Medicine and Health Sciences Commons^™

Frailty Explains Variation In Emergency Department Use For Older Veterans During The Covid-19 Pandemic, Justine Seidenfeld, Karen M. Stechuchak, Valerie A. Smith, Catherine Stanwyck, Chelsea Perfect, Courtney Van Houtven, Susan Nicole Hastings

Journal of Geriatric Emergency Medicine

Background: Older adults were critically vulnerable to disruptions in health care during the COVID-19 pandemic, but it is not known if changes in ED utilization varied based on patient characteristics. Using a cohort of older Veterans, we examined changes in ED visit rates based on four characteristics of interest: age, race, area deprivation index, and frailty

Methods: Participants were aged ≥65, with ≥2 visits in primary or geriatric clinics between 02/02/2018-05/07/2019. An adjusted negative binomial regression model was constructed for each characteristic. We report mean counts of all ED visits by quarter for subgroups separately, and report rate …

The Association Between Prolonged Sars-Cov-2 Symptoms And Work Outcomes, Arjun K Venkatesh, Huihui Yu, Caitlin Malicki, Michael Gottlieb, Joann G Elmore, Mandy J Hill, Ahamed H Idris, Juan Carlos C Montoy, Kelli N O'Laughlin, Kristin L. Rising, Kari A Stephens, Erica S Spatz, Robert A Weinstein

Department of Emergency Medicine Faculty Papers

While the early effects of the COVID-19 pandemic on the United States labor market are well-established, less is known about the long-term impact of SARS-CoV-2 infection and Long COVID on employment. To address this gap, we analyzed self-reported data from a prospective, national cohort study to estimate the effects of SARS-CoV-2 symptoms at three months post-infection on missed workdays and return to work. The analysis included 2,939 adults in the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) study who tested positive for their initial SARS-CoV-2 infection at the time of enrollment, were employed before the pandemic, and completed …

Demystifying The Virtualization Process: A Call For Standard Reporting Of Virtual Modifications To Evidence-Based Psychotherapies, Using The Frame Model, Derrecka M Boykin, Tracey L Smith, Barbara Rakel, Merlyn Rodrigues, Jennie Embree, Ken Woods, Angelic D Chaison, Lilian Dindo

Faculty, Staff and Students Publications

The sudden onset of the coronavirus disease led to a rapid expansion of video telehealth to deliver mental healthcare. Although video telehealth was not a new clinical practice, there was limited guidance on how best to modify evidence-based psychotherapies (EBPs) for virtual delivery (a process also referred to as virtualization). The virtualization process for EBPs remains unclear as newly emerging reports on this topic do not consistently report modification decisions. This commentary calls attention to the need to improve documentation practices to allow a greater understanding of modifications needed to maximize the positive effects of EBPs transported to a virtual …

Demystifying The Virtualization Process: A Call For Standard Reporting Of Virtual Modifications To Evidence-Based Psychotherapies, Using The Frame Model, Derrecka M Boykin, Tracey L Smith, Barbara Rakel, Merlyn Rodrigues, Jennie Embree, Ken Woods, Angelic D Chaison, Lilian Dindo

Faculty, Staff and Students Publications

The sudden onset of the coronavirus disease led to a rapid expansion of video telehealth to deliver mental healthcare. Although video telehealth was not a new clinical practice, there was limited guidance on how best to modify evidence-based psychotherapies (EBPs) for virtual delivery (a process also referred to as virtualization). The virtualization process for EBPs remains unclear as newly emerging reports on this topic do not consistently report modification decisions. This commentary calls attention to the need to improve documentation practices to allow a greater understanding of modifications needed to maximize the positive effects of EBPs transported to a virtual …

The Impact Of The Covid-19 Pandemic On The Incidence Of Sexual Assaults And Victim Services, Jessica Hunter

Student Works

The Impact of the Covid-19 Pandemic on the Incidence of Sexual Assaults and Victim Services

Purpose: The purpose of this literature review is to discuss incidents/rates of sexual assaults (SA), access to or accessibility of SA victim services, and the utilization of SA services during the COVID-19 pandemic.

