• QAIS-DSNN: Tumor Area Segmentation of MRI Image with Optimized Quantum Matched-Filter Technique and Deep Spiking Neural Network

      Ahmadi, Mohsen; Sharifi, Abbas; Hassantabar, Shayan; Enayati, Saman (2021-01-21)
      Tumor segmentation in brain MRI images is a noted process that can make the tumor easier to diagnose and lead to effective radiotherapy planning. Providing and building intelligent medical systems can be considered as an aid for physicians. In many cases, the presented methods’ reliability is at a high level, and such systems are used directly. In recent decades, several methods of segmentation of various images, such as MRI, CT, and PET, have been proposed for brain tumors. Advanced brain tumor segmentation has been a challenging issue in the scientific community. The reason for this is the existence of various tumor dimensions with disproportionate boundaries in medical imaging. This research provides an optimized MRI segmentation method to diagnose tumors. It first offers a preprocessing approach to reduce noise with a new method called Quantum Matched-Filter Technique (QMFT). Then, the deep spiking neural network (DSNN) is implemented for segmentation using the conditional random field structure. However, a new algorithm called the Quantum Artificial Immune System (QAIS) is used in its SoftMax layer due to its slowness and nonsegmentation and the identification of suitable features for selection and extraction. The proposed approach, called QAIS-DSNN, has a high ability to segment and distinguish brain tumors from MRI images. The simulation results using the BraTS2018 dataset show that the accuracy of the proposed approach is 98.21%, average error-squared rate is 0.006, signal-to-noise ratio is 97.79 dB, and lesion structure criteria including the tumor nucleus are 80.15%. The improved tumor is 74.50%, and the entire tumor is 91.92%, which shows a functional advantage over similar previous methods. Also, the execution time of this method is 2.58 seconds.
    • Rate of Decompensation of Normoxic Emergency Department Patients with SARS-CoV-2

      Schreyer, Kraftin; Isenberg, Derek; Satz, Wayne A.; Lucas, Nicole; Rosenbaum, Jennifer; Zandrow, Gregory; Gentle, Nina T.; Schreyer|0000-0001-8955-2060; Isenberg|0000-0001-5814-1023; Lucas|0000-0002-5251-2230 (2021-04-02)
      Introduction: As of October 30, 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected over 44 million people worldwide and killed over 1.1 million people. In the emergency department (ED), patients who need supplemental oxygen or respiratory support are admitted to the hospital, but the course of normoxic patients with SARS-CoV-2 infection is unknown. In our health system, the policy during the coronavirus 2019 (COVID-19) pandemic was to admit all patients with abnormal chest imaging (CXR) regardless of their oxygen level. We also admitted febrile patients with respiratory complaints who resided in congregate living. We describe the rate of decompensation among patients admitted with suspected SARS-CoV-2 infection but who were not hypoxemic in the ED. Methods: This is a retrospective observational study of patients admitted to our health system between March 1–May 5, 2020 with suspected SARS-CoV-2 infection. We queried our registry to find patients who were admitted to the hospital but had no recorded oxygen saturation of <92% in the ED and received no supplemental oxygen prior to admission. Our primary outcome was decompensation at 72 hours, defined by the need for respiratory support (oxygen, high-flow nasal cannula, non-invasive ventilation, or intubation). Results: A total of 840 patients met our inclusion criteria. Of those patients, 376 (45%) tested positive for SARS-CoV-2. Sixty patients (7.1%) with suspected COVID-19 required respiratory support at 72 hours including 27 (3%) of confirmed SARS-CoV-2 positive patients. Among the 376 patients who tested positive for SARS-CoV-2, 54 patients (14%) had normal CXR in the ED. One-third of patients with normal CXRs decompensated at 72 hours. Seven SARS-CoV-2 positive patients in our cohort died during their hospitalization, of whom five had normal CXRs on admission. Conclusion: Sixty (7.1%) of suspected COVID-19 patients hospitalized at 72 hours required respiratory support despite being normoxic in the ED. Further research should look to identify the normoxic SARS-CoV-2 patients at risk for decompensation.
    • #RealCollege 2021: Basic Needs Insecurity During the Ongoing Pandemic

