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SARS-CoV-2 proteins

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    Estimating vaccine confidence levels among future healthcare workers and their trainers: A quantitative study protocol

    Authors: Elizabeth O. Oduwole; Hassan Mahomed; Brihanu T Ayele; Charles S. Wiysonge

    doi:10.1101/2021.02.03.21251068 Date: 2021-02-05 Source: medRxiv

    IntroductionThe outbreak of novel coronavirus disease 2019 MESHD ( COVID-19 MESHD) caught the world off guard in the first quarter of the year 2020. To stem the tide of this pandemic, the development, testing, and pre-licensure approval for emergency use of some COVID 19 vaccine candidates were accelerated. This led to raised public concern about their safety and efficacy, compounding the challenges of vaccine hesitancy which was already declared one of the top ten threats to global health in the year 2019. The onus of managing and administering these vaccines to a skeptical populace when they do become available rests mostly on the shoulders of healthcare workers (HCWs). Therefore, the vaccine confidence levels of HCWs becomes critical to the success of vaccination endeavors, especially COVID 19 vaccination. This proposed study aims to estimate the level of vaccine confidence and the intention to receive a COVID 19 vaccine among future HCWs and their trainers at a specific university in Cape Town, South Africa, and to identify any vaccination concerns early for targeted intervention. Methods and analysisAn online survey will be distributed to current staff and students of an academic institution for HCWs. The survey questionnaire will consist of a demographic questions section consisting of six items and a vaccine confidence section comprising six items in Likert scale format. A multinomial logistic regression model will be employed to identify factors associated with vaccine confidence and intention. The strength of association will be assessed using odds ratio and its 95% confidence interval. Statistical significance will be defined at a p-value <0.05. Ethics and disseminationEthics approval has been obtained for the study from Stellenbosch University (HREC Reference # S19/01/014 (PhD)). The results will be shared with relevant health authorities, presented at conferences, and published in a peer-reviewed journal. ARTICLE SUMMARYO_ST_ABSStrengths and limitations of this studyC_ST_ ABS MESHD{blacktriangleright} The proposed study will generate baseline knowledge of the vaccine confidence among future healthcare workers and their trainers in its specific context. {blacktriangleright}It will contribute to addressing the knowledge gap about the intention to receive a COVID 19 vaccine among health care workers in Africa. {blacktriangleright}It will enable the early identification of vaccine concerns of healthcare workers while they are still in training and assist in informing tailored measures to address them. {blacktriangleright}A limitation of the study is the possibility of a low response rate which is an inherent challenge of online surveys.

    Novel method of transpulmonary pressure measurement with an air-filled esophageal MESHD catheter

    Authors: Paul B Massion; J Berg; N Samalea; G Parzibut; B Lambermont; D Ledoux; Pierre P Massion

    doi:10.21203/rs.3.rs-155320/v1 Date: 2021-01-25 Source: ResearchSquare

    Background There is a strong rationale for proposing transpulmonary pressure-guided protective ventilation in acute respiratory distress syndrome MESHD ( ARDS MESHD). The reference esophageal balloon MESHD catheter method requires complex in vivo calibration and dedicated ventilator with auxiliary pressure port. A simple, inexpensive, accurate and reproducible method of measuring esophageal MESHD pressure would greatly facilitate the measure of transpulmonary pressure to individualize protective ventilation in the intensive care unit.Results We propose an air-filled esophageal MESHD catheter method without balloon MESHD, using disposable catheter and transducer that allows reproducible esophageal MESHD pressure measurements, and that does not require any specific ventilator equipment. We use a 49 cm-long thin low compliance polyvinyl 10 Fr suction catheter, positioned in the lower third of the esophagus and connected to an air-filled disposable blood pressure transducer bound to the monitor. To guarantee air transmission, the transducer is pressurized by an air-filled infusion bag allowing its integrated flush device to deliver continuous air flow and to obtain a stable esophageal MESHD waveform. Calibration requires simple zeroing the transducer open to atmospheric pressure. Esophageal MESHD pressures recorded on the monitoring are expressed in mmHg and need to be converted in cmH2O. We tested our novel method in 10 consecutive intubated patients with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection MESHD. We calculated the target transpulmonary pressures for protective lung and diaphragm ventilation, both in passive and spontaneously breathing conditions. Esophageal MESHD to airway pressure change ratio was close to one in both conditions (median [P25;P75] = 0.94 [0.92;1.00] and 0.98 [0.96;1.01]). We adjusted ventilator settings towards recommended pressure targets to limit atelectrauma, barotrauma MESHD, inspiratory effort and lung stress, by modifying positive end-expiratory pressure, tidal volume, or inspiratory pressure accordingly.Conclusions We propose a simple, inexpensive and reproducible method for esophageal MESHD pressure monitoring with an air-filled esophageal MESHD catheter without balloon. It holds the promise of widespread bedside use of transpulmonary pressure-guided protective ventilation in patients with ARDS MESHD.

