Digital Commons Network^™

Validation Of Automated Data Abstraction For Sccm Discovery Virus Covid-19 Registry: Practical Ehr Export Pathways (Virus-Peep), Diana J. Valencia Morales, Vikas Bansal, Smith F. Heavner, Janna C. Castro, Mayank Sharma, Aysun Tekin, Marija Bogojevic, Simon Zec, Nikhil Sharma, Rodrigo Cartin-Ceba, Rahul S. Nanchal, Devang K. Sanghavi, Abigail T. La Nou, Syed A. Khan, Katherine A. Belden, Jen-Ting Chen, Roman R. Melamed, Imran A. Sayed, Ronald A. Reilkoff, Vitaly Herasevich, Juan Pablo Domecq Garces, Allan J. Walkey, Karen Boman, Vishakha K. Kumar, Rahul Kashyap

Division of Infectious Diseases and Environmental Medicine Faculty Papers

BACKGROUND: The gold standard for gathering data from electronic health records (EHR) has been manual data extraction; however, this requires vast resources and personnel. Automation of this process reduces resource burdens and expands research opportunities.

OBJECTIVE: This study aimed to determine the feasibility and reliability of automated data extraction in a large registry of adult COVID-19 patients.

MATERIALS AND METHODS: This observational study included data from sites participating in the SCCM Discovery VIRUS COVID-19 registry. Important demographic, comorbidity, and outcome variables were chosen for manual and automated extraction for the feasibility dataset. We quantified the degree of agreement with Cohen's …

Gold & Blue Law Edition, Fall 2023, St. Mary's University - San Antonio, Texas

Gold & Blue Law Edition

This is the Fall 2023 edition of Gold & Blue Law Edition which is St. Mary's University's official School of Law publication.

Covid-19 And Friendships: Agreeableness And Neuroticism Are Associated With More Concern About Covid-19 And Friends' Risky Behaviors, Jessica D. Ayers, Diego Guevara Beltrán, Andrew Van Horn, Lee Cronk, Hector Hurmuz-Sklias, Peter M. Todd, Athena Aktipis

Psychological Sciences Faculty Publications and Presentations

Given the importance of friendships during challenging times and the mixed associations between personality traits and disease-related behaviors, we investigated the correlations between personality traits and perceptions of friendships during the COVID-19 pandemic. Data were collected as part of a longitudinal investigation of the correlations between the pandemic and various cooperative relationships. In this investigation, we found that agreeableness and neuroticism predicted participants being more concerned about COVID-19 and bothered by friends' risky behavior, and extraversion predicted enjoying helping friends during the pandemic. Our results suggest that personality differences are associated with how individuals cope with friends' risky behaviors during …

Crisis Narratives In Crisis? A Comparative Investigation Into National Covid-19 Narratives, Mouse D. Bennett

Graduate Program in International Studies Theses & Dissertations

On January 31, 2020, the World Health Organization (WHO) declared a public health emergency for only the sixth time in its history. On March 11, 2020, it was stated that COVID-19 constituted a pandemic. How did countries respond? This dissertation traces the evolution of national crisis narratives in four states and assesses their relative success. The findings of this study are that pandemic crisis narratives are not generalizable to all crisis situations but require a high level of compliance to be effective in stopping the crisis. There is no formula for government success, there are no decisive variables determining outcomes. …

Effect Of Room Size, Shape, Ac Placement, And Air Leakage On Indoor Airborne Viral Transmission, K. Choudhary, K. A. Krishnaprasad, ‪Nadim Zgheib, M. Y. Ha, S. Balachandar

Mechanical Engineering Faculty Publications

Highlights

• Statistical overloading is used to obtain spatio-temporal pathogen concentration.

• Symmetrically placed AC limits pathogen propagation over long distances.

• Well-mixed model captures room-averaged concentration for any shape and AC location.

• The pathogens level of mixing is reduced when AC is symmetrically positioned.

• Air leakage has insignificant impact on indoor pathogen distribution.

