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1.
J Infect Public Health ; 15(4): 397-399, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1734756

ABSTRACT

To share our observations regarding the safety of prolonged prone ventilation admitted to our intensive care unit with critical COVID-19 pneumonia and required prone ventilation because of severe ARDS. Since our observations were limited to assessing the safety of prolonged prone ventilation in critical COVID-19 patients and not to analyze any mortality benefit, we did not compare prolonged prone ventilation with standard invasive ventilation or standard duration of prone ventilation.


Subject(s)
COVID-19 , Critical Illness , Critical Illness/therapy , Humans , Intensive Care Units , Research Report , Respiration, Artificial , SARS-CoV-2
2.
Prehosp Disaster Med ; 37(1): 139-141, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1692727

ABSTRACT

Following the Taliban influx in August 2021, several Western countries repatriated nationals and evacuated others from Kabul Airport in Afghanistan. This report aimed to describe medical experiences from the consular repatriation and evacuation operation.Memos from personal conversations with seven professionals involved in these operations formed the basis for this report.Minor trauma, gastrointestinal symptoms, dehydration, fever, and mental distress were common. Bandages, oral rehydration solution, and the administration of paracetamol were needed, in addition to medical evaluation of acuity. In consular repatriation and humanitarian evacuations, medical attendance should be prioritized to manage medical needs of individuals being evacuated, but also from a public health perspective. The medical needs covered a broad specter of infection disease symptoms, trauma, and mental health problems among patients of all ages. Since the nature of consular repatriations and evacuations can be challenging from safety and infrastructural aspects, general medical emergency awareness with an ability to effectively evaluate and manage both somatic and mental health emergencies on the ground and in the air, among both children and adults, is needed.


Subject(s)
Communicable Diseases , Military Personnel , Adult , Afghanistan , Child , Humans , Research Report , Retrospective Studies
4.
Ann N Y Acad Sci ; 1507(1): 70-83, 2022 01.
Article in English | MEDLINE | ID: covidwho-1673249

ABSTRACT

For many years, it was believed that the aging process was inevitable and that age-related diseases could not be prevented or reversed. The geroscience hypothesis, however, posits that aging is, in fact, malleable and, by targeting the hallmarks of biological aging, it is indeed possible to alleviate age-related diseases and dysfunction and extend longevity. This field of geroscience thus aims to prevent the development of multiple disorders with age, thereby extending healthspan, with the reduction of morbidity toward the end of life. Experts in the field have made remarkable advancements in understanding the mechanisms underlying biological aging and identified ways to target aging pathways using both novel agents and repurposed therapies. While geroscience researchers currently face significant barriers in bringing therapies through clinical development, proof-of-concept studies, as well as early-stage clinical trials, are underway to assess the feasibility of drug evaluation and lay a regulatory foundation for future FDA approvals in the future.


Subject(s)
Aging/genetics , Aging/metabolism , Congresses as Topic/trends , Longevity/physiology , Research Report , Autophagy/physiology , COVID-19/genetics , COVID-19/metabolism , COVID-19/mortality , Cardiovascular Diseases/genetics , Cardiovascular Diseases/metabolism , Cardiovascular Diseases/therapy , Humans , Metabolomics/methods , Metabolomics/trends , Nervous System Diseases/genetics , Nervous System Diseases/metabolism , Nervous System Diseases/therapy , Stem Cell Transplantation/methods , Stem Cell Transplantation/trends
5.
Med Clin (Barc) ; 157(10): 480-482, 2021 11 26.
Article in English, Spanish | MEDLINE | ID: covidwho-1665278
7.
Ann N Y Acad Sci ; 1506(1): 74-97, 2021 12.
Article in English | MEDLINE | ID: covidwho-1612914

ABSTRACT

Single cell biology has the potential to elucidate many critical biological processes and diseases, from development and regeneration to cancer. Single cell analyses are uncovering the molecular diversity of cells, revealing a clearer picture of the variation among and between different cell types. New techniques are beginning to unravel how differences in cell state-transcriptional, epigenetic, and other characteristics-can lead to different cell fates among genetically identical cells, which underlies complex processes such as embryonic development, drug resistance, response to injury, and cellular reprogramming. Single cell technologies also pose significant challenges relating to processing and analyzing vast amounts of data collected. To realize the potential of single cell technologies, new computational approaches are needed. On March 17-19, 2021, experts in single cell biology met virtually for the Keystone eSymposium "Single Cell Biology" to discuss advances both in single cell applications and technologies.