Background: In the U.S., 1 in 5 women experience rape or attempted rape, while 1 in 4 men experience some form of sexual violence in their lifetime. Additionally, SAs affect roughly one-third of the world's population, making SA a prominent problem worldwide.

Methods: Electronic searches in CINHAL and MEDLINE were performed using …

Impact Of Covid-19 On Dental Students’ Mental Health Status And Perception Of Sars-Cov-2 Vaccine, Man Hung, Nicole Hablitzel, Sharon Su, Samantha Melnitsky, Amir Mohajeri

Pacific Faculty Work

The COVID-19 pandemic disrupted dental education significantly, forcing adaptations in both didactic and clinical curricula. This study evaluates the impact of COVID-19 on dental students’ mental health and perceptions of the SARS-CoV-2 vaccine. An anonymous online survey was administered to dental students at Roseman University of Health Sciences, focusing on health experiences and vaccination perceptions. Results showed 56.8% of students were concerned about their emotional health, 82.1% felt stressed, and 60.6% felt depressed. About 81.9% received the vaccine, with 75.5% believing it effective, though only 55.3% supported mandatory vaccination. The pandemic negatively impacted students’ emotional health, indicating a need for …

Antiformer: Graph Enhanced Large Language Model For Binding Affinity Prediction, Qing Wang, Yuzhou Feng, Yanfei Wang, Bo Li, Jianguo Wen, Xiaobo Zhou, Qianqian Song

Faculty, Staff and Student Publications

Antibodies play a pivotal role in immune defense and serve as key therapeutic agents. The process of affinity maturation, wherein antibodies evolve through somatic mutations to achieve heightened specificity and affinity to target antigens, is crucial for effective immune response. Despite their significance, assessing antibody-antigen binding affinity remains challenging due to limitations in conventional wet lab techniques. To address this, we introduce AntiFormer, a graph-based large language model designed to predict antibody binding affinity. AntiFormer incorporates sequence information into a graph-based framework, allowing for precise prediction of binding affinity. Through extensive evaluations, AntiFormer demonstrates superior performance compared with existing methods, …

The Interplay Between Gender And Duration Of Hospitalization Modulates Psychiatric Symptom Severity In Subjects With Long Covid-19, Alessio Simonetti, Antonio Restaino, Claudia Calderoni, Emanuela De Chiara, Antonio Maria D'Onofrio, Salvatore Lioniello, Giovanni Camardese, Delfina Janiri, Matteo Tosato, Francesco Landi, Gabriele Sani

Faculty, Staff and Students Publications

Long COVID-19 is characterized by ongoing symptoms or prolonged or long-term complications of SARS-CoV-2 contraction which persist beyond 4 weeks from the initial onset of symptoms. Gender and duration of hospitalization (DH) are key risk factors for developing long COVID-19 syndrome, but their impact and interplay need further study. This research involved 996 long COVID-19 patients, and we compared the levels of general psychopathology, depression, agitated depression, anxiety, and medication use between hospitalized and non-hospitalized males and females. In the hospitalized patients, multivariate regressions assessed the impact of gender, DH, and the interaction of these variables. The females had higher …

Multi-Antigen Intranasal Vaccine Protects Against Challenge With Sarbecoviruses And Prevents Transmission In Hamsters, Ankita Leekha, Arash Saeedi, K M Samiur Rahman Sefat, Monish Kumar, Melisa Martinez-Paniagua, Adrian Damian, Rohan Kulkarni, Kate Reichel, Ali Rezvan, Shalaleh Masoumi, Xinli Liu, Laurence J N Cooper, Manu Sebastian, Courtney M Sands, Vallabh E Das, Nimesh B Patel, Brett Hurst, Navin Varadarajan