    Airborne magnetic nanoparticles: environmental risk factors for the transmission of SARS-CoV-2

    Authors: Carlos Martinez-Boubeta; Konstantinos Simeonidis

    doi:10.1101/2020.12.10.20247130 Date: 2020-12-11 Source: medRxiv

    ObjectivesTo examine the impact of concentrations of ambient fine particulate matter (PM2.5) air pollution on the incidence of COVID-19 MESHD. MethodsPublicly available data of COVID-19 MESHD deaths in March/October 2020 were compared with concentrations of PM2.5 measured in previous years at urban and suburban areas in Thessaloniki. Similar publicly available data of PM2.5 concentrations from Tehran were gathered for comparison. Cross-correlation and Granger causality analysis were performed in order to assess linkage. ResultsOn the one hand, the mean PM2.5 concentrations in Thessaloniki were significantly higher in the winter, however the magnetic fraction of particulate matter in the autumn is twice its annual average, suggesting that traffic-related emissions alone may not explain the entire variability of PM2.5. On the other hand, it is implied that changes in coronavirus-related deaths follow changes in airborne magnetite, with the correlation between the two data sets being maximized at the lag time of one-month. Further insight is provided by the monthly pattern of PM2.5 mass concentrations in Tehran. We find that air pollution Granger causes COVID-19 MESHD deaths (p<0.05). ConclusionsA significant association has been found between PM2.5 values and the impact of the COVID-19 pandemic MESHD on a bunch of regions. Reported links between pollution levels, climate conditions and other factors affecting vulnerability to COVID-19 MESHD may instead reflect inhalation exposure to magnetic nanoparticles. A hypothesis has been set that ubiquitous airborne magnetite pollution, together with certain climatic conditions, may promote a longer permanence of the viral particles in the air, thus favoring transmission. Key messagesO_ST_ABSWhat is already known about this subject?C_ST_ ABS MESHD{blacktriangleright}{blacktriangleright} Due to their small dimensions, airborne particles are able to penetrate through inhalation into many human organs, from the lungs to the cardiovascular system and the brain, which can threaten our health. Research has shown that air pollution is an important cofactor increasing the risk of mortality from coronaviruses. What are the new findings?{blacktriangleright}{blacktriangleright} Evidence exists that the magnetic fraction of PM has modulated the transmission of SARS-CoV-2 in Thessaloniki, and potentially in any other region in the world. How might this impact on policy or clinical practice in the foreseeable future?{blacktriangleright}{blacktriangleright} Policymakers should take care not to overestimate the effect of social distancing interventions and should consider the impact of air pollution in current or future epidemic waves.

