This version of BIP! Finder aims to ease the exploration of COVID-19-related literature by enabling ranking articles based on various impact metrics.
Last Update: 18 - 01 - 2023 (628506 entries)
Popularity: Citation-based measure reflecting the current impact.
Influence: Citation-based measure reflecting the total impact.
Reader Attention: The current number of Mendeley readers.
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*More details on these impact measures can be found here.
Exceptional score (in top 0.01%).
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CORD-19 dataset(1) (list of papers)
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PMC & PubMed (citations)
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| Title | Venue | Year | Impact | Source | |
|---|---|---|---|---|---|
| 6001 | Ebolavirus: Infection, Vaccination and Control Members of the genus Ebolavirus (family Filoviridae) are among the deadliest viral pathogens spread throughout the world with severe rate of mortality, at least 90% in some outbreaks. Their virions are filamentous and enveloped with enclosed negative-sense single-stranded RNA genome. The genome potentially expresses seven structural and nonstructural proteins. The replication cycle is complex consisting of multiple molecular processes and interactions with human-host factors and proteins. Due to high mortality rate of infection, the studies regarding cure is still infancy. This review covers the current understanding of the virus replication cycle and vaccine development, and herbal treatments to control Ebola covering the available literature on the subject. | Mol Gen Microbiol Virol | 2022 | CORD-19 | |
| 6002 | Product News SECO/WARWICK to Deliver Furnace for Hardening Aviation Steel SECO/WARWICK, Meadville, Pennsylvania, will deliver a Vector vacuum furnace to one of the largest European machinery groups. We are searching for metal-oxide supports with a high density of sites that interact strongly with catalytically active metal atoms, said Zdenek Dohnálek, a PNNL chemist who studies the detailed structure and function of catalysts. Graph: ORNL researchers used neutrons at the lab's Spallation Neutron Source to analyze modified high-entropy metal alloys with enhanced strength and ductility, or the ability to stretch, under high-stress without failing. [Extracted from the article] Copyright of Journal of Failure Analysis & Prevention is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.) | N/A | 2022 | CORD-19 | |
| 6003 | At-home medical student simulation: achieving knot-tying proficiency using video-based assessment PURPOSE: Due to the pandemic, we restructured our medical student knot-tying simulation to a virtual format. This study evaluated curriculum feasibility and effectiveness. METHODS: Over 4 weeks, second-year medical students (n = 229) viewed a video tutorial (task demonstration, errors, scoring) and self-practiced to proficiency (no critical errors, < 2 min) using at-home suture kits (simple interrupted suture, instrument tie, penrose drain model). Optional virtual tutoring sessions were offered. Students submitted video performance for proficiency verification. Two sets of 14 videos were viewed by two surgeons until inter-rater reliability (IRR) was established. Students scoring “needs remediation” attended virtual remediation sessions. Non-parametric statistics were performed using RStudio. RESULTS: All 229 medical students completed the curriculum within 1–4 h; 1.3% attended an optional tutorial. All videos were assessed: 4.8% “exceeds expectations”, 60.7% “meets expectations”, and 34.5% “needs remediation.” All 79 needing remediation due to critical errors achieved proficiency during 1-h group sessions. IRR Cohen’s κ was 0.69 (initial) and 1.0 (ultimate). Task completion time was 56 (47–68) s (median [IQR]); p < 0.01 between all pairs. Students rated the overall curriculum (79.2%) and overall curriculum and video tutorial effectiveness (92.7%) as “agree” or “strongly agree”. No definitive preference emerged regarding virtual versus in-person formats; however, 80.2% affirmed wanting other at-home skills curricula. Comments supported home practice as lower stress; remediation students valued direct formative feedback. CONCLUSIONS: A completely virtual 1-month knot-tying simulation is feasible and effective in achieving proficiency using video-based assessment and as-needed remediation strategies for a large student class. | N/A | 2022 | CORD-19 | |
| 6004 | The role of industrial actors in the circular economy for critical raw materials: a framework with case studies across a range of industries In this article, we explore concrete examples of circularity strategies for critical raw materials (CRMs) in commercial settings. We propose a company-level framework for systematically evaluating circularity strategies (e.g., material recycling, product reuse, and product or component lifetime extension) in specific applications of CRMs from the perspectives of specific industrial actors. This framework is applied in qualitative analyses—informed by relevant literature and expert consultation—of five case studies across a range of industries: (1) rhenium in high-pressure turbine components, (2) platinum group metals in industrial catalysts for chemical processing and oil refining, (3) rare earth permanent magnets in computer hard disk drives, (4) various CRMs in consumer electronics, and (5) helium in magnetic resonance imaging (MRI) machines. Drawing from these case studies, three broader observations can be made about company circularity strategies for CRMs. Firstly, there are multiple, partly competing motivations that influence the adoption of circularity strategies, including cost savings, supply security, and external stakeholder pressure. Secondly, business models and value-chain structure play a major role in the implementation of circularity strategies; business-to-business models appear to be more conducive to circularity than business-to-consumer models. Finally, it is important to distinguish between closed-loop circularity, in which material flows are contained within the “focal” actor’s system boundary, and open-loop circularity, in which material flows cross the system boundary, as the latter has limited potential for mitigating material criticality from the perspective of the focal actor. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13563-022-00304-8. | N/A | 2022 | CORD-19 | |
| 6005 | Decoding the rise of Central Bank Digital Currency in China: designs, problems and prospects During the Covid-19 pandemic, there has been a rapid shift in global transaction patterns from offline to online digital payment models, along with a growing interest in the development of Central Bank Digital Currencies (CBDCs) in various countries. This article spotlights the unexamined issue of digital currency regulation by examining the practice and related regulatory rules of the pilot CBDC in China. Beginning with the global design choices of digital currencies, the article comparatively examines the technical design of China’s CBDC, known as e-CNY. It further triggers a rethinking of conventional regulations for the protection of digital currency information by investigating the gap between the actual operation and design of e-CNY, as well as the gap between pilot policies and legal provisions such as the Cybersecurity Law, the Data Security Law, and the Personal Information Protection Law. This article argues that, on the one hand, the legislative balance between the protection of personal information and the regulation of illicit financial activities involved in the “loosely coupled account link” system of e-CNY should be reconsidered. On the other hand, the delineation of rights and responsibilities between dissemination institutions, payment service providers, and end-users needs to be further redefined and clarified. | N/A | 2022 | CORD-19 | |
| 6006 | Mining Resource Corridor development in Nigeria: critical considerations and actions for a diversified and sustainable economic future The low crude oil prices in 2019 add momentum to Nigeria’s need for economic diversification as its foreign earnings come primarily from crude oil sales. As a result, Nigeria is seeking to explore other economic potentials, such as developing a Mining Resource Corridor (MRC) to reduce poverty and assist the country’s sustained growth and development. MRCs catalyse mineral extraction, transportation, processing, and infrastructural development and integrate other sectors of the economy, thus, creating jobs and promoting economic diversification and inclusive growth. However, achieving this requires drawing up an articulated delivery mechanism through a framework strategic implementation plan to attain a strategic diversification away from hydrocarbons to minerals. This article takes an applied research approach to examine the critical considerations and actions that Nigeria should take in developing an MRC to ensure a diverse and sustainable economic future. Additionally, it discusses the lessons Nigeria can learn from two corridors in Mozambique. This study notes that the success of a MRC is a function of, among other things, a skilled and adequately strengthened institution, enabling infrastructure and the participation of communities in the decision-making process of the corridor development. It also includes the support of all levels of government and possible assistance from development partners and donor agencies such as the World Bank. | N/A | 2022 | CORD-19 | |
| 6007 | CRT-200.06 Impact of the COVID-19 Pandemic on Cardiology Services and Catheterization Volumes in the Second Year: A Comparison of 2020 and 2021 at a South Asian Cardiac Centre | JACC Cardiovasc Interv | 2022 | CORD-19 | |
| 6008 | CRT-200.05 Do People With Previous COVID-Positive Diagnosis Have Higher Pulse-Wave Values and Hemodynamic Parameters of Arterial Stiffness? | JACC Cardiovasc Interv | 2022 | CORD-19 | |
