Spatial and temporal effects on SARS-CoV-2 contamination of the healthcare environment

Abstract Background: The spatial and temporal extent of SARS-CoV-2 environmental contamination has not been precisely defined. We sought to elucidate contamination of different surface types and how contamination changes over time. Methods: We sampled surfaces longitudinally within COVID-19 patient rooms, performed quantitative RT-PCR for the detection of SARS-CoV-2 RNA, and modeled distance, time, and severity of illness on the probability of detecting SARS-CoV-2 using a mixed-effects binomial model. Results: The probability of detecting SARS-CoV-2 RNA in a patient room did not vary with distance. However, we found that surface type predicted probability of detection, with floors and high-touch surfaces having the highest probability of detection (floors odds ratio (OR) 67.8 (95% CrI 36.3 to 131); high-touch elevated OR 7.39 (95% CrI 4.31 to 13.1)). Increased surface contamination was observed in room where patients required high-flow oxygen, positive airway pressure, or mechanical ventilation (OR 1.6 (95% CrI 1.03 to 2.53)). The probability of elevated surface contamination decayed with prolonged hospitalization, but the probability of floor detection increased with duration of the local pandemic wave. Conclusions: Distance from patient’s bed did not predict SARS-CoV-2 RNA deposition in patient rooms, but surface type, severity of illness, and time from local pandemic wave predicted surface deposition.

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Role of Glycaemic Control in Predicting Severity of Illness in COVID 19 Patients with Diabetes Mellitus

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/48021.14934 ◽

2021 ◽

Author(s):

Jayanthi Hari Kishan ◽

Vollala Shravan Kumar

Keyword(s):

Diabetes Mellitus ◽

Glycaemic Control ◽

Severity Of Illness ◽

High Flow ◽

P Value ◽

Diabetic Patients ◽

Poor Glycaemic Control ◽

Non Invasive ◽

High Flow Oxygen

Introduction: Coronavirus Disease 2019 (COVID 19) pneumonia is a rapidly spreading disease and which causes morbidity and mortality of many patients. Diabetes mellitus is co-morbidity which is considered as the risk factor for COVID 19. Well-controlled diabetes is associated with better outcomes than poorly controlled diabetes. Measurement of glycated haemoglobin (HbA1c) is the standard method for assessing long term glycaemic control. Regardless of the level of hyperglycaemia, improvement in glycaemic control will lower the risk of diabetic complications. Aim: This study was conducted to identify the role of glycaemic control (HbA1c) in predicting the severity of illness in patients with COVID 19 pneumonia. Materials and Methods: This was a retrospective observational study of (51 diabetic and 51 were non diabetic) patients at Kamineni Academy of Medical Sciences, Hyderabad, India. The patients diagnosed with COVID 19 pneumonia, which includes both diabetics and non diabetics from June 2020 to September 2020. Patients age, sex, baseline HbA1c levels, and oxygen requirement during the hospital stay were analysed using Statistical Package for the Social Sciences (SPSS) software version 22.0. The Chi-Square test was used to analyse qualitative data and p-value significant at level <0.05. Results: In the study among diabetics (n=51), 20 (39.2%) were on room air, 24 (47.1%) required intermittent oxygen support, 3 (5.9%) high flow oxygen, and 4 (7.8%) non invasive ventilator support. Among non diabetics (n=51), 28 (54.9%) were on room air, 18 (35.3%) on intermittent oxygen, 2 (3.9%) high flow oxygen, and 3 (5.9%) Non Invasive Ventilator (NIV) support. It was observed that patients with HbA1c measurements with poor glycaemic control required more oxygen support during treatment in diabetics (p-value:0.469) Conclusion: In the present study, patients with poor glycaemic control required insignificantly, more oxygen support than patients with good glycaemic control.

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Analysis of the status of drug treatment in 746 inpatients with early-onset schizophrenia in China: a retrospective study

BMC Psychiatry ◽

10.1186/s12888-020-02962-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jiuping Zhang ◽

Xin Cheng ◽

Huihui Zhang ◽

Ping Xu ◽

Peiying Jin ◽

...

Keyword(s):