Faculty, Staff and Student Publications

Immunization programs against SARS-CoV-2 with commercial intramuscular vaccines prevent disease but are less efficient in preventing infections. Mucosal vaccines can provide improved protection against transmission, ideally for different variants of concern (VOCs) and related sarbecoviruses. Here, we report a multi-antigen, intranasal vaccine, NanoSTING-SN (NanoSTING-Spike-Nucleocapsid), eliminates virus replication in both the lungs and the nostrils upon challenge with the pathogenic SARS-CoV-2 Delta VOC. We further demonstrate that NanoSTING-SN prevents transmission of the SARS-CoV-2 Omicron VOC (BA.5) to vaccine-naïve hamsters. To evaluate protection against other sarbecoviruses, we immunized mice with NanoSTING-SN. We showed that immunization affords protection against SARS-CoV, leading to protection …

A Comparative Analysis Of Sars-Cov-2 Variants Of Concern (Voc) Spike Proteins Interacting With Hace2 Enzyme, Jiawei Chen, Lingtao Chen, Heng Quan, Soongoo Lee, Kaniz Fatama Khan, Ying Xie, Qiaomu Li, Maria Valero, Zhiyu Dai, Yixin Xie

2020-Current year OA Pubs

In late 2019, the emergence of a novel coronavirus led to its identification as SARS-CoV-2, precipitating the onset of the COVID-19 pandemic. Many experimental and computational studies were performed on SARS-CoV-2 to understand its behavior and patterns. In this research, Molecular Dynamic (MD) simulation is utilized to compare the behaviors of SARS-CoV-2 and its Variants of Concern (VOC)-Alpha, Beta, Gamma, Delta, and Omicron-with the hACE2 protein. Protein structures from the Protein Data Bank (PDB) were aligned and trimmed for consistency using Chimera, focusing on the receptor-binding domain (RBD) responsible for ACE2 interaction. MD simulations were performed using Visual Molecular Dynamics …

Gender-Specific Mental Health Outcomes In Central America: A Natural Experiment, Thea Nagasuru

Computer Science Summer Fellows

While COVID lockdown measures have had varying effects on the mental health of different demographics, several bodies of research have noted their disparate effect on women. Why is women's mental health more negatively impacted by lockdown measures, and how much more are they impacted than men? How can we predict and mitigate these negative effects on women? This paper aims to contribute to answering those questions by comparing COVID stringency measures and their effect on the gap in depression rates between men and women in two neighboring countries: Nicaragua and Honduras.

Abstracts From The 2024 Health Care Systems Research Network (Hcsrn) Annual Conference, Milwaukee, Wisconsin, Health Care Systems Research Network

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network (HCSRN) comprises 20 learning health systems with integrated care delivery and embedded research units. The network’s annual conference serves as a forum for research teams from member institutions to disseminate project findings, explore scientific collaborations, and share insights about population-based research practices that can measurably improve health and health care for all. The theme of this year’s conference was “Advancing high-quality, equitable research in the age of new health care technologies.” Abstracts presented at HCSRN 2024 are published in this issue supplement of the Journal of Patient-Centered Research and Reviews, the journal of record …

“We Rely On Each Other”: A Qualitative Exploration Of Rural Eastern Region Native American Experiences During The Covid-19 Pandemic, Robin M. Dawson Phd, Rn, Cpnp-Pc, Hunter M. Boehme, Stephen Criswell Ph.D., Julia Dunham-Thornton, Melissa S. Nolan Ph.D., Mph

Publications

Background: Native American communities suffered disproportionately negative effects during the COVID-19 pandemic, yet no research has explored the experiences of rural Eastern Region Native Americans. Methods: Informed by the Native Reliance Model and Indigenous Standpoint Theory, we conducted a qualitative descriptive project in the Spring and Summer of 2022; data included semi-structured interviews and focus groups with 24 individuals representing five South Carolina tribal groups. Findings: Thematic analysis yielded four emergent themes: 1) “Let's just finish the Indians off”: Pandemic distrust rooted in historical and contemporary Native American experiences; 2) “We have been misled”: Making sense of conflicting public health …

A Crisis In Clinical Research, David S Hong, Patricia Lorusso, Mario Sznol

Faculty, Staff and Student Publications

The clinical research pipeline is critical to ensuring continued development of novel treatments that can offer patients with cancer safe and effective options. Unfortunately, progress has slowed since the COVID-19 pandemic due to uncovered, systemic inefficiencies across critical processes. Towards initiating discussion on how to reinvigorate clinical research, the Society for Immunotherapy of Cancer (SITC) hosted a virtual summit that characterized issues and formed potential solutions. This commentary serves to highlight the crisis facing clinical research as well as stimulate field-wide discussion on how to better serve patients into the future.