| 6009 | CRT-200.09 Myocarditis After COVID-19 Vaccination: A Systematic Review of Case Studies Background: The coronavirus disease of 2019 (COVID-19) is a global pandemic with over 200 million cases and four million deaths worldwide. Anti-COVID-19 vaccinations have had exceptional success in subduing the incidence, prevalence, and disease severity of COVID-19, but rare cases of myocarditis have been reported after COVID-19 vaccinations. Methods: We performed a systematic literature search on PUBMED, MEDLINE, EMBASE, and Cochrane Reviews database from inception to July 18, 2021. Studies were analyzed based on predetermined eligibility criteria. Results: A total of 19 studies containing 73 cases of COVID-19 vaccine-associated myocarditis were catalogued. Mean age was 25 years, and male to female ratio was 17:1. For 87.7% of patients, myocarditis occurred after the second dose. Average time to onset and length of hospitalization were 3.5 days and 5.2 days, respectively. Prognosis was benign with 100% recovery. Chest pain (100%);elevation of troponin (100%) and CRP (94.4%);and ST elevation on EKG (81.4%) were common. NSAIDs (73.5%) were the most used medication, followed by colchicine (50%). Conclusions: Patients with COVID-19 vaccine-associated myocarditis are usually younger males presenting with chest pain 3.5 days after receiving their second dose. Work-up typically shows elevation of troponin and CRP with ST changes in EKG. Diagnosis is made after excluding all other etiologies. Given significant population benefit from COVID-19 vaccination, physicians should continue to encourage vaccination while remaining vigilant of the very rare occurrence of myocarditis following COVID-19 vaccination. [Formula presented] | JACC Cardiovasc Interv | 2022 | CORD-19 | |
| 6010 | CRT-400.06 Prevalence, Clinical Course and Etiology of Viral Myocarditis in the COVID-19 Era Background: Myocarditis is one of the most suspected etiologies in patients with unexplained heart failure (HF). We studied the in-hospital prevalence of viral myocarditis and recognize the etiologic cardiotropic viruses in patients admitted with unexplained HF during the COVID era. Method: This is a prospective observational study. We recruited patients with unexplained HF presenting at a university hospital from 1st October 2020 till 31st March 2021 (Fig.1). Patients were included if they present with unexplained acute HF associated with normal coronary angiography (CA). All patients were subjected to full history and examination, ECG, echocardiography, cardiac magnetic resonance (CMR) and CA. Sera were obtained from all suspected patients for detection of antibodies against the viruses by using ELISA and polymerase chain reaction (PCR). Results: Fifty-one patients fulfilled the inclusion criteria. 72.5% were males with mean age 39±16 years. We classified patients into 2 categories based on CMR results: Group A (CMR positive myocarditis) 12 patient (23.5%) and group B (CMR negative myocarditis) 35 (68.6%) patients. 51% of the patients presented with dyspnea, 27.5% with chest pain, 33.3% had LVEF >50%,19.6% with cardiogenic shock. 65.9% of patients (n=31/47) were associated with antibodies against the common cardiotropic viruses. Parvovirus B19 22 (46.8%) and Coxackie 16 (34%) were observed. 3 patients died at 6 months clinical follow up;91.5% from patients had recovered left ventricular ejection fraction. Conclusion: The in-hospital prevalence of myocarditis was 5 times higher in the COVID era. CMR is a good positive test for the diagnose acute myocarditis. Parvovirus B19 and Coxackie viruses represent most common pathogens in our locality. (Clinical trial registration no=NCT04312490, STDF grant no=26393 ) [Formula presented] | JACC Cardiovasc Interv | 2022 | CORD-19 | |
| 6011 | CRT-200.07 Six-Month Outcomes for COVID-19-Negative Patients With Acute Myocardial Infarction Before Versus During the COVID-19 Pandemic | JACC Cardiovasc Interv | 2022 | CORD-19 | |
| 6012 | CRT-200.04 Mapping the Recovery of Cardiac Services During the Second Year of COVID-19 Pandemic in Iraq Background: Earlier studies reported how significantly COVID-19 impacted the cardiology services globally. Many countries are surfing subsequent waves of COVID-19, yet there is no global data in general nor from Iraq in particular regarding the extent of return of cardiac services to normal during the second year of pandemic, so, we investigated the rate of change in cardiac services during the second year of pandemic in Iraq. Methods: A 23-item online survey was sent via social media to healthcare professionals who were involved in providing cardiac services. Survey focused on rate of change in non-invasive and invasive cardiac services in 2021 compared with 2020 and type of PPE currently used by participants. It also assessed the academic achievements of respondents during pandemic compared to pre-pandemic era. Results: Thirty-two healthcare professionals responded, 15.6% were women, 15.6 % work in COVID-19 designated hospital, 81.3% were interventional cardiologists,9.4% were clinical cardiologists and 9.3% were pharmacists. Respondents were fellows-in training in 54.3%. Transthoracic echocardiography (TTE) and hospital admissions were most reported cardiac services returning to pre-pandemic rate in 25% and 18.8% respectively. Telemedicine was used by 56.3% in outpatient consultations. COVID-19 vaccine was received by 93.8%. Surgical mask was most commonly used PPE(71.88 %). Compared to pre-pandemic, no change in number of academic publications in 37.5% while 46.9% reported decline in their contribution to conferences, 12.5% published COVID-19 related research. Conclusions: With increasingly vaccinated healthcare professionals and during the second year of pandemic there was an increase in the non-invasive cardiac services in Iraq with TTE services were the most reported services that returned to pre-pandemic rate. [Formula presented] | JACC Cardiovasc Interv | 2022 | CORD-19 | |
| 6013 | CRT-200.08 Outcomes of Acute Coronary Syndrome in Patients With Coronavirus 2019 Infection: A Systematic Review and Meta-Analysis | JACC Cardiovasc Interv | 2022 | CORD-19 | |
| 6014 | Hesitant intuitionistic fuzzy algorithm for multiobjective optimization problem Every real-life optimization problem with uncertainty and hesitation can not be with a single objective, and consequently, a class of multiobjective linear optimization problems (MOLOP) appears in the literature. Further, the experts assign values of uncertain parameters, and the expert’s opinions about the parameters are conflicting in nature. There are concerning methods based on fuzzy sets, or their other versions are available in the literature that only covers partial uncertainty and hesitation, but the hesitant intuitionistic fuzzy sets provides a collective understanding of the real-life MOLOP under uncertainty and hesitation, and it also reflects better practical aspects of decision-making of MOLOP. In this context, the paper defines the hesitant fuzzy membership function and nonmembership function to tackle the uncertainty and hesitation of the parameters. Here, a new solution called hesitant intuitionistic fuzzy Pareto optimal solution is defined, and some theorems are stated and proved. For the decision-making of MOLOP, we develop an iterative method, and an illustrative example shows the superiority of the proposed method. And lastly, the calculated results are compared with some popular methods. | N/A | 2022 | CORD-19 | |
| 6015 | Remittances and Labor Supply: Evidence from Tunisia The objective is to present our contribution to the theoretical literature through a simple theoretical model dealing with the effect of remittances on the labor market of the origin countries and on the other hand to test this relationship empirically in the case of Tunisia. The methodology used consists of estimating a panel of the nine main destinations of the Tunisian migrants in Europe between 1997 and 2017. The empirical results show that the main factors explaining the decision to emigrate are the economic factors related mainly to the income differential, the demographic factors related to the differential age structure of the origin and host populations, and the cultural factors linked basically to the language mastery. Indeed, the migrant stocks are one of the main determinants of the remittances to Tunisia. But there are other variables that do not lack importance such as the economic conditions linked by the host countries. This shows that Tunisian migrants react more to economic conditions in European countries than in Tunisia. The economic situation of European countries dominates the number of emigrants as an explanatory factor for the amount of transfers from Tunisian emigrants. Similarly, the results confirm that an increase in remittances significantly reduces the demand for employment and therefore increases the unemployment rate. This positive correlation reveals that the impact of demographic changes on the effect of remittances occurs through an increase in unemployment due to the aging of the population, which coincides with the case of Tunisia going through a demographic transition period. | N/A | 2022 | CORD-19 | |
| 6016 | Developing a Green Bonds Market: Lessons from China Since its launch in 2016, China’s green bonds market has amassed a significant size and is currently ranked as the second largest in the world. This paper takes a pioneering step to analyze how a transitional economy can develop a burgeoning green bonds market within a short period, using China as a case study. It concludes that the Chinese government plays an instrumental but also evolving role in this process. The carefully designed use of government mechanisms in the context of unique government structures can constructively facilitate the growth of a green bonds market. At the emerging stage of this unique market, the government can play an active role in designing a conducive regulatory environment through law and policy, providing the necessary financial infrastructure and appropriate incentives for investors and green bond issuers. Government intervention is warranted at this stage, given the special characteristics of the green market, in particular, the desired positive externalities on environmental protection and climate change. In China, such a regime is implemented with a focus on inter-ministerial, central-local and international collaboration, centralized policy-making, and alignment of green goals with performance assessment of local officials. However, as the green bonds market matures, this paper suggests a transition towards a market-oriented model where the government should assume a limited role, providing funding and monitoring, and letting market forces play a greater role in achieving market efficiency. Unleashing the potential of market forces can mitigate several of the challenges faced by a top–down approach. This paper also examines the challenges that have surfaced in China, including low-quality information disclosure and under-utilization of green bonds financing by private enterprises. In response, several solutions are proposed to address these specific challenges. | N/A | 2022 | CORD-19 | |
