RESUMEN
The number of homeless people at airports has increased in recent years. As airports are safe, transit-accessible, convenient, and climate-controlled facilities with food and amenities, these places are attractive to homeless people who need a safe and secure place to stay. The main struggle of airports in this regard is maintaining a balance between customers, who are mostly the traveling public, and dealing with homeless people delicately. Moreover, because of their poverty and insufficient or no access to healthcare, these people suffer from physical and mental issues. With the COVID-19 pandemic, this problem became more critical. Many news media outlets started to report on homelessness at airports. News-framing impacts have some contribution in the context of this issue. However, the impact of news coverage on ‘‘airport and homelessness'' has not yet been studied. News-framing effects have been identified in the context of tourist destinations. Although many studies have explored homelessness and transit, this issue at airports has not been well studied. This study provides a brief overview of the issue of homelessness in the transportation domain, including transit and aviation. Additionally, this study collected news articles related to ‘‘airport and homelessness'' (71 articles) both during the COVID-19 pandemic (March 1, 2020–July 21, 2021) and before the pandemic (before March 1, 2020). These news articles contain around 50,000 words. As the data is unsupervised in nature, a text network analysis was performed to determine the latent information from these textual contents. The findings of this study can shed some light on this scientifically unexplored but widely discussed issue. © National Academy of Sciences: Transportation Research Board 2022.
RESUMEN
Introduction: In the randomised double-blind placebo-controlled CounterCovid study, imatinib reduced mortality in COVID-19 patients. High levels of alpha-1 acid glycoprotein (AAG) were associated with increased total imatinib concentrations in COVID-19 patients. Aim(s): We aimed to explore possible relationships between pharmacokinetic(PK) profiles of oral imatinib in COVID19 patients and pharmacodynamic (PD) outcomes. We hypothesize that high total imatinib concentrations may be associated with improved clinical outcomes in COVID-19 patients, when adjusted for AAG. Method(s): PK profiles were expressed as trough concentration at steady state(Css). PD responses were the ratio between partial oxygen pressure and fraction of inspired oxygen(P/F), WHO ordinal scale for clinical improvement(WHO-score) and oxygen supplementation liberation(O2lib). Linear regression, linear mixed effects models and time-to-event analysis were performed and adjusted for possible confounders. Result(s): Individual Css could be determined from 168 patients. Css did associate significantly with P/F (beta=-199,42;p-value=0.013) and O2lib (HR 0.75;p-value= 0.021), adjusted for sex, age, neutrophil-lymphocyte ratio, dexamethasone usage, AAG and baseline P/F-and WHO-score. Css did not significantly associate with WHO-score. Concusion: Higher total exposure following oral imatinib in COVID-19 patients did not associate with improved clinical outcomes. Total Css showed an inverse association with PD-outcomes. This association may be biased by disease-course and variability in metabolic rate and protein binding. Therefore, additional PKPD analyses into unbound imatinib and its main metabolite at Css may better explain exposure-response associations.
RESUMEN
Background: A central hallmark of ARDS is hypoxemic respiratory failure due to increased pulmonary capillary leakage. The kinase inhibitor imatinib was shown to reverse vascular leak. This study aimed to investigate the effect of intravenous imatinib on pulmonary edema in patients with COVID-19 ARDS. Method(s): This multicentre, randomised, double-blind, placebo-controlled clinical trial (ClinicalTrial.gov identifier NCT04794088) included adult patients admitted to the ICU with moderate or severe COVID-19 ARDS. Patients were randomised 1:1 to receive 200mg intravenous imatinib or placebo twice daily for seven days or until ICU discharge. The change in extravascular lung water index between day 1 and day 4, measured using a PiCCO catheter, was chosen as the primary endpoint. Secondary outcomes included the PaO2/FiO2 ratio, number of ventilator free days, length of ICU admission and 28-day mortality rate. Study drug safety was assessed by daily screening of the patient records for adverse and serious adverse event occurrence and by performing ECGs and targeted clinical laboratory tests to monitor renal, liver and cardiac function. Result(s): Between March 2021 and 2022, 67 predominantly male (58%) patients with a mean age of 63+/-10 years were randomized to receive imatinib or placebo. No adverse events were considered to be related to study drug administration. At the moment of the submission, data cleaning is still ongoing. Conclusion(s): Thus far, intravenous imatinib administration seems safe and feasible in patients with COVID-19 related ARDS.