Appearance
🎉Ask the doctor🥳
OBJECTIVE Lay the groundwork for future survey validation and harmonization efforts by comparing prevalence rates of self-reported visual impairment (VI) and blindness measured across federally-funded national surveys by age-groups and to prevalence rates of presenting impairment and blindness measured by physical examination. DESIGN Cross-sectional comparison of national surveys. PARTICIPANTS Participants in: 2016 American Community Survey, the 2016 Behavioral Risk Factor Surveillance System, the 2016 National Health Interview Survey, the 1999-2008 National Health and Nutrition Examination Survey (NHANES), and the 2016 National Survey of Children's Health. METHODS We estimated VI and blindness prevalence rates and confidence intervals for each survey measure and age-group using the Clopper-Pearson method. We then estimated weighted self-reported VI and blindness prevalence rates across survey measures by age-group using inverse variance weighting, fitted trend lines to age-group estimates, and used the trend-line equations to estimate the number of U.S. persons with VI and blindness in 2016. We compared these self-report estimates to those generated from NHANES physical evaluations of presenting VI and blindness. MAIN OUTCOME MEASURES The variability of prevalence estimates of VI and blindness RESULTS: Survey response estimates of blindness varied between 0.1% and 5.6% for age-groups <65 years and between 0.6% to 16.6% for ages >=65. Estimates of VI varied between 1.6% and 24.8% for age-groups <65 years and between 2.2% and 26.6% for age-groups >=65. For summarized survey results and NHANES physical evaluation, prevalence rates for VI increased significantly with age-group. Blindness prevalence increased significantly with age-group for summarized survey responses but not for NHANES physical examination. Based on extrapolations of NHANES physical examination data to all ages, we estimated that in 2016, 23.4 million persons in the U.S. (7.2%) had VI or blindness, an evaluated visual acuity of 20/40 or worse in the better-seeing eye before correction; based on weighted self-reported surveys, we estimated 24.8 million persons (7.7%) had presenting VI or blindness. CONCLUSIONS Prevalence rates of VI and blindness obtained from national survey measures varied widely across surveys and age-groups. Additional research is needed to validate the ability of survey self-report measures of VI and blindness to replicate results obtained through clinical exam by an eye health professional.
VARIABILITY OF VISION HEALTH RESPONSES ACROSS MULTIPLE NATIONAL SURVEY IN THE UNITED STATES.
Strengths use is an essential personal resource to consider when designing higher-educational programs and interventions. Strengths use is associated with positive outcomes for both the student (e.g., study engagement) and the university (e.g., academic throughput/performance). The Strengths Use Scale (SUS) has become a popular psychometric instrument to measure strengths use in educational settings, yet its use has been subjected to limited psychometric scrutiny outside of the U.S. Further, its longitudinal stability has not yet been established. Given the wide use of this instrument, the goals of this study were to investigate (a) longitudinal factorial validity and the internal consistency of the scale, (b) its equivalence over time, and (c) criterion validity through its relationship with study engagement over time. Data were gathered at two-time points, 3 months apart, from a sample of students in the Netherlands (n = 360). Longitudinal confirmatory factor analyses showed support for a two-factor model for overall strengths use, comprised of Affinity for Strengths and Strengths Use Behaviors. The SUS demonstrated high levels of internal consistency at both the lower- and upper bound limits at both time points. Further, strict longitudinal measurement invariance was established, which confirmed the instrument's temporal stability. Finally, criterion validity was established through relating strengths use to study engagement at different time stamps. These findings support the use of the SUS in practice to measure strengths use and to track the effectiveness of strengths use interventions within the higher education sector.
