A national survey of early treatment seeking behavior among those with incident SARS-CoV-2 infection

Background: Despite effective means to treat SARS-CoV-2 infection, the early treatment seeking behavior of those newly diagnosed with infection is not clear. Methods: We surveyed users of a national SARS-CoV-2 testing company to assess the frequency and correlates of early treatment seeking behavior for a positive test result. We recruited adults (18 years or older) who had tested positive for SARS-CoV-2 by PCR at a large clinical laboratory. To be eligible, individuals had to have a positive test result within 7 days of enrollment. Surveys were anonymous and voluntary. We collected data on demographic characteristics, general health care access and utilization, awareness of treatment for COVID-19, treatment seeking behavior, and treatments received. Descriptive statistics and odds ratios (OR) with 95% confidence intervals (95% CI) were calculated on StataSE. Results: Participants were surveyed from 3-7 January 2022: among the 15,991 who viewed a survey request, 7,647 individuals were eligible and provided responses. The median age of a respondent was 42 years (interquartile range: 32 to 54), 68.9% of respondents were women, and respondents represented 33 different states, districts, and territories. Among respondents, 23.1% reported they had sought treatment or medical advice for their current COVID-19 diagnosis. Of those who were very aware of treatment for COVID-19, 31.0% sought treatment versus 16.7% who were unaware (p-value< 0.001). The odds of treatment seeking behavior were higher for those that were contacted by a medical professional after their diagnosis (OR: 4.57 [95% CI: 3.89 to 5.37]), those with a primary doctor (OR: 2.94 [95% CI: 2.52 to 3.43]), those who self-measured their oxygen saturation (OR: 2.53 [95% CI: 2.25 to 2.84]), and those over 65 years of age (OR: 2.36 [95% CI: 2.02 to 2.76]). There was no difference in those seeking treatment based on heritage, ethnicity, prior COVID-19 diagnosis, state political affiliation, or vaccination status. The odds of seeking treatment were lower among men (OR: 0.88 [95% CI: 0.78 to 0.99]) and those without insurance (OR: 0.62 [95% CI: 0.52 to 0.72]). The most common treatment locations were clinics and most common treatments were Vitamin C, Vitamin D, Zinc, Tylenol, and NSAIDs. Conclusion: More public outreach is needed to raise awareness of the benefits of treatment for COVID-19. We found that people who were more aware about treatment for COVID-19 were more likely to seek medical advice or therapy. Efforts to increase awareness might increase early treatment for SARS-CoV-2 infection. Increased outreach with treatment facilitation from medical professionals and/or public health staff to those with newly detected SARS-CoV-2 infections, particularly among those at higher-risk of complications, might also be helpful.

Multiplex Lateral Flow Immunoassay for the Detection of Expanded-Spectrum Hydrolysis and CTX-M Enzymes

Background: Early detection of expanded-spectrum cephalosporinase (ESC) hydrolyzing ß-lactamases is essential for antibiotic stewardship. Here we have developed a multiplex lateral flow immunoassay (LFIA) that detects cefotaxime-hydrolyzing activity as well as the most prevalent ESC-hydrolyzing ß-lactamases: the CTX-M-like. Methods: The Rapid LFIA ESC test was evaluated retrospectively on 188 (139 Enterobacterales, 30 Pseudomonas spp. and 14 Acinetobacter spp.) agar-grown bacterial isolates with well-characterized ß-lactamase content. One single colony was resuspended in 150 µL extraction buffer containing cefotaxime, incubated at room temperature for 30 min prior to loading on the LFIA for reading within 10 min. Results: Out of the 188 isolates, all 17 that did not express a β-lactamase hydrolyzing cefotaxime gave negative results, and all 171 isolates expressing a β-lactamase known to hydrolyze cefotaxime, gave a positive test result. In addition, all 86 isolates expressing a CTX-M-variant belonging to one of the five CTX-M-subgroups were correctly identified. The sensitivity and specificity was 100% for both tests. Conclusions: The results showed that the multiplex LFIA was efficient, fast, low cost and easy to implement in routine laboratory work for the confirmation of ESC hydrolyzing activity and the presence of CTX-M enzymes.

