Landslide hazard assessment and risk reduction in the rural community of Rampac Grande, Cordillera Negra, Peru (preprint)

Reducing landslide risk is a complex task, which requires knowledge of various environmental and social characteristics, the use of acceptable technical solutions and the collaboration of several actors. Scientists are among them, though usually limited attention is paid to understanding their constraints for participation in long-term landslide risk reduction projects. This article summarizes expert involvement in the twelve years long landslide investigations in the Rampac Grande community and illustrates that the voluntary commitment to the Sendai Partnerships for landslide disaster risk reduction could motivate research institutions to assume responsibility for community-centred landslide risk reduction. It also points out the possible negative effects of the expert–community contacts disruption due to the COVID-19 pandemic restrictions as one aspect increasing the community’s vulnerability to landslides. The study site represents a socially, culturally and geologically complex environment which limits applicable technical solutions for landslide risk reduction and demands a high level of community participation in all landslide risk reduction steps. Landslide surface movement monitoring and slope stability calculations show that the studied slopes are very close to failure. The detailed hazard assessment was combined with field investigations of household vulnerabilities to assess risk in the zone around the 2009 catastrophic landslide. Results show that high vulnerability, rather than very high hazard, is responsible for assigning houses to the high-risk classes. This finding points out the preferable direction of landslide risk reduction efforts.

Adapting Connect for Health Pediatric Weight Management Program for Telehealth in Response to the COVID-19 Pandemic (preprint)

Background: To address the evolving needs and context changes due to the COVID-19 pandemic, we adapted Connect for Health, an evidence-based, primary care, pediatric weight management intervention for telehealth. The objective of this study is to describe the systematic process we undertook to make adaptations and the results of stakeholder engagement to inform the adaptations to meet the needs of children and families at risk of poor access to care. Methods: Guided by adaptation frameworks, we identified the changing healthcare context during implementation due to the pandemic and adapted the program for telehealth. We surveyed parents of children with a BMI ³ 85th percentile and pediatric clinicians and examined their experiences using telehealth for pediatric weight management and needs and preferences. Using multivariable logistic regression, we examined the preferences of parents with limited English proficiency regarding key aspects of pediatric weight management. Results: We surveyed 200 parents and 43% had a primary language of Spanish. Parents wanted care to be a combination of in-person and virtual visits (80%). We found that parents with limited English proficiency had a higher odds ratio of affirming in-person visits are better than virtual visits for ensuring their child’s health concern can be taken care of (OR: 2.91; 95% CI: 1.36, 6.21), feeling comfortable when discussing personal information (OR:  3.91; 95% CI:  1.82, 8.43), talking about healthy behaviors and setting goals (OR: 3.09; 95% CI: 1.39, 6.90), and talking about mental health and overall well-being (OR: 4.02; 95% CI: 1.83, 8.87) than parents without limited English proficiency. We surveyed 75 clinicians and 60% felt telehealth was a useful tool to provide care for pediatric weight management. Clinicians felt virtual visits did not pose barriers to all aspects of care. We then adapted the core forms of Connect for Health to be used for telehealth and in-person to meet the needs of families at risk for poor access to care. Conclusions: By engaging stakeholders and adapting the program for telehealth, we optimized the program’s use and future sustainability. We have provided a real-world example of how clinical innovations can evolve and how to systematically plan adaptations. Trial registration: Clinicaltrials.gov (NCT04042493), Registered on August 2, 2019

A Novel Green Logistics Technique for Planning Merchandise Deliveries: A Case Study

Background: The health crisis due to COVID-19 has changed the habits of social coexistence and therefore has had a significant impact on several economic sectors, including logistics. Nowadays, this sector faces one of the most difficult challenges in history and hence has carried out innovative strategies to adjust to the new normal and guarantee the permanence of the supply chain. In this paper, a novel green logistics technique for planning merchandise deliveries is introduced herein. Methods: This technique is based on a modified version of the Resistive Grid Path Planning Methodology (RGPPM) to establish a path through georeferential locations for delivering merchandise to customers. To do this, multi-connected resistive grids are based at customer locations for searching the path connecting the positions through electronic circuit analysis techniques. Results: Experimental results reveal that the proposed method can find a minimum spanning tree that connects all hand-over points by a continuous path. This finding has represented a reduction of around 45% in the length of the path with respect to the longest path. Conclusions: Finally, this technique is capable of addressing different optimization strategies, locating a merchandise distribution center and exploring environmental standards to reduce fuel consumption.

Automated compliance checking in healthcare building design

Regulatory frameworks associated to building design are usually complex, representing extensive sets of requirements. For healthcare projects in the UK, this includes statutory and guidance documents. Existing research indicates that they contain subjective requirements, which challenge the practical adoption of automated compliance checking, leading to limited outcomes. This paper aims to propose recommendations for the adoption of automated compliance checking in the design of healthcare buildings. Design Science Research was used to gain a detailed understanding of how information from existing regulatory requirements affects automation, through an empirical study in the design of a primary healthcare facility. In this study, a previously proposed taxonomy was implemented and refined, resulting in the identification of different types of subjective requirements. Based on empirical data emerging from the research, a set of recommendations was proposed focusing on the revision of regulatory documents, as well as to aid designers implementing automated compliance in practice.

