Browsing by Subject "COVID"
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Item A Comparative Experimental and Computational Study on the Nature of the Pangolin-CoV and COVID-19 Omicron(MDPI, 2024-07-09) Wei, Lai; Song, Lihua; Dunker, A. Keith; Foster, James A.; Uversky, Vladimir N.; Goh, Gerard Kian-Meng; Biochemistry and Molecular Biology, School of MedicineThe relationship between pangolin-CoV and SARS-CoV-2 has been a subject of debate. Further evidence of a special relationship between the two viruses can be found by the fact that all known COVID-19 viruses have an abnormally hard outer shell (low M disorder, i.e., low content of intrinsically disordered residues in the membrane (M) protein) that so far has been found in CoVs associated with burrowing animals, such as rabbits and pangolins, in which transmission involves virus remaining in buried feces for a long time. While a hard outer shell is necessary for viral survival, a harder inner shell could also help. For this reason, the N disorder range of pangolin-CoVs, not bat-CoVs, more closely matches that of SARS-CoV-2, especially when Omicron is included. The low N disorder (i.e., low content of intrinsically disordered residues in the nucleocapsid (N) protein), first observed in pangolin-CoV-2017 and later in Omicron, is associated with attenuation according to the Shell-Disorder Model. Our experimental study revealed that pangolin-CoV-2017 and SARS-CoV-2 Omicron (XBB.1.16 subvariant) show similar attenuations with respect to viral growth and plaque formation. Subtle differences have been observed that are consistent with disorder-centric computational analysis.Item A Study on the Nature of SARS-CoV-2 Using the Shell Disorder Models: Reproducibility, Evolution, Spread, and Attenuation(MDPI, 2022-09-23) Goh, Gerard Kian-Meng; Dunker, A. Keith; Foster, James A.; Uversky, Vladimir N.; Biochemistry and Molecular Biology, School of MedicineThe basic tenets of the shell disorder model (SDM) as applied to COVID-19 are that the harder outer shell of the virus shell (lower PID-percentage of intrinsic disorder-of the membrane protein M, PIDM) and higher flexibility of the inner shell (higher PID of the nucleocapsid protein N, PIDN) are correlated with the contagiousness and virulence, respectively. M protects the virion from the anti-microbial enzymes in the saliva and mucus. N disorder is associated with the rapid replication of the virus. SDM predictions are supported by two experimental observations. The first observation demonstrated lesser and greater presence of the Omicron particles in the lungs and bronchial tissues, respectively, as there is a greater level of mucus in the bronchi. The other observation revealed that there are lower viral loads in 2017-pangolin-CoV, which is predicted to have similarly low PIDN as Omicron. The abnormally hard M, which is very rarely seen in coronaviruses, arose from the fecal-oral behaviors of pangolins via exposure to buried feces. Pangolins provide an environment for coronavirus (CoV) attenuation, which is seen in Omicron. Phylogenetic study using M shows that COVID-19-related bat-CoVs from Laos and Omicron are clustered in close proximity to pangolin-CoVs, which suggests the recurrence of interspecies transmissions. Hard M may have implications for long COVID-19, with immune systems having difficulty degrading viral proteins/particles.Item Anime Convention Attendance in Response to Covid-19(Journal of Anime and Manga Studies, 2022-12-14) Alberto, Maria; Tringali, BillyThe following report is meant to be paired with the dataset collected through the “Anime Conventions and COVID-19” survey. Designed by Maria K. Alberto and Billy Tringali, this survey collected participants’ thoughts about their involvement in and perception of anime conventions before, during, and after the Covid-19 pandemic lockdowns. Both the dataset and associated survey questions can be found in the supplemental files paired with this report, or downloaded through the Hive, the University of Utah’s Research Data Repository. See: “Dataset for: Survey of Anime Convention Attendance in Response to Covid-19” at https://hive.utah.edu/concern/datasets/qj72p722rItem Can Multisystem Inflammatory Syndrome in Children Be Managed in the Outpatient Setting? An EHR-Based Cohort Study From the RECOVER Program(Oxford University Press, 2023) Jhaveri, Ravi; Webb, Ryan; Razzaghi, Hanieh; Schuchard, Julia; Mejias, Asuncion; Bennett, Tellen D.; Jone, Pei-Ni; Thacker, Deepika; Schulert, Grant S.; Rogerson, Colin; Cogen, Jonathan D.; Bailey, L. Charles; Forrest, Christopher B.; Lee, Grace M.; Rao, Suchitra; RECOVER consortium; Pediatrics, School of MedicineUsing electronic health record data combined with primary chart review, we identified seven children across nine participant pediatric medical centers with a diagnosis of Multisystem Inflammatory Syndrome in Children (MIS-C) managed exclusively as outpatients. These findings should raise awareness of mild presentations of MIS-C and the option of outpatient management.Item A Case Study of Safe and Cost-Effective Hospital HVAC