Introduction: Given that the success of vaccines against coronavirus disease 2019 (COVID-19) relies on herd immunity, identifying patients at risk for vaccine hesitancy is imperative—particularly for those at high risk for severe COVID-19 (i.e., minorities and patients with neurological disorders). Methods: Among patients from a large neuroscience institute in Hawaii, vaccine hesitancy was investigated in relation to over 30 sociodemographic variables and medical comorbidities, via a telephone quality improvement survey conducted between 23 January 2021 and 13 February 2021. Results: Vaccine willingness (n = 363) was 81.3%. Univariate analysis identified that the odds of vaccine acceptance reduced for patients who do not regard COVID-19 as a severe illness, are of younger age, have a lower Charlson Comorbidity Index, use illicit drugs, or carry Medicaid insurance. Multivariable logistic regression identified the best predictors of vaccine hesitancy to be: social media use to obtain COVID-19 information, concerns regarding vaccine safety, self-perception of a preexisting medical condition contraindicated with vaccination, not having received the annual influenza vaccine, having some high school education only, being a current smoker, and not having a prior cerebrovascular accident. Unique amongst males, a conservative political view strongly predicted vaccine hesitancy. Specifically for Asians, a higher body mass index, while for Native Hawaiians and other Pacific Islanders (NHPI), a positive depression screen, both reduced the odds of vaccine acceptance. Conclusion: Upon identifying the variables associated with vaccine hesitancy amongst patients with neurological disorders, our clinic is now able to efficiently provide ancillary COVID-19 education to sub-populations at risk for vaccine hesitancy. While our results may be limited to the sub-population of patients with neurological disorders, the findings nonetheless provide valuable insight to understanding vaccine hesitancy.
Several validated scales have been developed to measure frailty, yet it remains unknown how these measures are related. We used data from 7,070 community-dwelling older adults who participated in National Health and Aging Trend Study round 5 to construct a crosswalk among frailty measures. We operationalized the 60-item Frailty Index (FI), Study of Osteoporotic Fracture (SOF) Index, FRAIL Scale, Frailty Phenotype, Clinical Frailty Scale (CFS), Vulnerable Elder Survey-13 (VES-13), Tilburg Frailty Indicator (TFI), Groningen Frailty Indicator (GFI), and Edmonton Frailty Scale (EFS). Missing data, needed for the calculation of frailty scores, were imputed using multiple imputation by chained equations method. We then linked the scores of each frailty measure to FI using the equipercentile method, a statistical procedure that links different scales by equating percentile distributions. Participants considered frail on FI (cutpoint of 0.25) corresponded to the following scores on each frailty measure: SOF 1.3, FRAIL 1.7, Phenotype 1.7, CFS 5.3, VES-13 5.5, TFI 4.4, GFI 4.4, and EFS 5.8. Conversely, individuals considered frail on each frailty measure corresponded to the following FI scores: 0.37 (SOF), 0.40 (FRAIL), 0.42 (Phenotype), 0.21 (CFS), 0.19 (VES-13), 0.28 (TFI), 0.22 (GFI), and 0.37 (EFS). The CFS, VES-13, TFI and GFI each discriminates between non-frail and frail people in the pre- to mildly frail spectrum on the FI, whereas the SOF, FRAIL Scale, Phenotype, and EFS detect those in the higher frailty spectrum on the FI. Our results provide clinicians and researchers with a useful tool to convert and interpret frailty across scales.
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Combined conductive and radiati ve heat transfer in a thermally developing two-phas e Poiseuille flow in a cylindrical duct is studied here. A two-phas e radiative transfer equation ( ) RTE considering radiation by both gas and particles is taken into account. A complex form ( of nonlinear integrodifferential RTE is solved by the discrete ordinates method DOM, or so ) called S method in axisymmetric geometry. After such validation , namely, the solution in N a two-dimensional channel flow between two flat plates is compared with that solved by the zone method, the program is then applied to fully developed gas-particle two-phas e flow in a cylindrical duct. A parametric study is performed for gas and particle absorptio n coefficients, particle number density, particle emissivity, and wall emissivity. The results show a significan t effect of two-phase radiation on the thermal characteristics. However, in all cases, it was found that conduction is predominan t near the wall. INTR OD UC TIONIndustrial he at processing systems such as boilers, combustors, and gasification plants usually contain some particles as well as hot exhaust gases exceeding 1000 K. Thereby, thermal analysis of two-phase mixtures in these facilities is very important from the viewpoint of energy savings and performance enhancement. Also, when such high-soot hydrocarbo n fuels as acetylene and ethylene or diesel fuel are burned, it is important to account for the two-phase radiation by gas and particles, since an accurate prediction of temperature distribution is also highly desirable to predict NO formation. This results from the fact that the temperature x drop of about 150 K in the open flame due to radiation accounts for about 50% of NO reduction. A two-phase medium is also useful in such high-temperature x equipment involving no phase change, such as direct-contact he at exchangers using particle-suspended gas as a he at transfe r medium; thereby, a higher efficiency of w x he at transfer could be obtaine d 1 .While many studies for single-phase radiation combined with other modes of he at transfe r have been performed in the past decades, only a limited number of studies regarding two-phase radiation are available . As for the former, only the gas w x participates in absorption and emission of radiation, while the particles scatter 2 , or only the particles are involved in absorption, emission, and scattering, while the
this study aims to investigate the knowledge, attitudes and practices of MS patients during COVID-19 pandemic. MethodsA telephone-based survey which recruited patients from Kasralainy Multiple Sclerosis Unit database, Cairo University hospitals from March 2020 till July 2020. It included 127 patients and an Arabic questionnaire was conducted which consisted of 14 questions including: Demographic data; MS related data, Data related to COVID-19 and attitude and awareness related to COVID-19. ResultsNear quarter of the patients were still working in their current jobs, only 12.8% on current leave due to Covid-19 while the majority were non-employed (66.4%).The majority of patients (64%) were compliant to their medications. Treating physician advised to stop DMT in 20.4% while 10.2% of patients stopped due to fear of side effects.Only 16.54% of the patients developed COVID-19 symptoms. The majority (89.2%) avoided visiting any medical institution. Different ways of communication were used by patient when any medical advice was needed. Facebook and WhatsApp applications represented almost half of the tools used to communicate. ConclusionsPatients with MS report increased awareness of COVID-19 precautions with high rate of DMT compliance.
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