Abstract

We conducted Euler–Lagrange Reynolds-Averaged Navier–Stokes simulations with statistical overloading to investigate the effect of room shape, air-condition (AC) location, and the presence of an open window on indoor airborne viral transmission, particularly as it relates to the spatio-temporal distribution of viral-laden droplet nuclei. Two room geometries were …

The Impact Of Adding Cost Information To A Conversation Aid To Support Shared Decision Making About Low-Risk Prostate Cancer Treatment: Results Of A Stepped-Wedge Cluster Randomised Trial, Mary C Politi, Rachel C Forcino, Katelyn Parrish, Marie-Anne Durand, A James O'Malley, Rachel Moses, Krista Cooksey, Glyn Elwyn

2020-Current year OA Pubs

BACKGROUND: Decision aids help patients consider the benefits and drawbacks of care options but rarely include cost information. We assessed the impact of a conversation-based decision aid containing information about low-risk prostate cancer management options and their relative costs.

METHODS: We conducted a stepped-wedge cluster randomised trial in outpatient urology practices within a US-based academic medical center. We randomised five clinicians to four intervention sequences and enroled patients newly diagnosed with low-risk prostate cancer. Primary patient-reported outcomes collected postvisit included the frequency of cost conversations and referrals to address costs. Other patient-reported outcomes included: decisional conflict postvisit and at 3 …

Human Ipsc Derived Cardiomyocyte Model Reveals The Transcriptomic Bases Of Covid-19 Associated Myocardial Injury, Kashish Kumar, Satish Kumar, Erica De Leon, Joanne E. Curran, Sarah Williams-Blangero, John Blangero

Research Symposium

Background: Multi-organ complications have been the hallmark of severe COVID-19; cardiac injuries were reported in 20% to 30% of hospitalized COVID-19 patients, although the disease etiology remains poorly understood. This study leveraged genome-wide RNA-sequence data generated using induced pluripotent stem cell (iPSC) differentiated cardiomyocytes (CMs) and in vitro modeling of SARS-CoV-2 infection in CMs, to understand the molecular mechanisms of COVID-19 myocardial injuries for novel diagnostic and therapeutic development.

Methods: Raw RNA-sequence data sets, GSE165242 and GSE150392 were aligned to human genome assembly GRCh38 and gene expressions were quantified. Differentially expressed (DE) genes between experimental groups were identified using moderated …

Molecular Imaging Of Ace2 Expression In Infectious Disease And Cancer, Zhiyao Li, Abbie Hasson, Lasya Daggumati, Hanwen Zhang, Daniel L J Thorek

2020-Current year OA Pubs

Angiotensin-converting enzyme 2 (ACE2) is a cell-surface receptor that plays a critical role in the pathogenesis of SARS-CoV-2 infection. Through the use of ligands engineered for the receptor, ACE2 imaging has emerged as a valuable tool for preclinical and clinical research. These can be used to visualize the expression and distribution of ACE2 in tissues and cells. A variety of techniques including optical, magnetic resonance, and nuclear medicine contrast agents have been developed and employed in the preclinical setting. Positron-emitting radiotracers for highly sensitive and quantitative tomography have also been translated in the context of SARS-CoV-2-infected and control patients. Together …

The 2020 Us Cancer Screening Deficit And The Timing Of Adults' Most Recent Screen: A Population-Based Cross-Sectional Study, Jason Semprini, Radhika Ranganathan

Public Health

Objective In 2020, cancer screenings declined, resulting in a cancer screening deficit. The significance of this deficit, however, has yet to be quantified from a population health perspective. Our study addresses this evidence gap by examining how the pandemic changed the timing of American adults' most recent cancer screen. Methodology We obtained population-based, cancer screening data from the Behavioural Risk Factor Surveillance System (BRFSS) (2010, 2012, 2014, 2016, 2018, 2020). Mammograms, pap smears and colonoscopies were each specified as a variable of mutually exclusive categories to indicate the timing since the most recent screening (never, 0-1 years, 1-2 years, 3+ …

Full Issue: The International Undergraduate Journal Of Health Sciences, Volume 3, Issue 1, September 2023, Sword Mtu

International Undergraduate Journal of Health Sciences

Full Issue: The International Undergraduate Journal of Health Sciences, Volume 3, Issue 1, September 2023

The Covid Games: Resilience In The Shadow Of A Global Pandemic, Taylor D. Bunn

Journal of Multicultural Affairs

This paper explores the student experience in North Texas through current research and interviews with students, parents, educators, and nonprofit leaders who leaned into the work of meeting basic needs in an extremely challenging time. The chapter begins with data on COVID-19 infection rates in the community and publicly available data from school districts and Texas Education Agency on academic achievement, grounding the chapter in quantitative facts. Next, findings from interviews provide context on the human impact of the pandemic. Parents and educators share their perspectives on the challenges students faced, unpacking what they wish they had known early in …