Strategies(2022-08-02) Caesar, Jeffrey; Ray, Matthew Veto; Koo, Dan; Dalir, HamidThe pressures of healthcare facilities to keep patients safe while also maintaining financial viability have been felt in recent years amongst industry leaders. The impacts COVID has had on patient safety and planning has in any way fast-tracked patient safety progress, but certainly at a financial cost. As hospital leaders and facility leaders attempt to grapple with these realities, a facility's operating strategy that addresses both safety and cost should be employed. The below study aims to solve two issues facing hospital facility leadership in regards to the facilities’ HVAC system. The first issue is how to decrease energy consumption and operating expenses in light of industry pressures to improve the financial outlook and secondly, how to increase patient safety as a direct result of COVID-19 realities. Increasing safety and ultimately flexibility can many times increase costs, so utilizing the most appropriate and tested techniques that follow patient safety protocols will be necessary. The importance of this study cannot be understated. As with any healthcare system, improving patient outcomes are at the heart of the industry and especially in light of our recent pandemic. The fundamental question as to how facilities can keep patients safer while simultaneously reducing energy consumption is a tough question to answer, but manageable due to both recent industry experience and up-to-date research on the topic. The methodology will be to conduct a straightforward cost benefit analysis that takes into account both patient safety and energy consumption. The first step will be to gather baseline data for Lutheran Hospital’s HVAC system to gauge current system performance vs. benchmarked performance. Next, the data will inform us as to what strategies to implement to both curb costs and increase patient safety. The third step will be to implement those strategies where possible and measure their benefits. Lastly, a conclusion will be made as to what long-term solutions will be most useful to both this hospital and the other hospitals within Lutheran Health Network.Item Coronavirus disease 2019-associated nephropathy in an African American patient: a case report and review of the literature(BMC, 2023-04-07) Dhillon, Vijaypal S.; Alkashash, Ahmad; Viquez‑Beita, Karolina; Pathology and Laboratory Medicine, School of MedicineBackground: Acute kidney injury is now recognized as a common complication of coronavirus disease 2019, affecting up to 46% of patients, with acute tubular injury as the most common etiology. Recently, we have seen an increase in cases of collapsing glomerulonephritis in patients with coronavirus disease 2019, also known as coronavirus disease 2019-associated nephropathy. It has been noted to be seen with a higher incidence in African American patients who are carriers of the APOL1 variant allele. Case presentation: A 47-year-old African American male with a past medical history of asthma presented to the emergency department with complaints of intermittent chest pain, shortness of breath, and worsening confusion. On admission, he was found to be hemodynamically stable, but labs were significant for elevated creatinine and blood urea nitrogen, signifying acute kidney injury. He was admitted and taken for emergent dialysis. During his hospitalization, he was found to be positive for coronavirus disease 2019. Renal biopsy was done, which showed collapsing glomerulopathy, and the patient continues to require outpatient dialysis after discharge. Conclusion: Collapsing glomerulonephritis has emerged as a complication in patients with coronavirus disease 2019. This condition should be particularly suspected in African American patients who present with acute kidney injury, nephrotic-range proteinuria, and who are positive for coronavirus disease 2019. Current treatment options are limited to supportive treatment and renal replacement therapy. More clinical cases and trials are needed to better understand and improve therapeutic outcomes in these patients.Item Leadership Changes to Support Healthcare Providers with Long COVID Care(2025-04) Weideman, Angela Katherine; Czabanowska, Katarzyna; Bigatti, Silvia; Modji, KomiObjective: To explore how public health leaders and long COVID stakeholders from the Midwest United States can best support healthcare providers in providing long COVID care and how they can help ease the burdens of such care. Data sources and study setting: Qualitative interviews with 34 long COVID stakeholders from the Midwest region of the United States, from 15 different stakeholder groups, were collected from December 2024 to February 2025. Study Design: The research design was a qualitative study in which key informant interviews were conducted with stakeholders of long COVID using a semi-structured interview. Data collection: Semi-structured, one-on-one interviews were conducted virtually using Microsoft teams, and interviews were audio recorded and transcribed using Microsoft teams. Interviews were then coded using NVivo