• 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 antibody prevalence in Sierra Leone, March 2021: a cross-sectional, nationally representative, age-stratified serosurvey

      Barrie, Mohamed Bailor; Lakoh, Sulaiman; Kelly, J. Daniel; Sam Kanu, Joseph; Squire, James Sylvester; Koroma, Zikan; Bah, Silleh; Sankoh, Osman; Brima, Abdulai; Ansumana, Rashid; Goldberg, Sarah A.; Chitre, Smit; Osuagwu, Chidinma; Frankfurter, Raphael; Maeda, Justin; Barekye, Bernard; Numbere, Tamuno-Wari; Abdulaziz, Mohammed; Mounts, Anthony; Blanton, Curtis; Singh, Tushar; Samai, Mohamed; Vandi, Mohamed; Richardson, Eugene T. (2021-11-11)
      Introduction: As of 26 March 2021, the Africa Centres for Disease Control and Prevention 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 October 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 sociodemographics, 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 estimated after applying sampling weights. Results: The overall weighted seroprevalence was 2.6% (95% CI 1.9% to 3.4%). This was 43 times higher than the reported number of cases. Rural seropositivity was 1.8% (95% CI 1.0% to 2.5%), and urban seropositivity was 4.2% (95% CI 2.6% to 5.7%). Discussion: Overall seroprevalence was low compared with countries in Europe and the Americas (suggesting relatively successful containment in Sierra Leone). This has ramifications for the country’s third wave (which started in June 2021), during which the average number of daily reported cases was 87 by the end of the month:this could potentially be on the order of 3700 actual infections per day, calling for stronger containment measures in a country with only 0.2% of people fully vaccinated. It may also reflect significant under-reporting of incidence and mortality across the continent.
    • SARS-CoV-2 BNT162b2 vaccine–induced humoral response and reactogenicity in individuals with prior COVID-19 disease

      Kelsen, Steven G.; Braverman, Alan S.; Aksoy, Mark O.; Hayman, Jacob A.; Patel, Puja S.; Rajput, Charu; Zhao, Huaqing; Fisher, Susan G.; Ruggieri, Michael; GENTILE, NINA; Zhao|0000-0002-0953-4768; Ruggieri Sr.|0000-0003-3052-3630; Gentile|0000-0002-1222-5966 (2022-01-12)
      BACKGROUND. Most individuals with prior COVID-19 disease manifest long-term protective immune responses against reinfection. Accordingly, we tested the hypothesis that humoral immune and reactogenicity responses to a SARS-CoV-2 mRNA vaccine differ in individuals with and without prior COVID-19 disease. METHODS. Health care workers (n = 61) with (n = 30) and without (n = 31) prior COVID-19 disease received two 30 μg doses of Pfizer BNT162b2 vaccine 3 weeks apart. Serum IgG antibody against the spike receptor-binding domain; serum neutralizing activity; and vaccine reactogenicity were assessed longitudinally every 2 weeks for 56 days after the first injection. RESULTS. The COVID-19 group manifested more rapid increases in spike IgG antibody and serum neutralizing activity after the first vaccine dose but showed little or no increase after the second dose compared with the infection-naive group. In fact, spike IgG was at its maximum level after the first dose in 36% of the COVID-19 group versus 0% of the infection-naive group. Peak IgG antibody levels were lower but appeared to fall more slowly in the COVID-19 group versus the infection-naive group. Finally, adverse systemic reactions, e.g., fever, headache, and malaise, were more frequent and lasted longer after both the first and second injection in the COVID-19 group than in the infection-naive group. CONCLUSION. Individuals with prior COVID-19 disease demonstrate a robust, accelerated humoral immune response to the first dose but an attenuated response to the second dose of BNT162b2 vaccine compared with controls. The COVID-19 group also experienced greater reactogenicity. Humoral responses and reactogenicity to BNT162b2 differ qualitatively and quantitatively in individuals with prior COVID-19 disease compared with infection-naive individuals. FUNDING. This work was supported by Temple University institutional funds.
    • 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%.
    • Selection analysis identifies unusual clustered mutational changes in Omicron lineage BA.1 that likely impact Spike function

