned Honors or High Pass in 2020 compared to 61% in 2019. Our formative assessments were highly predictive of summative exam performance, and students reported that they reduced exam stress. Furthermore, summative exam averages correlated strongly with NBME performance (p<0.0001, r =0.63). TTUHSC medical students estimated that a majority of their peers at other medical schools did not have any in person dissection in 2020. Our students ranked in person laboratory dissection as the most useful learning activity, 88% reported that our COVID-19 preparations were very good to outstanding, and 97% were satisfied with the quality of their anatomy education. We conclude that 1) When using appropriate precautions, in person cadaveric anatomy can be taught safely during a pandemic;2) cadaveric dissection is essential for mastery of anatomical concepts;and 3) coupling online learning modalities with rigorous formative assessments prevented a modest reduction in cadaveric dissection opportunities from negatively impacting student performance. 2.

12.
FASEB Journal ; 35(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1821838

ABSTRACT

Due to the COVID-19 pandemic, there is increased interest to effectively deliver educational curricula remotely to diverse student populations. Case-based cadaveric MRI visualization and extended reality (XR) technology enhances learning experiences in medicine. The purpose of this study was to demonstrate that a virtual, multi-departmental workflow utilizing MRI, XR technology, and a “patient” group, represented by the John A. Burns School of Medicine (JABSOM) Willed Body Program, supplements case-based learning and promotes student exploration and engagement equally in cross-cultural cohorts represented by American and Turkish medical students. Virtual case-based learning activities were developed and presented to American medical students at JABSOM and Turkish medical students, selected based on education and English proficiency, via Zoom. Subject, medical history, and physical exam data were presented to students who were then divided into breakout rooms where hypotheses regarding cadaveric, neurological findings were generated. Students then reviewed radiology and pathology reports and accessed relevant 3D segmented, photogrammetric and illustrative models. An optional survey was completed to evaluate student opinion based on a 5-point Likert scale. Comparisons between groups were performed using a non-parametric Mann Whitney U test. Data was reported as mean, median (min-max), and percentile. Significant differences (two-tailed P) less than 0.05 were significant. Results revealed significant differences between American (n=40) and Turkish (n=16) student opinion. The Turkish scale was significantly higher when asked if MRI scans of cadavers were useful as online learning tools (p =0.002), if MRI scans of cadavers provided an understanding of relevant anatomy (p<0.001), if 3D models provided a better understanding of anatomical relationships (p<0.001), whether students would like more interactive sessions using MRI scans (p<0.001), and if students would use similar resources in the future (p<0.001). The American scale was higher when asked if students were able to communicate effectively with their breakout groups (p=0.037). The learning activity was positively received by both cohorts as shown by no average score less than a 4 out of 5 for each question. The American scales may have been lower due to having previous experience with similar activities, whereas the learning activity was novel and exciting to Turkish students. Differences in communicating effectively in breakout rooms can be explained by the fact that American students were broken into longitudinal dissection groups, whereas Turkish students were randomly assigned. Based on these results, case-based learning, utilizing MRI and XR technology, enhances the learning experience of medical students and can be expanded to cross-cultural student populations.

13.
FASEB Journal ; 35(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1821817

ABSTRACT

Background The novel SARS-CoV-2 virus inflicts far-reaching health decrements, both directly and through secondary inflammatory stimulation. To date, there is little information regarding the effects of COVID-19 on the heart after infection, especially among young healthy adults. Purpose We sought to determine whether contracting SARS-CoV-2 affects cardiac function in young, otherwise healthy adults and whether these alterations recede after testing positive for SARS-CoV-2. Methods Transthoracic echocardiography was performed on 7 subjects with SARS-CoV-2 (3F/4M, 21±1y, 24±2 kg m ) who tested positive 3-4 weeks prior to baseline testing followed by 1- month and 2-month follow-up testing. A parasternal long-axis view was utilized to measure septal and left ventricular posterior wall thickness, left ventricular volume, and left ventricular outflow tract dimensions. A four-chamber view was utilized to measure mitral and tricuspid valve, left ventricular, and pulmonary vein function. Data are mean±SD. Results Stroke volume (Baseline: 44±11ml, 1-month: 42±13ml, 2-month: 54±12ml) and stroke index (Baseline: 24±6ml/m

14.
Journal of the American Medical Informatics Association ; 29(5):779-788, 2022.
Article in English | EMBASE | ID: covidwho-1821748