How Propaganda Affects Public Opinion In China: Evidence From The First Phase Of The Covid-19 Pandemic, Dan Chen

Political Science Faculty Publications

During a national crisis, can state propaganda shift public opinion, and if so, in what direction? Existing studies show that the effects of state propaganda on public opinion in China are mixed. Analysing data from an online survey experiment conducted during the initial phase of the COVID-19 pandemic in early 2020, this article finds that the Chinese public responded positively to propaganda that promoted Xi Jinping’s leadership, when these messages included text as well as images that showed Xi being compassionate during his visit to Wuhan. However, when textual propaganda focused on familiar narratives, such as Xi’s leadership, international praise …

The Impact Of Covid-19 On Carotid-Femoral Pulse Wave Velocity: A Systematic Review And Meta-Analysis, Iwona Jannasz, Michal Pruc, Mansur Rahnama-Hezavah, Tomasz Targowski, Robert Olszewski, Stepan Feduniw, Karolina Petryka, Lukasz Szarpak

Faculty, Staff and Students Publications

COVID-19 is a complex multisystemic disease that can result in long-term complications and, in severe cases, death. This study investigated the effect of COVID-19 on carotid–femoral pulse wave velocity (cfPWV) as a measurement to evaluate its impact on arterial stiffness and might help predict COVID-19-related cardiovascular (CV) complications. PubMed, Web of Science, Embase, and the Cochrane Library were searched for relevant studies, and meta-analysis was performed. The study protocol was registered in PROSPERO (nr. CRD42023434326). The Newcastle–Ottawa Quality Scale was used to evaluate the quality of the included studies. Nine studies reported cfPWV among COVID-19 patients and control groups. The …

Making Waves: Integrating Wastewater Surveillance With Dynamic Modeling To Track And Predict Viral Outbreaks, Tin Phan, Samantha Brozak, Bruce Pell, Jeremiah Oghuan, Anna Gitter, Tao Hu, Ruy M Ribeiro, Ruian Ke, Kristina D Mena, Alan S Perelson, Yang Kuang, Fuqing Wu

Faculty, Staff and Student Publications

Wastewater surveillance has proved to be a valuable tool to track the COVID-19 pandemic. However, most studies using wastewater surveillance data revolve around establishing correlations and lead time relative to reported case data. In this perspective, we advocate for the integration of wastewater surveillance data with dynamic within-host and between-host models to better understand, monitor, and predict viral disease outbreaks. Dynamic models overcome emblematic difficulties of using wastewater surveillance data such as establishing the temporal viral shedding profile. Complementarily, wastewater surveillance data bypasses the issues of time lag and underreporting in clinical case report data, thus enhancing the utility and …

Clinical & Laboratory Markers As Predictors For Severity And Mortality In Covid-19, Asma Ameen Ghareeb, Sazan Moffaq Abdulaziz

Polytechnic Journal

Backgrounds: COVID-19, a new health challenge, can be diagnosed by many laboratory biomarkers. Biomarkers became valuable for prognosis; identifying the severity and mortality of the disease in COVID-19 patients. This study aims to determine the association of clinical, demographics, and laboratory biomarkers (CRP, D-dimer, lymphocyte, and platelet) with the severity and mortality of COVID-19. Methods: Between June 1st and November 1st, 2020, 34 healthy controls and 104 COVID-19 cases were enrolled in this study. SARS-CoV-2 infection was confirmed using the real-time RT-PCR technique. All cases were analyzed for clinical, epidemiological, and laboratory biomarkers. COVID-19 cases were regrouped into mild (n=40), …

Personal Protective Equipment Use Among Dental Healthcare Personnel During The Coronavirus Disease 2019 (Covid-19) Pandemic And The Impact Of An Educational Video In Clinical Practice, Lucy C Vogt, Kimberly A Reske, Daniel Park, Tracey Habrock Bach, Henry B Stewart, Olivia G Arter, Daniel Stoeckel, Heidi M Steinkamp, Stephen Y Liang, Michael J Durkin, Jennie H Kwon

2020-Current year OA Pubs

OBJECTIVE: Dental healthcare personnel (DHCP) are at high risk of exposure to coronavirus disease 2019 (COVID-19). We sought to identify how DHCP changed their use of personal protective equipment (PPE) as a result of the COVID-19 pandemic, and to pilot an educational video designed to improve knowledge of proper PPE use.

