The COVID-19 pandemic has wreaked havoc on lives around the globe. In addition to the primary threat of infection, widespread secondary stressors associated with the pandemic have included social ...isolation, financial insecurity, resource scarcity, and occupational difficulties.
The current study examined the impact of these disruptions on psychological distress during the initial adjustment phase to the pandemic in North America.
A sample of 2463 residents of the US and Canada completed both baseline and follow-up surveys across several weeks between March and May 2020.
Those participants perceiving stress related to higher levels of personal threat to health and to the well-being of family members at baseline reported higher levels of depressive symptoms at follow-up, even after controlling for baseline depressive symptoms. In addition, pandemic-related secondary stressors (social isolation, financial insecurity, occupational difficulty, and resource scarcity) were all independently associated with depressive symptoms at follow-up, controlling for both baseline depression and perceived health threats. The results were robust and held up after controlling for demographic factors. Women, young adults, and those who reported lower income were all at higher risk for subsequent depressive symptoms.
Findings from the present study can help to identify key groups at risk for mental health problems during the pandemic, and indicate actionable areas for targeted intervention.
•Examines mental health during early stages of COVID-19 pandemic in North America.•COVID threat to oneself and loved ones was associated with increased depression.•Secondary pandemic-related stressors were also associated with depression risk.•Women, young adulthood, and low income were also risk factors for depression.
With the advent of Big Data Analytics (BDA) alongside the maturity of specific improvement approaches such as Lean Six Sigma (LSS) and Green Manufacturing (GM), the integration of these initiatives ...to achieve higher environmental performance (EP) is gathering the interest of both researchers and practitioners. The present study builds on the resources based view of capabilities to propose and empirically test a framework exploring whether LSS and GM mediate the relationship between BDA capabilities and EP. A two-stage hybrid Factorial Analysis - Structural Equation Modeling is used to draw insights from 201 industry practitioners from North African companies. The findings confirm the direct influence of BDA on EP and also identify LSS and GM as significant mediating variables that act as a catalyst to boost indirect impacts of BDA on EP. This study can help researchers and practitioners to fully understand and benefit from BDA capabilities and improvement initiatives such as LSS and GM while managing environmental issues. The study discusses theoretical and managerial implications for enhancing the environmental performance of the manufacturing organizations.
We collected and Facial Action Coding System (FACS) coded over 2,600 free-response facial and body displays of 22 emotions in China, India, Japan, Korea, and the United States to test 5 hypotheses ...concerning universals and cultural variants in emotional expression. New techniques enabled us to identify cross-cultural core patterns of expressive behaviors for each of the 22 emotions. We also documented systematic cultural variations of expressive behaviors within each culture that were shaped by the cultural resemblance in values, and identified a gradient of universality for the 22 emotions. Our discussion focused on the science of new expressions and how the evidence from this investigation identifies the extent to which emotional displays vary across cultures.
Autologous hematopoietic cell transplantation, or autotransplantation, is effective in light-chain amyloidosis (AL), but it is associated with a high risk of early mortality (EM). In a multicenter ...randomized comparison against oral chemotherapy, autotransplantation was associated with 24% EM. We analyzed trends in outcomes after autologous hematopoietic cell transplantation for AL in North America.
Between 1995 and 2012, 1,536 patients with AL who underwent autotransplantation at 134 centers were identified in the Center for International Blood and Marrow Transplant Research database. EM and overall survival (OS) were analyzed in three time cohorts: 1995 to 2000 (n = 140), 2001 to 2006 (n = 596), and 2007 to 2012 (n = 800). Hematologic and renal responses and factors associated with EM, relapse and/or progression, progression-free survival and OS were analyzed in more recent subgroups from 2001 to 2006 (n = 197) and from 2007 to 2012 (n = 157).
Mortality at 30 and 100 days progressively declined over successive time periods from 11% and 20%, respectively, in 1995 to 2000 to 5% and 11%, respectively, in 2001 to 2006, and to 3% and 5%, respectively, in 2007 to 2012. Correspondingly, 5-year OS improved from 55% in 1995 to 2000 to 61% in 2001 to 2006 and to 77% in 2007 to 2012. Hematologic response to transplantation improved in the latest cohort. Renal response rate was 32%. Centers performing more than four AL transplantations per year had superior survival outcomes. In the multivariable analysis, cardiac AL was associated with high EM and inferior progression-free survival and OS. Autotransplantation in 2007 to 2012 and use of higher dosages of melphalan were associated with a lowered relapse risk. A Karnofsky score less than 80 and creatinine levels 2 mg/m(2) or greater were associated with worsened OS.
Post-transplantation survival in AL has improved, with a dramatic reduction in early post-transplantation mortality and excellent 5-year survival. The risk-benefit ratio for autotransplantation has changed, and randomized comparison with nontransplantation approaches is again warranted.
In patients with newly diagnosed multiple myeloma, the effect of adding autologous stem-cell transplantation (ASCT) to triplet therapy (lenalidomide, bortezomib, and dexamethasone RVD), followed by ...lenalidomide maintenance therapy until disease progression, is unknown.