The Strengths Use Scale: Psychometric Properties, Longitudinal Invariance and Criterion Validity
Background: Physical distancing measures (e.g., keeping a distance of two metres from others, avoiding crowded areas, and reducing the number of close physical contacts) continue to be among the most important preventative measures used to reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID -19). Therefore, it is important to understand barriers and facilitators of physical distancing to help inform future public health campaigns. Methods: The current study aimed to qualitatively explore barriers and facilitators of physical distancing in the context of the COVID-19 pandemic using a qualitative interpretative design. Semi-structured one-to-one phone interviews were conducted with 25 participants aged 18+ years and living in the Republic of Ireland between September and October 2020. A purposive sampling strategy was used to maximise diversity in terms of age, gender, and socioeconomic status. Interviews were transcribed verbatim and analysed using inductive thematic analysis. Results: Analysis resulted in the development of six main themes related to barriers and facilitators of physical distancing: (1) Maintaining and negotiating close relationships; (2) Public environments support or discourage physical distancing; (3) Habituation to threat; (4) Taking risks to maintain well-being; (5) Personal responsibility to control the "controllables"; and (6) Confusion and uncertainty around government guidelines. Conclusions: Our study found that physical distancing measures are judged to be more or less difficult based on a number of internal and external psychosocial factors, including maintaining and negotiating close relationships, habituation to threat, risk compensation, structure of public environments, personal responsibility, and confusion or uncertainty around government guidelines. Given the diversity in our sample, it is clear that the identified barriers and facilitators vary depending on context and life stage. Messaging that targets sub-groups of the population may benefit from considering the identified themes in this analysis.
Exploring barriers and facilitators of physical distancing in the context of the COVID-19 pandemic: a qualitative interview study.
From data of USA, Japan, Germany, UK, Italy and Russian, it is claimed that the Global pandemic dictated by the dynamics of Corona virus exhibits distributions that would correspond to a morphology of Bessel-like type. Under the assumption that the pandemic contains phases of infection denoted by the velocity and acceleration of propagation of virus, then a model of polynomials given by the integer-order Bessel functions is proposed. These polynomials enter in a statistical approach to define the law of infections as function of time for the ongoing global pandemic. From this, the data evolution and their different behaviors are interpreted in terms of the different phases including the Delta variant for the recent months until August 2021.
Theory and Parameterization of Infections and Waves by Covid-19: A 6-Countries Data Analysis
Background: Reflecting on progress and challenges in meeting global human immunodeficiency virus (HIV) targets is often done ahead of World AIDS Day This article reflects on progress and the continuing challenges in meeting targets in South Africa (SA) Objective: To review policy and implementation related progress and continuing challenges towards eliminating HIV as a public health threat by 2030 Method: Policy analysis and review of modeling data from Thembisa 4 3 Results: South Africa has made significant progress in the adoption of policies with two exceptions While there are gaps in reaching the 90-90-90 implementation targets, progress has been made in the past decade Conclusion: While progress has been made in the past decade towards the global targets, much work remains to ensure that HIV transmission is curtailed and those that require treatment are initiated on treatment and are virally suppressed
World AIDS Day 2020: Reflections on global and South African progress and continuing challenges
BACKGROUND: Heterogeneity in COVID-19 morbidity and mortality is often associated with a country's health-services structure and social inequality. This study aimed to characterize social inequalities in COVID-19 mortality in S?o Paulo, the most populous city in Brazil and Latin America. METHODS: We conducted a population-based study, including COVID-19 deaths among S?o Paulo residents from March to September 2020. Age-standardized mortality rates and unadjusted rate ratios (RRs) [with corresponding 95% confidence intervals (CIs)] were estimated by race, sex, age group, district of residence, household crowding, educational attainment, income level and percentage of households in subnormal areas in each district. Time trends in mortality were assessed using the Joinpoint model. RESULTS: Males presented an 84% increase in COVID-19 mortality compared with females (RR = 1.84, 95% CI 1.79-1.90). Higher mortality rates were observed for Blacks (RR = 1.77, 95% CI 1.67-1.88) and mixed (RR = 1.42, 95% CI 1.37-1.47) compared with Whites, whereas lower mortality was noted for Asians (RR = 0.63, 95% CI 0.58-0.68). A positive gradient was found for all socio-economic indicators, i.e. increases in disparities denoted by less education, more household crowding, lower income and a higher concentration of subnormal areas were associated with higher mortality rates. A decrease in mortality over time was observed in all racial groups, but it started earlier among Whites and Asians. CONCLUSION: Our results reveal striking social inequalities in COVID-19 mortality in S?o Paulo, exposing structural inequities in Brazilian society that were not addressed by the governmental response to COVID-19. Without an equitable response, COVID-19 will further exacerbate current social inequalities in S?o Paulo.