| 6017 | Adrenal haemorrhage and infarction in the setting of vaccine induced immune thrombocytopenia and thrombosis after SARS-CoV-2 (Oxford-AstraZeneca) vaccination SUMMARY: Rare cases of vaccine-induced Immune thrombocytopenia and thrombosis (VITT) are being identified after vaccination with the SARS-CoV-2 Oxford–AstraZeneca vaccination. We report on two such patients with associated adrenal involvement, which is now being recognised. Both patients presented with abdominal pain, back pain and vomiting. Case 1 was a 46-year-old male who had received the first dose of the Oxford–AstraZeneca vaccination 8 days earlier. Imaging demonstrated a number of serious thrombotic complications including evolving bilateral adrenal haemorrhage (right adrenal haemorrhage identified at presentation, with the left-sided changes only evident on day 4 of the admission). Case 2 was a 38-year-old female who had received the first dose of Oxford–AstraZeneca vaccination 11 days prior. Imaging demonstrated left renal vein thrombosis and left adrenal infarction. VITT was diagnosed in both cases given these changes and other consistent haematological findings. Both patients were treated empirically for adrenal insufficiency, a diagnosis subsequently confirmed in case 1. We report these two cases of VITT presenting with adrenal complications (haemorrhage and infarction) after Oxford–AstraZeneca vaccination to highlight the association and the need for prompt management of co-existing adrenal insufficiency, especially given the potential for evolving adrenal involvement. LEARNING POINTS: Adrenal complications (thrombosis/infarction/haemorrhage) may develop as a part of vaccine-induced immune thrombocytopenia (VITT) after SARS-CoV-2 Oxford–AstraZeneca vaccination. Evolving adrenal involvement is possible and ongoing assessment is required to identify this promptly. Cortisol levels may be difficult to interpret when assessing for adrenal insufficiency, given high doses of corticosteroids may be used to manage VITT. Clinicians should have a low threshold for starting empirical replacement with corticosteroids until reliable assessment of adrenal function can be performed. | Endocrinol Diabetes Metab Case | 2022 | CORD-19 | |
| 6018 | CURIE: Towards an Ontology and Enterprise Architecture of a CRM Conceptual Model Companies face the challenge of managing customer relationships (CRM) in a context marked by a drastic digital transformation and unbridled evolution of consumer behavior, exacerbated by the COVID-19 pandemic. The customer is more demanding, has access to the global market and interacts with companies through multiple digital channels, such as email, social networks, mobile apps or instant messaging. In this situation, the success of a CRM implementation highly depends on information technology and the applications used. To harmonize this new business context with the development of information systems (IS), a suitable CRM ontology and enterprise architecture (EA) is needed. While an ontology-based conceptual model provides a unifying framework, aids sharing and reusing knowledge, and facilitates communication within a domain, an EA-based model unequivocally describes, analyzes, and visualizes how an organization should operate from the perspective of business, application, and technology. The purpose of the paper is the proposal of CURIE-O, a CRM OntoUML UFO-based ontology, together with CURIE-EA, a CRM ArchiMate-based EA to serve business managers and IS specialists an updated unifying framework of reference in the CRM domain as well as a highly efficient tool to support application development and maintenance in this changing and increasingly digital context. Modeling has proven to be an essential element to achieve high-performance information systems. In order to apply the ontology and the EA proposed here, the authors developed a CRM task management application prototype that was implemented as a case study in a consulting company. The methodology followed was design science research (DSR), in order to design and validate the artifacts. Within the DSR framework, other complementary research methods have been used, in particular literature research, interviews and focus groups carried out with several hotel chains in Tenerife (Canary Islands). The main existing CRM models in the scientific literature have also been analyzed together with the leading CRM market solutions. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12599-022-00744-0. | N/A | 2022 | CORD-19 | |
| 6019 | Same day discharge after vaginal hysterectomy in the covid-19 pandemic | Am J Obstet Gynecol | 2022 | CORD-19 | |
| 6020 | Effect of the covid-19 pandemic on benign emergent and non-emergent gynecological surgery case volume | Am J Obstet Gynecol | 2022 | CORD-19 | |
| 6021 | Evaluation of telehealth services in a pelvic floor physical therapy clinic | Am J Obstet Gynecol | 2022 | CORD-19 | |
| 6022 | Preoperative counseling regarding COVID-19 vaccination | Am J Obstet Gynecol | 2022 | CORD-19 | |
| 6023 | Secondary Pulmonary Tuberculosis Recognition by 4-Direction Varying-Distance GLCM and Fuzzy SVM Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Our study investigates the recognition of secondary pulmonary (SPTB). A novel F3 model is proposed. The first F means using a four-direction varying-distance gray-level co-occurrence matrix (FDVDGLCM) to analyze the chest CT images; the second F means a five-property feature set (FPFS) from the FDVDGLCM results; the third F means fuzzy support vector machine (FSVM). Besides, a slight adaption of multiple-way data augmentation is used to boost the training set. The 10 runs of 10-fold cross-validation demonstrate that this F3 model achieves a sensitivity of 93.68% ± 1.75%, a specificity of 94.17% ± 1.68%, a precision of 94.17% ± 1.55%, an accuracy of 93.92% ± 1.05%, an F1 score of 93.91% ± 1.07%, an MCC of 87.88% ± 2.09%, and an FMI of 93.92% ± 1.06%. The AUC is 0.9624. The FSVM can give better performance than ordinary SVM. The proposed F3 model is superior to six state-of-the-art SPTB recognition models. | N/A | 2022 | CORD-19 | |
| 6024 | Nature-inspired optimization algorithms and their significance in multi-thresholding image segmentation: an inclusive review Multilevel Thresholding (MLT) is considered as a significant and imperative research field in image segmentation that can efficiently resolve difficulties aroused while analyzing the segmented regions of multifaceted images with complicated nonlinear conditions. MLT being a simple exponential combinatorial optimization problem is commonly phrased by means of a sophisticated objective function requirement that can only be addressed by nondeterministic approaches. Consequently, researchers are engaging Nature-Inspired Optimization Algorithms (NIOA) as an alternate methodology that can be widely employed for resolving problems related to MLT. This paper delivers an acquainted review related to novel NIOA shaped lately in last three years (2019–2021) highlighting and exploring the major challenges encountered during the development of image multi-thresholding models based on NIOA. | N/A | 2022 | CORD-19 | |
| 6025 | The 6 A's model of social worker associations and COVID-19: A preliminary insight This paper offers the 6 A’s model of social worker associations and COVID-19, which includes (i) ‘Apprehend’, (ii) ‘act’, (iii) ‘advocate’, (iv) ‘alliance’, (v) ‘an emphasis on solidarity and resilience’ and (vi) ‘a future prospect’. The model is based on the findings of qualitative analysis of social worker associations’ reports on COVID-19. It also offers insights that can be utilised in similar crises in the future. | Qual Soc Work | 2022 | CORD-19 | |
| 6026 | Humanizing the posthuman: Digital labour, food delivery and openings for the new human during the pandemic Posthuman is a social condition of humans losing control, especially to technological forces, and a cultural framing beyond Enlightenment modernity. Building on the posthuman critique, this article examines digital labour and food delivery platforms during Covid-19 in Asian contexts. The main argument is that, while reinforcing inequalities through algorithm-based discrimination and control, the pandemic also creates openings for progressive change towards the humanizing of the posthuman, through human–non-human assemblage as well as ‘sticky labour’. As such, Covid-19 is more than a crisis that signifies the end of the ‘old normal’. It is, more importantly, another moment when existential crisis triggers innovation in working-class network society, leading to novel discourses, practices, and networks. How and why did this happen? What are the implications for pandemic-era cultural shaping of the digital? These questions will be discussed. | N/A | 2022 | CORD-19 | |
| 6027 | Confronting childism and prioritizing a holistic approach during the COVID-19 crisis This colloquium discusses the crucial need to reconcile the ironic dilemma of enforcing social-distancing measures and social relationships simultaneously during the COVID-19 crisis. Young children have been exposed to multifaceted challenges during this time. However, their well-being, education, and safety have often been overlooked, ignored, or compromised. It is argued that society should abandon childism, which is prejudice and/or discrimination against children, and implement a holistic approach to protect and prioritize children's well-being, fundamental rights, and humanity. | N/A | 2022 | CORD-19 | |
| 6028 | A158 COMPARING CORTIMENT AND PREDNISONE IN ULCERTATIVE COLITIS: A POPULATION-BASED STUDY OF OUTCOMES BACKGROUND: In August 2016 Cortiment® was approved for use in ulcerative colitis (UC) patients in Canada, but not approved for reimbursement; the Canadian Agency for Drugs and Technology in Health cited no comparable benefit for its use over other approved UC medications. Real-world data comparing Cortiment® to other UC medications is limited, especially during the COVID-19 pandemic where the use of steroids is counter-indicated for COVID-19-related outcomes. AIMS: To examine the comparative risk of hospitalization, surgery, and infection after initiation of Cortiment® or oral corticosteroids among UC patients using real-world data METHODS: Using population-based data from Alberta Canada, two cohorts were compared: 1. Patients dispensed Cortiment® and an ICD diagnostic code for UC [9: 556.X; 10: K51.X] (August 1, 2016 to October 31, 2019); and, 2. Validated (algorithm) UC patients dispensed a >30 day supply or >500mg in 24 hours of prednisone/prednisolone (April 1, 2016 to October 31, 2019). All hospitalizations, IBD-surgery, or infections (i.e., pneumonia, c.diff, sepsis, tuberculosis) that occurred 6 or 12 months from initial medication dispensing were identified. Cox-proportional hazard models, with Hazard Ratios (HR), assessed comparative outcomes. Kaplan-Meier survival curves were created, and Poisson regression (or negative binomial) used to assess the Average Monthly Percentage Change (AMPC) with associated 95% confidence intervals (CI). RESULTS: We identified 917 Cortiment® and 2,404 Prednisone patients. Over the study period, prednisone dispensing significantly decreased (AMPC:-2.53% [CI:-2.85,-2.21]) while Cortiment® remained stable. Dispensing of Cortiment® significantly decreased the hazard of hospitalization (all types, except surgery) at 12 months