In this phase 3 trial, adults (18 to 65 years of age) with symptomatic myeloma received one cycle of RVD. We randomly assigned these patients, in a 1:1 ratio, to receive two additional RVD cycles plus stem-cell mobilization, followed by either five additional RVD cycles (the RVD-alone group) or high-dose melphalan plus ASCT followed by two additional RVD cycles (the transplantation group). Both groups received lenalidomide until disease progression, unacceptable side effects, or both. The primary end point was progression-free survival.
Among 357 patients in the RVD-alone group and 365 in the transplantation group, at a median follow-up of 76.0 months, 328 events of disease progression or death occurred; the risk was 53% higher in the RVD-alone group than in the transplantation group (hazard ratio, 1.53; 95% confidence interval CI, 1.23 to 1.91; P<0.001); median progression-free survival was 46.2 months and 67.5 months. The percentage of patients with a partial response or better was 95.0% in the RVD-alone group and 97.5% in the transplantation group (P = 0.55); 42.0% and 46.8%, respectively, had a complete response or better (P = 0.99). Treatment-related adverse events of grade 3 or higher occurred in 78.2% and 94.2%, respectively; 5-year survival was 79.2% and 80.7% (hazard ratio for death, 1.10; 95% CI, 0.73 to 1.65).
Among adults with multiple myeloma, RVD plus ASCT was associated with longer progression-free survival than RVD alone. No overall survival benefit was observed. (Funded by the National Heart, Lung, and Blood Institute and others; DETERMINATION ClinicalTrials.gov number, NCT01208662.).
This research reports thermoset composites reinforced with cotton and polyester fibers (recovered from pre‐consumer textile waste). The carded web of cotton and polyester fibers and epoxy resin were ...used to develop the composites using the compression molding technique. The polyester/epoxy composites show average tensile and impact strength higher than cotton/epoxy composites. However, cotton/epoxy composites show average flexural strength higher than polyester/epoxy composites. The bearing strength in a pinned joint for polyester/epoxy composites is higher than cotton/epoxy composites. The equilibrium water content of polyester/epoxy composites was found much less than the corresponding cotton/epoxy composite. The cotton/epoxy and polyester/epoxy composites are thermally stable enough.
Development of thermoset composites using waste cotton and polyester fibres. Effect of fibre volume fraction on the mechanical properties of cotton/epoxy and polyester/epoxy composites. Effect of water absorption on mechanical properties of cotton/epoxy and polyester/epoxy composites. Effect of composite thickness on mechanical properties of cotton/epoxy composites. Water absorption and thermogravimetric properties of cotton/epoxy and polyester/epoxy composites.
Objective. There is a wide range in the estimates of cost of asthma that are available in the literature. Given the growing prevalence of asthma and its associated healthcare resource use in the ...United States (U.S.), it is important to obtain current and precise cost estimates attributable to asthma treatment. The objectives of this study were to estimate the incremental direct expenditures associated with asthma in the U.S. Methods. Retrospective analysis was conducted using the 2004 Medical Expenditure Panel Survey (MEPS) data that are representative of the civilian non-institutionalized population of the U.S. Asthma respondents were identified as those with International Classification of Diseases-9-Clinical Modification (ICD-9-CM) diagnosis codes for asthma in 2004 or those who had a self-report of having asthma in 2004. Incremental total expenditures and expenditures for various categories of resource use including physician office visits, emergency room visits, outpatient visits, inpatient visits, medications, and other medical visits associated with asthma were estimated separately in children (age < 18 years) and in adults (age ≥ 18 years) using generalized linear regression models. The models were adjusted for covariates including age, gender, race, ethnicity, education, marital status (for age group ≥ 18 years), geographic region, insurance status, and comorbidities. Results. The prevalence of asthma among children and adults in 2004 was estimated at 8.7% (6.4 million persons) and 6.72% (14.8 million persons), respectively. The annual adjusted mean incremental total expenditure associated with asthma was $1,004.6 (SE: $326.1; p = 0.002) per person among children and was $2,077.5 (SE: $544.5; p < 0.0001) per person among adults, after adjusting for covariates. Prescription medications and physician office visits were the major drivers of total expenditures and constituted approximately 38% and 49% of the total incremental expenditures for asthma in children and adults, respectively. Inpatient visit expenditures were high in both age groups but were not significantly different from zero. Conclusion. Given the prevalence of asthma among U.S. children and adults and its associated incremental expenditures, the annual direct medical expenditure attributable to asthma treatment is estimated at approximately $37.2 billion in 2007 U.S. dollars representing a significant portion of healthcare resource use in the U.S.
ObjectiveThis study examined profile and treatment outcomes of young patients with tuberculosis (TB) registered at a district TB centre under the National TB Elimination Programme in Faridabad ...district of Haryana state in India.MethodsIn this secondary data analysis, we studied the records of young TB patients aged 15–24 years registered under a TB programme during October 2013–December 2017 in Faridabad district of Haryana state.ResultsWe analysed records of 5257 young patients with TB. Majority (58.7%) were patients with pulmonary TB and most of them (83.6%) were registered as new patients. Majority of the young patients with TB (93.2%) had a successful treatment outcome, and patients having sputum result 2+ or less and patients who did not have a previous history of TB were found to be significantly associated with a successful treatment outcome on multivariable analysis.ConclusionThere was a high treatment success rate noted in young patients with TB. More focus is needed to patients having a history of TB and sputum result >2+. Targeted interventions can be designed for these groups in future programmatic strategies to reduce disease burden in this section of young population.
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