Summary of your 'study carrel' ============================== This is a summary of your Distant Reader 'study carrel'. The Distant Reader harvested & cached your content into a collection/corpus. It then applied sets of natural language processing and text mining against the collection. The results of this process was reduced to a database file -- a 'study carrel'. The study carrel can then be queried, thus bringing light specific characteristics for your collection. These characteristics can help you summarize the collection as well as enumerate things you might want to investigate more closely. This report is a terse narrative report, and when processing is complete you will be linked to a more complete narrative report. Eric Lease Morgan Number of items in the collection; 'How big is my corpus?' ---------------------------------------------------------- 39 Average length of all items measured in words; "More or less, how big is each item?" ------------------------------------------------------------------------------------ 1566 Average readability score of all items (0 = difficult; 100 = easy) ------------------------------------------------------------------ 49 Top 50 statistically significant keywords; "What is my collection about?" ------------------------------------------------------------------------- 15 COVID-19 8 SARS 2 severe 2 plasma 2 patient 1 treatment 1 trainee 1 perniosis 1 mask 1 inflammatory 1 famotidine 1 evidence 1 drug 1 contact 1 community 1 care 1 applicant 1 acute 1 TMPRSS2 1 SUD 1 STE 1 NIPPV 1 Myocardial 1 MDR 1 Kong 1 Hong 1 G6PD 1 EHR 1 ECG 1 Clinic 1 China 1 Bhatt 1 Angiotensin 1 Alcohol 1 ACE2 1 AACT Top 50 lemmatized nouns; "What is discussed?" --------------------------------------------- 540 patient 287 % 224 care 185 health 176 study 175 disease 153 infection 145 treatment 138 pandemic 137 risk 133 time 130 case 111 use 105 plasma 100 rate 100 r 95 outcome 95 day 95 coronavirus 92 mortality 91 datum 87 o 85 drug 81 virus 78 system 78 syndrome 76 evidence 69 trial 67 contact 66 individual 65 transmission 65 hospital 64 response 63 population 63 person 62 death 62 community 61 symptom 58 result 56 level 55 therapy 54 review 54 exposure 53 ventilation 53 author 52 date 52 analysis 50 strategy 50 intervention 49 transfusion Top 50 proper nouns; "What are the names of persons or places?" -------------------------------------------------------------- 376 COVID-19 254 SARS 109 CoV-2 98 Mayo 65 TB 65 China 63 Health 59 Clinic 54 • 51 Coronavirus 50 US 45 Disease 42 ACE2 39 NIPPV 39 CoV 39 Clin 38 J 38 AACT 37 United 37 ECG 36 States 34 TMPRSS2 34 Proc 31 nan 31 Wuhan 30 sha 29 New 26 York 24 SUD 24 April 23 G6PD 22 World 21 STE 21 Patients 21 Organization 20 Use 20 ST 20 Prevention 20 J. 20 Care 19 CDC 18 Clinical 18 Angiotensin 18 ARDS 17 Review 17 R. 16 Treatment 16 Control 15 et 15 PCR Top 50 personal pronouns nouns; "To whom are things referred?" ------------------------------------------------------------- 246 we 132 it 52 they 18 us 13 them 8 he 6 i 5 she 2 themselves 2 one 1 you 1 ourselves 1 itself 1 him Top 50 lemmatized verbs; "What do things do?" --------------------------------------------- 1673 be 505 have 147 use 118 include 86 base 82 do 78 provide 77 report 77 increase 71 associate 64 need 57 show 54 require 51 reduce 50 develop 49 make 48 hospitalize 45 follow 44 identify 44 consider 43 occur 43 continue 41 suggest 40 improve 40 control 39 infect 39 cause 38 remain 38 relate 38 compare 36 limit 36 become 33 treat 33 support 33 know 33 give 33 create 32 test 31 confirm 31 assess 30 find 30 emerge 29 expose 28 result 27 receive 27 lead 27 isolate 26 spread 25 take 25 implement Top 50 lemmatized adjectives and adverbs; "How are things described?" --------------------------------------------------------------------- 191 not 164 respiratory 164 clinical 129 more 128 acute 126 severe 122 high 111 covid-19 108 other 95 also 84 convalescent 81 most 78 - 76 such 70 medical 70 however 62 many 61 well 61 early 57 low 56 new 50 available 49 viral 48 only 48 first 47 primary 45 potential 44 key 44 human 44 effective 43 virtual 43 several 42 public 41 infectious 39 important 38 likely 38 initial 37 social 37 large 37 even 36 rapid 36 positive 35 current 35 critical 35 as 34 novel 33 great 31 vital 31 mechanical 31 further Top 50 lemmatized superlative adjectives; "How are things described to the extreme?" ------------------------------------------------------------------------- 29 most 13 good 9 Most 7 least 7 great 4 high 4 early 2 simple 2 big 1 wide 1 sick 1 low 1 late 1 large Top 50 lemmatized superlative adverbs; "How do things do to the extreme?" ------------------------------------------------------------------------ 52 most 6 least 3 well 1 hard Top 50 Internet domains; "What Webbed places are alluded to in this corpus?" ---------------------------------------------------------------------------- Top 50 URLs; "What is hyperlinked from this corpus?" ---------------------------------------------------- Top 50 email addresses; "Who are you gonna call?" ------------------------------------------------- Top 50 positive assertions; "What sentences are in the shape of noun-verb-noun?" ------------------------------------------------------------------------------- 3 infection control measures 3 plasma is safe 2 care is crucial 2 patients are able 2 system is not 1 % had diarrhea 1 % had myalgias 1 % increased risk 1 % require intensive 1 care are deep 1 care including psychiatry 1 care is not 1 care is now 1 case had symptoms 1 cases have now 1 cases reported thus 1 cases were mild 1 coronavirus is uncertain 1 cov-2 cause harm 1 cov-2 has irrevocably 1 cov-2 has rapidly 1 cov-2 is directly 1 cov-2 was positive 1 covid-19 has unsurprisingly 1 covid-19 is further 1 covid-19 is likely 1 covid-19 is more 1 covid-19 is primarily 1 covid-19 is unknown 1 covid-19 related myopericarditis 1 covid-19 remains unclear 1 covid-19 requiring admission 1 data included white 1 data provide continued 1 data provide early 1 data provide robust 1 data were also 1 data were previously 1 day following ccp 1 disease has not 1 disease included coronary 1 disease is also 1 disease is humans 1 disease requiring mechanical 1 drug is active 1 drugs are available 1 drugs improving mortality 1 infection are different 1 infection control officers 1 infection control precautions Top 50 negative assertions; "What sentences are in the shape of noun-verb-no|not-noun?" --------------------------------------------------------------------------------------- 1 care is not just 1 plasma had no minimum A rudimentary bibliography -------------------------- id = cord-261653-0vtghtp7 author = Andersen, Kylie J. title = Recruitment Strategy for Potential COVID-19 Convalescent Plasma Donors date = 2020-09-21 keywords = COVID-19; plasma summary = Thus, the present narrative overviews the strategy developed by our team to identify and recruit COVID-19 survivors to donate convalescent plasma at the Mayo Clinic Blood Donor Center in Rochester, Minnesota. Rochester, Minnesota required a strategy to interface with the community of recovering COVID-19 patients and recruit eligible convalescent plasma donors. Overall, this recruitment strategy utilized a simple survey, an algorithm for triaging donors, a workflow for connecting donors with Mayo Clinic Blood Donor Center, a team of physician navigators (including medical students) to screen eligible donors, and a support center for donor questions. Our web-based recruitment survey and all e-mail communications to interested potential donors contained the e-mail address for our convalescent plasma service center. The service center team used available resources from the US FDA, Mayo Clinic, and the blood banking community to support questions regarding donor eligibility and COVID-19 testing. doi = 10.1016/j.mayocp.2020.09.021 id = cord-345058-jfzzngce author = Baughn, Linda B. title = Targeting TMPRSS2 in SARS-CoV-2 infection date = 2020-07-19 keywords = ACE2; TMPRSS2 summary = We show that expression levels of ACE2 and TMPRSS2 are overall comparable between males and females in multiple tissues suggesting that differences in the expression levels of TMPRSS2 and ACE2 in the lung and other non-sex-specific tissues may not explain the gender disparities in SARS CoV-2 severity. Given the increased severity of disease among older males with SARS-CoV-2 infection, we also address the potential roles of ACE2 and TMPRSS2 in their contribution to the sex differences in disease severity. Given the necessity of ACE2 and TMPRSS2 genes for SARS CoV-2 infection, we evaluated their expression in human tissues using data from the Genotype-Tissue Expression (GTEx) Project (https://gtexportal.org). Combined, these findings suggest that differences in the expression levels of TMPRSS2 and ACE2 in the lung and other non-sex-specific tissues likely do not explain the gender disparities in SARS CoV-2 severity. This suggests that expression differences of TMPRSS2 and ACE2 in the lung and other non-sex-specific tissues may not explain the gender disparities in SARS CoV-2 severity. doi = 10.1016/j.mayocp.2020.06.018 id = cord-303747-o09canse author = Bennett, Courtney E. title = ST-segment Elevation, Myocardial Injury, and Suspected or Confirmed COVID-19 Patients: Diagnostic and Treatment Uncertainties date = 2020-04-11 keywords = COVID-19; Myocardial; STE summary = This approach, however, must be balanced against the need for a rapid and precise diagnosis in COVID-19 patients with STE due to an acute myocardial infarction in order for timely and appropriate reperfusion therapy including coronary revascularization to be implemented when appropriate. April 7, 2020 ST-segment Elevation, Myocardial Injury, and COVID-19 into account severity of illness coupled with risk stratification utilizing cardiac imaging in select cases to assess the potential benefit from coronary revascularization rather than a blanket policy of proceeding with diagnostic catheterization, often triggered by prehospital ECG testing, for all STE patients with suspected or known COVID-19. Our current approach in patients with a high suspicion for acute coronary occlusion who are candidates for coronary angiography with an expected benefit from coronary artery revascularization is to continue with the standard pre-hospital or emergency department (ED)-triggered STEMI activation of the cardiac catheterization laboratory (CCL) for anticipated primary percutaneous coronary intervention. doi = 10.1016/j.mayocp.2020.04.005 id = cord-026738-6jtcf4mz author = Berbari, Elie F. title = Mayo Clinic Strategies for COVID-19 Introduction date = 2020-06-13 keywords = Clinic summary = Early alignment with these 3 strategies has allowed Mayo Clinic to be more effective in responding to the COVID-19 pandemic. Another describes changes in local and federal regulations that served as catalysts for Mayo Clinic to provide home monitoring of patients with COVID-19 and to substantially increase telemedicine options for virtual visits. During the crisis, Mayo Clinic halted all elective and semielective procedures, which resulted in a backlog of patients without COVID-19 who need care. The commentaries also highlight how Mayo Clinic is reaching out to our neighboring communities during this pandemic. Importantly, we will discuss major lessons learned thus far around rapid change management strategies, effective We hope that this series of commentaries will be useful to you and to your organizations during this and any future pandemic or other extremely challenging health care situations. Health Care After the COVID-19 Pandemic and the Influence of Telemedicine 21. doi = 10.1016/j.mayocp.2020.06.005 id = cord-302513-u9n56pnb author = Breitinger, Scott title = Key Opportunities for the COVID-19 Response to Create a Path to Sustainable Telemedicine Services date = 2020-10-01 keywords = COVID-19; care summary = During the COVID-19 era, telemedicine has been an essential method to ensure the continuation of health care services while allowing for social distancing and reducing rates of COVID-19 transmission. With the increased exposure and comfort with virtual health care amongst patients and providers, the demand for expanded access to telehealth services is not likely to wane once the pandemic has passed. 8 Loosening restrictions on telehealth reimbursement under COVID-19 emergency orders has resulted in a dramatic expansion of virtual care, which has allowed for providing crucial medical services to vulnerable patient populations during the COVID-19 pandemic. • Federal legislation could be used to redefine the "place of service." Instead of the site of the patient arbitrarily defined as the virtual place of service, the site of the clinician redefined as the site of care delivery would alleviate the need for providers to have multiple state licenses to practice telemedicine. The expansion of telehealth during the COVID-19 pandemic has allowed many providers and patients to experience better access to effective care. doi = 10.1016/j.mayocp.2020.09.034 id = cord-322724-7l1668bf author = Challener, Douglas title = In Reply - Repeated testing in SARS-CoV-2 infection date = 2020-08-10 keywords = SARS summary = In general, we agree that repeat testing may be helpful in certain situations of ongoing high suspicion for active infection where alternative approaches are not feasible; however, we believe that testing should not be applied indiscriminately in a resource-constrained situation. Several studies have suggested that the number of unique patient specimens tested for SARS-CoV-2 is directly related to the positive identification of the virus and that there may be a high false-negative rate of molecular testing. 2, 3 The study by Zhang et al reported 41 hospitalized patients with an initial negative PCR test who had at least one positive result on subsequent testing. 4 We agree that there may be a role for repeat testing in patients with high clinical suspicion of Low Utility of Repeat Real-Time PCR Testing for SARS-CoV-2 in Clinical Specimens Distinct characteristics of COVID-19 patients with initial rRT-PCRpositive and rRT-PCR-negative results for SARS-CoV-2 doi = 10.1016/j.mayocp.2020.08.006 id = cord-299150-1noy0z88 author = Desai, Aakash title = Clinical Trial Endpoints in Severe COVID-19 date = 2020-06-06 keywords = severe summary = However, clinical trials of agents tested for severe COVID19 may not necessarily test for mortality outcomes as the primary endpoint, as was highlighted in the press release of the recent remdesivir trial. Since drugs improving mortality in severe COVID-19 is the most important endpoint to achieve both from clinical and public policy standpoint, we evaluated the type of primary endpoints currently being assessed in randomized controlled trials (RCTs) in severe COVID19. Our analysis found that only 6/19 (30%) ongoing phase III RCT in severe COVID19 have mortality as the standalone primary endpoint or a part of composite endpoint. Given that mortality is as high as 25% in severe COVID19 who need ICU care and average time to death is 3-6 days [2, 3] , the number of mortality events needed and follow-up time do not pose an impediment for analysis of mortality as the primary endpoint. doi = 10.1016/j.mayocp.2020.05.025 id = cord-325938-hb6fvgem author = Dobler, Claudia C. title = Non-Invasive Positive Pressure Ventilation in Patients With COVID-19 date = 2020-10-08 keywords = COVID-19; NIPPV summary = Amid increasing concerns of medical professionals about the harms associated with invasive ventilation, there is interest to explore the role of non-invasive positive pressure ventilation (NIPPV) in the treatment of acute hypoxemic respiratory failure (AHRF) and acute respiratory distress syndrome (ARDS) due to In this commentary we aim to summarize what is known about the role of NIPPV in patients with AHRF and ARDS due to COVID-19 and other viral infections, point out evidence gaps and make a case for consideration of NIPVV as a possible alternative to early intubation in patients with COVID-19. Severity of respiratory failure and outcome of patients needing a ventilatory support in the Emergency Department during Italian novel coronavirus SARS-CoV2 outbreak: Preliminary data on the role of Helmet CPAP and Non-Invasive Positive Pressure Ventilation doi = 10.1016/j.mayocp.2020.10.001 id = cord-298094-ctikhqvr author = Elias, Pierre title = The Prognostic Value of Electrocardiogram at Presentation to Emergency Department in Patients With COVID-19 date = 2020-08-15 keywords = COVID-19; ECG; patient summary = doi = 10.1016/j.mayocp.2020.07.028 id = cord-330104-wgo4pml6 author = Farrugia, Gianrico title = Innovation Lessons From the COVID-19 Pandemic date = 2020-06-06 keywords = COVID-19 summary = In the ensuing weeks, health care organizations, industry partners, and government agencies worldwide have quickly come together to address pandemic challenges such as scaling high-quality laboratory tests, conducting treatment research, and enabling virtual health care in a time of social distancing. What we have accomplished together to date demonstrates the opportunity for future cross-sector partnerships in science and technology to fight the disease, while simultaneously creating the new digital health care solutions that our world greatly needs. Instead, we must seize the opportunity for cross-sector partnerships in science and technology to fight the disease, while simultaneously deploying new digital health care solutions that our world greatly needs. The Federal Communications Commission (FCC) facilitated expanding access with The COVID-19 Telehealth Program, fasttracking application processes and funding to help health care providers quickly establish telehealth services for remote patients. doi = 10.1016/j.mayocp.2020.05.024 id = cord-343227-6n5el4hz author = Fischer, Philip R. title = Intentionality in Medical School Admissions in the COVID-19 Era date = 2020-09-24 keywords = Bhatt; applicant summary = And yet we wish to gently challenge a tendency towards solipsism-a propensity for self-absorption -as aspiring medical students face what Bhatt and Bhatt describe as "an increased sense of stress as carefully charted paths to medical school become so utterly disrupted." 1 That is, we want to remind applicants this season that they are not alone in having to deal with disruptions. A recent New York Times Op-Ed by Frank Bruni focuses on the ideas of Jeffrey Selingo, author of the recently published Who Gets In and Why: A Year Inside College Admissions. "The pandemic,"Bruni writes, "put many of those activities on hold, creating a pause in which [Selingo] believes some schools and some students will recognize the lunacy of this overkill." 2 Admissions committees have the opportunity to recalibrate their criteria to emphasize quality over quantity in selecting what truly matters in building the best future doctors. doi = 10.1016/j.mayocp.2020.09.026 id = cord-256422-4crdzojb author = Garg, Aakash title = Association of Renin Angiotensin System Blockers With Outcomes in Patients with COVID-19 date = 2020-09-14 keywords = Angiotensin summary = 5 Since renin angiotensin system (RAS) antagonists have been suggested to upregulate ACE2 in few animal models, concerns have been raised that these drugs might be associated with increased risk of infection or severe disease from Covid-19. Accordingly, we performed a meta-analysis to study the cumulative evidence for association of ACEI/ARB use with risk of mortality and severe illness with Covid-19. The following key words were used for search in different combinations: "Coronavirus 2019", "Covid-19", "SARS-Cov-2", "Renin angiotensin system", "Angiotensin converting enzyme", "Angiotensin converting enzyme inhibitors", "ACEI", "Angiotensin receptor blockers"; "ARB", and "Outcomes". Association of Inpatient Use of Angiotensin Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers with Mortality Among Patients With Hypertension Hospitalized With COVID-19 Association of Renin-Angiotensin System Inhibitors With Severity or Risk of Death in Patients With Hypertension Hospitalized for Coronavirus Disease 2019 (COVID-19) Infection in Wuhan doi = 10.1016/j.mayocp.2020.09.010 id = cord-315388-8sv00zqz author = Ghosh, Ritwik title = Famotidine against SARS-CoV2: A hope or hype? date = 2020-06-06 keywords = SARS; famotidine summary = doi = 10.1016/j.mayocp.2020.05.027 id = cord-324660-w81jgw7p author = Guharoy, Roy title = Medication Shortages: A Matter of National Security—Time for Action date = 2020-08-01 keywords = drug summary = To the Editor: As noted by Choo and Rajkumar 1 in the June 2020 issue of Mayo Clinic Proceedings, the COVID-19 (coronavirus disease 19) pandemic has exposed extreme vulnerabilities in our nation''s drug supply chain. d Create a national database for tracking of essential drug supplies and use predictive analytics to identify surge, production problems, and future shortages. 1 As supply chain management leaders at Mayo Clinic, we appreciate the attention these authors draw towards the issue of drug shortages and drug costs. 5 Because of the high use of vasopressin in critically ill COVID-19 patients and the greater than 6000% price increase that has occurred after completing the Unapproved Drugs Initiative process, vasopressin will likely become a top 10 drug expense within the hospital sector by the end of 2020. The FDA Unapproved Drugs Initiative: an observational study of the consequences for drug prices and shortages in the United States doi = 10.1016/j.mayocp.2020.06.025 id = cord-273150-bz617ovx author = John, Teny M. title = Migratory Pulmonary Infiltrates in a Patient with COVID-19 Infection and the Role of Corticosteroids date = 2020-06-24 keywords = COVID-19 summary = 2 Herein, we present a patient with chronic lymphocytic leukemia who developed organizing pneumonia (OP) as a late manifestation of COVID-19 after an initial improvement, who was successfully treated with corticosteroids. The patient was enrolled in John 4 the Mayo Clinic COVID-19 expanded access program for convalescent plasma (CCP) on day 9 of her illness and received one dose of CCP. A repeat chest CT, on day 17 of illness ( Figure 1, panel B) , revealed new and migratory ground-glass opacities in both lungs that were consistent with an organizing pneumonia (OP) pattern. 6 John 5 Ibrutinib, a highly potent inhibitor of BTK, is considered to protect against lung injury in COVID-19. Time to consider histologic pattern of lung injury to treat critically ill patients with COVID-19 infection The BTK-inhibitor ibrutinib may protect against pulmonary injury in COVID-19 infected patients doi = 10.1016/j.mayocp.2020.06.023 id = cord-322714-s0wge7o4 author = Joyner, Michael J. title = Safety Update: COVID-19 Convalescent Plasma in 20,000 Hospitalized Patients date = 2020-07-19 keywords = COVID-19; plasma summary = Recently, our investigation of key safety indicators in 5,000 patients transfused with COVID-19 convalescent plasma demonstrated an incidence of transfusion-related serious adverse events (SAE) of less than 1% and a mortality rate of 14.9% 10 . Web-based, standardized data reporting surveys were completed to assess clinical status of patients at regular time intervals (four-hours and seven-days after convalescent plasma transfusion) using the Research Electronic Data Capture system (REDCap, v.9.1.15 Vanderbilt University, Nashville, TN) 14, 15 . In this safety update of the US Convalescent Plasma Expanded Access Program of 20,000 hospitalized patients in the US with severe or life-threatening COVID-19, the overall frequency of SAEs classified as attributable or likely secondary to convalescent plasma transfusion continued to be low (<1% of all transfusions) and the seven-day mortality rate in this extremely high risk cohort was 8.6%. doi = 10.1016/j.mayocp.2020.06.028 id = cord-260402-9b1ltcf1 author = Lang, Adam Edward title = More Than Meets the Eye: The Similarities Between COVID-19 and Smoking date = 2020-08-11 keywords = SARS summary = To the Editor: Research shows that cigarette smoking upregulates ACE2, the receptor by which SARS-CoV-2 gains entry to the host resulting in COVID-19, in the lungs and therefore potentially leads to increased morbidity [1] . As part of a tobacco treatment campaign implemented at the beginning of the pandemic at McDonald Army Health Center, the authors performed a literature search and found that SARS-CoV-2 and smoking both contribute to myocarditis, thrombosis, immune impairment, and increased inflammation. SARS-CoV-2 and smoking upregulate this cytokine release and lead to an increased risk of coagulopathy [4, 5] . The upregulation of ACE2 in smokers may predispose this population to an increased risk of SARS-CoV-2 infection. The host cell transmembrane protease, serine 2 (TMPSRSS2), which primes the SAR-CoV-2 S protein for entry, may also be upregulated in smokers [6] , which would further increase the odds of viral infectivity. Smoking-Mediated Upregulation of the Androgen Pathway Leads to Increased SARS-CoV-2 Susceptibility doi = 10.1016/j.mayocp.2020.08.008 id = cord-280123-44206n7t author = Lucey, Michael R. title = The Heightened Risk of Fatty Liver Disorders in the Time of COVID-19 date = 2020-10-22 keywords = Alcohol summary = The pre-covid reasons for the growth in obesity/metabolic syndrome on the one hand, and alcohol use disorder (AUD) on the other are complex, but the trends are unequivocal. Furthermore, the growth in high-risk drinking and DSM-IV Alcohol Use Disorder (AUD) was seen in women, older-adults, racial/ethnic minorities, and lower income/educational levels [4] . [6] They used the Mayo Clinic Biobank to ask the question: how do alcohol consumption, body mass, and fatty liver disorder interact? Their analysis shows that increased body mass and alcohol, particularly with heavy alcohol use, interact in the path to fatty liver, whereas moderate alcohol consumption by persons with normal BMI and overweight is associated with lower mortality. A cohort study examining the interaction of alcohol consumption and obesity in hepatic steatosis and mortality Effect of chronic alcohol consumption on the development and progression of non-alcoholic fatty liver disease (NAFLD) Global Burden of Alcohol Use Disorders and Alcohol Liver Disease doi = 10.1016/j.mayocp.2020.10.020 id = cord-258307-nsdhvc8w author = Maki, Dennis G. title = SARS Revisited: The Challenge of Controlling Emerging Infectious Diseases at the Local, Regional, Federal, and Global Levels date = 2011-10-20 keywords = Hong; Kong; SARS; acute; severe summary = The most recent and perhaps most fearsome emerging infections are the appearance of West Nile virus encephalitis in New York City in 1999 and its rapid spread westward 6 ; inhalation anthrax, deriving from use of Bacillus anthracis spores as a biologic weapon against the US civilian population in 2001 7 ; the global outbreak of severe acute respiratory syndrome (SARS) in 2003 8 ; and the looming threat of pandemic influenza, especially global disease caused by the highly virulent avian subtype A (H5N1). If it is not, the effort will not have been wasted because it is likely that all the planning and resource allocation will prove invaluable for controlling the spread of natural emerging pathogens, such as SARS-CoV or a new strain of influenza virus, which are probably far more likely to pose a serious threat to human and animal health in the United States and worldwide. doi = 10.4065/79.11.1359 id = cord-319023-ucm8frol author = Nuzzo, Andrea title = Universal Shelter-in-Place vs. Advanced Automated Contact Tracing and Targeted Isolation: A Case for 21st-Century Technologies for SARS-CoV-2 and Future Pandemics date = 2020-06-22 keywords = AACT; SARS; contact summary = Model parameters included percentage population ordered to shelter-in-place, adoption rate of AACT, and percentage individuals who appropriately follow recommendations. Conclusion Wide adoption of digital contact tracing can mitigate infection spread similar to universal shelter-in-place, but with considerably fewer individuals isolated. Such Advanced Automated Contact Tracing (AACT) systems -which could infer exposure risk and propagate warnings to people at risk -may help curb disease spread by facilitating targeted self-isolation rather than universal mandates such as shelter-inplace. In AACT, an additional compartment Sq (Traced contacts that are exposed and under selfisolation) was used while for shelter-in-place, the compartment Q (Individuals isolated through universal enforcement measures) was used. The basic difference between the models is that isolation/quarantine is based solely on exposure history in AACT, while isolation orders apply to the entire population in universal shelter-in-place. Contact tracing can mitigate disease spread through a curated approach of identifying and isolating exposed individuals, as opposed to shelter-in-place orders. doi = 10.1016/j.mayocp.2020.06.027 id = cord-346607-1mewok8l author = Oesterle, Tyler S. title = Substance Use Disorders and Telehealth in the COVID-19 Pandemic Era: A New Outlook date = 2020-10-21 keywords = COVID-19; SUD; patient; treatment summary = This article reviews current literature for the use of tele/virtual interventions in the treatment of SUDs and offers recommendations on safe an effective implementation strategies based on the current literature. The COVID-19 pandemic makes it imperative for clinical practice to adapt rapidly in order to meet patient needs for SUD treatment while reducing risk of COVID-19 infection; hence, many providers are now using telehealth for the first time. When compared to treatment as usual for Alcohol Use Disorder, the addition of telephone-based services has been shown to improve abstinence rates and reduce binge drinking in the short term but not after the cessation of the interventions examined with no increase in adverse outcomes. A number of studies have shown group based treatment by videoconference, both support groups and treatment groups, including those targeting tobacco, alcohol and opioid use disorders have been shown to provide safe intervention, high patient satisfaction and appear to have similar outcomes to in person treatments. doi = 10.1016/j.mayocp.2020.10.011 id = cord-328548-5kjq9xqs author = Oliveira J. e Silva, Lucas title = Flexibilization of Science, