• Males Receive Low-Tidal Volume Component of Lung Protective Ventilation More Frequently than Females in the Emergency Department

      Isenberg, Derek L.; Bloom, Benjamin; Gentile, Nina; Reimer, Hannah; Glaze, Owen D.; Palumbo, Paige; Fenstermacher, Rachel (2020)
      Introduction: Mechanical ventilation is a commonly performed procedure in the emergency department (ED). Approximately 240,000 patients per year receive mechanical ventilation in the ED representing 0.23% of ED visits. An ED-based trial published in 2017 showed that a bundle of interventions in mechanically ventilated patients, including low tidal volume ventilation, reduced the development of acute respiratory distress syndrome by nearly 50%. Prior literature has shown that as many as 40% of ED patients do not receive lung protective ventilation. Our goal was to determine whether differences exist between the percent of males vs females who are ventilated at ≥ 8 milliliters per kilogram (mL/kg) of predicted body weight. Methods: We conducted this study at Temple University Hospital, a tertiary care center located in Philadelphia, Pennsylvania. This was a planned subgroup analysis of study looking at interventions to improve adherence to recommended tidal volume settings. We used a convenience sample of mechanically ventilated patients in our ED between September 1, 2017, and September 30, 2018. All adult patient > 18 years old were eligible for inclusion in the study. Our primary outcome measure was the number of patients who had initial tidal volumes set at > 8 mL/kg of predicted body weight. Our secondary outcome was the number of patients who had tidal volumes set at ≥ 8 mL/kg at 60 minutes after initiation of mechanical ventilation. Results: A total of 130 patients were included in the final analysis. We found that significantly more females were initially ventilated with tidal volumes ≥ 8 mL/kg compared to men: 56% of females vs 9% of males (p=<0.001). Data was available for 107 patients (82%) who were in the ED at 60 minutes after initiation of mechanical ventilation. Again, a significantly larger percentage of females were ventilated with tidal volumes ≥ 8 mL/kg at 60 minutes: 56% of females vs 10% of males (p<0.001). Conclusion: The vast majority of tidal volumes ≥ 8 mL/kg during mechanical ventilation occurs in females. We suggest that objective measurements, such as a tape measure and tidal volume card, be used when setting tidal volumes for all patients, especially females.
    • Individual Hurricane Preparedness During the COVID-19 Pandemic: Insights for Risk Communication and Emergency Management Policies

      Botzen, W.J.W.; Mol, Jantsje M.; Robinson, Peter John; Zhang, Juan; Czajkowski, Jeffrey (2020-01-01)
      Climate change adaptation strategies should anticipate that the 2020 situation which resembles an above average hurricane season coinciding with a pandemic may occur more frequently in the future. This study draws lessons on how individual hurricane preparedness is influenced by a pandemic, which turns out to be a combination of perceptions of flood and pandemic risks that have opposite effects on preparedness behavior. We conducted three waves of surveys during 2019-2020 to monitor hurricane preparedness activities in flood-prone coastal areas in Florida, including a survey of 600 respondents in early June 2020 to obtain insights into households’ risk perceptions and preparedness for this hurricane season under COVID-19. The results show that this hurricane season is dominated by concerns over COVID-19 which influences people’s evacuation intentions. Whereas hotel costs were the main obstacle to evacuating during Hurricane Dorian in 2019, the main evacuation obstacle identified in the 2020 hurricane season is COVID-19. Our statistical analyses that investigates the factors influencing evacuation intentions consistently show that older individuals are less likely to evacuate voluntarily, because they are concerned about becoming infected by COVID-19. We discuss the implications of our findings for adaptation policies that aim to improve hurricane preparedness in situations of a pandemic, such as risk communication and emergency management policies.
    • Beauty and the Mask