      Institute for Genomics and Evolutionary Medicine (Temple University) (2022-01-18)
      Among the 30 non-synonymous nucleotide substitutions in the Omicron S-gene are 13 that have only rarely been seen in other SARS-CoV-2 sequences. These mutations cluster within three functionally important regions of the S-gene at sites that will likely impact (i) interactions between subunits of the Spike trimer and the predisposition of subunits to shift from down to up configurations, (ii) interactions of Spike with ACE2 receptors, and (iii) the priming of Spike for membrane fusion. We show here that, based on both the rarity of these 13 mutations in intrapatient sequencing reads and patterns of selection at the codon sites where the mutations occur in SARS-CoV-2 and related sarbecoviruses, prior to the emergence of Omicron the mutations would have been predicted to decrease the fitness of any genomes within which they occurred. We further propose that the mutations in each of the three clusters therefore cooperatively interact to both mitigate their individual fitness costs, and adaptively alter the function of Spike. Given the evident epidemic growth advantages of Omicron over all previously known SARS-CoV-2 lineages, it is crucial to determine both how such complex and highly adaptive mutation constellations were assembled within the Omicron S-gene, and why, despite unprecedented global genomic surveillance efforts, the early stages of this assembly process went completely undetected.
    • Selection analysis identifies unusual clustered mutational changes in Omicron lineage BA.1 that likely impact Spike function

      Institute of Genomic and Evolutionary Medicine (iGEM) (Temple University) (2022-01-18)
      Among the 30 non-synonymous nucleotide substitutions in the Omicron S-gene are 13 that have only rarely been seen in other SARS-CoV-2 sequences. These mutations cluster within three functionally important regions of the S-gene at sites that will likely impact (i) interactions between subunits of the Spike trimer and the predisposition of subunits to shift from down to up configurations, (ii) interactions of Spike with ACE2 receptors, and (iii) the priming of Spike for membrane fusion. We show here that, based on both the rarity of these 13 mutations in intrapatient sequencing reads and patterns of selection at the codon sites where the mutations occur in SARS-CoV-2 and related sarbecoviruses, prior to the emergence of Omicron the mutations would have been predicted to decrease the fitness of any genomes within which they occurred. We further propose that the mutations in each of the three clusters therefore cooperatively interact to both mitigate their individual fitness costs, and adaptively alter the function of Spike. Given the evident epidemic growth advantages of Omicron over all previously known SARS-CoV-2 lineages, it is crucial to determine both how such complex and highly adaptive mutation constellations were assembled within the Omicron S-gene, and why, despite unprecedented global genomic surveillance efforts, the early stages of this assembly process went completely undetected.
    • Sextus chest radiograph severity score correlates to clinical outcomes in patients with COVID-19: A cross-sectional study

      Sun, Justin; Yu, Daohai; Yoo, Kevin; Choi, Robert; Lu, Xiaoning; Standiford, Taylor; Cohen, Gary; Marchetti, Nathaniel; Agosto, Omar; Kumaran, Maruti; Maresky, Hillel; Sun|0000-0002-1879-1598 (2021-11-12)
      The value of chest radiography (CXR) in detection and as an outcome predictor in the management of patients with coronavirus disease-2019 (COVID-19) has not yet been fully understood. To validate a standardized CXR scoring system and assess its prognostic value in hospitalized patients found to have COVID-19 by imaging criteria and to compare it to computed tomography (CT). In this cross-sectional chart review study, patients aged 18-years or older who underwent chest CT at a single institution with an imaging-based diagnosis of COVID-19 between March 15, 2020 to April 15, 2020 were included. Each patient's CXR and coronal CT were analyzed for opacities in a 6-zonal assessment method and aggregated into a “Sextus score.” Inter-reader variability and correlation between CXR and coronal CT images were investigated to validate this scoring system. Univariable and multiple logistic regression techniques were used to investigate relationships between CXR scores and clinical parameters in relation to patient outcomes. One hundred twenty-four patients (median [interquartile range] age 58.5 [47.5–69.0] years, 72 [58%] men, 58 [47%] Blacks, and 35 [28%] Hispanics) were included. The CXR Sextus score (range: 0–6) was reliable (inter-rater kappa = 0.76; 95% confidence interval [CI]: 0.69–0.83) and correlated strongly with the CT Sextus score (Spearman correlation coefficient = 0.75, P < .0001). Incremental increases of CXR Sextus scores of 2 points were found to be an independent predictor of intubation (adjusted odds ratio [95% CI]: 4.49 [1.98, 10.20], P = .0003) and prolonged hospitalization (≥10 days) (adjusted odds ratio [95% CI]: 4.06 [1.98, 8.32], P = .0001). The CXR Sextus score was found to be reproducible and CXR-CT severity scores were closely correlated. Increasing Sextus scores were associated with increased risks for intubation and prolonged hospitalization for patients with COVID-19 in a predominantly Black population. The CXR Sextus score may provide insight into identifying and monitoring high-risk patients with COVID-19.
    • 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 (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)
    • Should I leave this industry? The role of stress and negative emotions in response to an industry negative work event