as compared to prednisone, and significantly decreased the hazard of an infection at both 6 and 12 months (Table 1, Fig 1). CONCLUSIONS: The use of Cortiment® in a real-world setting is associated with fewer deleterious outcomes, and its use during a pandemic should be preferred, especially when it’s counterpart can exacerbate negative COVID-19-related outcomes. Table 1 [Image: see text] Kaplan-Meier Survival Curves of 1-year Outcomes: A) All Hospitalizations; B) IBD-Related Hospitalizations; C) IBD-Specific Hospitalizations; and, D) Any Infection. DASHED LINE: Cortiment Cohort SOLID LINE: Prednisone/Prednisolone Cohort FUNDING AGENCIES: Ferring Pharmaceuticals | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6029 | A253 IMPACT OF THE COVID-19 PANDEMIC LOCKDOWN ON PHYSICAL ACTIVITY LEVELS IN CHILDREN AND ADOLESCENTS WITH INFLAMMATORY BOWEL DISEASE IN QUEBEC BACKGROUND: An average daily moderate-to-vigorous physical activity (MVPA) of at least 60 minutes was recommended by the Canadian Guidelines for children. Because of lockdown restrictions during the COVID-19 pandemic, maintaining physical activity levels (PAL) has been a challenge for youth. AIMS: The primary aim of this study was to compare MVPA levels in children with inflammatory bowel diseases (IBD) before and after this period. The secondary aims were to assess clinical factors that might influence any changes in MVPA patterns. METHODS: Patients with IBD, age ≥5 years, were enrolled in a prospective study on PAL starting June 2018 (self-reported questionnaires during outpatient visits). They were then surveyed online at the end of the second lockdown in July-August 2021. PAL were assessed with the Canadian Health Measure Survey Children-Physical Activity Questionnaire. The responses were converted into metabolic equivalents of tasks by using validated tables. Influence of clinical factors of IBD on changes in MVPA was assessed. A multivariate logistic regression was performed to investigate the association between several risk factors and PAL. RESULTS: We included 72 patients (38 males; mean (SD) age 17.0 (2.89) years, 48 (66.7%) diagnosed with Crohn’s disease, 19 (26.4%) with ulcerative colitis, and 5 (6.9%) with indeterminate colitis). At last follow-up, 90.3% were in clinical remission according to validated disease activity score. During summer 2021, 16.7% of patients reached the Canadian PAL target, compared to 38.9% before the pandemic. The median daily duration of MVPA in summer 2021 decreased from 37 (Interquartile range (IQR) = 3–82) to 21 (IQR=3–40) minutes. The proportion of sedentary patients increased by 1.4% (37.5% to 38.9%). The proportion of extremely active patients decreased by 16.7% (27.8% to 11.1%), while moderately active patients increased by 20.9% (8.3% to 29.2%). Age, gender, disease type and activity were not significantly associated with the PAL at baseline or at follow-up. CONCLUSIONS: This study found a significant decrease in PAL and time spent doing MVPA in children with IBD in Quebec following the COVID-19 pandemic lockdown. While the recommended target was far from being met before the pandemic, the gap has widened further during the pandemic. We found no clinical factors associated with the PAL. The impact of low PAL on well-being, weight, disease activity and quality of life will be assessed during the follow-up of this cohort. FUNDING AGENCIES: None | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6030 | A214 SIMPLIFICATION OF CARE FOR HCV IS EFFECTIVE DURING THE COVID PANDEMIC: A RETROSPECTIVE STUDY OF HCV TREATMENT UTILIZING THE BRITISH COLUMBIA HEPATITIS C NETWORK BACKGROUND: The COVID-19 pandemic has impacted healthcare access, including to curative treatment for hepatitis C (HCV) infection in the form of direct-acting antivirals (DAAs). A 49% decrease in DAA dispensations in Canada during the pandemic has been reported, but little is known about these treated populations. AIMS: To explore the patient characteristics and treatment patterns in those who were treated for HCV during the COVID pandemic. METHODS: A retrospective chart review was conducted at one site of utilizing the British Columbia Hepatitis C Network. Only patients included into the database were analyzed. Patients started on treatment between 03/17/2020-03/16/2021 were included as the “pandemic group” and patients from the 03/17/2019-03/16/2020 were included as a comparison “pre-pandemic group”. Data were extracted for clinicodemographic variables, laboratory investigations, treatment start date, regimen, and sustained virologic response at 12 weeks (SVR12). RESULTS: 97 patients were treated during the pandemic compared to 143 patients the year prior, representing a 32% decline. Patients treated during the pandemic were predominantly new referrals (n=70, 72% vs n=64, 45% pre-pandemic, p<0.01) and had fewer total appointments (median 2 per patient vs 4 per patient pre-pandemic, p<0.01). There was a median of 1 in-person visit and 1 telehealth appointment per patient during the pandemic (vs median 2 per patient of each type pre-pandemic). Pandemic patients were younger (mean age 56.0 years vs 59.6 pre-pandemic, p=0.04), and a greater proportion were on opioid agonist therapy (28% vs 13% pre-pandemic, p<0.01). Less transient elastography (TE) was performed during the pandemic (69% vs 89% pre-pandemic). Amongst those with TE scores, a lower proportion of those treated during the pandemic were cirrhotic (13% vs 21% pre-pandemic). During the pandemic, treatment patterns shifted towards more prescriptions for glecaprevir/pibrentasvir (56% of all prescriptions vs 44% pre-pandemic) and sofosbuvir/velpatasvir (37% vs 29% pre-pandemic). There was slightly less use of sofosbuvir/velpatasvir/voxilaprevir at (2% vs 4% pre-pandemic). The proportion of patients who completed lab work for SVR was similar during the pandemic (n=83/97, 85.6%) compared to pre-pandemic (n=120/143, 83.9%). Similarly, SVR12 remained high during the pandemic at 98.7% (vs 99.3% pre-pandemic). Of all 97 patients prescribed DAAs during the pandemic, 92 (94.8%) completed treatment. CONCLUSIONS: Less persons were treated during the COVID pandemic, which may deter progress towards HCV elimination targets. Very high SVR12 and treatment completion rates during the pandemic suggest that patients can be effectively treated with less pre-treatment investigations and fewer appointments. [Image: see text] FUNDING AGENCIES: None | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6031 | A82 DELIVERY OF AMBULATORY CARE DURING THE COVID-19 PANDEMIC IN THE DIVISION OF DIGESTIVE CARE & ENDOSCOPY, HALIFAX, NS BACKGROUND: The COVID-19 pandemic has placed the Canadian healthcare system under substantial strain requiring rapid and systemic changes to healthcare delivery in gastroenterology ambulatory care, including a shift to providing synchronous clinical visits virtually. It is important to describe and evaluate the impact of this care delivery change on patients, providers and the healthcare system in order to improve the quality of virtual care in the future. AIMS: As part of a larger quality improvement initiative, the aim of this project was to better understand the health system impact of the shift from in-person to virtual care delivery in the Division of Digestive Care & Endoscopy in Halifax, NS. METHODS: Using a before-and-after observational study design, outpatient encounters from January-March 2020 (Pre-COVID) were compared to encounters after the pandemic restrictions began April-June 2020 (COVID-Impacted). The primary objective was to compare the proportion of synchronous clinic encounters in the gastroenterology ambulatory space conducted virtually before versus after pandemic restrictions were implemented. Secondary objectives were to determine whether patient, disease, or provider-specific factors were associated with virtual care visits or changed with the implementation of pandemic restrictions. Endoscopic encounters were excluded. Descriptive statistics were used to compare patient and encounter characteristics in the Pre-COVID and COVID-Impacted periods. Multiple logistic regression modeling was used to evaluate the association between patient and provider characteristics and use of virtual care delivery. Unadjusted and adjusted odds ratio with associated 95% CI were estimated. RESULTS: A total of 4,923 unique patients (60.1% Pre-COVID and 39.9% in the COVID-Impacted period) and 6,659 encounters were identified. The proportion of synchronous clinical visits conducted virtually increased after February 2020, increasing from 25% (Pre-COVID) to 91% (COVID-Impacted). The Pre-COVID versus COVID-Impacted periods also differed with respect to median patient age (56 vs. 59, P = 0.000), mean proximity to the hospital (40km vs. 48km, P = 0.007) and proportion of new consults deemed urgent (9.8% vs. 20.0%, P = 0.000). Patients with family physicians, return visits, and patient age greater than 65 years were associated with the use of synchronous virtual care visits. CONCLUSIONS: This project details the abrupt and significant disruption in in-person ambulatory, non-endoscopic digestive care and the dramatic uptake in virtual care delivery as a result of COVID-19 restrictions in Halifax, NS. Future research will explore virtual care use as pandemic restrictions ease to inform how virtual care is integrated into post-pandemic practice to guide new standards of care. [Image: see text] FUNDING AGENCIES: None | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6032 | A85 LIKELIHOOD OF ENDOSCOPY CANCELLATION BASED ON VANCOMYCIN-RESISTANT ENTEROCOCCI (VRE) COLONIZATION STATUS AND INFECTION CONTROL PRACTICES BACKGROUND: “Terminal cleaning” is a practice of rigorous cleaning of endoscopy suite following endoscopies for patients colonized with vancomycin-resistant enterocci (VRE) with the intention of reducing VRE transmission. Such practice entails double-wiping all surfaces including the floor with disinfectants before a non-VRE patient can use the endoscopy room. While intuitive, such time-consuming practice is not supported by evidence and may have unintended negative impact on patient access to timely endoscopic evaluation. AIMS: To determine whether terminal cleaning of endoscopy suite for VRE-colonized patients has any negative impact on inpatient access to timely endoscopic evaluation. METHODS: As part of a quality improvement study, inpatient endoscopy data was gathered over a 3-month period between February 2021 and April 2021 at a tertiary centre. EUS, ERCP, and travel cases outside of the endoscopy suite were excluded. The cancellation rates were compared between VRE-colonized patients and non-VRE patients using the Fisher’s exact test. P value of <0.05 was considered statistically significant. RESULTS: A total of 262 inpatient endoscopic procedures were scheduled and included in the