      The Hope Center for College, Community, and Justice (Temple University) (Temple University. The Hope Center for College, Community, and Justice, 2021-03-31)
      Entering the fall 2020 term, higher education was reeling from the coronavirus pandemic. Enrollment was down—particularly among students most at risk of basic needs insecurity; fewer students had completed the Free Application for Federal Student Aid (FAFSA); and college retention rates had dropped. Students and faculty were stressed and anxious. By the end of the term, more than 267,000 Americans died. At the same time, the federal government pumped an unprecedented $6 billion into student emergency aid via the Coronavirus Aid, Relief, and Economic Security (CARES) Act. This report examines the pandemic’s impact on #RealCollege students who were able to continue their education in this challenging environment. Using our sixth annual #RealCollege Survey, fielded in fall 2020, we assessed students’ basic needs security and their well-being, as indicated by employment status, academic engagement, and mental health. In total, over 195,000 students from 130 two-year colleges and 72 four-year colleges and universities responded to the 2020 #RealCollege Survey.
    • Recent Smell Loss Is the Best Predictor of COVID-19 Among Individuals With Recent Respiratory Symptoms

      Gerkin, Richard C.; Ohla, Kathrin; Veldhuizen, Maria G.; Joseph, Paule V.; Kelly, Christine E.; Bakke, Alyssa J.; Steele, Kimberley E.; Farruggia, Michael C.; Pellegrino, Robert; Pepino, Marta Y.; Bouysset, Cédric; Soler, Graciela M.; Pereda-Loth, Veronica; Dibattista, Michele; Cooper, Keiland W.; Croijmans, Ilja; Di Pizio, Antonella; Ozdener, Mehmet Hakan; Fjaeldstad, Alexander W.; Lin, Cailu; Sandell, Mari A.; Singh, Preet B.; Brindha, V. Evelyn; Olsson, Shannon B.; Saraiva, Luis R.; Ahuja, Gaurav; Alwashahi, Mohammed K.; Bhutani, Surabhi; D'Errico, Anna; Fornazieri, Marco A.; Golebiowski, Jérôme; Hwang, Liang Dar; Öztürk, Lina; Roura, Eugeni; Spinelli, Sara; Whitcroft, Katherine L.; Faraji, Farhoud; Fischmeister, Florian Ph S.; Heinbockel, Thomas; Hsieh, Julien W.; Huart, Caroline; Konstantinidis, Iordanis; Menini, Anna; Morini, Gabriella; Olofsson, Jonas K.; Philpott, Carl M.; Pierron, Denis; Shields, Vonnie D.C.; Voznessenskaya, Vera V.; Albayay, Javier; Altundag, Aytug; Bensafi, Moustafa; Bock, María Adelaida; Calcinoni, Orietta; Fredborg, William; Laudamiel, Christophe; Lim, Juyun; Lundström, Johan N.; Macchi, Alberto; Meyer, Pablo; Moein, Shima T.; Santamaría, Enrique; Sengupta, Debarka; Dominguez, Paloma Rohlfs; Yanik, Hüseyin; Hummel, Thomas; Hayes, John E.; Reed, Danielle R.; Niv, Masha Y.; Munger, Steven D.; Parma, Valentina (2020-12-25)
      In a preregistered, cross-sectional study, we investigated whether olfactory loss is a reliable predictor of COVID-19 using a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0–100 visual analog scales (VAS) for participants reporting a positive (C19+; n = 4148) or negative (C19−; n = 546) COVID-19 laboratory test outcome. Logistic regression models identified univariate and multivariate predictors of COVID-19 status and post-COVID-19 olfactory recovery. Both C19+ and C19− groups exhibited smell loss, but it was significantly larger in C19+ participants (mean ± SD, C19+: −82.5 ± 27.2 points; C19−: −59.8 ± 37.7). Smell loss during illness was the best predictor of COVID-19 in both univariate and multivariate models (ROC AUC = 0.72). Additional variables provide negligible model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms (e.g., fever). Olfactory recovery within 40 days of respiratory symptom onset was reported for ~50% of participants and was best predicted by time since respiratory symptom onset. We find that quantified smell loss is the best predictor of COVID-19 amongst those with symptoms of respiratory illness. To aid clinicians and contact tracers in identifying individuals with a high likelihood of having COVID-19, we propose a novel 0–10 scale to screen for recent olfactory loss, the ODoR-19. We find that numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (4 < OR < 10). Once independently validated, this tool could be deployed when viral lab tests are impractical or unavailable.
    • Recombination and purifying selection preserves covariant movements of mosaic SARS-CoV-2 protein S