Subject(s)
Cell Differentiation/physiology , Cellular Reprogramming/physiology , Congresses as Topic/trends , Embryonic Development/physiology , Research Report , Single-Cell Analysis/trends , Animals , Cell Lineage/physiology , Humans , Macrophages/physiology , Single-Cell Analysis/methods
10.
BMJ ; 375: n2813, 2021 11 18.
Article in English | MEDLINE | ID: covidwho-1526486
12.
J Clin Epidemiol ; 142: 10-18, 2022 02.
Article in English | MEDLINE | ID: covidwho-1492240

ABSTRACT

AIM: The objectives of this scoping review are to identify the challenges to conducting evidence synthesis during the COVID-19 pandemic and to propose some recommendations addressing the identified gaps. METHODS: A scoping review methodology was followed to map the literature published on the challenges and solutions of conducting evidence synthesis using the Joanna Briggs Methodology of performing scoping review. We searched several databases from the start of the Pandemic in December 2019 until 10th June 2021. RESULTS: A total of 28 publications was included in the review. The challenges cited in the included studies have been categorised into four distinct but interconnected themes including: upstream, Evidence synthesis, downstream and contextual challenges. These challenges have been further refined into issues with primary studies, databases, team capacity, process, resources, and context. Several proposals to improve the above challenges included: transparency in primary studies registration and reporting, establishment of online platforms that enables collaboration, data sharing and searching, the use of computable evidence and coordination of efforts at an international level. CONCLUSION: This review has highlighted the importance of including artificial intelligence, a framework for international collaboration and a sustained funding model to address many of the shortcomings and ensure we are ready for similar challenges in the future.


Subject(s)
COVID-19 , Research Report/standards , Databases, Bibliographic , Evidence-Based Practice , Guidelines as Topic/standards , Humans , Information Dissemination
13.
J Med Libr Assoc ; 109(3): 395-405, 2021 Jul 01.
Article in English | MEDLINE | ID: covidwho-1463959

ABSTRACT

OBJECTIVE: We analyzed the COVID-19 Open Research Dataset (CORD-19) to understand leading research institutions, collaborations among institutions, major publication venues, key research concepts, and topics covered by pandemic-related research. METHODS: We conducted a descriptive analysis of authors' institutions and relationships, automatic content extraction of key words and phrases from titles and abstracts, and topic modeling and evolution. Data visualization techniques were applied to present the results of the analysis. RESULTS: We found that leading research institutions on COVID-19 included the Chinese Academy of Sciences, the US National Institutes of Health, and the University of California. Research studies mostly involved collaboration among different institutions at national and international levels. In addition to bioRxiv, major publication venues included journals such as The BMJ, PLOS One, Journal of Virology, and The Lancet. Key research concepts included the coronavirus, acute respiratory impairments, health care, and social distancing. The ten most popular topics were identified through topic modeling and included human metapneumovirus and livestock, clinical outcomes of severe patients, and risk factors for higher mortality rate. CONCLUSION: Data analytics is a powerful approach for quickly processing and understanding large-scale datasets like CORD-19. This approach could help medical librarians, researchers, and the public understand important characteristics of COVID-19 research and could be applied to the analysis of other large datasets.


Subject(s)
Academies and Institutes/statistics & numerical data , Biomedical Research/statistics & numerical data , COVID-19/diagnosis , COVID-19/physiopathology , COVID-19/therapy , Periodicals as Topic/statistics & numerical data , Research Report , Bibliometrics , China , Humans , SARS-CoV-2 , United States
14.
BMJ Open ; 10(8): e037643, 2020 08 13.
Article in English | MEDLINE | ID: covidwho-1455703

ABSTRACT

INTRODUCTION: Digital health interventions (DHIs) are defined as health services delivered electronically through formal or informal care. DHIs can range from electronic medical records used by providers to mobile health apps used by consumers. DHIs involve complex interactions between user, technology and the healthcare team, posing challenges for implementation and evaluation. Theoretical or interpretive frameworks are crucial in providing researchers guidance and clarity on implementation or evaluation approaches; however, there is a lack of standardisation on which frameworks to use in which contexts. Our goal is to conduct a scoping review to identify frameworks to guide the implementation or evaluation of DHIs. METHODS AND ANALYSIS: A scoping review will be conducted using methods outlined by the Joanna Briggs Institute reviewers' manual and will conform to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Studies will be included if they report on frameworks (ie, theoretical, interpretive, developmental) that are used to guide either implementation or evaluation of DHIs. Electronic databases, including MEDLINE, EMBASE, CINAHL and PsychINFO will be searched in addition to grey literature and reference lists of included studies. Citations and full text articles will be screened independently in Covidence after a reliability check among reviewers. We will use qualitative description to summarise findings and focus on how research objectives and type of DHIs are aligned with the frameworks used. ETHICS AND DISSEMINATION: We engaged an advisory panel of digital health knowledge users to provide input at strategic stages of the scoping review to enhance the relevance of findings and inform dissemination activities. Specifically, they will provide feedback on the eligibility criteria, data abstraction elements, interpretation of findings and assist in developing key messages for dissemination. This study does not require ethical review. Findings from review will support decision making when selecting appropriate frameworks to guide the implementation or evaluation of DHIs.