for inductive coding, used to identify and describe themes. Principal findings: The challenges identified related to diagnosis, access to care, provider concern, communication, and treatment. Stakeholders identified that they have impact and influence related to helping patients get to diagnosis and treatment more quickly, setting or supporting policies, making long COVID a priority in their organizations, making it easier for people to access long COVID care, and to support the people who are giving long COVID care. Numerous strategies were offered by stakeholders for supporting healthcare providers who are providing long COVID care. These include better characterization of the disease, increased treatment options, increased prevention efforts, advocacy, communication strategies, support for providers, collaboration with stakeholders, policy development, and learning from the success of advancement of care for other chronic conditions. Conclusion: Long COVID is a novel condition that requires change leadership support especially in the areas of diagnosis, access to care, communication, treatment, and provider knowledge and relations. It will take a multidisciplinary approach from a variety of stakeholders to create and implement a plan to support healthcare professionals who provide long COVID care. If these changes can be implemented and maintained, those who are suffering with long COVID symptoms can get to diagnosis and treatment more quickly and receive better quality care and treatment. This will have a positive impact on long COVID patients, their family members, employers, schools, medical professionals, health systems, governments, and the economy.Item Techniques and Strategies to Optimize Efficiencies in the Office and Operating Room: Getting Through the Patient Backlog and Preserving Hospital Resources(Elsevier, 2021) Meneghini, R. Michael; Orthopaedic Surgery, School of MedicineThe effects of the coronavirus disease 2019 pandemic are pervasive and have decreased the volume of hip and knee arthroplasty procedures since the mandated cessation of elective surgical procedures at the height of the pandemic in early 2020. Therefore, a backlog of patients in need of these elective procedures is a probable consequence and increased productivity and efficiency in patient care delivery is essential now and into the future. This article outlines multiple strategies and techniques to develop and optimize efficiency in the hip and knee arthroplasty practice. Techniques for increasing surgical efficiency are detailed, along with perioperative strategies in the hospital, ambulatory surgery center, and office settings are outlined and discussed.Item Validity evidence for an instrument for cognitive load for virtual didactic sessions(Wiley, 2022-02-01) Hickam, Grace; Jordan, Jaime; Haas, Mary R. C.; Wagner, Jason; Manthey, David; Cico, Stephen John; Wolff, Margaret; Santen, Sally A.; Emergency Medicine, School of MedicineBackground: COVID necessitated the shift to virtual resident instruction. The challenge of learning via virtual modalities has the potential to increase cognitive load. It is important for educators to reduce cognitive load to optimize learning, yet there are few available tools to measure cognitive load. The objective of this study is to identify and provide validity evidence following Messicks' framework for an instrument to evaluate cognitive load in virtual emergency medicine didactic sessions. Methods: This study followed Messicks' framework for validity including content, response process, internal structure, and relationship to other variables. Content validity evidence included: (1) engagement of reference librarian and literature review of existing instruments; (2) engagement of experts in cognitive load, and relevant stakeholders to review the literature and choose an instrument appropriate to measure cognitive load in EM didactic presentations. Response process validity was gathered using the format and anchors of instruments with previous validity evidence and piloting amongst the author group. A lecture was provided by one faculty to four residency programs via ZoomTM. Afterwards, residents completed the cognitive load instrument. Descriptive statistics were collected; Cronbach's alpha assessed internal consistency of the instrument; and correlation for relationship to other variables (quality of lecture). Results: The 10-item Leppink Cognitive Load instrument was selected with attention to content and response process validity evidence. Internal structure of the instrument was good (Cronbach's alpha = 0.80). Subscales performed well-intrinsic load (α = 0.96, excellent), extrinsic load (α = 0.89, good), and germane load (α = 0.97, excellent). Five of the items were correlated with overall quality of lecture (p < 0.05). Conclusions: The 10-item Cognitive Load instrument demonstrated good validity evidence to measure cognitive load and the subdomains of intrinsic, extraneous, and germane load. This instrument can be used to provide feedback to presenters to improve the cognitive load of their presentations.