Epidemiology of ILDs and their progressive-fibrosing behaviour in six European countries

The PERSEIDS study aimed to estimate incidence/prevalence of interstitial lung diseases (ILDs), fibrosing Interstitial lung diseases (F-ILDs), idiopathic pulmonary fibrosis (IPF), systemic sclerosis-associated ILD (SSc-ILD), other non-IPF F-ILDs and their progressive-fibrosing (PF) forms in six European countries, as current data are scarce.This retrospective, two-phase study used aggregate data (2014–2018). In Phase 1, incident/prevalent cases of ILDs above were identified from clinical databases through an algorithm based on codes/keywords, and incidence/prevalence was estimated. For non-IPF F–ILDs, the relative percentage of subtypes was also determined. In Phase 2, a subset of non-IPF F-ILD cases was manually reviewed to determine the percentage of PF behaviour and usual interstitial pneumonia-like (UIP-like) pattern. A weighted mean percentage of progression was calculated for each country and used to extrapolate incidence/prevalence of progressive-fibrosing ILDs (PF–ILDs).In 2018, incidence/105 person-years ranged between 9.4–83.6(ILDs), 7.7–76.2(F-ILDs), 0.4–10.3(IPF), 6.6–71.7(non-IPF F-ILDs) and 0.3–1.5(SSc-ILD); and prevalence/105 persons ranged between 33.6–247.4(ILDs), 26.7–236.8(F-ILDs), 2.8–31.0(IPF), 22.3–205.8(non-IPF F-ILDs) and 1.4–10.1(SSc-ILD). Among non-IPF F-ILDs, sarcoidosis was the most frequent subtype. PF behaviour and UIP-like pattern were present in a third of non-IPF F-ILD cases each and hypersensitivity pneumonitis showed the highest percentage of progressive behaviour. Incidence of PF-ILDs ranged between 2.1–14.5/105 person-years, and prevalence between 6.9–78.0/105 persons.To our knowledge, PERSEIDS is the first study assessing incidence, prevalence and rate of progression of ILDs across several European countries. Still below the threshold for orphan diseases, the estimates obtained were higher and more variable than reported in previous studies, but differences in study design/population must be considered.

Development & Testing of a Comprehensive Digital Self-Care Support System for Older Adults With Chronic Conditions

This 3-phase study involves the conceptualization and design, development and usability testing of a Comprehensive Digital Self-care Support System (CDSSS) named myHESTIA for older adults with multiple chronic conditions (MCC). The objective of this study was to test whether a CDSSS can be developed for those who are dealing with MCC and whether such a system that is specifically developed for older adult patients will enable daily capture of self-care data. Participants for this 3-phase study included: 10 older adults (age>60) and 10 caregivers in Phase 1; 15 Geriatrics clinicians and 25 community-dwelling low-income older adults in Phase 2; and, 10 older adults (age>60) with MCC in Phase 3. Agile method of system development was used for the design and development of the system. The first two phases involved collecting data for designing and developing myHESTIA. The third phase involved small group usability and feasibility testing, in which the participants used myHESTIA trackers for 4 weeks. Results from phase 3 shows daily inputs were possible and the self-reported data shows that it was not at all difficult for older adults to track their symptoms daily. User experience data (n=10) shows overall positive experience along pragmatic (5.8 out of 7), hedonic (4.6 out of 7), sociability (5.5 out of 7) and usability (6.3 out of 7) experience dimensions. Finally, all the participants (n=10) who completed the phase 3 study reported intention to continue using myHESTIA. Results indicate that it is feasible to design a CDSSS for older adults with MCC.

Adult Protective Services Study on the Impact of COVID-19

The purpose of study was to explore changes in implemented of APS programs in response to the COVID-19 pandemic. This three-phase study began with telephone interviews with eight state-level APS administrators of early phase “hot-spots” that were used to inform questions for the Phase II national survey of state APS programs. Forty-seven states completed an on-line survey on the effects of the pandemic on work and workload, policy and practice, staff, partnerships, and preparedness. Phase III interviews with 7 local APS programs provided an “on-the-ground” view of challenges of meeting clients’ needs. Although most APS programs reported fewer reports of adult maltreatment than before the pandemic, the stress and disruption of COVID-19 required new work arrangements, to which programs adapted technological and managerial support to care for the needs of both APS staff and the clients they served. Finding provide insight for policy and planning requirements for future catastrophic events.