      Yu, Heyao; Lee, Lindsey; Popac, Iuliana; Madera, Juan M. (2021-04)
      The effects of subjective stress and negative emotions on work have been theorized and widely researched, but the literature has mostly focused on organization-specific contexts. The purpose of the current paper was to understand the impact of subjective stress and negative emotions associated with COVID-19 on employee attitudes and behaviors toward the hospitality industry. In Study 1, qualitative interviews showed that the COVID-19 pandemic is (1) perceived as a negative event affecting the industry, rather than only affecting a particular job or company, and (2) distressful, provoking negative emotions. In Study 2, a quantitative study examined subjective stress and negative emotions associated with COVID-19, as well as industry turnover intentions and industry negative word-of-mouth as responses to the stress and negative emotions associated with the COVID-19 pandemic. The current research underscores the importance of studying work events that impact an industry and attitudes and behaviors toward the industry.
    • Single-component, self-assembling, protein nanoparticles presenting the receptor binding domain and stabilized spike as SARS-CoV-2 vaccine candidates

      Fels Institute for Cancer Research and Molecular Biology (Temple University) (2021-03-19)
      Vaccination against SARS-CoV-2 provides an effective tool to combat the COVID-19 pandemic. Here, we combined antigen optimization and nanoparticle display to develop vaccine candidates for SARS-CoV-2. We first displayed the receptor-binding domain (RBD) on three self-assembling protein nanoparticle (SApNP) platforms using the SpyTag/SpyCatcher system. We then identified heptad repeat 2 (HR2) in S2 as the cause of spike metastability, designed an HR2-deleted glycine-capped spike (S2GΔHR2), and displayed S2GΔHR2 on SApNPs. An antibody column specific for the RBD enabled tag-free vaccine purification. In mice, the 24-meric RBD-ferritin SApNP elicited a more potent neutralizing antibody (NAb) response than the RBD alone and the spike with two stabilizing proline mutations in S2 (S2P). S2GΔHR2 elicited twofold higher NAb titers than S2P, while S2GΔHR2 SApNPs derived from multilayered E2p and I3-01v9 60-mers elicited up to 10-fold higher NAb titers. The S2GΔHR2-presenting I3-01v9 SApNP also induced critically needed T cell immunity, thereby providing a promising vaccine candidate.
    • Smell and taste changes are early indicators of the COVID-19 pandemic and political decision effectiveness

      Pierron, Denis; Pereda-Loth, Veronica; Mantel, Marylou; Moranges, Maëlle; Bignon, Emmanuelle; Alva, Omar; Kabous, Julie; Heiske, Margit; Pacalon, Jody; David, Renaud; Dinnella, Caterina; Spinelli, Sara; Monteleone, Erminio; Farruggia, Michael C.; Cooper, Keiland W.; Sell, Elizabeth A.; Thomas-Danguin, Thierry; Bakke, Alyssa J.; Parma, Valentina; Hayes, John E.; Letellier, Thierry; Ferdenzi, Camille; Golebiowski, Jérôme; Bensafi, Moustafa; 0000-0003-0276-7072 (2020-10-14)
      In response to the COVID-19 pandemic, many governments have taken drastic measures to avoid an overflow of intensive care units. Accurate metrics of disease spread are critical for the reopening strategies. Here, we show that self-reports of smell/taste changes are more closely associated with hospital overload and are earlier markers of the spread of infection of SARS-CoV-2 than current governmental indicators. We also report a decrease in self-reports of new onset smell/taste changes as early as 5 days after lockdown enforcement. Cross-country comparisons demonstrate that countries that adopted the most stringent lockdown measures had faster declines in new reports of smell/taste changes following lockdown than a country that adopted less stringent lockdown measures. We propose that an increase in the incidence of sudden smell and taste change in the general population may be used as an indicator of COVID-19 spread in the population.
    • Social Determinants of Health and Health Disparities: COVID-19 Exposures and Mortality Among African American People in the United States

      Maness, Sarah B.; Merrell, Laura; Thompson, Erika L.; Griner, Stacey B.; Kline, Nolan; Wheldon, Christopher (2020-11-11)
      The coronavirus disease 2019 (COVID-19) pandemic in the United States provides yet another example of the enduring and pernicious effect of social determinants of health (SDH) on African American communities. SDH, as defined by the Healthy People 2020 SDH framework, include domains of economic stability, education, social and community context, health and health care, and neighborhood and built environment.1 Within each domain, key areas represent elements of focus for the decade (Box). Compared with non-Hispanic White people, African American people have higher rates of COVID-19 cases (2.6 times higher), hospitalization (4.7 times higher), and death (2.1 times higher).2-4 Although the pandemic is ongoing, it is not premature to call attention to the root causes of health inequity in the United States that have persisted for decades and are being highlighted in the current crisis.