Barriers To And Facilitators Of Implementing Colorectal Cancer Screening Evidence-Based Interventions In Federally Qualified Health Centers: A Qualitative Study, Emanuelle M Dias, Joe R Padilla, Paula M Cuccaro, Timothy J Walker, Bijal A Balasubramanian, Lara S Savas, Melissa A Valerio-Shewmaker, Roshanda S Chenier, Maria E Fernandez

Faculty, Staff and Student Publications

Background: There is an urgent need to increase colorectal cancer screening (CRCS) uptake in Texas federally qualified health centers (FQHCs), which serve a predominantly vulnerable population with high demands. Empirical support exists for evidence-based interventions (EBIs) that are proven to increase CRCS; however, as with screening, their use remains low in FQHCs. This study aimed to identify barriers to and facilitators of implementing colorectal cancer screening (CRCS) evidence-based interventions (EBIs) in federally qualified health centers (FQHCs), guided by the Consolidated Framework for Implementation Research (CFIR).

Methods: We recruited employees involved in implementing CRCS EBIs (e.g., physicians) using data from a …

America Is Unprepared To Meet The Needs Of Its Growing Older Adult Population, Sierra Kaplan

Population Health Research Brief Series

In 2030, nearly 73 million Americans will be aged 65 years or older. As Americans continue to have fewer children than in the past, the number of older adults will outnumber children. Thus, fewer young adults will be around to support and care for the older adult population. Coupled with COVID-19 pandemic-driven disruptions to the healthcare industry, America’s health and aging care system is unprepared to support its large and growing older adult population. Over time, we will see increased health care scarcity and inequality in the distribution of elder care services, especially with continued healthcare worker shortages and drastic …

Caregiver Recruitment Strategies For Interventions Designed To Optimize Transitions From Hospital To Home: Lessons From A Randomized Trial, Allison M Gustavson, Molly J Horstman, Jodie A Cogswell, Diane E Holland, Catherine E Vanderboom, Jay Mandrekar, William S Harmsen, Brystana G Kaufman, Cory Ingram, Joan M Griffin

Faculty, Staff and Students Publications

Challenges to recruitment of family caregivers exist and are amplified when consent must occur in the context of chaotic healthcare circumstances, such as the transition from hospital to home. The onset of the COVID-19 pandemic during our randomized controlled trial provided an opportunity for a natural experiment exploring and examining different consent processes for caregiver recruitment. The purpose of this publication is to describe different recruitment processes (in-person versus virtual) and compare diversity in recruitment rates in the context of a care recipient's hospitalization. We found rates of family caregiver recruitment for in-person versus virtual were 28% and 23%, respectively …

Which Types Of People Were Least Likely To Get The Covid-19 Vaccine?, Xue Zhang, Shannon M. Monnat

Population Health Research Brief Series

Vaccine hesitancy is a long-standing challenge that worsened during the COVID-19 pandemic. Understanding the reasons behind different types of vaccine hesitancy is crucial for developing effective vaccine messaging strategies that can increase confidence in and uptake of future vaccines. This brief summarizes the findings from a study that used data from the 2022 National Wellbeing Survey on 7,612 U.S. adults aged 18-64 to identify characteristics of adults who were least likely to get the COVID-19 vaccine and the characteristics associated with different types of vaccine hesitancy. The authors considered three non-mutually exclusive types of vaccine hesitancy: 1) watchful (concerned about …

Vaccine-Sensitive Allocation - Another Divide To Divide Us?, Joelle Robertson-Preidler, Olivia Schuman

Faculty and Staff Publications

No abstract provided.