Decreasing Barriers to Care: Voices of Riders, Drivers, and Staff of a Rural Transportation Program

Eastern North Carolina (eNC) is a rural, poor, and underserved region of the state with 1 in 5 adults living below the poverty level. Residents experience health disparities driven by limited access to healthcare and inequitable distribution of social determinants of health. Project TRIP (Transporting Residents with Innovative Practices) is a potential solution to barriers in accessing care in eNC. Results presented include the first phase of a multi-phase study evaluating and replicating TRIP’s effectiveness. Data from qualitative interviews with TRIP riders, drivers, and staff (e.g., case managers) will be presented (n= 20). As a result of the COVID-19 pandemic, interviews were conducted by telephone with the goal of understanding both strengths and weaknesses of the transportation program from riders, drivers, and staff to gain a holistic understanding of TRIP. Of the riders interviewed, the majority (91%) were age 50 and over and African American. Themes that emerged from the data that highlighted strengths of the program included: improved health outcomes, no wait times for pick up or drop offs, cost free, and accommodating service. Themes related to areas of weaknesses or improvement included: needing more transportation vendors and a dedicated TRIP case manager and scheduling concerns. The presentation will conclude with considerations in translating the findings into a pilot and expansion of TRIP in another eNC county (study phases 2 & 3), and how the data can inform the development of transportation interventions in other states, with the goal of increasing access to healthcare for vulnerable rural populations.

Design and Evaluation of Efavirenz Loaded Solid Lipid Nanoparticle for Boosting Oral Bioavailability

Present work illustrates that efavirenz-loaded solid lipid nanoparticles were prepared with the objective of increasing bioavailability and protection of drugs due to biocompatible lipidic content. Efavirenz is generally used for the treatment of HIV. Selection of the suitable lipid phase, surfactant, and cosurfactant was done by individual screening method with the construction of pseudo-ternary phase study. The formulations were prepared by the microemulsion method followed by the lyophilization technique. EFV-SLN has shown a mean particle size of 55.73 ± 3.9 nm having a PDI of 0.153 ± 0.451. Zeta potential was found to be -9.98mV and the formulation was found stable. In vivo pharmaco-kinetic studies exhibited 5.41-fold enhancement in peak plasma concentration (

Reactivity Study of Bimetallic Fe-Mn Oxides with Addition of TiO2 for Chemical Looping Combustion Purposes

The objective of the research was to prepare Mn-based materials for use as oxygen carriers and investigate their reactivity in terms of their applicability to energy systems. The family of Fe2O3-MnO2 with the addition of TiO2 was prepared by mechanical mixing method and calcination. Five samples with addition of Fe2O3 (20, 30, 35, and 50 wt.%) to MnO2 (65, 55, 50, 35, and 85 wt.%) with constant amount of inert TiO2 (15 wt.%) were prepared. The performance of TiO2 supported Fe-Mn oxides oxygen carriers with hydrogen/air in an innovative combustion technology known as chemical looping combustion (CLC) was evaluated. Thermogravimetric analysis was used for reactivity studies within a wide temperature range (800–1000 °C). Comprehensive characterization contained multipurpose techniques for newly synthesized materials. Moreover, post-reaction experiments considered morphology analysis by SEM, mechanical strength testing by dynamometry, and crystal phase study by XRD. Based on wide-ranging testing, the F50M35 sample was indicated as the most promising for gaseous fuel combustion via CLC at 850–900 °C temperature.

Intracluster Sulphur Dioxide Oxidation by Sodium Chlorite Anions: A Mass Spectrometric Study

The reactivity of [NaL·ClO2]− cluster anions (L = ClOx−; x = 0–3) with sulphur dioxide has been investigated in the gas phase by ion–molecule reaction experiments (IMR) performed in an in-house modified Ion Trap mass spectrometer (IT-MS). The kinetic analysis revealed that SO2 is efficiently oxidised by oxygen-atom (OAT), oxygen-ion (OIT) and double oxygen transfer (DOT) reactions. The main difference from the previously investigated free reactive ClO2− is the occurrence of intracluster OIT and DOT processes, which are mediated by the different ligands of the chlorite anion. This gas-phase study highlights the importance of studying the intrinsic properties of simple reacting species, with the aim of elucidating the elementary steps of complex processes occurring in solution, such as the oxidation of sulphur dioxide.

Outdoor Adventure and Experiential Education and COVID-19: What Have We Learned?

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) now known as COVID-19 changed the world and the outdoor adventure and experiential education (OAEE) fields were not immune. These changes significantly impacted various OAEE programs in multiple ways and at different levels of intensity. Purpose: The purpose of this study was to ascertain the impacts of the COVID-19 pandemic on the OAEE fields and identify how OAEE organizations have responded to those impacts. Methodology/Approach: Using a three-phase study and a multi-method approach to data collection and analyses, respondents from 115 OAEE organizations (N=115) were asked to indicate how and in what ways their organizations have been impacted by the pandemic and in what ways their organizations have responded to those challenges. Findings/Conclusions: Many organizations responded not being ready for the impacts from the COVID-19 pandemic. Significant impacts were noted from most of the OAEE organizations responding and included closings, staff reductions, and downsizing as well as operational changes. Many organizations reported ways they are attempting to mitigate the pandemic effects. Implications: Important questions were raised in this paper as to how well prepared the OAEE fields might be for the next crisis.