      Patel, Viren; Mazzaferro, Daniel M.; Sarwer, David; Bartlett, Scott P.; Sarwer, David B|0000-0003-1033-5528 (2020-01-01)
      Coronavirus disease 2019 has profoundly changed society, culture, commerce, and perhaps most importantly, human interaction. As the citizens of the world followed government-imposed stay-at-home orders, and as the phrase “social distancing” became part of the daily lexicon in a matter of weeks, the public largely adopted the use of face coverings in public places to reduce potential transmission of the virus. The practice of using face coverings for the nose and mouth, whether with homemade fabrics or with surgical masks, undoubtedly has effects on facial perception. Although emotions such as intense fear can be communicated with contraction of the muscles of the brow and those around the eyes, communication of genuine happiness requires contraction of the muscles around the mouth, which is unlikely to be seen behind a face covering. 1 Additionally, the lower half of the face, and specifically the perioral area, has been shown to be vital for determinations of attractiveness. In the 1980s, Dr. Leslie Farkas, widely recognized as the father of craniofacial anthropometry, sought to define the facial measurements and proportions associated with attractive faces.2 When comparing attractive and unattractive faces, Dr. Farkas found that the greatest differences in facial measurements and proportions were centered around the perioral area, including but not limited to a narrow philtrum, a wider oral commissure distance, and a greater protrusion of the upper vermilion.3 With this in mind, it is interesting to consider how masks concealing the lower half of the face would affect perceived attractiveness, which has been shown to influence judgments of a range of interpersonal characteristics, such as competence and trustworthiness.1,4,5 The present study was undertaken to assess whether judgments of attractiveness differ when the lower face is covered by a surgical mask. We anticipated that faces covered with surgical masks would be judged as more attractive than faces not covered by a mask.
    • A Statistical Approach to Batched Prevalence Testing for Coronavirus

      Berger, William; Dabrowski, Konrad; Robinson, Jake; Sales, Adam (2020-03-30)
      As cases of novel coronavirus mount, the ability to conduct expeditious prevalence testing becomes paramount. A statistical approach to batched prevalence testing offers a more rapid and efficient means of monitoring at-risk populations.
    • A deficit of more than 250,000 public health workers is no way to fight Covid-19

      Taylor Wilson, Robin; Troisi, Catherine L.; Gary-Webb, Tiffany L. (2020-04-05)
    • COVID-19 Q&A for Philadelphia Workers

      The Sheller Center for Social Justice (Temple University) (2020-04-10)
    • Mathematical Modeling Study of the 2020 CoVID-19 Outbreak in the United States

      Sinha, Durgesh; Klahn, Nicholas; 0000-0001-7749-3710 (2020-04-12)
      A mathematical model was developed for the currently evolving COVID-19 outbreak. Data analysis and model fitting using Latin Hypercube Sampling partial Correlation Coefficient Method was used to determine the model’s parameters and basic reproduction numbers. The infectivity values from symptomatic infectious people was 0.118461389 (95% CI [0.1136278, 0.12329497]), asymptomatic transmission was 0.100111427 (95% CI [0.1000297, 0.10019314]), and quarantined transmission was 0.057337278 (95% CI [0.0504738, 0.0642008]). The United states reached its peak basic reproduction number on March 10th where R0=58, but it has since lowered to 1.47 as of April 5th. Also, those in quarantine had contributed the most to the basic reproduction number, with asymptomatic people being second, and regular symptomatic people contributing the least. Our simulations showed that the United States has reached its peak occurred on April 11, 2020 with a total 461,700 number of cases and it will reach on June 12, 2020 where the confirmed case count would reach 1.439 million. As for the longevity of the virus, our prediction shows that it could be under preventive measure within two years by February 10, 2022, would be 14,130.
    • Mobilization and Preparation of a Large Urban Academic Center During the COVID-19 Pandemic

      Chowdhury, Junad M.; Patel, Maulin; Zheng, Matthew; Abramian, Osheen; Criner, Gerard J. (2020-04-21)
    • COVID-19 Deaths: Are We Sure It Is Pneumonia? Please, Autopsy, Autopsy, Autopsy!

      Pomara, Cristoforo; Li Volti, Giovanni; Cappello, Francesco; 0000-0001-9288-1148 (2020-04-26)
      The current outbreak of COVID-19 severe respiratory disease, which started in Wuhan, China, is an ongoing challenge, and a major threat to public health that requires surveillance, prompt diagnosis, and research efforts to understand this emergent pathogen and to develop an effective response. Due to the scientific community’s efforts, there is an increasing body of published studies describing the virus’ biology, its transmission and diagnosis, its clinical features, its radiological findings, and the development of candidate therapeutics and vaccines. Despite the decline in postmortem examination rate, autopsy remains the gold standard to determine why and how death happens. Defining the pathophysiology of death is not only limited to forensic considerations; it may also provide useful clinical and epidemiologic insights. Selective approaches to postmortem diagnosis, such as limited postmortem sampling over full autopsy, can also be useful in the control of disease outbreaks and provide valuable knowledge for managing appropriate control measures. In this scenario, we strongly recommend performing full autopsies on patients who died with suspected or confirmed COVID-19 infection, particularly in the presence of several comorbidities. Only by working with a complete set of histological samples obtained through autopsy can one ascertain the exact cause(s) of death, optimize clinical management, and assist clinicians in pointing out a timely and effective treatment to reduce mortality. Death can teach us not only about the disease, it might also help with its prevention and, above all, treatment.
    • Mathematical model and simulations of COVID-19 2020 outbreak in New York: Predictions and implications for control measures