Early Onset ◽

Atypical Antipsychotics ◽

Antipsychotic Drugs ◽

Severity Of Illness ◽

Typical Antipsychotic ◽

Limited Evidence ◽

Early Onset Schizophrenia ◽

Before And After ◽

The Status ◽

Changes Over Time

Abstract Background There is limited evidence on the use of antipsychotics in patients with early-onset schizophrenia, which lags significantly behind the studies on adult patients’ medication and has a large disparity from actual clinical needs. Hence, this study aims to analyse the status of the drug use and its changes for patients with early-onset schizophrenia in our ward and to provide references on clinical medications for children and adolescents with schizophrenia. Methods The distribution of antipsychotics on the day of discharge and their changes over time were retrospectively analysed in our inpatient department from March 2012 to July 2019. Descriptive statistical methods and χ2 tests were carried out. Results A total of 746 inpatients with early-onset schizophrenia were included. Among them, 99.3% of patients were prescribed atypical antipsychotic drugs, with 5.5% of patients prescribed typical antipsychotic drugs. The top five most commonly used antipsychotics were aripiprazole, olanzapine, risperidone, paliperidone and clozapine. Olanzapine and risperidone were used more frequently in men (P < 0.01), whereas aripiprazole was used less frequently (P < 0.01). Olanzapine and paliperidone were used more frequently in patients with adolescent-onset schizophrenia (AOS) (P < 0.05), and risperidone was used more frequently in patients with child-onset schizophrenia (COS) (P < 0.01). Multiple antipsychotics during hospitalization were prescribed in 23.1% of patients. The combination of aripiprazole and olanzapine was the most common in the AOS group, and the combination of risperidone and clozapine was the most common in the COS group. Before and after approval by the competent Chinese authorities, the use of paliperidone and aripiprazole tended to be stable. Conclusion Atypical antipsychotics have been increasingly valued and used clinically. The consideration of medications for patients with early-onset schizophrenia needs to include factors such as age, sex, and severity of illness, metabolism and cognitive function at baseline.

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Ground Validation and Error Sources Identification for GPM IMERG Product over the Southeast Coastal Regions of China

Remote Sensing ◽

10.3390/rs12244154 ◽

2020 ◽

Vol 12 (24) ◽

pp. 4154

Author(s):

Xinxin Sui ◽

Zhi Li ◽

Ziqiang Ma ◽

Jintao Xu ◽

Siyu Zhu ◽

...

Keyword(s):

Coastal Areas ◽

Probability Of Detection ◽

Surface Type ◽

Error Sources ◽

Precipitation Measurement ◽

Ground Validation ◽

Precipitation Estimates ◽

Microwave Imager ◽

Type Factor ◽

Global Precipitation

The Integrated Multi-satellitE Retrievals for the Global Precipitation Measurement mission (IMERG) has been widely evaluated. However, most of these studies focus on the ultimate merged satellite-gauge precipitation estimate and neglect the valuable intermediate estimates which directly guide the improvement of the IMERG product. This research aims to identify the error sources of the latest IMERG version 6 by evaluating the intermediate and ultimate precipitation estimates, and further examine the influences of regional topography and surface type on these errors. Results show that among six passive microwave (PMW) sensors, the Microwave Humidity Sounder (MHS) has outstanding comprehensive behavior, and Special Sensor Microwave Imager/Sounder (SSMIS) operates advanced at precipitation detection, while the Sounder for Atmospheric Profiling of Humidity in the Intertropics by Radiometry (SAPHIR) has the worst performance. More precipitation events are detected with larger quantitative uncertainty in low-lying places than in highlands, in urban and water body areas than in other places, and more in coastal areas than in inland regions. Infrared (IR) estimate has worse performance than PMW, and the precipitation detectability of IR is more sensitive to the factors of elevation and the distance to the coast, as larger critical successful index (CSI) over lowlands and coastal areas. PMW morphing and the mixing of PMW and IR algorithms partly reverse the conservative feature of the precipitation detection of PMW and IR estimates, resulting in higher probability of detection (POD) and false alert ratio (FAR). Finally, monthly gauge calibration improves most of the statistical indicators and reduces the influence of elevation and surface type factor on these errors.

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A Measure of Primary Sociobiological Functions

International Journal of Health Services ◽

10.2190/uurl-2ryu-wryd-ey3k ◽

1976 ◽

Vol 6 (3) ◽

pp. 493-508 ◽

Cited By ~ 758

Author(s):

Sidney Katz ◽

C. Amechi Akpom

Keyword(s):

Severity Of Illness ◽

Child Growth ◽

Developmental Studies ◽

Management Planning ◽

Research And Teaching ◽

Or Groups ◽

Hierarchical Nature ◽

Changes Over Time ◽

Survey Measure

The Index of Independence in Activities of Daily Living (Index of ADL) is a scale whose grades reflect profiles of behavioral levels of six sociobiological functions, namely, bathing, dressing, toileting, transfer, continence, and feeding. Its hierarchical nature makes it possible to rank the overall functional status of people in an ordered manner, to make comparisons among them as individuals or groups, and to detect changes over time. Developmental studies have encompassed children as well as adults, the mentally retarded as well as physically disabled, and noninstitutionalized as well as institutionalized people. In view of relationships to behavior of primitive societies and parallelisms between the order of index functions and patterns of child growth and development, the Index of ADL appears to be based on functions of sociobiological primacy. This concept is supported by twenty years of methodological and applied observations. The Index has been used to produce predictive information about chronic conditions and to evaluate the benefits of long-term services. It has been used in profiled measures of severity of illness. As a screening measure and survey measure, it has contributed information about health needs and outcomes which is useful for management, planning, policy making, research, and teaching.