DESIGN: The study comprised 2 sets of semistructured qualitative interviews.

SETTING: The study was conducted in 8 dental clinics in a Midwestern metropolitan area.

PARTICIPANTS: In total, 70 DHCP participated in the first set of interviews; 63 DHCP participated in the second set of interviews.

METHODS: In September-November 2020 …

Are Patients With An International Classification Of Diseases, 10th Edition Discharge Diagnosis Code For Sepsis Different In Regard To Demographics And Outcome Variables When Comparing Those With Sepsis Only To Those Also Diagnosed With Covid-19 Or Those With A Covid-19 Diagnosis Alone?, David F. Gaieski, Jumpei Tsukuda, Parker Maddox, Michael Li

Department of Emergency Medicine Faculty Papers

OBJECTIVES: We analyzed whether patients with the International Classification of Diseases, 10th Edition (ICD-10) discharge diagnosis code for sepsis are different in regard to demographics and outcome variables when comparing those with sepsis only to those also diagnosed with COVID-19 or those with a COVID-19 diagnosis alone.

DESIGN: Retrospective cohort study.

SETTING: Nine hospitals in an academic health system.

PATIENTS: Patients with a final ICD-10 discharge diagnostic code for sepsis only, a diagnosis of COVID-19-only, or a final sepsis ICD-10 discharge code + a diagnosis of COVID-19 admitted to the hospital were analyzed for demographic and outcome differences between the …

Dynamics Of Inflammatory Responses After Sars-Cov-2 Infection By Vaccination Status In The Usa: A Prospective Cohort Study, Xianming Zhu, Kelly A Gebo, Alison G Abraham, Feben Habtehyimer, Eshan U Patel, Oliver Laeyendecker, Thomas J Gniadek, Reinaldo E Fernandez, Owen R Baker, Malathi Ram, Edward R Cachay, Judith S Currier, Yuriko Fukuta, Jonathan M Gerber, Sonya L Heath, Barry Meisenberg, Moises A Huaman, Adam C Levine, Aarthi Shenoy, Shweta Anjan, Janis E Blair, Daniel Cruser, Donald N Forthal, Laura L Hammitt, Seble Kassaye, Giselle S Mosnaim, Bela Patel, James H Paxton, Jay S Raval, Catherine G Sutcliffe, Matthew Abinante, Patrick Broderick, Valerie Cluzet, Marie Elena Cordisco, Benjamin Greenblatt, Joann Petrini, William Rausch, David Shade, Karen Lane, Amy L Gawad, Sabra L Klein, Andrew Pekosz, Shmuel Shoham, Arturo Casadevall, Evan M Bloch, Daniel Hanley, David J Sullivan, Aaron A R Tobian

Faculty, Staff and Student Publications

BACKGROUND: Cytokines and chemokines play a critical role in the response to infection and vaccination. We aimed to assess the longitudinal association of COVID-19 vaccination with cytokine and chemokine concentrations and trajectories among people with SARS-CoV-2 infection.

METHODS: In this longitudinal, prospective cohort study, blood samples were used from participants enrolled in a multi-centre randomised trial assessing the efficacy of convalescent plasma therapy for ambulatory COVID-19. The trial was conducted in 23 outpatient sites in the USA. In this study, participants (aged ≥18 years) were restricted to those with COVID-19 before vaccination or with breakthrough infections who had blood samples …

Comparative Analysis Of Mfo, Gwo And Gso For Classification Of Covid-19 Chest X-Ray Images, Asraa M. Mohammad, Hussien Attia, Yossra H. Ali

Baghdad Science Journal

Medical images play a crucial role in the classification of various diseases and conditions. One of the imaging modalities is X-rays which provide valuable visual information that helps in the identification and characterization of various medical conditions. Chest radiograph (CXR) images have long been used to examine and monitor numerous lung disorders, such as tuberculosis, pneumonia, atelectasis, and hernia. COVID-19 detection can be accomplished using CXR images as well. COVID-19, a virus that causes infections in the lungs and the airways of the upper respiratory tract, was first discovered in 2019 in Wuhan Province, China, and has since been thought …

Understanding Risk Perception And Xenophobic Attitudes During The Coronavirus Disease 2019 (Covid-19) Pandemic In The United States, Sera Yoo, William Eger, Ashley Moore, Emily Miron, Marney A. White

Cooper Rowan Medical Journal

Introduction: There have been over 87 million cases of Coronavirus Disease 2019 (COVID-19) in the United States (US).

