Sickle cell disease and coronavirus disease-2019 (COVID-19) infection: a single-center experience.

PURPOSE: Sickle cell disease (SCD) has been found to be associated with an increased risk of hospitalization and death from coronavirus disease-2019 (COVID-19). We sought to study clinical outcomes in patients with SCD and a diagnosis of COVID-19 infection. METHODS: We conducted a retrospective analysis of adult patients (>18 years) with SCD who were diagnosed with COVID-19 infection between 1 March 2020 and 31 March 2021. Data on baseline characteristics and overall outcomes were collected and analyzed using SAS 9.4 for Windows. RESULTS: A total of 51 patients with SCD were diagnosed with COVID-19 infection in the study period, out of which 39.3% were diagnosed and managed in the outpatient setting/emergency room (ER) and 60.3% in the inpatient setting. Disease-modifying therapy such as hydroxyurea did not impact inpatient vs outpatient/ER management (P > 0.05). Only 5.71% (n = 2) required intensive care unit admission and were mechanically ventilated and 3.9% (2 patients) died of complications of COVID-19 infection. CONCLUSION: We identified a lower mortality (3.9%) rate among patients in our cohort in comparison to previous studies and a higher burden of inpatient hospitalizations as compared to outpatient/ER management. Further prospective data are needed to validate these findings. Key messages What is already known on this topic COVID-19 has been shown to have a disproportionately unfavorable impact on African Americans, including longer hospital stays, higher rates of ventilator dependence, and a higher overall mortality rate. Limited data also suggest that sickle cell disease (SCD) is associated with an increased risk of hospitalization and death from COVID-19. What this study adds Our analysis did not show a higher mortality due to COVID-19 in patients with SCD. However, we identified a high burden of inpatient hospitalizations in this population. COVID-19-related outcomes did not improve with the use of disease-modifying therapies. How this study might affect research, practice, or policy These results will aid in decision making for triage of patients with COVID-19 and SCD and ensure the most appropriate use of healthcare resources. Our analysis underscores the need for more robust data to identify patients at higher risk of severe disease and/or mortality, necessitating inpatient hospitalization and aggressive management.

Assessing changes to adolescent health-promoting behaviors following the onset of the COVID-19 pandemic: A multi-methods exploration of the role of within-person combinations of trait perfectionism.

The current work provides a multi-methods exploration of how within-person subtypes of self-oriented perfectionism (SOP) and socially prescribed perfectionism (SPP) were related to shifts in health-promoting behaviors among adolescents following the onset of the COVID-19 pandemic. Study One tested the 2 × 2 and tripartite models of perfectionism through a quantitative test of how such subtypes predicted changes in health behaviors pre-pandemic to intra-pandemic among 202 adolescents (M = 17.86, SD = 1.421). Results indicated that the combination of high SOP/high SPP was linked to the most maladaptive changes to health-promoting behaviors, supporting the tripartite model. Study Two aimed to contextualize these findings by analyzing semi-structured interviews with 31 adolescent self-identified perfectionists (M = 15.97, SD = 1.991) during the initial lockdown mandate. Results indicated that participants experienced a welcome break and found more time to engage in health-promoting behaviors. However, those high in SOP - regardless of their level of SPP - had more difficulty relaxing due to a resistance to relenting their perfectionistic standards. Altogether, these findings support the exacerbating role of SOP when combined with SPP posited by the tripartite model of perfectionism with respect to adolescents' health-promoting behaviors during the COVID-19 pandemic.

Perfectionistic Cognitions Pre-Pandemic Predict Greater Anxiety Symptoms During the Pandemic Among Emerging Adults: A Two-Wave Cross-Lagged Study.

This study employed a two-wave cross-lagged panel analysis to examine associations between perfectionistic cognitions, anxiety, and depression pre-pandemic to during the pandemic in a sample of 171 (57% female, n = 98) emerging adults. Results demonstrated that perfectionistic cognitions decreased, anxiety increased, and depressive symptoms did not change pre-pandemic to during the pandemic. Cross-lagged results indicated that pre-pandemic perfectionistic cognitions predicted higher levels of anxiety symptoms (but not depressive symptoms) during the pandemic after accounting for pre-pandemic levels of anxiety and depressive symptoms. These results held with the inclusion of covariates (i.e., sex, age, education, exposure to COVID-19, whether or not participants knew someone diagnosed with COVID-19, had lost income due to the pandemic, and how often they thought about COVID-19). Psychological distress (i.e., anxiety and depressive symptoms) pre-pandemic did not predict perfectionistic cognitions during the pandemic after accounting for pre-pandemic levels of perfectionistic cognitions. Results support assertions that individuals with heightened levels of perfectionism are at an increased risk for poorer mental health during the pandemic. Findings underscore the importance of assessing perfectionistic cognitions for the prevention and treatment of anxiety symptoms among emerging adults during and post-pandemic.

Trait Perfectionism and Dance Goals Among Young Female Dancers: An Application of the 2 × 2 Model of Perfectionism.

This study provided the first test of the 2 × 2 model of perfectionism with respect to dancers' goals for dancing in competitive dance. Four hundred twenty-five young female North American competitive dancers (M = 11.33 years; SD = 2.14) completed questionnaires assessing multidimensional perfectionism and goals for participation in dance. The latent moderated structural equations approach along with procedures outlined by Gaudreau indicated partial support for the 2 × 2 model of perfectionism. Pure Evaluative Concerns Perfectionism was associated with fewer intrinsic goals for dance and greater extrinsic goals for dance relative to nonperfectionism. Pure Personal Standards Perfectionism was related to less endorsement of extrinsic goals relative to nonperfectionism. Findings were complex with respect to mixed perfectionism, with this form of perfectionism being related to greater endorsement of both intrinsic and extrinsic goals for dance. Results provide partial support for the 2 × 2 model in youth dance.

