Project description:COVID-19 poses a unique set of challenges to the healthcare system due to its rapid spread, intensive resource utilization, and relatively high morbidity and mortality. Healthcare workers are at especially high risk of exposure given the viruses spread through close contact. Reported cardiac complications of COVID-19 include myocarditis, acute coronary syndrome, cardiomyopathy, pericardial effusion, arrhythmia, and shock. Thus, echocardiography is integral in the timely diagnosis and clinical management of COVID-19 patients. Rush University Medical Center has been at the forefront of the COVID-19 response in Illinois with high numbers of cases reported in Chicago and surrounding areas. The echocardiography laboratory at Rush University Medical Center (RUMC) proactively took numerous steps to balance the imaging needs of a busy, nearly 700-bed academic medical center while maintaining safety.
Project description:We present a 71-year-old male, who had had a heart transplantation 24 years prior, who came to our clinic with a low-grade fever and a new II/VI holosystolic murmur. Echocardiography showed a large mass in the right atrium with attachment near the junction of the right atrium and superior vena cava. The patient was taken to the operating room for resection of the mass. Microscopic evaluation was consistent with thrombus. Differential diagnosis of cardiac masses after cardiac transplant includes tumour, thrombus, and vegetation. Final diagnosis can be challenging; multimodality imaging and biopsy or resection often are required for final diagnosis.
Project description:The aim of this study was to empirically investigate differences in role expectations, among the stakeholders involved, about the devolved personnel management role of front-line managers (FLMs). In particular, we researched the role expectation differences between FLMs, their middle managers, and Human Resource (HR) practitioners. In total, nineteen semi-structured interviews have been conducted involving eleven FLMs, eight middle managers, and two HR practitioners working at the same Dutch hospital. Most discovered role expectation differences were related to how FLMs should execute their HR tasks (i.e., process ambiguity). FLMs were often uncertain if their role enactment met those of their middle managers and/or HR practitioners, herewith indicating role stress. Our findings underline the importance of paying attention to role expectations' differences in aligning components of the HRM-performance relationship. Future research could include the role expectations of other important stakeholders, such as: subordinates and top management. The outcomes of this empirical work are translated into four interventions to diminish FLMs' role stress.
Project description:Many of our decisions take place under uncertainty. To successfully navigate the environment, individuals need to estimate the degree of uncertainty and adapt their behaviors accordingly by learning from experiences. However, uncertainty is a broad construct and distinct types of uncertainty may differentially influence our learning. We provide a semi-systematic review to illustrate cognitive and neurobiological processes involved in learning under two types of uncertainty: learning in environments with stochastic outcomes, and with volatile outcomes. We specifically reviewed studies (N = 26 studies) that included an adolescent population, because adolescence is a period in life characterized by heightened exploration and learning, as well as heightened uncertainty due to experiencing many new, often social, environments. Until now, reviews have not comprehensively compared learning under distinct types of uncertainties in this age range. Our main findings show that although the overall developmental patterns were mixed, most studies indicate that learning from stochastic outcomes, as indicated by increased accuracy in performance, improved with age. We also found that adolescents tended to have an advantage compared with adults and children when learning from volatile outcomes. We discuss potential mechanisms explaining these age-related differences and conclude by outlining future research directions.
Project description:This article is a narrative review of the rapidly moving coronavirus disease 2019 vaccine field with an emphasis on clinical efficacy established in both randomized trials and postmarketing surveillance of clinically available vaccines. We review the major clinical trials that supported authorization for general use of the Janssen (Ad.26.CoV2), Pfizer-BioNTech (BNT162b2), and Moderna (mRNA-1273) vaccines and the publicly available postmarketing information with the goal of providing a broad, clinically relevant comparison of efficacy and safety. This review is primarily focused on the US market.
Project description:COVID-19 is a pandemic of unprecedented proportions in recent human history. Less than 18 months since the onset of the pandemic, there are close to two hundred million confirmed cases and four million deaths worldwide. There have also been massive efforts geared towards finding safe and effective vaccines. By July 2021 there were 184 COVID-19 vaccine candidates in pre-clinical development, 105 in clinical development, and 18 vaccines approved for emergency use by at least one regulatory authority. These vaccines include whole virus live attenuated or inactivated, protein-based, viral vector, and nucleic acid vaccines. By mid-2021 three billion doses of COVID-19 vaccine have been administered around the world, mostly in high-income countries. COVID-19 vaccination provides hope for an end to the pandemic, if and only if there would be equal access and optimal uptake in all countries around the world.
Project description:Given the interest in the COVID mRNA vaccines, we sought to investigate how the RNA modification N1-methylpseudouridine (and its related modification, pseudouridine) is read by ribosomes and reverse transcriptases. By looking at reverse transcriptase data, we can gain information on how the modification affects duplex stability, which may have important consequences for the tRNA-mRNA interactions found in the ribosome.
Project description:Memory T and B cells in lymphoid and mucosal tissues maintain long-term protection, though their generation following vaccination remains challenging to assess in humans. Here, we investigated immune memory generated to COVID-19 mRNA vaccines across blood, lymphoid organs, and lungs from 42 vaccinated organ donors aged 23-86, of whom 57% were previously infected with SARS-CoV-2. Using high-dimensional profiling, we reveal that Spike (S)-reactive memory T cells distribute in lymphoid organs and lungs, variably express tissue resident markers based on infection history, and exhibit site-specific compositions of effector and regulatory memory T cells. S-reactive B cells are mostly class-switched memory cells localized to lymphoid organs correlating with circulating antibodies. Importantly, tissue memory T cells are more stably maintained post-vaccination and over age and exhibit a bias towards regulatory cell functional profiles compared to circulating populations. Our results show that mRNA vaccines can induce heterogeneous memory populations across sites for protection and controlling immune pathology.
Project description:The ongoing COVID-19 pandemic and its unprecedented global societal and economic disruptive impact highlight the urgent need for safe and effective vaccines. Taking substantial advantages of versatility and rapid development, two mRNA vaccines against COVID-19 have completed late-stage clinical assessment at an unprecedented speed and reported positive results. In this review, we outline keynotes in mRNA vaccine development, discuss recently published data on COVID-19 mRNA vaccine candidates, focusing on those in clinical trials and analyze future potential challenges.