Social inequalities and COVID-19 mortality in the city of S?o Paulo, Brazil
No one trained to teach during a pandemic, and even veteran teachers are navigating uncharted waters In this sense, everyone is a first-year teacher, so perhaps some of the sage advice given to brand new teachers can help guide all of us through This is a curation of the best advice for new teachers from both seasoned experts and young teachers who were recently in those shoes In addition, this article offers school librarians ways to apply such advice in order to address their current needs and responsibilities
Uncharted Territory in COVID Times
The rapid spread of SARS-CoV-2 has placed a significant burden on public health systems to provide rapid and accurate diagnostic testing highlighting the critical need for innovative testing approaches for future pandemics. In this study, we present a novel sample pooling procedure based on compressed sensing theory to accurately identify virally infected patients at high prevalence rates utilizing an innovative viral RNA extraction process to minimize sample dilution. At prevalence rates ranging from 0-14.3%, the number of tests required to identify the infection status of all patients was reduced by 75.6% as compared to conventional testing in primary human SARS-CoV-2 nasopharyngeal swabs and a coronavirus model system. Additionally, our modified pooling and RNA extraction process minimized sample dilution which remained constant as pool sizes increased. Our use of compressed sensing can be adapted to a wide variety of diagnostic testing applications to increase throughput for routine laboratory testing as well as a means to increase testing throughput to combat future pandemics. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=113 SRC="FIGDIR/small/21261669v1_ufig1.gif" ALT="Figure 1"> View larger version (37K): [email protected]@1480d21org.highwire.dtl.DTLVardef@1562579org.highwire.dtl.DTLVardef@b65ace_HPS_FORMAT_FIGEXP M_FIG C_FIG
Use of compressed sensing to expedite high-throughput diagnostic testing for COVID-19 and beyond
BACKGROUND: All 50 states have school\entry immunization requirements, and many also allow exemptions based on medical and non\medical reasons. School nurses are responsible for managing student immunization compliance based on state policies, but lack standardized resources and guidance. METHODS: Pennsylvania school nurses (N = 21) participated in semi\structured interviews regarding their strategies for communication and management of student immunization information, along with resources needed for practice improvement. Data were analyzed using descriptive content analysis. RESULTS: Nurses reported similarities in timelines used for communication of immunization requirements, but differences in mechanisms used to secure and manage immunization records. Nurses reported a need for clarity regarding exclusions and exemption policy implementation and requested standardized resources and guidance for navigating immunization compliance. CONCLUSIONS: A need exists for standardized processes that support immunization compliance. Furthermore, nurses highlighted a need for additional training and enhanced networks to develop creative strategies for promoting immunization uptake among families.
In Their Own Words: Resources Needed by School Nurses to Facilitate Student Immunization Compliance
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2021. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2021. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from https://link.springer.com/bookseries/8901.
Secondary infections in critically ill patients with COVID-19
Severe acute respiratory syndrome - coronavirus 2 (SARS-CoV-2) continues to effect communities across the world. One way to combat these effects is to enhance our collective ability to remotely monitor community spread. Monitoring SARS-CoV-2 in wastewater is one approach that enables researchers to estimate the total number of infected people in the region; however, estimates are often made at the sewershed level which may mask the geographic nuance required for targeted interdiction efforts. In this work, we utilize an apportioning method to compare the spatial and temporal trends of daily case count with the temporal pattern of viral load in the wastewater at smaller units of analysis within Austin, TX. We find different lag-times between wastewater loading and case reports. Daily case reports for some areas follow the temporal trend of viral load more closely than others. These findings are then compared to socio-demographic characteristics across the study area.