Quantitative SERS Detection of Uric Acid via Formation of Precise Plasmonic Nanojunctions within Aggregates of Gold Nanoparticles and Cucurbit[n]uril.

This work describes a rapid and highly sensitive method for the quantitative detection of an important biomarker, uric acid (UA), via surface-enhanced Raman spectroscopy (SERS) with a low detection limit of ~0.2 µM for multiple characteristic peaks in the fingerprint region, using a modular spectrometer. This biosensing scheme is mediated by the host-guest complexation between a macrocycle, cucurbit[7]uril (CB7), and UA, and the subsequent formation of precise plasmonic nanojunctions within the self-assembled Au NP: CB7 nanoaggregates. A facile Au NP synthesis of desirable sizes for SERS substrates has also been performed based on the classical citrate-reduction approach with an option to be facilitated using a lab-built automated synthesizer. This protocol can be readily extended to multiplexed detection of biomarkers in body fluids for clinical applications.

The effect of age and sex on selected hematologic and serum biochemical analytes in 4,804 elite endurance-trained sled dogs participating in the Iditarod Trail Sled Dog Race pre-race examination program.

Endurance-trained sled dogs provide a unique translational model to characterize changes in hematologic and serum biochemical analytes due to the aging process. The primary objective of this study was to determine the effect of age and sex on specific hematologic and serum biochemical parameters in the endurance trained sled dog. Longitudinal and cross-sectional data were analyzed from 9,746 blood and serum samples from 4,804 dogs collected over 7 years as part of the Iditarod Trail Sled Dog Race pre-race examination program. Mixed models analysis was used for statistical analysis and P < 0.01 was considered significant. Dogs ranged from 1-12 years of age and 39% were female. Serum total calcium and phosphorus concentrations and white blood cell count decreased nonlinearly to asymptotic values by 6.6, 3.1, and 6.9 years of age, respectively, equivalent to estimated physiologic ages in human years of 44, 27, and 46 years. Serum glucose concentrations reached their lowest value at 7.8 years of age, equivalent to an estimated human physiologic age of 50 years, after which time the concentration increased. Serum globulin concentrations increased with age, but nonlinearly for females and linearly for males. Most sex-related differences were <5%; however, females had lower serum urea nitrogen (14.7%) and creatinine (7.3%) concentrations, lower serum alanine aminotransferase activity (16.6%), and higher serum total bilirubin concentration (12.8%) and platelet count (6.0%). The endurance-trained sled dog provides an excellent model to separate the physiologic effects of age from those of a sedentary lifestyle on hematologic and serum biochemical analytes.

Psychopathic Traits and the Cheater-Hawk Hypothesis.

The present study was a direct test of the cheater-hawk hypothesis which argues that psychopathy is related to two potentially adaptive interpersonal strategies: cheating and aggression. As expected, the measures of cheater and hawk behaviors comprised a single factor, according to a maximum-likelihood factor analysis. As hypothesized, psychopathic traits exhibited large positive correlations with measures of both cheater (entitlement, exploitiveness, and short-term mating orientation) and hawk (vengeance and aggression) behaviors. Furthermore, psychopathic traits were associated with the tendency of using individualistic and competitive tactics in an altruism game and being less likely to act in a prosocial manner. Finally, scores on the combined-cheater hawk variable were significantly correlated with psychopathic traits. As hypothesized, individuals scoring high on Factor 1 of psychopathy were more likely to utilize behaviors and strategies associated with the cheater-hawk designation, whether or not they scored high on Factor 2 of psychopathy. In general, the findings support the conceptualization that psychopathy represents a fast life-history strategy characterized by seeking personal gain over others, including exploitiveness (cheater), aggression (hawk), and risk taking. Results also indicate that cheater and hawk behaviors are part of a single strategy more often employed by those higher on psychopathic traits. Implications for treatment success are discussed.

Implementing speech supplementation strategies: effects on intelligibility and speech rate of individuals with chronic severe dysarthria.

A growing body of experimental research suggests that speech supplementation strategies can markedly increase speech intelligibility for individuals with dysarthria (D. Beukelman & K. Yorkston, 1977; E. Crow & P. Enderby, 1989; L. Hunter, T. Pring, & S. Martin, 1991; K. C. Hustad & D. R. Beukelman, 2001). However, studies in which speech supplementation strategies were actually implemented by speakers with dysarthria are limited, leaving their clinical efficacy unknown. The present study compared intelligibility and speech rate differences following speaker implementation of 3 strategies (topic, alphabet, and combined topic and alphabet supplementation) and a habitual (noncued) speech control condition for 5 speakers with severe dysarthria. Results revealed that combined cues and alphabet cues yielded significantly higher intelligibility scores and slower speech rates than topic cues and noncued speech. Overall, topic cues and noncued speech did not differ from one another with regard to intelligibility or speech rate. Combined cues and alphabet cues did not differ from one another with regard to intelligibility; however, speech rate was significantly different between the 2 strategies. Individual differences among speakers were generally consistent with group findings. Results were somewhat different from previous research in which strategies were experimentally superimposed on the habitual speech signal. However, findings provide evidence that alphabet cues and combined cues can have an important effect on intelligibility for speakers with severe dysarthria.