      Sinha, Durgesh; Tan, Peiwen; 0000-0001-7749-3710 (2020-05-01)
      The outbreak of the novel coronavirus has resulted in significant morbidity and mortality in the affected 210 countries with 2.4 million people infected and over 163 thousand deaths. The COVID-19 spike protein is effective at binding to human cells, but this COVID-19 backbone differed substantially from other, already known coronaviruses and mostly resembled viruses found in bats and pangolins. To help predict possible dynamics of COVID-19 as well as ways to contain it, this paper develops a mathematical model for the disease, which includes two different infectious routes. The model’s predictions are fitted to data from the outbreak in New York State from the first reported case from March 01, 2020 to April 19, 2020. The containment time and the severity of the outbreaks depend crucially on the contact coefficients and the isolation rate constant. When randomness is added to the model coefficients, the simulations show that the model is sensitive to the scaled contact rate among people and to the isolation rate. The model is analyzed using stability theory for ordinary differential equations and indicates that when using only isolation for control and advising self-recovery, the endemic steady state is locally stable and attractive. After reaching the peak of COVID-19 on April 14, 2020, new infections by the virus would slow down, particularly from the beginning of May at New York State if people keep the isolation. Numerical simulations with parameters estimated from New York State illustrate the analytical results and the model behavior, which may have important implications for the disease containment in other cities. Indeed, the model highlights the importance of isolation of infected individuals and advising self-recovery may be used to assess other control measures. The model is general and may be used to analyze outbreaks in other states of the United States and other countries.
    • Mathematical Modeling to Estimate the Reproductive Number and the Outbreak Size of COVID-19: The case of India and the World

      Sinha, Durgesh; 0000-0001-7749-3710 (2020-05-04)
      Coronavirus disease (COVID-19) has become a global pandemic with more than 218,000 deaths in 211 different countries around the world. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for this deadliest disease. This paper describes a mathematical model for India, a country with the second highest population in the world with an extremely high population density of about 464 people per km2. This disease has multiphasic actions and reaction mode and our model SEIAQIm is based on six compartmental groups in the form of susceptible, exposed, infectious, asymptomatic, quarantine, and recovered immune factions. Latin Hypercube Sampling Partial Rank Correlation Coefficient method was used for the data analysis and model fitting. According to our model, India would reach its basic reproduction number R0=0.97 on May 14, 2020 with a total number of 73,800 estimated cases. Further, this study also equates the world's situation using the same model system and predicts by May 7, 2020 with a total number of 3,772,000 estimated confirmed cases. Moreover, the current mathematical model highlights the importance of social distancing as an effective method of containing spread of COVID-19.
    • Genetic and Cell biology Discriminants of Sars-CoV2 Infection and Susceptibility to Covid-19 pulmonary complication

      Center for Biotechnology, Sbarro Institute for Cancer Research and Molecular Medicine (Temple University) (2020-05-04)
      The agent of Covid19, Sars-CoV-2 has caused thousands of fatalities worldwide and overshadowed the number of deaths of other previous coronavirus outbreaks (Sars-CoV1 2002 and MERS-CoV 2012). Although the new coronavirus pathogenicity is actively under investigation, part of its infectious behavior can be linked to its higher binding affinity to the angiotensin-converting enzyme 2 (ACE2) in the respiratory tracts. However, the expression of ACE2 per se may not be sufficient to justify the individual variability observed among affected patients in terms of clinical outcome in apparently non-immune depressed, non-elders subjects. The present update provides an overview of the most recent scientific findings related to genetic factors involved in the Sars-CoV-2 infectious process and their potential role in affecting the virus pathogenicity. The present update can provide valuable hints towards developing a predictive screening/susceptibility profile testing on individuals not yet infected and/or in non symptomatic positive subjects towards managing the current morbidity and mortality risk and establishing personalized intervention protocols for the early treatment of the Sars-CoV-2-associated life-threatening pulmonary complication.
    • Cast Face Shield Process & User Manual