Space-time analysis of COVID-19 cases and SARS-CoV-2 wastewater loading: A geodemographic perspective
R.E. Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology of the National Academy of Science of Ukraine has been studying the mechanisms and specificities of individual radiation sensitivity (IRS) formation in professionals who work in the field of ionizing radiation, cancer patients and representatives of other population groups. Our data based on the use of G2-test in in vitro irradiated blood lymphocytes in late G2-period of cell cycle indicated an increased carcinogenic risk in professionals with high IRS. We suggest that the COVID-19 pandemic could make significant adjustments in the formation of IRS in professionals who have survived the disease and continue to work with ionizing radiation (IR). Increased systemic inflammatory activity, which persists for a long time in COVID-19 patients, in combination with low-dose range irradiation (professionals who continue to work with IR) and with local irradiation in the high-dose range (radiation therapy for cancer patients) may affect IRS. Repeated determination of IRS in professionals who have had COVID-19 infection, using chromosomal G2-radiation sensitivity assay will answer the question: can SARS-CoV-2 coronavirus affect the IRS? The proposed hypothesis of the radiosensitivity evolution needs further experimental validation using a set of radiobiological indices to clarify the mechanism of IRS formation following COVID-19 infection. The detected changes (increase) of human IRS after COVID-19 must be taken into account for personalized planning of radiotherapy of COVID-19 cancer patients.
Can SARS-CoV-2 change individual radiation sensitivity of the patients recovered from COVID-19? (experimental and theoretical background).
We have investigated the impact of reduced emissions due to COVID-19 lockdown measures in spring 2020 on air quality in Canada's four largest cities: Toronto, Montreal, Vancouver, and Calgary. Observed daily concentrations of NO2, PM2.5, and O3 during a "pre-lockdown" period (15 February-14 March 2020) and a "lockdown" period (22 March-2 May 2020), when lockdown measures were in full force everywhere in Canada, were compared to the same periods in the previous decade (2010-2019). Higher-than-usual seasonal declines in mean daily NO2 were observed for the pre-lockdown to lockdown periods in 2020. For PM2.5, Montreal was the only city with a higher-than-usual seasonal decline, whereas for O3 all four cities remained within the previous decadal range. In order to isolate the impact of lockdown-related emission changes from other factors such as seasonal changes in meteorology and emissions and meteorological variability, two emission scenarios were performed with the GEM-MACH air quality model. The first was a Business-As-Usual (BAU) scenario with baseline emissions and the second was a more realistic simulation with estimated COVID-19 lockdown emissions. NO2 surface concentrations for the COVID-19 emission scenario decreased by 31 to 34% on average relative to the BAU scenario in the four metropolitan areas. Lower decreases ranging from 6 to 17% were predicted for PM2.5. O3 surface concentrations, on the other hand, showed increases up to a maximum of 21% close to city centers versus slight decreases over the suburbs, but Ox (odd oxygen), like NO2 and PM2.5, decreased as expected over these cities. Supplementary Information: The online version contains supplementary material available at 10.1007/s11869-021-01039-1.
Isolating the impact of COVID-19 lockdown measures on urban air quality in Canada
During the COVID-19 pandemic and the related lockdowns, outpatient follow-up visits for patients with chronic neurological diseases have been suspended. Managing people affected by amyotrophic lateral sclerosis (ALS) has become highly complicated, leaving patients without the standard multidisciplinary follow-up. This study aimed to analyze the impact of the COVID-19 lockdown on ALS disease progression. We compared the clinical data and progression in the first year following diagnosis for patients who received ALS diagnosis during 2020 (G20, N = 34), comparing it with a group of diagnosed in 2018 (G18, N = 31). Both groups received a comparable multidisciplinary model of care in our Tertiary Expert ALS Centre, Novara, Italy. The monthly rate of ALSFRS-R decline during the lockdown was significantly increased in G20 compared to G18 (1.52 2.69 vs. 0.76 0.56; p-value: 0.005). In G20, 47% required non-invasive ventilation (vs. 32% of G18). Similarly, in G20, 35% of patients died vs. 19% of patients in G18 (p-value: 0.01). All results were corrected for gender, age, site of onset, and diagnostic delay. Several factors can be implicated in making ALS more severe, with a faster progression, such as reduced medical evaluations and the possibility of therapeutic changes, social isolation, and rehabilitation therapy suspension.