ABSTRACT

Objective: The US Preventive Services Task Force (USPSTF) requires the estimation of lifetime pack-years to determine lung cancer screening eligibility. Leading electronic health record (EHR) vendors calculate pack-years using only the most recently recorded smoking data. The objective was to characterize EHR smoking data issues and to propose an approach to addressing these issues using longitudinal smoking data. Materials and Methods: In this cross-sectional study, we evaluated 16-874 current or former smokers who met USPSTF age criteria for screening (50-80 years old), had no prior lung cancer diagnosis, and were seen in 2020 at an academic health system using the Epic® EHR. We described and quantified issues in the smoking data. We then estimated how many additional potentially eligible patients could be identified using longitudinal data. The approach was verified through manual review of records from 100 subjects. Results: Over 80% of evaluated records had inaccuracies, including missing packs-per-day or years-smoked (42.7%), outdated data (25.1%), missing years-quit (17.4%), and a recent change in packs-per-day resulting in inaccurate lifetime pack-years estimation (16.9%). Addressing these issues by using longitudinal data enabled the identification of 49.4% more patients potentially eligible for lung cancer screening (P <. 001). Discussion: Missing, outdated, and inaccurate smoking data in the EHR are important barriers to effective lung cancer screening. Data collection and analysis strategies that reflect changes in smoking habits over time could improve the identification of patients eligible for screening. Conclusion: The use of longitudinal EHR smoking data could improve lung cancer screening.

15.
Medical Acupuncture ; 34(2):88-95, 2022.
Article in English | EMBASE | ID: covidwho-1821670

ABSTRACT

Objective: Evidence of effectiveness and demand for acupuncture to treat acute pain conditions is growing, as is the need for acupuncturists trained to deliver patient care in a hospital setting. This articles describes collaboration between Bastyr University and Harborview Medical Center to incorporate Doctor of Acupuncture and Oriental Medicine (DAOM) students into a trauma hospital setting. Materials and Methods: A model was developed to integrate DAOM students into an Anesthesiology Acute Pain Service to provide acupuncture to postoperative inpatients. That in-person model pivoted to remote student education and patient self-care education during the COVID 19 outbreak. A review was conducted of 323 consecutive patients who received acupuncture while they were hospitalized. Results: The review of 323 consecutive patients who received acupuncture for pain during their hospital admission indicated that as few as one acupuncture treatment resulted in clinically significant benefits. No serious complications or safety concerns were reported. Conclusions: Collaboration between academic and clinical programs can provide the structure to integrate acupuncture into hospital settings safely and with benefit to patients and students.

17.
Aktuelle Rheumatologie ; 47(2):93-94, 2022.
Article in German | EMBASE | ID: covidwho-1821628
18.
Aktuelle Rheumatologie ; 47(2):85, 2022.
Article in German | EMBASE | ID: covidwho-1821627
19.
Journal of Clinical and Translational Science ; 2022.
Article in English | EMBASE | ID: covidwho-1821562

ABSTRACT

Museum engagement may be an effective approach for decreasing social disconnection and pain among individuals living with chronic pain. In October, 2019 we launched a randomized controlled trial (RCT) to assess the feasibility of museum engagement for individuals living with chronic pain;the study was halted in March, 2020 due to Covid-19 related safety concerns. This paper describes the process of transitioning from in-person to virtual museum programming in order to continue the study. Virtual museum programming is a feasible option for individuals living with chronic pain that is amenable to research and which may improve accessibility, inclusivity, and scalability relative to in-person programming.

20.
Public Health ; 206:94-101, 2022.
Article in English | EMBASE | ID: covidwho-1821458

ABSTRACT

Objectives: Concerns have been raised about the quantity and quality of research conducted during the COVID-19 pandemic, particularly related to the mental health and wellbeing of health care workers (HCWs). For understanding the volume, source, methodological rigour and degree of overlap in COVID-19, studies were conducted among HCWs in the United Kingdom (UK). Study design: Mixed methods approach, literature review and audit. Methods: First, a literature review of published research studies and second, an audit of studies HCWs have been invited to complete. For the literature review, we searched Medline, PsycINFO and Nexis, webpages of three medical organisations (Royal Society of Medicine, Royal College of Nursing and British Medical Association), and the YouGov website. For the audit, a non-random purposive sample of six HCWs from different London NHS Trusts reviewed email, WhatsApp and SMS messages they received for study invitations. Results: The literature review identified 27 studies;the audit identified 70 study invitations. Studies identified by the literature review were largely of poor methodological rigour: only eight studies (30%) provided response rate, one study (4%) reported having ethical approval, and one study (4%) reported funding details. There was substantial overlap in the topics measured. In the audit, volunteers received a median of 12 invitations. The largest number of study invitations were for national surveys (n = 23), followed by local surveys (n = 16) and research surveys (n = 8). Conclusion: HCWs have been asked to complete numerous surveys that frequently have methodological shortcomings and overlapping aims. Many studies do not follow scientific good-practice and generate questionable, non-generalisable results.

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