study. Sixty-six (25.2%) of inpatient procedures were cancelled during this period (Table 1). A total of 24 procedures were scheduled for VRE patients, 9 of which were cancelled because of insufficient operating time and two due to concurrent carbapenamase-producing organism carriage and poor bowel preparation. In the non-VRE group, 55 (23.3%) procedures were cancelled for various reasons (Table 1). In subgroup analysis where cancellations related to COVID-19 (n=14) were omitted, VRE patients had a significantly higher rate of procedure cancellations compared to non-VRE patients (42.3% vs. 18.5%; p<0.01). CONCLUSIONS: The overall endoscopy cancellation rate for VRE-colonized patients was higher than those who were non-VRE-colonized. We propose that this is likely secondary to the delays from unnecessary terminal cleans imposed for VRE-colonized patients and await for post-intervention data. FUNDING AGENCIES: None | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6033 | A223 THE CHAIR STAND TEST IS A RELIABLE FRAILTY METRIC FOR PREDICTING WAITLIST MORBIDITY AND MORTALITY IN PATIENTS WITH CIRRHOSIS BACKGROUND: Frailty is defined as a clinical state of increased vulnerability to health and age associated stressors. The liver frailty index (LFI), composed of grip strength, chair stand and balance testing, is an accepted predictor of morbidity and mortality in cirrhosis. With the need for COVID-19 related social distancing, many appointments are being carried out virtually. The chair stand subcomponent of the LFI has the potential to be evaluated virtually, with a high reliability as compared to in-person testing noted in other disease populations. AIMS: To determine if the chair stand test is an independent predictor of morbidity and mortality in patients with cirrhosis. METHODS: 822 adult patients with cirrhosis were prospectively enrolled from five centers (3 in Canada, 1 in the United States, and 1 in India). Inclusion criteria included adult patients with cirrhosis. 787 of these patients completed a chair stand test at baseline, measured as the time (seconds) a patient takes to rise from sitting with their arms folded across their chest five times (measured in-person). The times were divided into 3 categories: >15 seconds, between 10 and 15 seconds, and <10 seconds. Patients who could not complete 5 chair stands were classified in the >15 seconds category. Primary outcome was all-cause mortality. Secondary outcome was unplanned all-cause hospital admission. Fine-Gray proportional hazard regression models were used to evaluate the association between the chair stand time and the outcomes. We adjusted for baseline age, sex, and MELD score and accounted for liver transplantation as a competing risk. Cumulative incidence functions were used to create a graphical representation of the survival analysis. RESULTS: Patients were divided into three groups: group 1, <10 seconds (n = 276); group 2, 10–15 seconds (n = 290); and group 3, >15 seconds (n = 221). Mortality was increased in group 3 in comparison to group 1 (HR 3.21, 95% CI: 2.16–4.78, p<0.001). Similarly, the hazard of non-elective hospitalizations was higher in group 3 in comparison to group 1 (HR 2.24, 95% CI: 1.73–2.91, p<0.001). Overall, patients with chair stand times greater than 15 seconds had increased all-cause mortality (HR 2.78, 95% CI 2.01–3.83, p<0.001) and non-elective hospitalizations (HR 1.84, 95% CI 1.48–2.29, p<0.001) when compared to patients with times less than 15 seconds. CONCLUSIONS: A time to complete 5 chair stands of >15 seconds predicts morbidity and mortality in patients with cirrhosis. This test shows promise as a frailty measure that could be evaluated over a virtual platform. [Image: see text] FUNDING AGENCIES: None | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6034 | A45 INFLIXIMAB IN COMBINATION WITH AN IMMUNOMODULATOR IS ASSOCIATED WITH AN ATTENUATED ANTIBODY RESPONSE TO BNT162B2 SARS-COV-2 VACCINE IN PEDIATRIC INFLAMMATORY BOWEL DISEASE PATIENTS BACKGROUND: Adult data have shown that Infliximab (IFX) impairs the antibody response to a single dose of the mRNA-BNT162b2 SARS-CoV-2 vaccine in patients with inflammatory bowel disease (IBD). The true impact of IFX on SARS-CoV-2 vaccine efficacy in pediatric IBD (PIBD) patients is unknown. AIMS: To evaluate the humoral immune response to the BNT162b2 SARS-CoV-2 in PIBD patients treated with anti-tumor necrosis factor (TNF) therapy. METHODS: PIBD patients treated with anti-TNF therapy either alone or in combination with an immunomodulator, who received at least one dose of the BNT162b2 SARS-CoV-2 vaccine, were prospectively enrolled from 1st June 2021 at BC Children’s Hospital. Serum antibody levels for [spike (S) protein and receptor-binding domain (RBD)] were determined at baseline and 28 days after their first and second vaccine doses. Antibody responses were assessed using multiplex serology IgG assay against four SARS-CoV-2 antigens: S-protein, RBD, N-terminal domain (NTD) and N-protein using the SARS-CoV-2 Panel 2 (Meso Scale Diagnostics). RESULTS: Forty-two PIBD patients received a single dose of BNT162b2 (median age 14.5yrs (IQR 14–16); 43% female; 79% crohn’s disease, 21%, ulcerative colitis). Of those on IFX monotherapy (43%), both S-protein and RBD antibody concentrations 28 days post BNT162b2 were comparable to healthy adult controls (n=20, median age: 36yrs (IQR 29–40); 65% female) who had received one dose of BNT162b2 (p = 0.07) [Figure 1]. In PIBD patients on IFX in combination with either azathioprine or methotrexate (57%) both S-protein and RBD antibody concentrations were significantly lower than controls after 1 dose of BNT162b2 (p = 0.0003) [Figure 1]. In the PIBD cohort (n=27) who received 2 doses of BNT162b2 vaccine (median age 14yrs (IQR 14–16);41% female;63% crohn’s disease, 37% ulcerative colitis; median interval between doses 56 days (IQR 22–105)), there was no difference in antibody response after 2 doses compared to healthy adult controls (n=14, median age: 44 years (IQR 36–51); 29% female) whether they were on IFX monotherapy (41%) or in combination with an immunomodulator (59%) [Figure 1]. CONCLUSIONS: We provide evidence of an attenuated antibody response in PIBD patients on IFX in combination with an immunomodulator after a single dose of BNT162b2. However, our data show a robust antibody response in PIBD patients, despite their infliximab treatment, after two doses of BNT162b2 vaccine. Our results are consistent with adult IBD data and highlight the importance of administering the second vaccine dose to achieve protection in this vulnerable patient population. Long-term follow-up to assess longevity of vaccine protection is warranted. FUNDING AGENCIES: None | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6035 | A129 CYP2C19 PHARMACOGENETIC TESTING IN pediatric PATIENTS WITH EOSINOPHILIC ESOPHAGITIS INFLUENCES DOSING OF PROTON-PUMP-INHIBITORS AND RESPONSE TO THERAPY BACKGROUND: Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder that can be treated with a proton pump inhibitor (PPI). Pharmacogenetics (PGx) is the study of how variations in an individual’s genome influences drug response. Genetic variation in the metabolism gene CYP2C19 can produce differences in enzyme activity which is known to be a contributing factor for therapeutic failure with PPI treatment. Use of 2(nd) generation PPI (rabeprazole) can be beneficial in some as this PPI is less effected by CYP2C19 metabolism. PGx has been studied in PPI therapy for peptic ulcer disease but has not been demonstrated in patients with EoE. AIMS: To describe the CYP2C19 metabolism in patients with EoE on PPI and to estimate the clinical utility of PGx testing in directing subsequent changes in therapy with improvement in remission rates. METHODS: Interim analyses of a single centre, non-interventional, ongoing descriptive pilot study investigating CYP2C19 metabolism in patients with EoE, as part of a larger PGx pilot study and EoE- AHEAD Registry Study at SickKids. Patients with EoE that were newly diagnosed and started PPI or those not in remission on current non-PPI therapy or not in remission on dose PPI (2 mg/kg/day, max 30 mg lansoprazole BID) were included. Active disease was defined as a peak eosinophil count >15/hpf. RESULTS: 37 patients met the inclusion criteria with completed PGx test; mean age was 13 years, 29(78%) were male, and 13(35%) had concurrent atopic disease. PGx testing showed that 12(32%) and 4(11%) were rapid (RM) and ultrarapid metabolizers (URM) respectively (Fig.1), which is significantly higher than the population average. Of this subgroup, 9 started rabeprazole, 3 had a lansoprazole dose increase, and 4 had no changes. Overall, changes in therapy based on PGx testing were made in 29(78%) patients, 8 are awaiting follow-up (Fig 2). Currently, the patients with available repeat biopsy results after PGx test-guided therapy changes is limited due COVID-19 related delays in endoscopies. CONCLUSIONS: The preliminary findings of our study using PGx to guide PPI dosing in pediatric patients with EoE demonstrate that PGx test results lead to a change in clinical management in most patients. In RM and URM, PGx results trigger an adjustment of PPI dose or type could lead to earlier disease remission in PPI-responsive patients, thereby optimizing PPI efficacy. PGx may support dose reduction in poor metabolizers aiming to avoid long-term adverse events. Further correlation with endoscopy and histology findings of patients after PGx-guided therapy changes will follow. Furthermore, it is important to examine if CYP2C19 variant information available before PPI therapy further streamlines an initial phase of the treatment. [Image: see text] FUNDING AGENCIES: Dr. Marcon: J Garfield Campbell Fund, Dr. Hulst: Start-up Funds from the Department of Pediatrics at SickKids | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6036 | A224 COVID-19 INFECTION IN LIVER TRANSPLANT RECIPIENTS: CLINICAL FEATURES, HOSPITALIZATION, AND MORTALITY FROM A CANADIAN MULTICENTRE COHORT BACKGROUND: The COVID-19 pandemic has brought significant challenges to clinicians caring for liver transplant (LT) recipients. Researchers have sought to better understand the risk and clinical outcomes of LT recipients infected with COVID-19 globally, however, there is a paucity of data from within Canada. AIMS: Our multi-center study aims to examine the characteristics and clinical outcomes of LT patients with COVID-19 in Canada. METHODS: We identified a retrospective cohort of adult LT recipients with RT-PCR confirmed COVID-19 from 7 Canadian tertiary care centers between March 2020 and June 2021. Demographic and clinical data were compiled by clinicians within those centers. We identified liver enzyme profile at the time of COVID-19 infection, immunosuppression type and post-infection adjustments, rate of hospitalization, ICU