      Tagliamonte, Massimiliano S.; Abid, Nabil; Ostrov, David A.; Chillemi, Giovanni; Pond, Sergei; Salemi, Marco; Mavian, Carla; 0000-0003-4817-4029 (2020-06-10)
      In depth evolutionary and structural analyses of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) isolated from bats, pangolins, and humans are necessary to assess the role of natural selection and recombination in the emergence of the current pandemic strain. The SARS-CoV-2 S glycoprotein unique features have been associated with efficient viral spread in the human population. Phylogeny-based and genetic algorithm methods clearly show that recombination events between viral progenitors infecting animal hosts led to a mosaic structure in the S gene. We identified recombination coldspots in the S glycoprotein and strong purifying selection. Moreover, although there is little evidence of diversifying positive selection during host-switching, structural analysis suggests that some of the residues emerged along the ancestral lineage of current pandemic strains may contribute to enhanced ability to infect human cells. Interestingly, recombination did not affect the long-range covariant movements of SARS-CoV-2 S glycoprotein monomer in pre-fusion conformation but, on the contrary, could contribute to the observed overall viral efficiency. Our dynamic simulations revealed that the movements between the host cell receptor binding domain (RBD) and the novel furin-like cleavage site are correlated. We identified threonine 333 (under purifying selection), at the beginning of the RBD, as the hinge of the opening/closing mechanism of the SARS-CoV-2 S glycoprotein monomer functional to hACE2 binding. Our findings support a scenario where ancestral recombination and fixation of amino acid residues in the RBD of the S glycoprotein generated a virus with unique features, capable of extremely efficient infection of the human host.
    • Repeated COVID-19 relapse during post-discharge surveillance with viral shedding lasting for 67 days in a recovered patient infected with SARS-CoV-2

      Liu, Fang; Cai, Zhao-bin; Huang, Jin-song; Niu, Hai-ying; Yu, Wen-yan; Zhang, Yan; Yan, Ting-bo; Chen, Chen; Liu, Yuan; Xu, Ai-fang (2020-08-06)
      A case who revealed the longest duration of viral shedding (67 days) in current reports, presented complicated characteristic on the relapse of COVID-19 due to the inconsistent performance of chest radiography and SARS-CoV-2-RNA detection after discharge. Lopinavir-interferon α2b boosted ribavirin following with lopinavir boosted budesonide might be a potent treatment for viral clearance.
    • Response to: ‘Correspondence on ‘Preliminary predictive criteria for COVID-19 cytokine storm’’ by Tampe et al

      Caricchio, Roberto; Gallucci, Marcello; Dass, Chandra; Zhang, Xinyan; Gallucci, Stefania; Fleece, David; Bromberg, Michael; Criner, Gerard J.; Caricchio|0000-0002-1379-1118 (2021-01-07)
    • Retrospective analysis of high flow nasal therapy in COVID-19-related moderate-to-severe hypoxaemic respiratory failure

      Patel, Maulin; Gangemi, Andrew; Marron, Robert; Chowdhury, Junad; Yousef, Ibraheem; Zheng, Matthew; Mills, Nicole; Tragesser, Lauren; Giurintano, Julie; Gupta, Rohit; Gordon, Matthew; Rali, Parth; D'Alonso, Gilbert; Fleece, David; Zhao, Huaqing; Patlakh, Nicole; Criner, Gerard; 0000-0001-6558-1924; 0000-0002-8764-6538; 0000-0003-2775-2918; 0000-0002-0953-4768| (2020-08-26)
      Invasive mechanical has been associated with high mortality in COVID-19. Alternative therapy of high flow nasal therapy (HFNT) has been greatly debated around the world for use in COVID-19 pandemic due to concern for increased healthcare worker transmission.This was a retrospective analysis of consecutive patients admitted to Temple University Hospital in Philadelphia, Pennsylvania, from 10 March 2020 to 24 April 2020 with moderate-to-severe respiratory failure treated with HFNT. Primary outcome was prevention of intubation. Of the 445 patients with COVID-19, 104 met our inclusion criteria. The average age was 60.66 (+13.50) years, 49 (47.12 %) were female, 53 (50.96%) were African-American, 23 (22.12%) Hispanic. Forty-three patients (43.43%) were smokers. Saturation to fraction ratio and chest X-ray scores had a statistically significant improvement from day 1 to day 7. 67 of 104 (64.42%) were able to avoid invasive mechanical ventilation in our cohort. Incidence of hospital-associated/ventilator-associated pneumonia was 2.9%. Overall, mortality was 14.44% (n=15) in our cohort with 13 (34.4%) in the progressed to intubation group and 2 (2.9%) in the non-intubation group. Mortality and incidence of pneumonia was statistically higher in the progressed to intubation group.
    • Reviewing COVID-19 Modelling amidst Recent United States Protests

