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Infectious disease outbreaks related to outdoor sporting events are an underacknowledged environmental health risk. We reviewed documented instances of sporting events that led to outbreaks of illness due to interactions of athletes with environmental pathogen reservoirs such as soil or water. We note that aspects of outdoor athletic activities can mediate a suppression in immune function. The implications of this review are of particular interest to environmental health professionals and healthcare professionals, as they show that populations of young, otherwise healthy adult athletes and other members of their communities are a contextually at-risk group to be aware of in order to improve and speed ability to cluster individuals in outbreaks, and for diagnosis and prevention for individual patients. This review highlights an opportunity where environmental health professionals can provide a critical linkage between patients and the environment., Introduction: Risk Factors of Infection for the Outdoor Athlete Contact with environmental sources of pathogens provides numerous avenues--directly and indirectly--for infection and illness. In the case of participants in outdoor [...]

Coronavirus disease (COVID-19)-associated mucormycosis (CAM) is an emerging systemic fungal infection caused by Mucorales species. Reports of CAM are increasing, especially in India, where 187 cases have been described (1). [...]

The authors trialed a mobile application, DiabetesXcel, which included type 2 diabetes–focused educational videos and modules, in 50 adults of Bronx, NY, a region with a high prevalence of diabetes and diabetes complications. From baseline to 4 months and from baseline to 6 months, there was significantly improved quality of life, self-management, knowledge, self-efficacy, depression, A1C, and LDL cholesterol among those who used DiabetesXcel. There was also a significant decrease in diabetes-related emergency department visits and hospital admissions from baseline to 6 months. This study demonstrates that DiabetesXcel could be beneficial for type 2 diabetes management. [ABSTRACT FROM AUTHOR]

The aim of this scoping review is to evaluate the impact of smartphone application (SPA) technology in patients undergoing elective colonoscopy to measure compliance with appointments, cost-effectiveness, bowel preparation, and quality of life. The scoping review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Ovid Medline, Web of Science, Science Direct, Scopus, Cochrane Library, and PubMed were screened up to Oct 14, 2020, and bibliographies of the retrieved articles were included. Based on pre-specified inclusion and exclusion criteria, 8 primary studies were included in the final analysis from a total of 3,979 non-duplicate articles. Seven out of eight studies measured the bowel preparation quality. In six of these studies, patients in the smartphone group had a successful bowel preparation when compared with the control arm; on the other hand, one study did not find any differences between groups. Adherence to colonoscopy screening was assessed by one study. Patients in the digital intervention arm were significantly more likely to complete a screening test. Patient satisfaction during the periprocedural period of colonoscopy was assessed by five studies which reported significantly higher patient satisfaction in the intervention arm compared to the control arm. None of the studies measured cost-effectiveness. We came to the conclusion that a well-designed, user-friendly SPA can help and guide patients undergoing colonoscopy through the process of following up on their appointments, adhering to bowel preparation, and better understanding their disease condition. Future trials investigating SPAs should include cost-effectiveness and adherence to appointments as an endpoint. [ABSTRACT FROM AUTHOR]