An Occupational Therapy Guide To Promoting Social And Emotional Health Among Youth In A Post Covid-19 Era, Alejandra Olvera, Jazminne Orozco Arteaga

Summer 2024 OTD Capstone Symposium

The COVID-19 pandemic has contributed to a significant rise in mental health challenges among children and adolescents, impacting their daily performance and overall well-being. These psychosocial effects underscore an urgent need for comprehensive support from educators, parents, and communities to effectively address the increasing mental and behavioral health issues among young individuals.

The purpose of this project was to implement a program that would improve the social and emotional health of youth and adolescents, as well as to educate educators and parents. By fostering resilience and promoting mental well-being among youth and adolescents, the program's initiatives seek to mitigate the …

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome After Sars-Cov-2 Infection, Elizabeth R. Unger, Jin-Mann S. Lin, Lauren E. Wisk, Huihui Yu, Michelle L'Hommedieu, Helen Lavretsky, Juan Carlos C. Montoy, Michael A. Gottlieb, Kristin L. Rising, Nicole L. Gentile, Michelle Santangelo, Arjun K. Venkatesh, Robert M. Rodriguez, Mandy J. Hill, Rachel E. Geyer, Efrat R. Kean, Sharon Saydah, Samuel A. Mcdonald, Ryan Huebinger, Ahamed H. Idris, Jocelyn Dorney, Bala Hota, Erica S. Spatz, Kari A. Stephens, Robert A. Weinstein, Joann G. Elmore

Department of Emergency Medicine Faculty Papers

IMPORTANCE: Chronic symptoms reported following an infection with SARS-CoV-2, such as cognitive problems, overlap with symptoms included in the definition of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

OBJECTIVE: To evaluate the prevalence of ME/CFS-like illness subsequent to acute SARS-CoV-2 infection, changes in ME/CFS symptoms through 12 months of follow-up, and the association of ME/CFS symptoms with SARS-CoV-2 test results at the acute infection-like index illness.

DESIGN, SETTING, AND PARTICIPANTS: This prospective, multisite, longitudinal cohort study (Innovative Support for Patients with SARS-CoV-2 Infections Registry [INSPIRE]) enrolled participants from December 11, 2020, to August 29, 2022. Participants were adults aged 18 to 64 …

Change In Trust In Us Government Health Agencies For Cancer Information In The Covid-19 Era, Onyema G Chido-Amajuoyi, Rajesh Talluri, Henry K Onyeaka, Itunu Sokale, Gideon T Dosunmu, Noelle Loconte, Sanjay Shete

Faculty, Staff and Student Publications

This cross-sectional study assesses changes in levels of public trust in US government health agencies providing cancer information.

The Saga Of Covid-19 In Chronic Lung Disease: History Repeats Itself, Amir Sharafkhaneh, Javad Razjouyan

Faculty, Staff and Students Publications

No abstract provided.

Outcomes Of The Emdataresource Cryo-Em Ligand Modeling Challenge, Catherine L Lawson, Andriy Kryshtafovych, Grigore D Pintilie, Stephen K Burley, Jiří Černý, Vincent B Chen, Paul Emsley, Alberto Gobbi, Andrzej Joachimiak, Sigrid Noreng, Michael G Prisant, Randy J Read, Jane S Richardson, Alexis L Rohou, Bohdan Schneider, Benjamin D Sellers, Chenghua Shao, Elizabeth Sourial, Chris I Williams, Christopher J Williams, Ying Yang, Venkat Abbaraju, Pavel V Afonine, Matthew L Baker, Paul S Bond, Tom L Blundell, Tom Burnley, Arthur Campbell, Renzhi Cao, Jianlin Cheng, Grzegorz Chojnowski, K D Cowtan, Frank Dimaio, Reza Esmaeeli, Nabin Giri, Helmut Grubmüller, Soon Wen Hoh, Jie Hou, Corey F Hryc, Carola Hunte, Maxim Igaev, Agnel P Joseph, Wei-Chun Kao, Daisuke Kihara, Dilip Kumar, Lijun Lang, Sean Lin, Sai R Maddhuri Venkata Subramaniya, Sumit Mittal, Arup Mondal, Nigel W Moriarty, Andrew Muenks, Garib N Murshudov, Robert A Nicholls, Mateusz Olek, Colin M Palmer, Alberto Perez, Emmi Pohjolainen, Karunakar R Pothula, Christopher N Rowley, Daipayan Sarkar, Luisa U Schäfer, Christopher J Schlicksup, Gunnar F Schröder, Mrinal Shekhar, Dong Si, Abhishek Singharoy, Oleg V Sobolev, Genki Terashi, Andrea C Vaiana, Sundeep C Vedithi, Jacob Verburgt, Xiao Wang, Rangana Warshamanage, Martyn D Winn, Simone Weyand, Keitaro Yamashita, Minglei Zhao, Michael F Schmid, Helen M Berman, Wah Chiu