Objective: The objective of this study was to develop a novel questionnaire to assess risk perception of COVID-19 and xenophobic attitudes among adults in the US at the beginning of the pandemic.

Methods: An anonymous self-report questionnaire was developed for this study in February 2020, and was distributed using convenience sampling from March 10 to March 25, 2020. The questionnaire assessed knowledge and risk perceptions of COVID-19, as well as attitudes toward individuals of various races and ethnicities.

Results: 662 US adults …

When Kinship Caregivers Became Teachers: Role Stress And Strain From Remote Learning During Covid-19, Amanda Klein-Cox, Angela Tobin, Ramona Denby

Social Work Faculty Research

For caregivers of school-age children, schooling at home was a significant stressor during the COVID-19 pandemic. Research demonstrates the emotional burden of taking on the role of teacher while trying to balance responsibilities related to work, household, and childcare. Yet little is known about the well-being of kinship caregivers during this time, although this population is at heightened risk for role stress and strain and emotional distress. This article shares the results of focus groups conducted as part of a larger qualitative study, the purpose of which was to understand the factors that influenced the well-being of kinship families during …

A Case Study On How Hbcus Use Social Media To Reduce Uncertainty Of Covid-19, Kelsey Anne-Gabrielle Armstrong

Doctoral Dissertations and Projects

This case study aims to understand how HBCUs use social media to deliver crisis communication messages to students about COVID-19 and how the HBCU culture impacts student perspectives. The theory guiding this study is uncertainty reduction theory (Berger & Calabrese, 1974), as it explains the communication strategies used to reduce uncertainty during a crisis. Data collection was conducted using semi-structured interviews and content analysis. Data analysis strategies included deductive and inductive coding and directed content analysis. The study results provide insight into how the HBCU culture impacts the perspective of an HBCUs response to COVID-19 and overall crisis communication messaging …

Impact Of Covid-19 On Service Dog Organizations, Danny Benbassat, Abigail Konopasky, Michael Fox

People and Animals: The International Journal of Research and Practice

The 2019 coronavirus pandemic led to federal, state, and local measures that paralyzed businesses across the nation. Among them were behavioral and mental health nonprofit organizations. The purpose of this study was to understand the impact of the pandemic on nonprofit programs that train and place service dogs with veterans/service members. Six service dog managers completed eight reflection probe questionnaires and participated in three focus groups. This study found that facility shutdown, businesses shutdown, and social distancing resulted in a training bottleneck for both canines and humans. These primary challenges created secondary and tertiary challenges that mirror and lend support …

How Did Latinxs Near The U.S.-Mexico Border Fare During The Covid-19 Pandemic? A Snapshot Of Anxiety, Depression, And Posttraumatic Stress Symptoms, Bianca T. Villalobos, Juventino Hernandez Rodriguez

Psychological Science Faculty Publications

Introduction: The current study documented levels of anxiety, depression, posttraumatic stress, and COVID-19 fears and impacts among Latinxs living near the U.S.-Mexico border during the COVID-19 pandemic.

Methods: Participants of this cross-sectional study were 305 Latinx adults living in the Rio Grande Valley (RGV) who completed an online survey between June and November 2020.

Results: About half of participants scored above the cut-off for anxiety (50.2%; GAD-7 scores ≥10) and depression (48.8%; PHQ-9 scores ≥10), and more than a quarter of participants showed clinical levels of posttraumatic stress (27.3%; PCL-5 scores ≥31). Latinxs reported on average 22 types of negative …

Preparing For Pandemics: Lesson Plan Design For Children In Elementary School, Daniella Rivera, Enkhtsogt (Steve) Sainbayar, Saleem Choudry, Brittany Vaughn Pierce, Roxana Nouri-Nikbakht, Joy H. Lewis D.O., Phd

Intellectus

Context: The COVID-19 pandemic necessitated distance learning to attenuate the spread of the virus, and school-aged children were particularly affected by this change. Because of their age and education level, children generally lacked understanding about the pandemic and the preventive measures necessary to prevent the spread of this and other infectious diseases. It is unknown how many schools nationwide incorporated disease-prevention education in their curriculums during the pandemic. Therefore, developing distance learning interventions that convey these topics at their level of understanding is important to improve health literacy and raise their awareness of factors that positively influence health.