Subject(s)
Delivery of Health Care , Research Report , Diagnostic Tests, Routine , Publications , Reproducibility of Results , Review Literature as Topic , Systematic Reviews as Topic
15.
Anaesthesist ; 70(7): 582-597, 2021 Jul.
Article in German | MEDLINE | ID: covidwho-1453677

ABSTRACT

BACKGROUND AND OBJECTIVE: During the initial phase of the COVID-19 pandemic the government of the state of Bavaria, Germany, declared a state of emergency for its entire territory for the first time in history. Some areas in eastern Bavaria were among the most severely affected communities in Germany, prompting authorities and hospitals to build up capacities for a surge of COVID-19 patients. In some areas, intensive care unit (ICU) capacities were heavily engaged, which occasionally made a redistribution of patients necessary. MATERIAL AND METHODS: For managing COVID-19-related hospital capacities and patient allocation, crisis management squads in Bavaria were expanded by disaster task force medical officers ("Ärztlicher Leiter Führungsgruppe Katastrophenschutz" [MO]) with substantial executive authority. The authors report their experiences as MO concerning the superordinate patient allocation management in the district of Upper Palatinate (Oberpfalz) in eastern Bavaria. RESULTS: By abandoning routine patient care and building up additional ICU resources, surge capacity for the treatment of COVID-19 patients was generated in hospitals. In parts of the Oberpfalz, ICU capacities were almost entirely occupied by patients with corona virus infections, making reallocation to other hospitals within the district and beyond necessary. The MO managed patient pathways in an escalating manner by defining local (within the region of responsibility of a single MO), regional (within the district), and cross-regional (over district borders) reallocation lanes, as needed. When regional or cross-regional reallocation lanes had to be established, an additional management level located at the district government was involved. Within the determined reallocation lanes, emitting and receiving hospitals mutually agreed on any patient transfer without explicitly involving the MO, thereby maintaining the established interhospital routine transfer procedures. The number of patients and available treatment resources at each hospital were monitored with the help of a web-based treatment capacity registry. If indicated, reallocation lanes were dynamically revised according to the present situation. To oppose further virus spreading in nursing homes, the state government prohibited patient allocation to these facilities, which led to considerably longer hospital length of stay of convalescent elderly and/or dependent patients. In parallel to the flattening of the COVID-19 incidence curve, routine hospital patient care could be re-established in a stepwise manner. CONCLUSION: Patient allocation during the state of emergency by the MO sought to keep up routine interhospital reallocation procedures as much as possible, thereby reducing management time and effort. Occasionally, difficulties were observed during patient allocations crossing district borders, if other MO followed different management principles. The nursing home blockade and conflicting financial interests of hospitals posed challenges to the work of the disaster task force medical officers.


Subject(s)
COVID-19 , Decision Making, Organizational , Pandemics , Surge Capacity/organization & administration , Critical Care , Disease Management , Emergency Service, Hospital , Germany , Humans , Intensive Care Units , Length of Stay , Nursing Homes , Patient Transfer , Research Report , Resource Allocation
16.
J Orthop Sports Phys Ther ; 51(11): 542-550, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1456252

ABSTRACT

OBJECTIVES: To determine the prevalence of prospective clinical trial registration and postrandomization bias in published musculoskeletal physical therapy randomized clinical trials (RCTs). DESIGN: A methods review. LITERATURE SEARCH: Articles indexed in MEDLINE and published between January 2016 and July 2020 were included. STUDY SELECTION CRITERIA: Two independent blinded reviewers identified the RCTs using Covidence. We included RCTs related to musculoskeletal interventions that were published in International Society of Physiotherapy Journal Editors member journals. DATA SYNTHESIS: Data were extracted independently for the variables of interest from the identified RCTs by 2 blinded reviewers. The data were presented descriptively or in frequency tables. RESULTS: One hundred thirty-eight RCTs were identified. One third of RCTs were consistent with their prospectively registered intent (49/138); consistency with prospectively registered intent could not be determined for two thirds (89/138) of the RCTs. Four RCTs (8%)reported inconsistent results with the primary aims and 7 (14%) with the outcomes from the prospective clinical trial registry, despite high methodological quality (Physiotherapy Evidence Database [PEDro] scale score). Differences between prospectively registered and non-prospectively registered RCTs for PEDro scale scores had a medium effect size (r = 0.30). Two of 15 journals followed their clinical trial registration policy 100% of the time; in 1 journal, the published RCTs were consistent with the clinical trial registration. CONCLUSION: Postrandomization bias in musculoskeletal physical therapy RCTs could not be ruled out, due to the lack of prospective clinical trial registration and detailed data analysis plans. J Orthop Sports Phys Ther 2021;51(11):542-550. Epub 21 Sep 2021. doi:10.2519/jospt.2021.10491.