admission, mechanical ventilation, and death. RESULTS: A total of 49 patients with a history of LT and COVID-19 infection were identified. Twenty nine patients (59%) were male, the median time from LT was 66 months (1, 128) and the median age at COVID-19 infection was 59 years (52, 65). At COVID-19 diagnosis, the median ALT was 37 U/L (21, 41), AST U/L was 34 (20, 37), ALP U/L was 156 (88, 156), Total Bilirubin was 11 umol/L (7, 14), and INR was 1.1 (1.0, 1.1). The majority of patients (92%) were on tacrolimus monotherapy or a combination of tacrolimus and mycophenolate mofetil (MMF); median tacrolimus level at COVID-19 diagnosis was 5.3 ug/L (4.0, 8.1). Immunosuppression was modified in 8 (16%) patients post-infection; either the tacrolimus dose was reduced or MMF was held. One patient developed acute cellular rejection which recovered after re-initiation of the prior regimen. Eighteen patients (37%) required hospitalization, 6 (12%) were treated with dexamethasone, and 3 (6%) required ICU admission and mechanical ventilation. Four patients (8%) died due to complications of COVID-19. On univariate analysis, neither age, sex, co-morbidities nor duration post-transplant were associated with risk of hospitalization. CONCLUSIONS: In our national retrospective study, approximately 40% of patients required hospitalization with a mortality rate of < 10%. Previous studies have shown proximity to LT as an independent factor for mortality with COVID-19; the median time from LT for our patients was 5 years, which may explain the lower mortality rate. Of note, the median tacrolimus levels were much lower in comparison to the target of 8–10 ug/L used in the first year post-transplant. As the landscape of COVID-19 changes with vaccination, evolving treatments, and increasing rates of variant transmission, additional studies are required to continue identifying trends in clinical outcomes. FUNDING AGENCIES: None | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6037 | A75 AUTOMATED FOLLOW-UP USING A PATIENT-GUIDED COMPLICATION TRACKING SYSTEM (PACTS): AN UPDATE ON PROGRESS BACKGROUND: In recent years, there has been an increase in automated interventions in medicine. The COVID-19 outbreak has further fueled this rise. In response to the pandemic, Healthcare systems have developed a multitude of technological strategies for case identification and contact tracing. It is in this evolving digital landscape, that a PAtient-guided Complication Tracking System (PACTS) was launched. PACTS allows clinics to track complications using the Short Message Service (SMS). This program also offers opportunities to augment medical services and support patients having complications. Before PACTS can be widely implemented in clinics, research needs to be conducted to investigate its potential as a complication tracking software. AIMS: To assess the outcomes of an automated follow-up program implemented at St. Paul’s Hospital in Vancouver, BC. METHODS: A prospective study was designed to contact outpatients one-week post-procedure using PACTS. This program was delivered in two phases. Stage 1 ran from November 2019-March 2020. During this pilot stage, patients having a colonoscopy or gastroscopy were asked to participate in the study. Stage 2 ran from August 2020-August 2021. For this phase, patients having a colonoscopy, gastroscopy or flexible sigmoidoscopy were automatically enrolled in the study. An independent t-test was completed to assess response rate differences between stages. SMS responses were recorded and patients having unplanned events were contacted by phone to categorize complications. Adverse events (AE) were defined as side-effects requiring telehealth follow-up or emergency room visitation. Severe adverse events (SAE) were classified as complications requiring admission to hospital (>24 hrs). RESULTS: SMS prompts were sent to 6975 patients and the overall mean response rate was 89%. The mean response rates from Stages 1 and 2 were 92% and 88% respectively. The independent t-test revealed a statistically significant difference in response rates between phases, two-sample t(174) = 4.56, p = 9.58 x 10(–6). 498 (8%) of SMS respondents reported having unplanned events. Of these patients, 372 (75%) were reached by phone and 257 (69%) were confirmed to have had a side effect. 65 of these complications were AEs and of these, 3 cases were SAEs. The most common AEs were abdominal pain (37%), bleeding (35%), nausea and vomiting (14%). CONCLUSIONS: The high response rates achieved during this study provide further evidence for the use of automated follow-up systems in medicine. This study also demonstrates the potential of PACTS as a complication tracking software. Future research should devise strategies to optimize the collection of complication data using an SMS-based service. FUNDING AGENCIES: None, NRC | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6038 | A96 RAPID IMPLEMENTATION OF AN EVIDENCE-BASED, VIRTUAL COVID-19 VACCINE EDUCATION CLINIC AT NOVA SCOTIA COLLABORATIVE INFLAMMATORY DISEASE CLINIC (NSCIBD) BACKGROUND: Rapid adaptation of clinical management as well as policy decisions in relation to implementation of COVID-19 vaccination programs for persons living with IBD has been required throughout the pandemic. AIMS: To meet the need for public health-mandated COVID-19 vaccine education for patients living with IBD in Nova Scotia a novel, evidence-based, virtual COVID-19 vaccine educational intervention was developed, implemented, and evaluated. METHODS: An observational, cross sectional, implementation-effectiveness study was conducted at the NSCIBD program between April and July, 2021. The educational intervention consisted of a standardized evidence-based letter describing risks and benefits of COVID-19 vaccine emailed to patients in advance of a virtual clinic appointment. Virtual appointments were offered to all patients contacting the NSCIBD program with questions or concerns about vaccination. During these virtual visits standardized, evidence-based information was provided by a gastroenterologist (n=2) or IBD nurse practitioners (n=2) and patients were provided with an opportunity to address specific disease and treatment related concerns. Following the session, a link to an anonymous questionnaire was distributed via email to evaluate key implementation metrics including satisfaction, appropriateness, usefulness, perceived impact on knowledge and vaccine hesitancy, and recommendations for improvement. Data analysis was descriptive. Group means were expressed as proportions for categorical variables and means for numerical variables. RESULTS: A total of 298 patients participated in a virtual patient education session of which 265 provided a valid email address and invited to participate in the on-line survey. The response rate was 49% (131/265). Before the session, 48.9% (64/131) expressed vaccine hesitancy. Twenty-six percent (35/131) expressed concerns relating to risks versus benefits of COVID-19 vaccines. Ninety-one percent (119/131) of respondents found the education program helpful. The proportion of those willing to get vaccinated rose from 61% (pre) to 86.3% (post). Only 1.5% (2/131) indicated they would not get vaccinated. Seventy-seven percent (101/131) found the written and virtually administered educational content to be satisfactory. Eighty-eight percent (115/131) of respondents were willing to participate in similar types of virtual education offerings in the future. CONCLUSIONS: Implementation of an evidence-based, multidisciplinary, virtual COVID-19 vaccination education intervention was perceived to be feasible, acceptable, and effective by IBD patients. Further research on innovative, evidence-based, multidisciplinary educational interventions and the impact of these interventions on IBD clinical outcomes are needed. FUNDING AGENCIES: None | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6039 | A83 BEST PRACTICES FOR THE PROVISION OF VIRTUAL CARE IN IBD AND BEYOND: A SYSTEMATIC REVIEW OF CURRENT GUIDELINES BACKGROUND: Telemedicine has emerged as a feasible adjunct to in-person care in multiple clinical contexts, including inflammatory bowel disease (IBD), and its role has expanded in the context of the COVID-19 pandemic. However, there exists a general paucity of information surrounding best practice recommendations for conducting specialty or disease-specific virtual care. AIMS: The purpose of this study was to systematically review existing best practice guidelines for conducting telemedicine encounters, both in general and specific to patients with IBD. METHODS: A systematic review of MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) of existing guidelines for the provision of virtual care was performed. Data was synthesized using the Synthesis Without Meta-Analysis (SWiM) guideline, and the AGREE II tool was used to evaluate quality of evidence RESULTS: A total of 60 studies providing guidance for virtual care encounters were included; 52% of these were published during the COVID-19 pandemic. No gastroenterology-specific guidelines were found. The majority (95%) of provider guidelines specified a type of virtual encounter to which their guidelines applied. Of included studies, 65% provided guidance regarding confidentiality/security, 58% discussed technology/setup, and 56% commented on patient consent. 