Children’s Nutrition Research Center Staff Publications

The EMDataResource Ligand Model Challenge aimed to assess the reliability and reproducibility of modeling ligands bound to protein and protein-nucleic acid complexes in cryogenic electron microscopy (cryo-EM) maps determined at near-atomic (1.9-2.5 Å) resolution. Three published maps were selected as targets: Escherichia coli beta-galactosidase with inhibitor, SARS-CoV-2 virus RNA-dependent RNA polymerase with covalently bound nucleotide analog and SARS-CoV-2 virus ion channel ORF3a with bound lipid. Sixty-one models were submitted from 17 independent research groups, each with supporting workflow details. The quality of submitted ligand models and surrounding atoms were analyzed by visual inspection and quantification of local map quality, model-to-map …

Provider Experiences With Daily Use Of Elastomeric Half-Mask Respirators In Health Care, Morgan Lane, Lisa Pompeii, Janelle Rios, Elisa Benavides, Marie Kasbaum, Scott Patlovich, Luis Ostrosky-Zeichner, Adam Hornbeck, Caitlin Mcclain, Rohan Fernando, Margaret Sietsema, Colleen Kraft

Faculty, Staff and Student Publications

Background: During public health emergencies, demand for N95 filtering facepiece respirators (N95 FFRs) can outpace supply. Elastomeric half-mask respirators (EHMRs) are a potential alternative that are reusable and provide the same or higher levels of protection. This study sought to examine the practical aspects of EHMR use among health care personnel (HCP).

Methods: Between September and December 2021, 183 HCPs at 2 tertiary referral centers participated in this 3-month EHMR deployment, wearing the EHMR whenever respiratory protection was required according to hospital protocols (ie, when an N95 FFR would typically be worn) and responding to surveys about their experience.

Results: …

Health Care Workers’ Comfort Ratings For Elastomeric Half-Mask Respirators Versus N95® Filtering Facepiece Respirators During The Covid-19 Pandemic, Lisa Pompeii, Janelle Rios, Colleen S Kraft, Marie Kasbaum, Elisa Benavides, Scott J Patlovich, Luis Ostrosky-Zeichner, Adam Hornbeck, Caitlin Mcclain, Rohan D Fernando, Margaret Sietsema, Morgan Lane

Faculty, Staff and Student Publications

BACKGROUND: Reusable elastomeric half-mask respirators (EHMR) are an alternative to address shortages of disposable respirators. While respirator discomfort has been noted as a barrier to adherence to wearing an N95 filtering facepiece respirator (FFR) among health care personnel (HCP), few have examined EHMR comfort while providing patient care, which was the purpose of this study.

METHOD: Among a cohort of 183 HCP, we prospectively examined how HCP rated EHMR tolerability using the Respirator Comfort, Wearing Experience, and Function Instrument (R-COMFI) questionnaire at Study Week 2 and Week 10. At the completion of the study (Week-12), HCP compared EHMR comfort with …

Long-Term Immune Response To Sars-Cov-2 Infection And Vaccination In Children And Adolescents, Sarah E Messiah, Yashar Talebi, Michael D Swartz, Rachit Sabharwal, Haoting Han, Emma Bergqvist, Harold W Kohl, Melissa Valerio-Shewmaker, Stacia M Desantis, Ashraf Yaseen, Steven H Kelder, Jessica Ross, Lindsay N Padilla, Michael O Gonzalez, Leqing Wu, David Lakey, Jennifer A Shuford, Stephen J Pont, Eric Boerwinkle

Faculty, Staff and Student Publications

BACKGROUND: This analysis examined the durability of antibodies present after SARS-CoV-2 infection and vaccination in children and adolescents.