      Fasehun, Luther-King; 0000-0002-8798-5433 (2020-07-06)
    • Rhinovirus and Innate Immune Function of Airway Epithelium

      Ganjian, Haleh; Rajput, Charu; Elzoheiry, Manal; Sajjan, Umadevi; 0000-0001-7420-9307; 0000-0002-5756-3651 (2020-06-19)
      Airway epithelial cells, which lines the respiratory mucosa is in direct contact with the environment. Airway epithelial cells are the primary target for rhinovirus and other inhaled pathogens. In response to rhinovirus infection, airway epithelial cells mount both pro-inflammatory responses and antiviral innate immune responses to clear the virus efficiently. Some of the antiviral responses include the expression of IFNs, endoplasmic reticulum stress induced unfolded protein response and autophagy. Airway epithelial cells also recruits other innate immune cells to establish antiviral state and resolve the inflammation in the lungs. In patients with chronic lung disease, these responses may be either defective or induced in excess leading to deficient clearing of virus and sustained inflammation. In this review, we will discuss the mechanisms underlying antiviral innate immunity and the dysregulation of some of these mechanisms in patients with chronic lung diseases.
    • Safety and immunogenicity of a Recombinant Stabilized Prefusion SARS-CoV-2 Spike Protein Vaccine (MVCCOV1901) Adjuvanted with CpG 1018 and Aluminum Hydroxide in healthy adults: A Phase 1, dose-escalation study

      Hsieh, Szu-Min; Liu, Wang-Da; Huang, Yu-Shan; Lin, Yi-Jiun; Hsieh, Erh-Fang; Lian, Wei-Cheng; Chen, Charles; Janssen, Robert; Shih, Shin-Ru; Huang, Chung-Guei; Tai, I-Chen; Chang, Shan-Chwen (2021-06-26)
      Background: This was a phase 1, dose-escalation open-label trial to evaluate the safety and immunogenicity of MVCsingle bondCOV1901, a SARS-CoV-2 S-2P protein vaccine adjuvanted with aluminum hydroxide and CpG 1018. Methods: Between September 28 and November 13 2020, 77 participants were screened. Of these, 45 healthy adults from 20 to 49 years of age were to be administered two doses of MVCsingle bondCOV1901 in doses of 5 μg, 15 μg, or 25 μg of spike protein at 28 days apart. There were 15 participants in each dose group; all were followed for 28 days after the second dose at the time of the interim analysis. Adverse events and laboratory data were recorded for the safety evaluation. Blood samples were collected for humoral, and cellular immune response at various time points. Trial Registration: ClinicalTrials.gov NCT 04487210. Findings: Solicited adverse events were mostly mild and similar. No subject experienced fever. After the second dose, the geometric mean titers (GMTs) for SARS-CoV-2 spike-specific immunoglobulin G were 7178.2, 7746.1, 11,220.6 in the 5 μg, 15 μg, and 25 μg dose groups, respectively. The neutralizing activity were detected in both methods. (Day 43 GMTs, 538.5, 993.1, and 1905.8 for pseudovirus; and 33.3, 76.3, and 167.4 for wild-type virus). The cellular immune response induced by MVCsingle bondCOV1901 demonstrated substantially higher numbers of IFN-γ- producing cells, suggesting a Th1-skewed immune response. Interpretation: The MVCsingle bondCOV1901 vaccine was well tolerated and elicited robust immune responses and is suitable for further development. Funding: Medigen Vaccine Biologics Corporation.
    • Safety and Immunogenicity of CpG 1018 and Aluminium Hydroxide-Adjuvanted SARS-CoV-2 S-2P Protein Vaccine MVC-COV1901: A Large-Scale Double-Blind, Randomised, Placebo-Controlled Phase 2 Trial