Background: Vocal biomarker–based machine learning approaches have shown promising results in the detection of various health conditions, including respiratory diseases, such as asthma. Objective: This study aimed to determine whether a respiratory-responsive vocal biomarker (RRVB) model platform initially trained on an asthma and healthy volunteer (HV) data set can differentiate patients with active COVID-19 infection from asymptomatic HVs by assessing its sensitivity, specificity, and odds ratio (OR). Methods: A logistic regression model using a weighted sum of voice acoustic features was previously trained and validated on a data set of approximately 1700 patients with a confirmed asthma diagnosis and a similar number of healthy controls. The same model has shown generalizability to patients with chronic obstructive pulmonary disease, interstitial lung disease, and cough. In this study, 497 participants (female: n=268, 53.9%; <65 years old: n=467, 94%; Marathi speakers: n=253, 50.9%; English speakers: n=223, 44.9%; Spanish speakers: n=25, 5%) were enrolled across 4 clinical sites in the United States and India and provided voice samples and symptom reports on their personal smartphones. The participants included patients who are symptomatic COVID-19 positive and negative as well as asymptomatic HVs. The RRVB model performance was assessed by comparing it with the clinical diagnosis of COVID-19 confirmed by reverse transcriptase–polymerase chain reaction. Results: The ability of the RRVB model to differentiate patients with respiratory conditions from healthy controls was previously demonstrated on validation data in asthma, chronic obstructive pulmonary disease, interstitial lung disease, and cough, with ORs of 4.3, 9.1, 3.1, and 3.9, respectively. The same RRVB model in this study in COVID-19 performed with a sensitivity of 73.2%, specificity of 62.9%, and OR of 4.64 (P <.001). Patients who experienced respiratory symptoms were detected more frequently than those who did not experience respiratory symptoms and completely asymptomatic patients (sensitivity: 78.4% vs 67.4% vs 68%, respectively). Conclusions: The RRVB model has shown good generalizability across respiratory conditions, geographies, and languages. Results using data set of patients with COVID-19 demonstrate its meaningful potential to serve as a prescreening tool for identifying individuals at risk for COVID-19 infection in combination with temperature and symptom reports. Although not a COVID-19 test, these results suggest that the RRVB model can encourage targeted testing. Moreover, the generalizability of this model for detecting respiratory symptoms across different linguistic and geographic contexts suggests a potential path for the development and validation of voice-based tools for broader disease surveillance and monitoring applications in the future. [ABSTRACT FROM AUTHOR]

There is growing evidence that vaping has the potential to cause adverse health effects. Vaping is affecting the younger and healthier population which is a public concern. Mycoplasma pneumoniae pneumonia is a benign condition and is usually underdiagnosed and is managed in an outpatient setting. Here we present a case of fulminant MPP in a young adult probably associated with VAPI. A 24-year-old woman presented to our hospital for severe hypoxic respiratory failure needing intubation and intensive care unit admission. She had a history for vaping for 2 years prior to presentation. She had fever and an elevated white count. Her Chest X-Ray and CT scan of the chest were consistent with bilateral predominantly lower lobe patchy opacities. She had mildly elevated serum LDH and Urine toxicology screen was positive for THC. Serum IgM Mycoplasma level was positive and her BAL fluid analysis showed lipid-laden macrophages. She was diagnosed as a probable case of VAPI per CDC guidelines with superimposed fulminant MPP. Vaping is known to increase the risk of viral and bacterial pneumonia by compromising the respiratory local immune response. Vaping also causes lipoid pneumonia where the alveoli are filled with lipid-laden macrophages with surrounding inflammation. We hypothesize that this patient had fulminant MPP in the setting of background VAPI. The association between vaping and MPP infection has not been established in the literature and this is the first documented report to establish a link between e-cigarettes and fulminant MPP. Further research is needed to confirm this association. [ABSTRACT FROM AUTHOR]

Background: Residents of the Bronx suffer marked health disparities due to socioeconomic and other factors. The coronavirus disease 2019 pandemic worsened these health outcome disparities and health care access disparities, especially with the abrupt transition to online care., Objectives: This study classified electronic health literacy (EHL) among patients at an urban, academic hospital in the Bronx, and assessed for associations between EHL levels and various demographic characteristics., Methods: We designed a cross-sectional, observational study in adults 18 years or older presenting to the Montefiore Einstein Center for Cancer Care (MECCC) Department of Radiation Oncology or the Montefiore Department of Medicine in the Bronx. We assessed EHL using the eHealth Literacy Scale (eHEALS) survey, a previously validated tool, and our newly developed eHealth Literacy Objective Scale-Scenario Based (eHeLiOS-SB) tool., Results: A total of 97 patients recruited from the MECCC and Department of Medicine participated in this study. There was a statistically significant association between age and EHL as assessed by both eHEALS and eHeLiOS-SB, with older adults having lower EHL scores. Additionally, a question designed to assess general attitudes toward digital health technologies found that most participants had a positive attitude toward such applications., Conclusion: Many patients, especially older adults, may require additional support to effectively navigate telehealth. Further research is warranted to optimize telemedicine strategies in this potentially-marginalized population and ultimately to create telehealth practices accessible to patients of all ages and demographics., Competing Interests: None declared., (Thieme. All rights reserved.)