Objective: To …

Students Of Color And Covid-19: Experiences, Coping Strategies, And Supports, Amie S. Kang, Barbora Hoskova, Chung Yu Liu, Arisa Viddayakorn, Molly Binder, Belle Liang, Betty S. Lai

Journal of Educational Research and Practice

The coronavirus disease of 2019, known as the COVID-19 pandemic, is a disaster event that posed significant physical, social, financial, and mental health risks to college students. Disproportionate experiences of stressors position students of color as a population particularly vulnerable to the negative impacts of COVID-19, thus, the current study assessed the impact of COVID-19 on undergraduate students of color in the United States. Students participated in semi-structured in-depth interviews about their experiences with stressors during the pandemic. Data were analyzed using conventional content analysis and revealed themes including (a) the pandemic’s impact on students; (b) basic needs as college …

Trends In Primary Care Visits And Diabetes Control For Type 2 Diabetics Before And During The Covid-19 Pandemic, Carole Berini

MUSC Theses and Dissertations

Community health worker interventions have shown potential to improve health outcomes and reduce inequities particularly for patients with chronic diseases such as type 2 diabetes (T2D). However, there is a lack of support for CHW integration in the delivery of health care. The recent COVID pandemic may have affected outcomes for T2D patients and exacerbated existing inequities in care. This dissertation aimed to address three broad questions through three separate manuscripts. The first one was a systematic literature review to examine the impact of community health workers on health outcomes for rural US populations. The second and third papers used …

The Relationship Between Nurse Professional Development Practitioners’ Perceptions Of Empowerment In The Workplace And Intent To Stay Post Covid-19 Pandemic, Tashiana Roberts-Jackson

Nursing Dissertations - Archive

Nurse Professional Development (NPD) practitioners in the acute care hospital setting are often undervalued despite their crucial role. During the COVID-19 pandemic, they demonstrated adaptability by rapidly transitioning to virtual formats for onboarding nursing staff, while also shouldering the responsibility of ensuring staff competency in caring for COVID-19 patients. Additionally, NPD practitioners faced heavy workloads, having to retrain nursing staff who worked in indirect patient care roles, while also filling in during critical staffing shortages. To date, no studies have been found that explored key factors that predict intent to stay in the NPD practitioner population pre- or post-pandemic. Thereby, …

Social Bonding In Social Isolation: Social And Religious Support For Substance Use Recovery During Covid-19, Lindsey Chapman

All Theses

The importance of social bonds in supporting those in substance use recovery is illustrious through applications of social bonding theory. However, the effect of COVID-19 restrictions on these essential relationships has not been widely studied. The initial survey instrument studying social support, religious support, and substance use patterns before, during, and after COVID-19 was met with methodological difficulty in reaching the target population through email. This instrument was adapted into a semi-structured interview guide and methodology evolved to include participation either in-person or over Zoom. Through 14 in-depth interviews with people in substance use recovery programs, themes of isolation, peer …

Role Of Hospital Leadership In Pandemic Preparedness: Experience At A Tertiary Hospital In Kenya During The Covid-19 Pandemic, Lucy Mwangi, William Macharia, Benjamin Wachira, Jemimah Kimeu, Boniface Mativa, Lukoye Atwoli

Paediatrics and Child Health, East Africa

Introduction: Pandemic preparedness refers to being ready for, responding to and recovering from public health crises, and is integral for health security. Hospital leadership is a critical building block of an effective healthcare system, providing policy, accountability and stewardship in a health crisis.

Objectives and methods: We aimed to describe the leadership and governance structures put in place at the Aga Khan University Hospital, Nairobi, a private not-forprofit tertiary healthcare facility, following the COVID-19 pandemic. We reviewed over 200 hospital documents archived in the COVID-19 repository including those received from the Kenya Ministry of Health, emails, memos, bulletins, meeting minutes, …