      Szu-Min, Hsieh; Liu, Ming-Che; Chen, Yen-Hsu; Lee, Wen-Sen; Hwang, Shinn-Jang; Cheng, Shu-Hsing; Ko, Wen-Chien; Hwang, Kao-Pin; Wang, Ning-Chi; Lee, Yu-Lin; Lin, Yi-Ling; Shih, Shin-Ru; Huang, Chung-Guei; Liao, Chun-Che; Liang, Jian-Jong; Chang, Chih-Shin; Chen, Charles; Lien, Chia En; Tai, I-Chen; Lin, Tzou-Yien (2021-08-08)
      Background: We have assessed the safety and immunogenicity of the COVID-19 vaccine MVC-COV1901, a recombinant protein vaccine containing prefusion-stabilized spike protein S-2P adjuvanted with CpG 1018 and aluminium hydroxide. Methods: This is a phase 2, prospective, randomised, double-blind, placebo-controlled, and multi-centre study to evaluate the safety, tolerability, and immunogenicity of the SARS-CoV-2 vaccine candidate MVC-COV1901. The study comprised 3,844 participants of ≥ 20 years who were generally healthy or with stable pre-existing medical conditions. The study participants were randomly assigned in a 6:1 ratio to receive either MVC-COV1901 containing 15 μg of S-2P protein or placebo containing saline. Participants received two doses of MVC-COV1901 or placebo, administered 28 days apart via intramuscular injection. The primary outcomes were to evaluate the safety, tolerability, and immunogenicity of MVC-COV1901 from Day 1 (the day of first vaccination) to Day 57 (28 days after the second dose). Immunogenicity of MVC-COV1901 was assessed through geometric mean titres (GMT) and seroconversion rates (SCR) of neutralising antibody and antigen-specific immunoglobulin. This clinical trial is registered at ClinicalTrials.gov: NCT04695652. Findings: From the start of this phase 2 trial to the time of interim analysis, no vaccine-related Serious Adverse Events (SAEs) were recorded. The most common solicited adverse events across all study participants were pain at the injection site (64%), and malaise/fatigue (35%). Fever was rarely reported (<1%). For all participants in the MVC-COV1901 group, at 28 days after the second dose against wild type SARS-CoV-2 virus, the GMT was 662·3 (408 IU/mL), the GMT ratio was 163·2, and the seroconversion rate was 99·8%. Interpretation: MVC-COV1901 shows good safety profiles and promising immunogenicity responses. The current data supports MVC-COV1901 to enter phase 3 efficacy trials and could enable regulatory considerations for Emergency Use Authorisation (EUA). Funding: Medigen Vaccine Biologics Corporation and Taiwan Centres for Disease Control.
    • 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)
    • SARS-CoV-2 antibody prevalence in Sierra Leone, March 2021: a cross-sectional, nationally representative, age-stratified serosurvey

      Barrie, Mohamed Bailor; Lakoh, Sulaiman; Kelly, J. Daniel; Kanu, Joseph Sam; Squire, James; Koroma, Zikan; Bah, Silleh; Sankoh, Osman; Brima, Abdulai; Ansumana, Rashid; Goldberg, Sarah A.; Chitre, Smit; Osuagwu, Chidinma; Maeda, Justin; Barekye, Bernard; Numbere, Tamuno-Wari; Abdulaziz, Mohammed; Mounts, Anthony; Blanton, Curtis; Singh, Tushar; Samai, Mohamed; Vandi, Mohamed A.; Richardson, Eugene T. (2021-07-05)
      Background: As of 26 March 2021, the Africa CDC had reported 4,159,055 cases of COVID-19 and 111,357 deaths among the 55 African Union Member States; however, no country has published a nationally representative serosurvey as of May 2021. Such data are vital for understanding the pandemic’s progression on the continent, evaluating containment measures, and policy planning. Methods: We conducted a cross-sectional, nationally representative, age-stratified serosurvey in Sierra Leone in March 2021 by randomly selecting 120 Enumeration Areas throughout the country and 10 randomly selected households in each of these. One to two persons per selected household were interviewed to collect information on socio-demographics, symptoms suggestive of COVID-19, exposure history to laboratory-confirmed COVID-19 cases, and history of COVID-19 illness. Capillary blood was collected by fingerstick, and blood samples were tested using the Hangzhou Biotest Biotech RightSign COVID-19 IgG/IgM Rapid Test Cassette. Total seroprevalence was was estimated after applying sampling weights. Findings: The overall weighted seroprevalence was 2.6% (95% CI 1.9-3.4). This is 43 times higher than the reported number of cases. Rural seropositivity was 1.8% (95% CI 1.0-2.5), and urban seropositivity was 4.2% (95% CI 2.6-5.7). Interpretation: Although overall seroprevalence was low compared to countries in Europe and the Americas (suggesting relatively successful containment in Sierra Leone), our findings indicate enormous underreporting of active cases. This has ramifications for the country’s third wave (which started in June 2021), where the average number of daily reported cases was 87 by the end of the month—this could potentially be on the order of 3,700 actual infections, calling for stronger containment measures in a country with only 0.2% of people fully vaccinated. It may also reflect significant underreporting of incidence and mortality across the continent. Funding: This study was supported by NIAID K08 AI139361, the Sierra Leone Ministry of Health and Sanitation, and the Africa CDC.
    • SARS-CoV-2 Vaccine Hesitancy in a Sample of US Adults: Role of Perceived Satisfaction With Health, Access to Healthcare, and Attention to COVID-19 News