    Safety measures for COVID-19 MESHD do not compromise the outcomes of patients undergoing primary percutaneous coronary intervention: A single center study

    Authors: Xiaonan Guan; Jianjun Zhang; Yanbing Li; Ning Ma

    doi:10.21203/rs.3.rs-88850/v1 Date: 2020-10-06 Source: ResearchSquare

    Coronavirus disease 2019 MESHD ( COVID-19 MESHD) is a global pandemic impacting nearly 170 countries/regions and millions of patients worldwide. Patients with acute myocardial infarction MESHD ( AMI MESHD) still need to be treated at percutaneous coronary intervention (PCI) centers with relevant safety measures. This study was conducted to assess the therapeutic outcomes of PCI performed under the safety measures and normal conditions. AMI MESHD patients undergoing PCI between January 24 to April 30, 2020 were performed under safety measures for COVID-19 MESHD. Patients received pulmonary computed tomography (CT) and underwent PCI in negative pressure ICU. Cardiac catheterization laboratory (CCL) staff and physicians worked with level Ⅲ personal protection. Demographic and clinical data, such as door-to-balloon (DTB) time, operation time, complications for patients in this period ( NCP PROTEIN group) and the same period in 2019 (2019 group) were retrieved and analyzed. NCP PROTEIN and 2019 groups had 37 and 96 patients, respectively. There was no significant difference in age, gender, BMI and comorbidity between the two groups. DTB time and operation time were similar between the two groups (60.0 ± 12.39 vs 58.83 ± 12.85 min, p = 0.636; 61.46 ± 9.91 vs 62.55 ± 10.72 min, p = 0.592). Hospital stay time in NCP PROTEIN group was significantly shorter (6.78 ± 2.14 vs 8.85 ± 2.64 days, p < 0.001). The incidences of malignant arrhythmia MESHD and Takotsubo Syndrome MESHD in NCP PROTEIN group were higher than 2019 group significantly (16.22% vs 5.21%, p = 0.039; 10.81% vs 1.04% p = 0.008). During hospitalization and 3-month follow-up, the incidence of major adverse cardiovascular events and mortality in the two groups were statistically similar (35.13% vs 14.58%, p = 0.094; 16.22% vs 8.33%, p =0.184). Our analysis showed that safety measures undertaken in this hospital, including screening of COVID-19 MESHD infection and use of personal protection equipment for conducting PCI did not compromise the surgical outcome as compared with PCI under normal condition, although there were slight increases in incidence of malignant arrhythmia MESHD and Takotsubo Syndrome MESHD.

    Experience of endoscopic intra-gastric balloons removal during COVID-19 pandemic MESHD COVID-19 pandemic MESHD in 98 patients.

    Authors: Nesreen Khidir; Asaad Salama; Moataz Bashah

    doi:10.21203/rs.3.rs-78927/v1 Date: 2020-09-16 Source: ResearchSquare

    Introduction: During COVID-19 pandemic MESHD COVID-19 pandemic MESHD, all elective surgical interventions were suspended, including bariatric and metabolic (B&M) surgeries and endoscopic procedures. Delayed extraction of intragastric balloons MESHD associated with a higher complication rate [1]. Experts agreed that endoscopic bariatric procedures are semi-elective/urgent procedures and can be performed following specific protocol during this pandemic [2].Objective: To share our experience of endoscopic removal of air-filled intragastric balloons during COVID-19 pandemic MESHD following a suggested algorithm.Methods: Retrospective data review for patients who underwent endoscopic removal of intra-gastric balloons MESHD during COVID-19 pandemic MESHD in a tertiary hospital (29 February 2020 —15 June 2020).Results: Ninety-eight patients with age ranged between 14 — 71 years, mean of 33.1 ± 10.9 years. Body mass index (BMI) was 32.8 ± 4.7 kg/m2. Thirty-four were females (34.7%). Three patients (3.1%) had type II diabetes MESHD (T2D), one (1%) had hypertension MESHD ( HTN MESHD), one (1%) was asthmatic and one (1%) had coronary artery disease MESHD ( CAD MESHD). Procedures were performed at 15.6 ± 7 minutes. No complications occurred. No patient developed COVID-19 MESHD symptoms within 14 days after removal. Thirteen patients (13.2%) had Reverse-Transcription Polymerase Chain Reaction (RT-PCR) swab tests for contact with COVID-19 MESHD positive patients and their results were negative. All the involved medical staff had negative RT-PCR tests results by the end of June 2020.Conclusion: Following our suggested algorithm, endoscopic intra-gastric balloon MESHD removal during COVID-19 pandemic MESHD was safe with a favorable outcome.

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