31 studies also provided guidance to patients or caregivers. Overall guideline quality was poor. CONCLUSIONS: General best practices for successful telemedicine encounters include ensuring confidentiality and consent, preparation prior to a visit, and clear patient communication. Future studies should aim to objectively assess the efficacy of existing clinician practices in order to further optimize the provision of virtual care for specific populations, such as patients with IBD. [Image: see text] FUNDING AGENCIES: None | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6040 | A84 SECURE ELECTRONIC DOCUMENT SIGNING UPTAKE IN BIOLOGIC PRESCRIBING FOR IMMUNE MEDIATED DISEASES BACKGROUND: The COVID-19 pandemic drastically impacted workflows in gastroenterology practice. Physicians managing immune-mediated diseases (IMDs) must complete special authorization (SA) and prescription renewal (Rx) forms for patients on biologic therapy. This adds significant administrative burden potentially leading to delays in therapy initiation and care continuity. Historically, document completion has largely been paper-based, with forms faxed between patient support programs (PSPs) and physician offices. Disruption of normal office processes during the pandemic necessitated the movement of existing paper-based workflows online. The use of secure electronic document signing (SEDS) platforms has allowed physicians to receive and complete documents digitally. AIMS: To evaluate the impact of SEDS-based biologic documentation on clinical practice. Objectives were 1) to determine if the use of SEDS platforms increased timeliness of document returns compared to traditional workflows 2) assess whether SEDS usage is acceptable and sustainable and 3) assess MD satisfaction with SEDS platforms. METHODS: This was a retrospective audit of SEDS and paper-based biologic document workflows from a single PSP (Abbvie Care). Outcomes of interest were the number of documents completed monthly using SEDS, new monthly users, and the number of active monthly users between April 1, 2020-March 31, 2021. Time (days) to SEDS completion (vs. paper process) was determined by reviewing timepoint data for SA and Rx documents from May 2019-January 2020 (‘pre- SEDS’) and for SEDS documents from May 2020-January 2021(‘SEDS’). The return time (RT) was defined as the time between date sent to a physician’s office by the PSP to the date returned to the PSP. Documents in the pre-SEDS cohort with a RT exceeding 30 days were excluded RESULTS: In totality, 5573 SA and Rx documents were completed by 383 physicians using the SEDS platform from April 2020-March 2021. A mean of 14.6 (sd 21.8) documents were signed per physician. The number of monthly electronic documents processed increased from 104 in April 2020 to 800 in March 2021. Active monthly users increased from 24 in April 2020 to 213 in March 2021 (31 new users monthly). A total of 19,387 paper documents were processed during the ‘pre-SEDS’ period and 3,317 electronic documents processed in the ‘SEDS’ period. The mean RT in the ‘pre-SEDS’ period was 8.03 days (Sd 8.2) and the ‘SEDS’ period was 1.11 days (sd 2.6). CONCLUSIONS: This data demonstrates acceptability, appropriateness, and improved processing efficiency of a SEDS platform improving timeliness of patient care. Next steps in this research include surveying physicians to understand the work-flow impact of SEDS, functionality, long-term sustainability, satisfaction and impacts on disease related outcomes. FUNDING AGENCIES: None | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6041 | A25 CRITICAL APPRAISAL OF GI ENDOSCOPY CLINICAL PRACTICE GUIDELINES DURING THE COVID-19 PANDEMIC BACKGROUND: Clinical Practice Guidelines (CPGs) are integral during a pandemic, offering guidance to clinicians through uncertainty. Existing literature has established that the need for rapid publication of CPGs during previous infectious disease outbreaks resulted in less rigorous guidelines. CPGs were rapidly developed since the onset of the pandemic in December 2019, providing guidance in gastrointestinal (GI) endoscopy, an area where COVID-19 may pose risk of transmission. AIMS: To evaluate the quality of GI endoscopy guidelines developed during the COVID-19 pandemic and to compare these with (a) endoscopy CPGs developed prior to the pandemic; (b) CPGs for other endoscopic topics unrelated to COVID-19; and, (c) non-endoscopic CPGs published during the pandemic. METHODS: We systematically searched Medline, Embase and Scopus for CPGs published by GI societies from January 1, 2018 to December 31, 2020. A grey literature search was conducted. Two authors screened full-texts. In this interim analysis, CPGs were grouped based on publication year: before 2020, or 2020. Endoscopy CPGs published in 2020 were categorized as COVID or non-COVID related. Two authors independently assessed the CPGs using the AGREE II tool, consisting of six domains for evaluating guidelines. A domain score of 60 was set as a threshold to indicate good quality. RESULTS: There were 70 endoscopy guidelines and 27 CPGs focused on other GI topics. The mean overall scores were 69% (±12%) for endoscopy CPGs published before 2020 (n=28), and 51% (±23%) for CPGs published in 2020 (n=42). For individual AGREE II domains, mean scores for pre-2020 CPGs ranged from 33.11 (±17.39) in Applicability to 81.55 (±10.37) in Clarity of Presentation. For CPGs published during COVID-19, mean domain scores ranged from 34.18 (±10.52) in Applicability to 75.26 (±13.85) in Clarity of Presentation. 21 of 42 CPGs published in 2020 were related to COVID. Mean overall scores were 35% (±20%) for COVID-related CPGs and 67% (±13%) for non-COVID-19 CPGs. For COVID-19 CPGs, scores ranged from 27.88 (±20.31) in Rigour of Development to 69.58 (±10.81) in Scope and Purpose. For non-COVID CPGs, the scores ranged from 37.30 (±8.93) in Applicability to 84.52 (±5.93) in Clarity of Presentation. CONCLUSIONS: The difference in overall scores between COVID-19 endoscopy CPGs and non-COVID endoscopy CPGs may suggest that the urgency to disseminate COVID-19 information decreased CPG quality or completeness of reporting. This interim analysis is limited by the lack of distinction between peer-reviewed CPGs and non-peer reviewed recommendations. Given the importance of CPGs in clinical decision making, it is important to ensure that the rapid development of guidelines does not compromise quality and rigour. FUNDING AGENCIES: None | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6042 | A22 IMPACT OF COVID-19 PANDEMIC ON FOREIGN BODY INGESTION IN CHILDREN AND ADOLESCENTS: A CROSS-SECTIONAL STUDY BACKGROUND: Foreign Body Ingestions (FBI), sometimes associated with severe complications, are a common reason for emergency unit visits in children. In Quebec, since March 2020, the restrictions in response to the COVID-19 pandemic have increased the time children spend at home. We hypothesized that this could contribute to a rise in FBI incidence and severity. AIMS: The primary objective of our study was to evaluate the incidence as well as the clinical presentation of FBI cases seen at CHU Sainte-Justine Children’s Hospital in Montreal (CHUSJ) during the COVID-19 pandemic as compared to the two previous years. Our secondary objectives were to estimate the rate of severe FBI (involving hospitalisations and/or complications) and to evaluate the nature of the foreign bodies that were ingested. METHODS: All children referred to or who presented at CHUSJ for FBI between March 2018 and February 2020 (pre-pandemic) as well as between March 2020 and February 2021 (pandemic) were included (n=690). Cases of food impaction were excluded (n=78). Incidence of FBI was calculated by dividing the number of FBI cases by the total number of emergency department visits per period. Differences between the two groups were analyzed by Student T test or Chi-square test. RESULTS: Between March 2018 and February 2021, 612 patients (median age 3.5 years (1.6–5.9); 54% male) were eligible. The mean monthly number of FBI cases (min-max) in 2020–2021 was 18.6 (9–28), significantly higher than the year 2018 [16.6 (8–22)] and the year 2019 [15.5 (9–24)]; p=0.04. The incidence rate of FBI doubled during the pandemic as compared to the prepandemic group: respectively 57.5/10,000 emergency department visits and 23.2/10,000 visits (p=0.002). Almost one fourth of the cohort was hospitalized. The hospitalization rate (>1 day) was similar between the 2 periods: 8.8% before the pandemic and 7.1% during the pandemic. Digestive endoscopy was performed in 21.5% of cases, a rate similar before and during the pandemic. A total of 3.3% of the children developed complications related to FBI. This rate remained stable between the two periods. The most frequently ingested objects were coins (25.0%), toys (10.8%), button batteries (10.6%), magnets (6.2%), and jewellery (6.2%). There was no significant difference in the nature of FB ingested between the 2 periods although the number of magnet ingestions increased during the pandemic (18 per year vs 10 per year). CONCLUSIONS: The incidence of FBI increased significantly during the pandemic in comparison with the two previous years. The high hospitalization and complications rates, although stable during the pandemic, underline the significant impact of pediatric FBI. FUNDING AGENCIES: None | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6043 | A180 CLINICAL OUTCOMES OF COVID-19 AND IMPACT ON DISEASE COURSE IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE BACKGROUND: The impact of COVID-19 has been of great concern in patients with IBD worldwide, including an increased risk of severe outcomes and/or flare of IBD. AIMS: This study aims to evaluate prevalence, outcomes, the impact of COVID-19 in patients with IBD, and risk factors associated with severe COVID-19 or flare of IBD. METHODS: A consecutive cohort of IBD patients diagnosed with COVID was obtained between March 2020 - April 2021. RESULTS: A total of 3,516 IBD cohort patients were included. 82 patients (2.3%) were diagnosed with COVID infection (median age 39.0, 77% with Crohn’s disease). The prevalence of COVID-19 in IBD was significantly lower compared to the general population in Canada and Quebec (3.5% vs. 4.3%, p<0.001). Severe COVID occurred in 6 patients (7.3%); 2 patients (2.4%) died. A flare of IBD post-COVID infection was reported in 8 patients (9.8%) within 3 months. Age ≥55 years (OR 11.1, 95%CI:1.8–68.0), systemic corticosteroid use (OR:4.6, 95%CI:0.7–30.1), active IBD (OR:3.8, 95%CI:0.7–20.8) and comorbidity (OR:4.9, 95%CI:0.8–28.6) were associated with severe COVID. After initial infection, 61% received vaccinations. CONCLUSIONS: The prevalence of COVID-19 among patients with IBD was lower than the general population. Severe COVID and flare of IBD were relatively rare. Older age, comorbidities, active IBD, and corticosteroid, but not biological therapy were associated with severe COVID. Outcome of COVID-19 in IBD patients, disease course of IBD, and vaccination after COVID infection [Image: see text] FUNDING AGENCIES: None | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6044 | A132 ACHALASIA FOLLOWING A SARS-COV-2 INFECTION: A CASE REPORT BACKGROUND: SARS-CoV-2 is a novel virus currently causing a major pandemic. Recent studies have shown that SARS-CoV-2 has an affinity to ACE2 receptors which are present in the olfactory epithelium as well as the pulmonary and gastrointestinal (GI) systems. It is stipulated that these receptors are responsible for the entry of the virus into cells explaining the respiratory and GI symptoms of this infection. The anosmia related to COVID-19 is likely due to an aberrant immune response to the virus rather than direct damage to the olfactory epithelium. Similarly, achalasia is also believed to result from an aberrant immune response through which there is degeneration of inhibitory neurons in the myenteric plexus. In this case report, we present the first case of achalasia thought to be linked to a SARS-CoV-2 infection in contemporary literature. AIMS: We hypothesize that SARS-CoV-2 caused an aberrant immune response in our patient, leading him to develop achalasia. We hope to expose clinicians to this potential complication of COVID-19, allowing them to consider it sooner in their differential. METHODS: The patient’s file