METHODS: Data were collected over 4 time points between October 2020-November 2022 as part of a prospective population-based cohort aged 5-to-19 years (N = 810). Results of the (1) Roche Elecsys® Anti-SARS-CoV-2 Immunoassay for detection of antibodies to the SARS-CoV-2 nucleocapsid protein (Roche N-test); and (2) qualitative and semi-quantitative detection of antibodies to the SARS CoV-2 spike protein receptor binding domain (Roche S-test); and (3) self-reported antigen/PCR COVID-19 test results, vaccination and symptom status were analyzed.

RESULTS: N antibody levels reached a …

Clinical Presentation And Outcomes Of Care In Adults With Diabetic Ketoacidosis Pre-Covid-19 And During-Covid-19 At A Tertiary, Referral Hospital In Nairobi, Kenya, Sairabanu Sokwalla, Jasmit Shah, Sangeeta Chauhan, Reena Shah, Salim Surani, Eric Njenga, Nancy Kunyiha

Internal Medicine, East Africa

Background: Prognosis of DKA has improved over time with the availability of evidence-based protocols and resources. However, in Kenya, there are limited resources for the appropriate diagnosis and management of DKA, mostly limited to tertiary-level referral facilities. This study aimed to review the clinical presentation, management, and outcomes of adult patients admitted with DKA and assess differences in these parameters before and during the COVID-19 pandemic.

Methods: This was a retrospective study of DKA admissions from January 2017 to December 2021. Patient data were retrieved from the medical records department using ICD-10 codes, and individual details were abstracted on clinical …

Hepatitis B Reactivation And Liver Failure Because Of Covid-19 Infection, Muhammad Mushtaq, Keegan Colletier, Akshata Moghe

Faculty, Staff and Student Publications

Coronavirus disease 2019 (COVID-19) has been associated with liver injury incidence reported between 15% and 53%. Viral binding to ACE2 receptors in hepatobiliary cells is believed to cause liver inflammation. The relationship between hepatitis B and COVID-19 is poorly understood, but patients treated with immunosuppressive therapy for COVID-19 are at higher risk of hepatitis B reactivation (HBVr). We present a case of a patient with HBVr because of COVID-19, in the absence of any immunosuppressive treatment, leading to fulminant liver failure and subsequent requiring liver transplantation. Given low incidence, limited data, and no current guidelines, further studies are needed to …

Social Media And Dermatology During The Covid-19 Pandemic: Analyzing User-Submitted Posts Seeking Dermatologic Advice On Reddit, Vivek V Shukla, Benjamin A Carper, Namasivayam Ambalavanan, Matthew A Rysavy, Edward F Bell, Abhik Das, Ravi M Patel, Carl T D'Angio, Kristi L Watterberg, C Michael Cotten, Stephanie L Merhar, Myra H Wyckoff, Pablo J Sánchez, Neha Kumbhat, Waldemar A Carlo, Eunice Kennedy Shriver National Institute Of Child Health And Human Development Neonatal Research Network

Faculty, Staff and Student Publications

HYPOTHESIS: Increased social distancing was associated with a lower incidence of extremely preterm live births (EPLB) during the initial COVID-19 pandemic period.

STUDY DESIGN: Prospective study at the NICHD Neonatal Research Network sites comparing EPLB (22

RESULTS: EPLB and EPIS percentages did not significantly decrease (1.58-1.45%, p = 0.07, and 0.08-0.06%, p = 0.14, respectively). SDI was not significantly correlated with percent change of EPLB (CC = 0.29, 95% CI = -0.12, 0.71) or EPIS (CC = -0.23, 95% CI = -0.65, 0.18). Percent change in mean gestational age was positively correlated with SDI (CC = 0.49, 95% CI = …