Pulmonary abscess as a complication of COVID-19 associated pneumonia: a clinical case

The article describes a case of polysegmental destructive viral-bacterial pneumonia complicated with acute pulmonary abscess, pleural empyema, and pneumopleurofibrosis in a 50-year-old female patient infected with the SARS-CoV-2 virus. The first clinical, laboratory and radiological signs of purulent-necrotic inflammation appeared only 20 days after receiving a positive RT-PCR test result with a nasopharyngeal swab. A month later, an emerging abscess in the lower lobe of the right lung was diagnosed. Subsequently, it spontaneously drained into the pleural cavity.Coagulopathy with the formation of microthrombi in small pulmonary vessels is one of the causative factors of lung abscess in patients infected with the SARS-CoV-2 virus.

COVID-19 vaccination breakthrough infections in a real-world setting: Using community reporters to evaluate vaccine effectiveness

Background COVID-19 has highlighted the need for new methods of pharmacovigilance. Here we use community volunteers to obtain systematic information on vaccine effectiveness and the nature and severity of breakthrough infections. Methods Between December 15, 2020 to September 16, 2021, 10,412 unpaid community-based participants reported the following information to an on-line registry: COVID-19 test results, vaccination (Pfizer, Moderna, or Johnson & Johnson), COVID-19 symptoms and perceived severity using a 4-point scale. COVID-19 infections were described for those who were 1) fully vaccinated, 2) partially vaccinated (received first of two dose vaccines or were <14 days post-final dose), or 3) unvaccinated. Results Of 8,554 who were vaccinated, COVID-19 infections were reported by 74 (1.0%) of those who were fully vaccinated and 198 (2.3%) of those who were partially vaccinated. Among the 74 participants who reported a breakthrough infection after full vaccination, the median time to reported positive test result was 104.5 days (Interquartile range: 77-135 days), with no difference among vaccine manufactures. One quarter (25.7%) of breakthrough infections in the fully vaccinated cases were asymptomatic. More than 97% of fully vaccinated participants reported no moderate/severe symptoms compared to 89.3% of the unvaccinated cases; and only 1.4% of fully vaccinated participants reported experiencing at least 3 moderate to severe symptoms compared to 7.8% in the unvaccinated. Conclusion Person-generated health data, also referred to as patient-reported outcomes, is a useful resource for quantifying breakthrough infections and their severity, showing here that fully vaccinated participants report no or very mild COVID-19 symptoms.

Direct Comparison of SARS Co-V-2 Nasal RT- PCR and Rapid Antigen Test (BinaxNOWTM) at a Community Testing Site During an Omicron Surge

In 731 persons seeking COVID-19 testing at a walk-up San Francisco community site in January 2022, simultaneous nasal rapid antigen testing (BinaxNOWTM) and RT-PCR testing was performed. There were 296 (40.5%) positive tests by RT-PCR; 97% of a random sample were the omicron variant. Sensitivity of a single antigen test was 95.2% (95% CI 92-98%); 82.1% (95% CI 77-87%) and 65.2% (95% CI 60-70%) for Ct threshold of < 30, < 35 and no threshold, respectively. A single BinaxNowTM rapid antigen test detected 95% of high viral load omicron cases from nasal specimens. As currently recommended, repeat testing should be done for high- risk persons with an initial negative antigen test result.

Gel Textural Characteristics of Hair Gel with Cocoa Shell Extract by Using Mixture D-optimal Method

This study was used a mixture design to optimize the spreadability and viscosity of topical hair gel incorporates cocoa shell extract. The factor of the hair gel ingredient was thickener (0.2 – 0.8%), styling polymer A (2-5%), styling polymer B (2-6%), and solvent (84.63-91.63%) were studied on two responses selected spreadability and viscosity. The data collected were fitted to the model with high coefficient determination (R2= 0.994 for the spreadability and 0.9937 for the viscosity). The model can be predicted by showing the good lack of fit test result not significant with the p-value bigger than 0.05. From the ramp function simulation, the optimized formulation was selected and established at thickener (0.55%), styling polymer A (3.61%), styling polymer B (3.72%), and solvent (88.55%) with the spreadability and viscosity at 353.77 g.s and 39.91 pa.s respectively. The benefit of using mixture design in this experiment, it can help a formulator to understand the complex interaction between factors and can easily modify the formulation through ramp function simulation to obtain the desired result. The predicted validation test shows that both values were comparable. Under this condition showed that the model development could be used to predict future observations within the design range thickener (0.2 – 0.8%), styling polymer A (2-5%), styling polymer B (2-6%), and solvent (84.63-91.63%).