Accelerated Early Progression of Amyotrophic Lateral Sclerosis over the COVID-19 Pandemic
Today's heavy machine learning tasks are fueled by large datasets. Computing is performed with power hungry processors whose performance is ultimately limited by the data transfer to and from memory. Optics is one of the powerful means of communicating and processing information and there is intense current interest in optical information processing for realizing high-speed computations. Here we present and experimentally demonstrate an optical computing framework based on spatiotemporal effects in multimode fibers for a range of learning tasks from classifying COVID-19 X-ray lung images and speech recognition to predicting age from face images. The presented framework overcomes the energy scaling problem of existing systems without compromising speed. We leveraged simultaneous, linear, and nonlinear interaction of spatial modes as a computation engine. We numerically and experimentally showed the ability of the method to execute several different tasks with accuracy comparable to a digital implementation.
Scalable Optical Learning Operator
ABSTRACT: During the COVID-19 pandemic, many firms began operating in a working-from-home environment (WFH). This study focuses on the relationship between WFH and small business performance during the pandemic. We built a theoretical framework based on firm profit maximization, compiled an up-to-date (March through November) real-time daily and weekly multifaceted data set, and empirically estimated fixed-effect panel data, fractional logit, and multilevel mixed effects models to test our hypotheses. We find that in states with higher WFH rates, small businesses performed better overall with industry variations, controlling for the local pandemic, economic, demographic, and policy factors. We also find that WFH rates increased even after stay-at-home orders (SHOs) were rescinded. With the ready technology and practice of WFH in the pandemic, our robust empirics confirm our theory and hypotheses and demonstrate WFH as a potential force that may expedite creative destruction instance and permanently impact industrial structure and peoples work lives. PLAIN ENGLISH SUMMARY: The Rise of Working from Home (WFH) as a Silver Lining and Creative Destruction in the Pandemic: WFH Helps Small Businesses Perform Better with Industry Variations and Continues to Shine after Stay-at-Home Orders Ended. This study focuses on the role of working from home (WFH) for small business performance during the COVID-19 pandemic. We built a theoretical framework based on firm profit maximization and identified WFH as a rational business choice. We then compiled a real-time multifaceted data set, estimated panel fixed-effect, fractional logit, and multilevel mixed effects models, and find that (1) small businesses in states with higher WFH rates performed better with industry variations, controlling for local pandemic and socioeconomic factors; and (2) WFH rates increased after stay-at-home orders were rescinded. Our study demonstrates WFH as a potential creative destruction force that may expedite our technologically ready WFH adoption and permanently impact industrial structure and peoples work lives.
Working from home: small business performance and the COVID-19 pandemic
Introduction: Patients after SARS-CoV-2 infection frequently face Post-COVID-19 Syndrome, defined by symptoms that develop during or after COVID-19, continue for more than 12 weeks, and are not explained by an alternative diagnosis. We aimed to evaluate the presence of post-COVID-19 syndrome and its predictors in kidney transplant recipients (KTR) 6 months after the disease. Materials and Methods: A total of 67 KTR (38 m) with a mean age of 53.6 14 years, 7.3 6.4 years post-transplant were included in the cohort longitudinal study. Thirty-nine (58.2%) of them were hospitalized, but not one required invasive ventilation therapy. They were interviewed 6 months after being infected, with a series of standardized questionnaires: a self-reported symptoms questionnaire, the modified British Medical Research Council (mMRC) dyspnea scale, EQ-5D-5L questionnaire, and EQ-VAS scale. Results: Post-COVID-19 syndrome was diagnosed in 70.1% of KTR and 26.9% of them reported at least three persistent symptoms. The most common symptoms were fatigue (43.3%), hair loss (31.3%), memory impairment (11.9%), muscle aches, and headaches (11.9%). Dyspnea with an mMRC scale grade of at least 1 was reported by 34.3% patients vs. 14.9% before infection; 47.8% stated that they still feel worse than before the disease. Mean EQ-VAS scores were 64.83 vs. 73.34 before infection. The persistent symptoms are more frequent in older patients and those with greater comorbidity. Conclusions: Persistent symptoms of post-COVID-19 syndrome are present in the majority of KTR, which highlights the need for long-term follow-up as well as diagnostic and rehabilitation programs.