was reviewed to extract the relevant information. A second gastroenterologist’s opinion was obtained on the manometry to confirm the diagnosis of type III achalasia. RESULTS: A 61-year-old man with a medical history of myasthenia gravis, chronic obstructive pulmonary disease, hypothyroidism, and chronic renal failure was treated in our establishment for a SARS-CoV-2 pneumonia. He experienced new severe dysphagic symptoms, regurgitations, and lost 10 pounds during his hospitalization. He also developed anosmia and diarrhea. A CT-scan of his neck and thorax showed no extrinsic compression of his esophagus. No neoplasm was found on his gastroscopy. A barium study was then conducted showing a stagnation of contrast in the distal third of his esophagus. No relaxation of the inferior gastroesophageal sphincter was noted. A manometry was then performed and confirmed a type III achalasia. The mean lower esophageal sphincter residual pressure was elevated at 43.7 mmHg. A calculated 69% of wet swallows were premature contractions with a distal latency value less than 4.5 seconds. The mean distal contractile integral was 13613 mmHg. This corroborates the spastic nature of type III achalasia. CONCLUSIONS: Considering that our patient developed anosmia and knowing its pathogenesis in the context of COVID-19, an inappropriate immune response to SARS-CoV-2 could have equally taken place in the esophagus. This inflammatory response might have caused the degeneration of the inhibitory neurons in the myenteric plexus responsible for the achalasia. Furthermore, given the fact that our patient had diarrhea, this suggests that the virus has a GI tropism supporting our hypothesis. We therefore believe that achalasia may be a potential complication of COVID-19. [Image: see text] High resolution esophageal motility study showing a type III achalasia pattern. FUNDING AGENCIES: None | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6045 | A209 EXPERT CONSENSUS CRITERIA AND PRACTICAL RECOMMENDATIONS FOR PBC CARE IN THE COVID-19 ERA AND BEYOND BACKGROUND: Primary biliary cholangitis (PBC) is a chronic autoimmune cholestatic liver disease that can progress to liver fibrosis and cirrhosis, and requires timely diagnosis, optimal treatment, and risk stratification. Several guidelines for the management of PBC have been published, including the American Association for the Study of Liver Disease (AASLD) and European Association for the Study of the Liver (EASL) Clinical Practice Guidelines, which include goals for standards of PBC care. However, recent audits have identified deficiencies in real-world PBC care. In addition, the global coronavirus (COVID-19) pandemic has generally reduced access to care, diminished healthcare resources and accelerated the use of remote patient management. There is therefore a need for simple, actionable guidance that physicians can implement in order to maintain standards of care in PBC in the new environment. AIMS: A working group of ten PBC specialists from Europe and Canada were convened by Intercept Pharmaceuticals in January 2020 with the aim of defining key criteria for the care of patients with PBC. METHODS: Following the outbreak of the COVID-19 pandemic, based on these criteria, a smaller working group of six PBC specialists developed practical recommendations to assist physicians in maintaining standards of care and to guide remote management of patients. RESULTS: The working group defined five key criteria for care in PBC, encompassing PBC diagnosis, initiation of first line therapy with ursodeoxycholic acid (UDCA), risk stratification on UDCA, symptom management, and initiation of 2L therapy. The group developed 21 practical recommendations for the management of patients with PBC in the COVID-19 environment including modality, frequency and timing of investigations and monitoring. (Figure 1). CONCLUSIONS: The delivery of PBC care during the COVID-19 pandemic carries significant challenges. These consensus criteria and practical recommendations provide guidance for the management of PBC during the pandemic era and beyond. [Image: see text] FUNDING AGENCIES: NoneIntercept Pharmaceutical | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6046 | A100 A PROVINCIAL APPROACH TO ASSESSING ENDOSCOPY PATIENT EXPERIENCE ENHANCES SITE PARTICIPATION AND CANADA-GLOBAL RATING SCALE COMPLIANCE BACKGROUND: The Canada-Global Rating Scale (C-GRS) is a web-based, patient centered endoscopy quality improvement tool. It assesses the quality of services a unit provides in two dimensions: clinical quality and patient experience. Endoscopy units submit results to the Canadian Association of Gastroenterology twice a year. In Alberta, units receive an A, B, C or D grade for each of the 12 C-GRS Items and a C-GRS score. The C-GRS promotes that patient feedback is sought annually. Patient feedback is important because it informs practice improvement opportunities. However, survey creation, distribution, analysis and reporting can be time consuming and costly for an endoscopy unit and is a potential barrier to participation. AIMS: The purpose of this quality improvement project is to demonstrate how a provincial infrastructure, which includes coordination, management and reporting of an endoscopy patient satisfaction survey, can enhance provincial endoscopy unit survey participation and facilitate C-GRS compliance. METHODS: The Digestive Health Strategic Clinical Network (DHSCN), the Alberta Colorectal Cancer Screening Program and Primary Data Support (PDS) collaborated on the Provincial Endoscopy Patient Experience Survey (PEPES) in 2019. An existing paper survey was adapted to meet the needs of the 50 endoscopy units in AB with the addition of an electronic version. Education about the PEPES process was provided via a webinar and site visits. Each unit was responsible for distribution of the surveys to their patients. PDS coordinated the paper survey process and the DHSCN managed the electronic survey submissions. Paper survey results were merged with electronic PEPES data. A summary report was provided to units and shared with each AHS Zone Endoscopy Executive Leadership Team. RESULTS: Provincially coordinated implementation of the PEPES fosters compliance with C-GRS criteria. Participating endoscopy units were able to achieve at minimum 9 C-GRS descriptors and improve their C-GRS score in the following 7 of the 12 C-GRS Items: consent, comfort, equality, booking, privacy, aftercare and feedback. Initial enrollment in the PEPES increased with the onset of provincial coordination (Figure 1). However, subsequent participation was negatively impacted by COVID-19 as many endoscopy units in AB were required to decrease their capacity and redeploy staff. CONCLUSIONS: A provincially coordinated approach to the management of an endoscopy patient experience survey is an effective way to enhance site participation and improve C-GRS scores. Units can focus on actioning survey results, rather than the burden of survey administration. Future work includes comparison of results across sites allowing for potential provincial equity issues to be addressed. [Image: see text] FUNDING AGENCIES: None | J Can Assoc Gastroenterol | 2022 | CORD-19 | |
| 6047 | Impact of COVID-19 pandemic and lockdown on gender-based violence homicides in Spain Circumstances under COVID-19 pandemic and lockdown have reduced the number of gender-based violence homicides in 2020, with a total number of 45, the lowest in the historical statistics. Analysis of these circumstances generated by the lockdown and mobility reduction, together the economical negative impact, has produced an increment of 49,6% in the number of calls to 016 (telephone for victims’ assistance), and a reduction of 14,6% in the complaints of violence during the months of lockdown. This situation reflects a higher control of victims and more difficulties to exit from violence, that has decreased the number of homicides to 4 during these months, the lowest within Spanish statistics. These circumstances are compatible with an increment of risk of aggressions and lethality, factor that can be related with the increment of homicides limited to August, when the mobility and socio-labor opportunities were recovered. The study of the social circumstances originated by the pandemic allows to describe three different patterns in the impact on gender-based violence. | N/A | 2021 | CORD-19 | |
| 6048 | Mongolia-Central Asia relations and the implications of the rise of China on its future evolution This article provides an analysis of Mongolia’s foreign relations with the post-Soviet Central Asian states, particularly with Kazakhstan and Kyrgyzstan, and their prospects going forward. It provides an overview of relations and analysis of why, despite shared geocultural identities and geopolitical imperatives, their relationship remains more distant than Mongolia’s relations with its other neighbors of East Asia. It then assesses the changes brought by the dynamics of a rising Chinese power projection as manifested through its Belt and Road Initiative in the region, and, using the IR theories on rising powers and weak state behavior, examines the impetus of these shifting dynamics for future Mongolia–Central Asia relations. | N/A | 2022 | CORD-19 | |
| 6049 | Impacts of COVID-19 on the post-pandemic behaviour: The role of mortality threats and religiosity This study explores the influence of intra-pandemic perceptions on travellers' post-pandemic hotel booking behaviour among crisis-resistant travellers and crisis-sensitive groups. It also examines the moderating role of mortality threats and religiosity on these behaviours. We collected quantitative data utilising survey method via questionnaires to address various levels of the research. We used PLS-SEM to evaluate our proposed model. We collected data from 1580 who had booked hotels in Egypt. Our study indicated that intra-pandemic perception has a stronger effect on travellers’ post-pandemic hotel booking behaviours if the travellers are less religious and feel deeply threatened by the idea of their own level of mortality. Moreover, it revealed that intra-pandemic perceptions had a stronger association with post-pandemic planned behaviour for travellers who chose to cancel their hotel booking plans. Our study also indicated that emergency public information plays a critical role in influencing post-pandemic planned behaviour. Our study offers effective strategies to aid hospitality and tourism practitioners when risky and threating situations such as COVID-19 arise, specifically in the period of response and recovery. | N/A | 2022 | CORD-19 | |
| 6050 | Lesiones acroisquémicas tras la vacunación contra la COVID-19 | N/A | 2022 | CORD-19 |
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(3) Currently tweets of June 23rd to June 29th 2022 have been considered.