International practice variation in perioperative laboratory testing in glioblastoma patients—a retrospective cohort study

Purpose Although standard-of-care has been defined for the treatment of glioblastoma patients, substantial practice variation exists in the day-to-day clinical management. This study aims to compare the use of laboratory tests in the perioperative care of glioblastoma patients between two tertiary academic centers—Brigham and Women’s Hospital (BWH), Boston, USA, and University Medical Center Utrecht (UMCU), Utrecht, the Netherlands. Methods All glioblastoma patients treated according to standard-of-care between 2005 and 2013 were included. We compared the number of blood drawings and laboratory tests performed during the 70-day perioperative period using a Poisson regression model, as well as the estimated laboratory costs per patient. Additionally, we compared the likelihood of an abnormal test result using a generalized linear mixed effects model. Results After correction for age, sex, IDH1 status, postoperative KPS score, length of stay, and survival status, the number of blood drawings and laboratory tests during the perioperative period were 3.7-fold (p < 0.001) and 4.7-fold (p < 0.001) higher, respectively, in BWH compared to UMCU patients. The estimated median laboratory costs per patient were 82 euros in UMCU and 256 euros in BWH. Furthermore, the likelihood of an abnormal test result was lower in BWH (odds ratio [OR] 0.75, p < 0.001), except when the prior test result was abnormal as well (OR 2.09, p < 0.001). Conclusions Our results suggest a substantially lower clinical threshold for ordering laboratory tests in BWH compared to UMCU. Further investigating the clinical consequences of laboratory testing could identify over and underuse, decrease healthcare costs, and reduce unnecessary discomfort that patients are exposed to.

Markers of Alzheimer’s disease in handwriting

The aim of the research. Alzheimer’s disease is the most common form of dementia. One of the potential tools for early detection of the onset of the disease is the handwriting analysis. It can be a warning signal for a serious medical investigation. The dynamics of handwriting changes are also a good indicator of the progression of the disease and the eff ectiveness of therapy. Methods. The authors have developed two corresponding tests. The fi rst (AD-HS) allows the assessment of handwriting markers of cognitive impairment and Alzheimer’s disease from an available handwriting sample. The second (ADHC) is designed to assess dynamics by comparing two handwritten documents written at diff erent times. Results. The pilot study includes 16 patients who were found to be at diff erent stages of the disease by medical examination. They all provided old handwriting samples dated 10–20 years ago and new handwriting samples specifi cally written as part of the experiment. Evaluation of 36 handwriting characteristics showed that both tests were eff ective in identifying Alzheimer’s disease and its stage. The correlation between the handwriting analysis and the medical test result was 0.62. Conclusion. Further refi nement of the proposed tests and expansion of the research base will enable handwriting exercises to be incorporated into supportive therapy to slow the progression of the disease.

Modeling the Output Power of Direct Methanol Fuel Cells Using SVR

The output power of Direct Methanol Fuel Cells (DMFC) is one of the most important elements which limit the performance of DMFC. In order to enhance performance of DMFC, it is necessary to have model to modeling the output power of DMFC. In this paper, a novel model base on Support Vector Regression (SVR) to modeling the output power of DMFC base on output current (I) and operating temperature (T). The test result is shown that the generalization ability of SVR model is high accuracy. This investigation suggests that SVR is quite satisfied used to developing a DMFC model and can be used for controlling, optimal designing and feasibility study of the DMFC system.

Experimental Investigation on the Pressure Distribution Law and Calculation Method of Muddy Water with High Silt Content

The pressure distribution law of muddy water with high silt content has great influence on the stress and strain calculation of the dam body. Currently, there is a few research studies referring to the calculation method of high silt content muddy water pressure, which leads to no reliable theoretical basis for muddy water pressure calculation in dam design. In this paper, muddy water with high silt content was prepared and the imitation tests and model tests were carried out to investigate the pressure distribution law. Based on the test result analysis, it is indicated that the muddy water with high silt content is also in a flowable and viscous state, which is consistent with the law of fluid behavior; the horizontal pressure is equal to the vertical pressure at the same position, and this relationship is generally time independent; through the test result analysis, a pressure formula for muddy water with high silt content is proposed; through comparison between the pressure formula-calculated results and monitoring data, it is indicated that the proposed pressure formula is applicable in the calculation of muddy water pressure. The formula can be a useful tool in the dam safety and design calculation.