Post-COVID-19 Sydrome and Decrease in Health-Related Quality of Life in Kidney Transplant Recipients after SARS-COV-2 InfectionA Cohort Longitudinal Study from the North of Poland
Acute viral pneumonia, hypoxemic respiratory failure and severe inflammatory response are hallmarks of severe coronavirus disease 2019 (COVID-19). The COVID-19-associated inflammatory state may further lead to symptomatic thromboembolic complications despite prophylaxis. We report a 66-year-old female patient with post-mortem diagnosis of COVID-19 who presented progressive livedo racemosa, acute renal failure and myocardial injury, as well as an absence of respiratory symptoms. Transthoracic echocardiography showed severe spontaneous echo contrast in the right cardiac chambers and right-sided cardiac overload presumed to result from pulmonary microvascular thrombosis or embolism. D-dimer levels were increased. The patient developed an acute ischemic stroke and died 2 days following presentation despite therapeutic anticoagulation. Her predominantly thromboembolic presentation supports the concept of coronavirus infection of endothelial cells and hypercoagulability, or COVID-19 endotheliitis. The case we report highlights that COVID-19-associated hyperacute multi-organ thromboembolic storm may precede or present disproportionately to respiratory involvement.
Hyperacute multi-organ thromboembolic storm in COVID-19: a case report
This paper systematically reviews and synthesizes the relevant literature on sedentary time research. A bibliometric analysis was conducted to evaluate the publications from 2010 to 2020 in the Web of Science (WoS) core collection database. Derwent Data Analyzer software was used for the cleaning, mining, and visualization of the data. Historical trends of the topics, main contributors, leading countries, leading institutions, leading research areas, and journals were explored. A total of 3020 publications were studied. The United States, the United Kingdom, and Australia are the three most productive countries. The Australian institution Baker Heart and Diabetes Institute led the list of productive institutions, and Ekelund U published the most papers. Sedentary time raised the concerns of scholars from 106 research areas, and public health was the dominant field. Physical activity, accelerometer, children, and obesity were the most frequently used keywords. The findings suggest that sedentary time is rapidly emerging as a global issue that has detrimental effects on public health. The hotspots shifted in the past 10 years, and COVID-19 was the most popular topic of sedentary time research.
Recent Trends in Sedentary Time: A Systematic Literature Review
We evaluated whether stroke severity, functional outcome, and mortality are different in patients with ischemic stroke with or without coronavirus disease 2019 (COVID-19) infection. METHODS: A prospective, observational, multicentre cohort study in Catalonia, Spain. Recruitment was consecutive from mid-March to mid-May 2020. Patients had an acute ischemic stroke within 48 hours and a previous modified Rankin Scale (mRS) score of 0 to 3. We collected demographic data, vascular risk factors, prior mRS score, National Institutes of Health Stroke Scale score, rate of reperfusion therapies, logistics, and metrics. Primary end point was functional outcome at 3 months. Favourable outcome was defined depending on the previous mRS score. Secondary outcome was mortality at 3 months. We performed mRS shift and multivariable analyses. RESULTS: We evaluated 701 patients (mean age 72.313.3 years, 60.5% men) and 91 (13%) had COVID-19 infection. Median baseline National Institutes of Health Stroke Scale score was higher in patients with COVID-19 compared with patients without COVID-19 (8 [3C18] versus 6 [2C14], P=0.049). Proportion of patients with a favourable functional outcome was 33.7% in the COVID-19 and 47% in the non-COVID-19 group. However, after a multivariable logistic regression analysis, COVID-19 infection did not increase the probability of unfavourable functional outcome. Mortality rate was 39.3% among patients with COVID-19 and 16.1% in the non-COVID-19 group. In the multivariable logistic regression analysis, COVID-19 infection was a risk factor for mortality (hazard ratio, 3.14 [95% CI, 2.10C4.71]; P<0.001). CONCLUSIONS: Patients with ischemic stroke and COVID-19 infection have more severe strokes and a higher mortality than patients with stroke without COVID-19 infection. However, functional outcome is comparable in both groups.
Impact of COVID-19 Infection on the Outcome of Patients With Ischemic Stroke