Doctors’ and Nurses’ Social Media Ads Reduced Holiday Travel and COVID-19 infections: A cluster randomized controlled trial in 13 States (preprint)

During the COVID-19 epidemic, many health professionals started using mass communication on social media to relay critical information and persuade individuals to adopt preventative health behaviors. Our group of clinicians and nurses developed and recorded short video messages to encourage viewers to stay home for the Thanksgiving and Christmas Holidays. We then conducted a two-stage clustered randomized controlled trial in 820 counties (covering 13 States) in the United States of a large-scale Facebook ad campaign disseminating these messages. In the first level of randomization, we randomly divided the counties into two groups: high intensity and low intensity. In the second level, we randomly assigned zip codes to either treatment or control such that 75% of zip codes in high intensity counties received the treatment, while 25% of zip codes in low intensity counties received the treatment. In each treated zip code, we sent the ad to as many Facebook subscribers as possible (11,954,109 users received at least one ad at Thanksgiving and 23,302,290 users received at least one ad at Christmas). The first primary outcome was aggregate holiday travel, measured using mobile phone location data, available at the county level: we find that average distance travelled in high-intensity counties decreased by −0.993 percentage points (95% CI −1.616, −0.371, p -value 0.002) the three days before each holiday. The second primary outcome was COVID-19 infection at the zip-code level: COVID-19 infections recorded in the two-week period starting five days post-holiday declined by 3.5 percent (adjusted 95% CI [-6.2 percent, −0.7 percent], p -value 0.013) in intervention zip codes compared to control zip codes. One sentence summary In a large scale clustered randomized controlled trial, short messages recorded by health professionals before the winter holidays in the United States and sent as ads to social media users led to a significant reduction in holiday travel, and to a decrease in subsequent COVID-19 infection at the population level.

Doctors and Nurses Social Media Ads Reduced Holiday Travel and COVID-19 infections: A cluster randomized controlled trial in 13 States (preprint)

During the COVID-19 epidemic, many health professionals started using mass communication on social media to relay critical information and persuade individuals to adopt preventative health behaviors. Our group of clinicians and nurses developed and recorded short video messages to encourage viewers to stay home for the Thanksgiving and Christmas Holidays. We then conducted a two-stage clustered randomized controlled trial in 820 counties (covering 13 States) in the United States of a large-scale Facebook ad campaign disseminating these messages. In the first level of randomization, we randomly divided the counties into two groups: high intensity and low intensity. In the second level, we randomly assigned zip codes to either treatment or control such that 75% of zip codes in high intensity counties received the treatment, while 25% of zip codes in low intensity counties received the treatment. In each treated zip code, we sent the ad to as many Facebook subscribers as possible (11,954,109 users received at least one ad at Thanksgiving and 23,302,290 users received at least one ad at Christmas). The first primary outcome was aggregate holiday travel, measured using mobile phone location data, available at the county level: we find that average distance travelled in high-intensity counties decreased by -0.993 percentage points (95% CI -1.616, -0.371, p-value 0.002) the three days before each holiday. The second primary outcome was COVID-19 infection at the zip-code level: COVID-19 infections recorded in the two-week period starting five days post-holiday declined by 3.5 percent (adjusted 95% CI [-6.2 percent, -0.7 percent], p-value 0.013) in intervention zip codes compared to control zip codes.

Patients with Asthma and Chronic Obstructive Pulmonary Disease (COPD) have increased levels of plasma inflammatory mediators upregulated in severe COVID-19 (preprint)

BackgroundChronic obstructive pulmonary disease (COPD) is associated with increased risk of severe COVID-19, but the mechanisms are unclear. Besides, patients with severe COVID-19 have been reported to have increased levels of several immune mediators. ObjectiveTo perform an immunoproteomic profiling of dysregulated plasma proteins in patients with asthma and COPD and to evaluate their relationship with biomarkers of severe COVID-19. MethodsNinety-two proteins were quantified in 315 plasma samples from adult subjects (age 40-90 years) including 118 asthmatics, 99 COPD patients and 98 healthy controls, that have been recruited in two reference pneumology clinics in Colombia before the beginning of the COVID-19 pandemic. Protein levels were compared between each disease group and healthy controls. Significant proteins were compared to the gene signatures of SARS-CoV-2 infection reported in the "COVID-19 Drug and Gene Set Library" and with known protein biomarkers of severe COVID-19. ResultsForty-one plasma proteins showed differences between patients and controls. Asthmatic patients have increased levels in IL-6 while COPD patients have a broader systemic inflammatory dysregulation driven by HGF, OPG, and several chemokines (CXCL9, CXCL10, CXCL11, CX3CL1, CXCL1, MCP-3, MCP-4, CCL3, CCL4 and CCL11). These proteins are involved in chemokine signaling pathways related with response to viral infections and some, were found up-regulated upon SARS-CoV-2 experimental infection of Calu-3 cells as reported in the COVID-19 Related Gene Sets database. An increase of HPG, CXCL9, CXCL10, IL-6, MCP-3, TNF and EN-RAGE has also been found in patients with severe COVID-19. ConclusionsCOPD patients have altered levels of plasma proteins that have been reported increased in patients with severe COVID-19. Our study suggests that COPD patients have a systemic dysregulation in chemokine networks (including HGF and CXCL9) that could make them more susceptible to severe COVID-19. Our study also suggest that IL-6 levels are increased in some asthmatics and this may influence their immune response to COVID-19.