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Nasal high flow oxygen therapy in COVID-19 patients does not cause environmental surface contamination

Journal of Hospital Infection ◽

10.1016/j.jhin.2021.04.034 ◽

2021 ◽

Author(s):

Oriol Roca ◽

Andrés Pacheco ◽

Jordi Rodon ◽

Andrés Antón ◽

Júlia Vergara-Alert ◽

...

Keyword(s):

Oxygen Therapy ◽

High Flow ◽

Surface Contamination ◽

High Flow Oxygen ◽

Environmental Surface

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High Flow Oxygen Therapy and the Pressure to Feed Infants With Acute Respiratory Illness

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-19-00158 ◽

2020 ◽

Vol 5 (4) ◽

pp. 1006-1010

Author(s):

Jennifer Raminick ◽

Hema Desai

Keyword(s):

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Oxygen Therapy ◽

Respiratory Illness ◽

High Flow ◽

Oral Feeding ◽

Respiratory Support ◽

Acute Respiratory Illness ◽

High Flow Oxygen

Purpose Infants hospitalized for an acute respiratory illness often require the use of noninvasive respiratory support during the initial stage to improve their breathing. High flow oxygen therapy (HFOT) is becoming a more popular means of noninvasive respiratory support, often used to treat respiratory syncytial virus/bronchiolitis. These infants present with tachypnea and coughing, resulting in difficulties in coordinating sucking and swallowing. However, they are often allowed to feed orally despite having high respiratory rate, increased work of breathing and on HFOT, placing them at risk for aspiration. Feeding therapists who work with these infants have raised concerns that HFOT creates an additional risk factor for swallowing dysfunction, especially with infants who have compromised airways or other comorbidities. There is emerging literature concluding changes in pharyngeal pressures with HFOT, as well as aspiration in preterm neonates who are on nasal continuous positive airway pressure. However, there is no existing research exploring the effect of HFOT on swallowing in infants with acute respiratory illness. This discussion will present findings from literature on HFOT, oral feeding in the acutely ill infant population, and present clinical practice guidelines for safe feeding during critical care admission for acute respiratory illness. Conclusion Guidelines for safety of oral feeds for infants with acute respiratory illness on HFOT do not exist. However, providers and parents continue to want to provide oral feeds despite clinical signs of respiratory distress and coughing. To address this challenge, we initiated a process change to use clinical bedside evaluation and a “cross-systems approach” to provide recommendations for safer oral feeds while on HFOT as the infant is recovering from illness. Use of standardized feeding evaluation and protocol have improved consistency of practice within our department. However, further research is still necessary to develop clinical practice guidelines for safe oral feeding for infants on HFOT.

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Surfaced mileage of rural roads and municipal streets, by surface type: 1904–1979

Historical Statistics of the United States: Millennial Edition Online ◽

10.1017/isbn-9780511132971.df184-577 ◽

2010 ◽

Author(s):

Louis P. Cain

Keyword(s):

Surface Type ◽

Rural Roads

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Comparison of two devices for measuring exercise transcutaneous oxygen pressures in patients with claudication

VASA ◽

10.1024/0301-1526/a000454 ◽

2015 ◽

Vol 44 (5) ◽

pp. 355-362 ◽

Cited By ~ 8

Author(s):

Marie Urban ◽

Alban Fouasson-Chailloux ◽

Isabelle Signolet ◽

Christophe Colas Ribas ◽

Mathieu Feuilloy ◽

...

Keyword(s):

Oxygen Pressure ◽

Optical Sensors ◽

Chemical Sensors ◽

Transcutaneous Oxygen ◽

Starting Values ◽

Two Systems ◽

Transcutaneous Oxygen Pressure ◽

New Sensors ◽

Changes Over Time ◽

Over Time

Abstract. Summary: Background: We aimed at estimating the agreement between the Medicap® (photo-optical) and Radiometer® (electro-chemical) sensors during exercise transcutaneous oxygen pressure (tcpO2) tests. Our hypothesis was that although absolute starting values (tcpO2rest: mean over 2 minutes) might be different, tcpO2-changes over time and the minimal value of the decrease from rest of oxygen pressure (DROPmin) results at exercise shall be concordant between the two systems. Patients and methods: Forty seven patients with arterial claudication (65 + / - 7 years) performed a treadmill test with 5 probes each of the electro-chemical and photo-optical devices simultaneously, one of each system on the chest, on each buttock and on each calf. Results: Seventeen Medicap® probes disconnected during the tests. tcpO2rest and DROPmin values were higher with Medicap® than with Radiometer®, by 13.7 + / - 17.1 mm Hg and 3.4 + / - 11.7 mm Hg, respectively. Despite the differences in absolute starting values, changes over time were similar between the two systems. The concordance between the two systems was approximately 70 % for classification of test results from DROPmin. Conclusions: Photo-optical sensors are promising alternatives to electro-chemical sensors for exercise oximetry, provided that miniaturisation and weight reduction of the new sensors are possible.

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