      TUCAT (Temple University) (2020-05-05)
    • Coronavirus Outbreak in Italy: Physiological Benefits of Home-Based Exercise During Pandemic

      Center for Biotechnology, Sbarro Institute for Cancer Research and Molecular Medicine (Temple University) (2020-05-07)
      The Coronavirus Disease 2019 (COVID-19) pandemic has forced the hardest-hit populations, like Italians, to radically change their daily habits, starting with social distancing, strict preventive measures, and self-isolation. These precautions also apply to sport-related facilities and activities. The difficulty to practice physical activity during this dramatic moment in time adds to the risks associated with sedentary habits, due to staying all the time at home. Here, the importance and the benefits of maintaining exercise routine, even at home, are emphasized in order to avoid the consequences of inactivity.
    • Elite Athletes and COVID-19 Lockdown: Future Health Concerns for an Entire Sector

      Center for Biotechnology, Sbarro Institute for Cancer Research and Molecular Medicine (Temple University) (2020-05-07)
      In this editorial, we focused our attention on elite athletes during the COVID-19 lockdown. A high level of physical fitness is required by elite athletes irrespective of the specific type of sport. Generally speaking, elite athletes avoid long periods of rest during and at the end of the competitive season. Normally, elite athletes stop training or reduce training volume and intensity for a period that ranges from two weeks to a maximum of four weeks.
    • Sampling bias and incorrect rooting make phylogenetic network tracing of SARS-COV-2 infections unreliable

      Mavian, Carla; Pond, Sergei; Marini, Simone; Magalis, Brittany Rife; Vandamme, Anne-Mieke; Dellicour, Simon; Scarpino, Samuel V.; Houldcroft, Charlotte; Villabona-Arenas, Julian; Paisie, Taylor K.; Trovão, Nídia S.; Boucher, Christina; Zhang, Yun; Scheuermann, Richard H.; Gascuel, Olivier; Lam, Tommy Tsan-Yuk; Suchard, Marc A.; Abecasis, Ana; Wilkinson, Eduan; de Oliveira, Tulio; Bento, Ana I.; Schmidt, Heiko A.; Martin, Darren; Hadfield, James; Faria, Nuno; Grubaugh, Nathan D.; Neher, Richard A.; Baele, Guy; Lemey, Philippe; Stadler, Tanja; Albert, Jan; Crandall, Keith A.; Leitner, Thomas; Stamatakis, Alexandros; Prosperi, Mattia; Salemi, Marco; 0000-0003-4817-4029 (2020-05-07)
    • 3D Printed Face Shield & Assembly Guide

      TUCAT (Temple University) (2020-05-07)
    • Homemade Face Shield Assembly Guide

      TUCAT (Temple University) (2020-05-07)
    • Coronaviruses and the Chemical Senses: Past, Present, and Future

      Pellegrino, Robert; Cooper, Keiland W.; Di Pizio, Antonella; Joseph, Paule V.; Bhutani, Surabhi; Parma, Valentina; 0000-0003-0276-7072 (2020-05-14)
      A wealth of rapidly evolving reports suggests that olfaction and taste disturbances may be manifestations of the novel COVID-19 pandemic. While otolaryngological societies worldwide have started to consider chemosensory evaluation as a screening tool for COVID-19 infection, the true nature of the relationship between the changes in chemosensory ability and COVID-19 is unclear. Our goal with this review is to provide a brief overview of published and archived literature, as well as the anecdotal reports and social trends related to this topic up to April 29, 2020. We also aim to draw parallels between the clinical/chemosensory symptomology reported in association to past coronavirus pandemics (such as SARS and MERS) and the novel COVID-19. This review also highlights current evidence on persistent chemosensory disturbances after the infection has resolved. Overall, our analysis pinpoints the need for further studies: (1) to better quantify olfaction and taste disturbances associated with SARS-CoV-2 infection, compared to those of other viral and respiratory infections, (2) to understand the relation between smell, taste, and chemesthesis disturbances in COVID-19, and (3) to understand how persistent are these disturbances after the infection has resolved.