Search

BACKGROUND: The clinical burden of Long COVID, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and other post-infectious fatiguing illnesses (PIFI) is increasing. There is a critical need to advance understanding of the effectiveness and sustainability of innovative approaches to clinical care of patients having these conditions. METHODS: We aim to assess the effectiveness of a Long COVID and Fatiguing Illness Recovery Program (LC&FIRP) in a two-arm, single-blind, pragmatic, quality improvement, professional cluster, randomized controlled trial in which 20 consenting clinicians across primary care clinics in a Federally Qualified Health Center system in San Diego, CA, will be randomized at a ratio of 1:1 to either participate in (1) weekly multi-disciplinary team-based case consultation and peer-to-peer sharing of emerging best practices (i.e., teleECHO (Extension for Community Healthcare Outcomes)) with monthly interactive webinars and quarterly short courses or (2) monthly interactive webinars and quarterly short courses alone (a control group); 856 patients will be assigned to participating clinicians (42 patients per clinician). Patient outcomes will be evaluated according to the study arm of their respective clinicians. Quantitative and qualitative outcomes will be measured at 3- and 6-months post-baseline for clinicians and every 3-months post assignment to a participating clinician for patients. The primary patient outcome is change in physical function measured using the Patient-Reported Outcomes Measurement Information System (PROMIS)-29. Analyses of differences in outcomes at both the patient and clinician levels will include a linear mixed model to compare change in outcomes from baseline to each post-baseline assessment between the randomized study arms. A concurrent prospective cohort study will compare the LC&FIRP patient population to the population enrolled in a university health system. Longitudinal data analysis approaches will allow us to examine differences in outcomes between cohorts. DISCUSSION: We hypothesize that weekly teleECHO sessions with monthly interactive webinars and quarterly short courses will significantly improve clinician- and patient-level outcomes compared to the control group. This study will provide much needed evidence on the effectiveness of a technology-enabled multi-disciplinary team-based care model for the management of Long COVID, ME/CFS, and other PIFI within a federally qualified health center. TRIAL REGISTRATION: ClinicalTrials.gov, NCT05167227 . Registered on December 22, 2021.

BackgroundA national serosurvey of U.S. blood donors conducted in partnership with the Centers for Disease Control and Prevention (CDC) was initiated to estimate the prevalence of SARS-CoV-2 infections and vaccinations.MethodsBeginning in July 2020, the Nationwide Blood Donor Seroprevalence Study collaborated with multiple blood collection organizations, testing labs, and leadership from government partners to capture, test, and analyze approximately 150,000 blood donation specimens per month in a repeated, cross-sectional seroprevalence survey.ResultsA CDC website (https://covid.cdc.gov/covid-data-tracker/#nationwide-blood-donor-seroprevalence) provided stratified, population-level results to public health professionals and the general public.DiscussionThe study adapted operations as the pandemic evolved, changing specimen flow and testing algorithms, and collecting additional data elements in response to changing policies on universal blood donation screening and administration of SARS-CoV-2 spike-based vaccines. The national serosurvey demonstrated the utility of serosurveillance testing of residual blood donations and highlighted the role of the blood collection industry in public-private partnerships during a public health emergency.

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development's (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security.

This essay argues that Pope Boniface VIII (1294-1303) used clothing in a highly intentional and performative manner to communicate his status and authority. His audience, however, was quite limited - essentially, the small community of those who aspired to hold or influence the power of the Holy See - and the messages conveyed were not particularly complex. Attempting a reception history of papal attire c.1300, the essay surveys remarks regarding clothing in late thirteenth- and early fourteenth-century chronicles and analyses in depth the evidence of two sources: ambassadorial reports to King James II of Aragon (1291-1327) and the De electione et coronatione sanctissimi patris domini Bonifatii pape octavi of Cardinal Jacopo Caetani Stefaneschi (c.1270-1343). A suggestive finding is that performativity, or the highly theatrical use of garments, appears to have been used by Boniface VIII to foster dissemination of simple communications across great distances.

Using evidence from both papal and cardinal inventories, as well as from cardinal wills, this essay argues that the papal curia developed a distinctive language for describing liturgical vestments in the late thirteenth and early fourteenth centuries that emphasised the peoples and places that made the materials and ornaments of these garments. Examples from inventories of local dioceses and religious houses are offered to illustrate the peculiarity of the curial descriptions, and comparisons are also made to royal and mercantile inventories. While the curial emphasis on the places and peoples producing the materials used in ecclesiastical vestments may simply have been the performance of connoisseurship within an elite institutional culture, the author suggests that it may also express the expansive papal claims to dominion articulated by Boniface VIII (1294–1303) and his immediate successors.

Background Methods Results Conclusion In December 2021, the U.S. Food and Drug Administration published a letter to clinical laboratory staff and healthcare providers detailing a risk of false Rapid Plasma Reagin (RPR) when using the Bio‐Rad Laboratories BioPlex 2200 Syphilis Total & RPR kit in people who had received COVID‐19 vaccination; Treponema pallidum particle agglutination assays did not appear to be impacted by this issue. We evaluated reactivity rates of syphilis screening with negative confirmatory testing at our institution by year and seasonality.We performed a retrospective study of routine syphilis testing of whole blood (WB) collections at an academic hospital‐based donor center in the eastern United States. All WB donations from 2011 to 2023 which demonstrated reactive syphilis screening (Beckman Coulter PK TP Microhemagglutination) with negative confirmatory testing (CAPTIA Syphilis (T. pallidum)‐G) were evaluated. Reactivity rates by year and season of donation were compared using unpaired t‐tests.A total of 109 WB donations from 86 unique donors who donated from 2011 to 2023 screened reactive for syphilis with negative confirmatory testing. The unconfirmed syphilis reactivity rate increased from 2018 to 2023 (mean: 0.360%) compared to 2011–2017 (mean: 0.071%, p < .05). An autumnal peak in unconfirmed reactives was observed.The unconfirmed syphilis reactivity rate among WB donors at our institution increased markedly since 2017 compared to the 7 years prior and doubled from 2020 to 2021. No testing assay changes explain these results. The autumnal peak in unconfirmed reactives suggests a possible environmental trigger such as viral infection or vaccination. [ABSTRACT FROM AUTHOR]

As a contribution to the Common Knowledge symposium "Caroline Walker Bynum across the Disciplines," this essay traces the origins and development of Bynum's interest in the material artifacts of late medieval Christian spirituality. The author narrates these evolutions through analyses of a single object, the Louvain beguine cradle from the collections of the Metropolitan Museum of Art. The essay begins by treating Bynum's research from the 1980s to the early 1990s as moving toward a "visual theology" and then charts her movement from an interest in matter to an interest in materiality over the second half of the 1990s and first decade of the twenty‐first century. Finally, the author uses the Louvain cradle's appearance in Bynum's most recent book, Dissimilar Similitudes, to articulate and reflect upon her contribution to material culture studies. [ABSTRACT FROM AUTHOR]