      Siminoff Research Group (Temple University) (2021-04-29)
      Understanding which communities are most likely to be vaccine hesitant is necessary to increase vaccination rates to control the spread of SARS-CoV-2. This cross-sectional survey of adults (n = 501) from three cities in the United States (Miami, FL, New York City, NY, San Francisco, CA) assessed the role of satisfaction with health and healthcare access and consumption of COVID-19 news, previously un-studied variables related to vaccine hesitancy. Multilevel logistic regression tested the relationship between vaccine hesitancy and study variables. Thirteen percent indicated they would not get vaccinated. Black race (OR 2.6; 95% CI: 1.38–5.3), income (OR = 0.64; 95% CI: 0.50–0.83), inattention to COVID-19 news (OR = 1.6; 95% CI: 1.1–2.5), satisfaction with health (OR 0.72; 95% CI: 0.52–0.99), and healthcare access (OR = 1.7; 95% CI: 1.2–2.7) were associated with vaccine hesitancy. Public health officials should consider these variables when designing public health communication about the vaccine to ensure better uptake.
    • SARS-CoV-2, ACE2, and Hydroxychloroquine: Cardiovascular Complications, Therapeutics, and Clinical Readouts in the Current Settings

      Center for Translational Medicine (Temple University) (2020-07-07)
      The rapidly evolving coronavirus disease 2019 (COVID-19, caused by severe acute respiratory syndrome coronavirus 2- SARS-CoV-2), has greatly burdened the global healthcare system and led it into crisis in several countries. Lack of targeted therapeutics led to the idea of repurposing broad-spectrum drugs for viral intervention. In vitro analyses of hydroxychloroquine (HCQ)’s anecdotal benefits prompted its widespread clinical repurposing globally. Reports of emerging cardiovascular complications due to its clinical prescription are revealing the crucial role of angiotensin-converting enzyme 2 (ACE2), which serves as a target receptor for SARS-CoV-2. In the present settings, a clear understanding of these targets, their functional aspects and physiological impact on cardiovascular function are critical. In an up-to-date format, we shed light on HCQ’s anecdotal function in stalling SARS-CoV-2 replication and immunomodulatory activities. While starting with the crucial role of ACE2, we here discuss the impact of HCQ on systemic cardiovascular function, its associated risks, and the scope of HCQ-based regimes in current clinical settings. Citing the extent of HCQ efficacy, the key considerations and recommendations for the use of HCQ in clinics are further discussed. Taken together, this review provides crucial insights into the role of ACE2 in SARS-CoV-2-led cardiovascular activity, and concurrently assesses the efficacy of HCQ in contemporary clinical settings.
    • Screen Time Parenting Practices and Associations with Preschool Children’s TV Viewing and Weight-Related Outcomes

      Neshteruk, Cody D.; Tripicchio, Gina; Lobaugh, Stephanie; Vaughn, Amber E.; Luecking, Courtney T.; Mazzucca, Stephanie; Ward, Dianne S.; Tripicchio|0000-0003-2820-5756 (2021-07-09)
      The purpose of this study was to examine associations between screen time (ST) parenting practices and 2–5-year-old children’s TV viewing and weight status. Data were collected from 252 parent–child dyads enrolled in a randomized parent-focused childhood obesity prevention trial from 2009–2012. ST parenting practices were assessed at baseline using a validated parent-reported survey. Parent-reported child TV viewing and objectively measured anthropometrics were assessed at baseline, post-intervention (35 weeks), and follow-up (59 weeks). Marginal effect models were developed to test the association between baseline ST parenting practices and children’s TV viewing, BMI z-score, and waist circumference across all time points. Limiting/monitoring ST was associated with decreased weekly TV viewing (β = −1.79, 95% CI: −2.61; −0.95), while exposure to TV was associated with more weekly TV viewing over 59 weeks (β = 1.23, 95% CI: 0.71; 1.75). Greater parent use of ST as a reward was associated with increased child BMI z-score (β = 0.15, 95% CI: 0.03; 0.27), while limiting/monitoring ST was associated with decreased BMI z-score (β = −0.16, 95% CI: −0.30; −0.01) and smaller waist circumference (β = −0.55, 95% CI: −1.04; −0.06) over the study period. These findings suggest that modifying parent ST practices may be an important strategy to reduce ST and promote healthy weight in young children.
    • Securing the Basic Needs of College Students in Greater Philadelphia During a Pandemic: A #RealCollegePHL Report

      The Hope Center for College, Community, and Justice (Temple University) (Temple University. The Hope Center for College, Community, and Justice, 2021-05)
      Philadelphia-area colleges and universities were reeling from the coronavirus pandemic as they entered fall 2020. Mirroring national trends, enrollment was down, particularly among those students most at risk of basic needs insecurity; fewer students completed the Free Application for Federal Student Aid (FAFSA); and college retention rates dropped. Students and faculty were stressed and anxious. By the end of the term, local hospitals spent weeks caring for almost a thousand Philadelphians suffering with and often dying from COVID-19, the disease caused by the coronavirus. This report examines how Philadelphia-area students and institutions fared during that exceptionally challenging time. The data come from our sixth-annual #RealCollege Survey, which assessed students’ experiences of food and housing insecurity, homelessness, employment, mental health, and academic engagement. While past work by The Hope Center indicates that more than half of area two-year students and about one-third of area four-year students experience food and/or housing insecurity, and more than one in 10 experience homelessness, this report sheds light on the unique challenges faced in 2020 during the pandemic. The report is part of our #RealCollegePHL project, which aims to document basic needs insecurity among area college students and to bolster institutional and community efforts to address those needs. In the Philadelphia region, the survey was distributed to more than 82,700 students attending 13 colleges and universities, and taken by 8,953 students, yielding an estimated response rate of 11%.
    • Shared Decision Making in Primary Care Based Depression Treatment: Communication and Decision-Making Preferences Among an Underserved Patient Population

      Matthews, Elizabeth B.; Savoy, Margot; Paranjape, Anuradha; Washington, Diana; Hackney, Treanna; Galis, Danielle; Zisman-Ilani, Yaara; Zisman-Ilani|0000-0001-6852-2583; Paranjape|0000-0003-3151-9932 (2021-07-12)
      Objectives: Although depression is a significant public health issue, many individuals experiencing depressive symptoms are not effectively linked to treatment by their primary care provider, with underserved populations have disproportionately lower rates of engagement in depression care. Shared decision making (SDM) is an evidence-based health communication framework that can improve collaboration and optimize treatment for patients, but there is much unknown about how to translate SDM into primary care depression treatment among underserved communities. This study seeks to explore patients' experiences of SDM, and articulate communication and decision-making preferences among an underserved patient population receiving depression treatment in an urban, safety net primary care clinic. Methods: Twenty-seven patients with a depressive disorder completed a brief, quantitative survey and an in-depth semi-structured interview. Surveys measured patient demographics and their subjective experience of SDM. Qualitative interview probed for patients' communication preferences, including ideal decision-making processes around depression care. Interviews were transcribed verbatim and analyzed using thematic analysis. Univariate statistics report quantitative findings. Results: Overall qualitative and quantitative findings indicate high levels of SDM. Stigma related to depression negatively affected patients' initial attitude toward seeking treatment, and underscored the importance of patient-provider rapport. In terms of communication and decision-making preferences, patients preferred collaboration with doctors during the information sharing process, but desired control over the final, decisional outcome. Trust between patients and providers emerged as a critical precondition to effective SDM. Respondents highlighted several provider behaviors that helped facilitated such an optimal environment for SDM to occur. Conclusion: Underserved patients with depression preferred taking an active role in their depression care, but looked for providers as partner in this process. Due to the stigma of depression, effective SDM first requires primary care providers to ensure that they have created a safe and trusting environment where patients are able to discuss their depression openly.
    • Short- and Long-Term Impacts of COVID-19 on Outdoor Public Spaces

      Public Policy Lab (Temple University) (Temple University. Public Policy Lab, 2021-07-20)