Subject(s)
Periodicals as Topic , Bias , Humans , Physical Therapy Modalities , Prevalence , Registries , Research Report
18.
BMJ Open ; 11(10): e052214, 2021 Oct 04.
Article in English | MEDLINE | ID: covidwho-1450607

ABSTRACT

OBJECTIVE: To comprehensively update and survey the current provision of recovery, rehabilitation and follow-up services for adult critical care patients across the UK. DESIGN: Cross-sectional, self-administered, predominantly closed-question, electronic, online survey. SETTING: Institutions providing adult critical care services identified from national databases. PARTICIPANTS: Multiprofessional critical care clinicians delivering services at each site. RESULTS: Responses from 176 UK hospital sites were included (176/242, 72.7%). Inpatient recovery and follow-up services were present at 127/176 (72.2%) sites, adopting multiple formats of delivery and primarily delivered by nurses (n=115/127, 90.6%). Outpatient services ran at 130 sites (73.9%), predominantly as outpatient clinics. Most services (n=108/130, 83.1%) were co-delivered by two or more healthcare professionals, typically nurse/intensive care unit (ICU) physician (n=29/130, 22.3%) or nurse/ICU physician/physiotherapist (n=19/130, 14.6%) teams. Clinical psychology was most frequently lacking from inpatient or outpatient services. Lack of funding was consistently the primary barrier to service provision, with other barriers including logistical and service prioritisation factors indicating that infrastructure and profile for services remain inadequate. Posthospital discharge physical rehabilitation programmes were relatively few (n=31/176, 17.6%), but peer support services were available in nearly half of responding institutions (n=85/176, 48.3%). The effects of the COVID-19 pandemic resulted in either increasing, decreasing or reformatting service provision. Future plans for long-term service transformation focus on expansion of current, and establishment of new, outpatient services. CONCLUSION: Overall, these data demonstrate a proliferation of recovery, follow-up and rehabilitation services for critically ill adults in the past decade across the UK, although service gaps remain suggesting further work is required for guideline implementation. Findings can be used to enhance survivorship for critically ill adults, inform policymakers and commissioners, and provide comparative data and experiential insights for clinicians designing models of care in international healthcare jurisdictions.


Subject(s)
COVID-19 , Critical Illness , Cross-Sectional Studies , Follow-Up Studies , Humans , Pandemics , Research Report , SARS-CoV-2 , United Kingdom
20.
J Med Toxicol ; 17(4): 333-362, 2021 10.
Article in English | MEDLINE | ID: covidwho-1415107

ABSTRACT

The Toxicology Investigators Consortium (ToxIC) Registry was established by the American College of Medical Toxicology in 2010. The registry collects data from participating sites with the agreement that all bedside and telehealth medical toxicology consultation will be entered. This eleventh annual report summarizes the Registry's 2020 data and activity with its additional 6668 cases. Cases were identified for inclusion in this report by a query of the ToxIC database for any case entered from January 1 to December 31, 2020. Detailed data was collected from these cases and aggregated to provide information which included demographics, reason for medical toxicology evaluation, agent and agent class, clinical signs and symptoms, treatments and antidotes administered, mortality, and whether life support was withdrawn. Gender distribution included 50.6% cases in females, 48.4% in males, and 1.0% identifying as transgender. Non-opioid analgesics were the most commonly reported agent class, followed by opioid and antidepressant classes. Acetaminophen was once again the most common agent reported. There were 80 fatalities, comprising 1.2% of all registry cases. Major trends in demographics and exposure characteristics remained similar to past years' reports. Sub-analyses were conducted to describe race and ethnicity demographics and exposures in the registry, telemedicine encounters, and cases related to the COVID-19 pandemic.


Subject(s)
Congresses as Topic , Hazardous Substances/toxicity , Poisoning/diagnosis , Poisoning/therapy , Registries/statistics & numerical data , Research Report , Toxicology/statistics & numerical data , Adult , Aged , Aged, 80 and over , COVID-19 , Canada , Female , Humans , Israel , Male , Middle Aged , Pandemics/statistics & numerical data , SARS-CoV-2 , Thailand , United States
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