A comprehensive county level model to identify factors affecting hospital capacity and predict future hospital demand

The sustained COVID-19 case numbers and the associated hospitalizations have placed a substantial burden on health care ecosystem comprising of hospitals, clinics, doctors and nurses. However, as of today, only a small number of studies have examined detailed hospitalization data from a planning perspective. The current study develops a comprehensive framework for understanding the critical factors associated with county level hospitalization and ICU usage rates across the US employing a host of independent variables. Drawing from the recently released Department of Health and Human Services weekly hospitalization data, we study the overall hospitalization and ICU usage—not only COVID-19 hospitalizations. Developing a framework that examines overall hospitalizations and ICU usage can better reflect the plausible hospital system recovery path to pre-COVID level hospitalization trends. The models are subsequently employed to generate predictions for county level hospitalization and ICU usage rates in the future under several COVID-19 transmission scenarios considering the emergence of new COVID-19 variants and vaccination rates. The exercise allows us to identify vulnerable counties and regions under stress with high hospitalization and ICU rates that can be assisted with remedial measures. Further, the model will allow hospitals to understand evolving displaced non-COVID hospital demand.

Coverage, Usage, Physical Integrity, and Bio-efficacy of Olyset Nets in the Plateau Region, South Benin Following the 2011 Nationwide Distribution

The present study investigated in 8 villages of the Plateau region the coverage, usage, physical integrity, and bio-efficacy of the Olyset nets distributed nationwide by the Benin's National Malaria Control Programme in July 2011. The questionnaire administered as well as the observations made in the households allowed estimating the coverage and usage rates of the 2011 Olyset nets. While their physical integrity was assessed through standard WHO methodology, their bio-efficacy was evaluated through gas chromatography, and WHO cone testing performed with the Kisumu susceptible strain. Mosquito collections through human landing catches (HLCs) were also performed in torn nets to assess if a loss of protection of sleepers occurred as the nets fabric integrity got more damaged. Nine months postdistribution, the coverage and usage rates of the 2011 Olyset nets were 67.4% (95% CI: 65.8–68.9) and 73.3% (95% CI: 70.7–75.8) respectively. About 28% of the 2011 Olyset nets were torn. A drastic drop of the insecticide quantity on the fibers of the nets [from 7.08 µg (95% CI: 5.74–8.42) to 0.2 µg (95% CI: 0.01–0.38)] as well as mortality rates <80% were observed with most nets evaluated. Moreover, the biting rates of An. gambiae s.l. (Diptera: Culicidae) inside torn nets increased in line with their fabric integrity loss. These data support the conclusion that future deployment of nets in the field must be strengthened by community sensitization on their correct use in order to postpone as much as possible appearance of holes and loss of insecticidal activity and encourage repairing of torn nets.

Linguistic and Psychological Features of Autogenous and Reactive Obsessions in Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is typically thought of as a single mental health disorder. More recently, internally-focused (autogenous) and externally-focused (reactive) subtypes have been proposed. This study examined the language used in describing these subtypes using anonymous posts from Reddit. The study used natural language processing software to look at differences in the use of the linguistic variables of first-person singular, first-person plural, third-person singular, and third-person plural as well as use of the psychological variables negative emotion, anger, anxiety, insight, causation, certainty, risk, religion, swear words, body, health, sexual, discrepancy, future, and death. A log likelihood ratio (G2) was calculated to determine the differences of usage rates in the two corpuses. The results showed a large effect size of the use of first-person singular pronouns in both the autogenous and reactive corpuses. The psychological variables of “insight” and “sexual” had the largest effect sizes in the autogenous corpus, while “health” and “body” had the largest effect sizes in the reactive corpus. The differences in the usage rates of the linguistic and psychological variables in the corpuses show the heterogeneity of OCD and the importance of understanding lesser known forms of obsessions such as those with repugnant themes. Clinical implications and future research recommendations are discussed.Keywords: reactive OCD, autogenous OCD, obsessive-compulsive disorder, LIWC, corpus linguistics

Correlating cognitive effort and noun role in spoken Japanese

Models of language processing assume that the cognitive cost to integrate a noun with a verb depends on the distance between the noun and the verb. Such models predict that subjects require more cognitive effort than objects in SOV languages, such as Japanese. This study tests that prediction by investigating apparent cognitive effort differences in topic, nominative, accusative, dative, genitive, and predicative noun usage, using two corpora of spoken Japanese. A cognitive effort index score was determined for each text in the two corpora. The correlations between index scores and usage rates for each grammatical role were determined. Accusative, dative, and genitive noun usage significantly correlated with cognitive effort index scores, but topic, nominative, and predicate noun usage rates did not. These results suggest that the cognitive cost of noun integration depends not only on distance but also on the grammatical role of the noun.

Business Models in the Sharing Economy: Manufacturing Durable Goods in the Presence of Peer-to-Peer Rental Markets

With peer-to-peer sharing of durable goods like cars, boats, and condominiums, it is unclear how manufacturers should react. They could seek to encourage these markets or compete against them by offering their own rentals. This work shows why the best business model depends on whether consumer usage rates vary or not. Contrary to what might be expected, this paper shows that manufacturers have an incentive to facilitate transactions of P2P rental markets in a large variety of cases. We find that when consumer variation in usage rates is intermediate, the manufacturer is surprisingly best off avoiding offering its own direct rentals option and instead, facilitating a peer-to-peer rental market where consumers can share among themselves. The reason for this is an effect unique to the sharing economy, the equalizing effect. The equalizing effect shows that peer-to-peer rentals uniquely make previously heterogeneous willingness-to-pay among consumers more similar, making it easier for the firm to discriminate between the higher- and lower-value consumers, thus allowing it to extract a higher portion of consumers’ surplus. Surprisingly, there are some cases where peer-to-peer rentals benefit the manufacturer, but consumers are hurt overall (though the lower-usage consumers do always benefit from the availability of peer-to-peer rentals).

Mobile versus fixed automated external defibrillators (AED deployment in a geographically dispersed population: analysis of the girona territori cardioprotegit project

Introduction/Aim Public defibrillation doubles out-of-hospital cardiac arrest survival. However, the best way to provide public defibrillation coverage to geographically dispersed populations remains unknown. The aim of this study is to compare usage rates and effectivity between mobile versus fixed Automated External Defibrillators (AED). Methods This project is a prospective registry of the usage rate of public AED (542 fixed AED, 241 mobile AED) and the analysis of the electrocardiographic traces, from June 2011 until December 2019. We compared the usage rate, the proportion of shockable rhythms and defibrillation success between fixed versus mobile AED. Results Of 566 registered usages, we obtained 494 electrocardiographic traces, of which 108 (21%) were from fixed AED. The usage rate of fixed and mobile AED were 0.022use/AED-year and 0.177use/AED-year respectively. In Fixed AED group we observed a higher proportion of shockable rhythms (34.2% vs. 20.3%, p=0,01) and higher defibrillation success (79% vs. 63%, p=0,02). The proportion of patients with shockable rhythms who were transferred to a hospital were 62.1% and 50% in Fixed AED and Mobile AED group respectively (p=0,306). Conclusions In Fixed AED group we observed more shockable rhythms and higher defibrillation success rates. Mobile AED were 8 times more used. FUNDunding Acknowledgement Type of funding sources: None.

Changes in Passengers’ Travel Behavior Due to COVID-19

The COVID-19 outbreak in 2020 has changed the way people travel due to its highly contagious nature. In this study, changes in the travel behavior of passengers due to COVID-19 in the first half of 2020 were examined. To determine whether COVID-19 has affected the use of transportation by passengers, paired t-tests were conducted between the passenger volume of private vehicles in Seoul prior to and after the pandemic. Additionally, the passenger occupancy rate of different modes of transportation during the similar time periods were compared and analyzed to identify the changes in monthly usage rate for each mode. In the case of private vehicles and public bicycles, the usage rates have recovered or increased when compared to those of before the pandemic. Conversely, bus and rail passenger service rates have decreased from the previous year before the pandemic. Furthermore, it is found that existing bus and rail users have switched to the private auto mode due to COVID-19. Based on the results, traffic patterns of travelers after the outbreak and implications responding to the pandemic are discussed.

509 Use of a burn sepsis screening protocol results in lower antibiotic usage rates

Introduction Antibiotic stewardship is widely recognized as being a necessary component of modern hospital care but remains difficult to put into practice particularly on burn services where the risk of infection is known to be higher than the general hospital population. Our burn service instituted a protocol for sepsis screening triggers and antibiotic usage, becoming the only unit in our hospital to do so. In-house quality metrics have shown this protocol to be successful in reducing utilization. Methods With the opening of our burn unit in April 2018, a burn sepsis screening protocol was put in place (see accompanying image). Briefly, the first level of screening consists of threshold hemodynamic and physiologic parameters. If these are met the pathway leads to drawing of basic laboratory tests plus lactate and procalcitonin. Group A findings consist of either Serum Lactic Acid >2.2mmol/Lor Procalcitonin >0.69ng/ml, and Group B findings consist of: Platelets < 100,000/mmorGlucose >150 mg/dL or New Insulin Requirement. If one finding from each of groups A and B are present, antibiotics are started, and a source work up is initiated. De-identified aggregate data on antibiotic usage are routinely tracked as a quality metric by our hospital’s Infection Control Committee. The results from calendar year 2019 are presented here for all antibiotics, vancomycin usage, and beta-lactam usage. One-way Analysis of Variance with Tukey’s post-hoc testing was used to analyze the differences in intravenous antibiotic usage rates between the Burn Intensive Care Unit (BICU), the Trauma ICU (TICU), and the remainder of the hospital. Results The BICU used significantly fewer IV antibiotics than the TICU across all examined parameters and fewer than the remainder of the hospital for all antibiotics and vancomycin usage. Data is presented as antibiotic days/1000 patient days. Conclusions Initiation of a formal protocol for sepsis screening and IV antibiotic initiation significantly lowers antibiotic utilization. Future work will focus on this protocol’s impact on clinical outcomes.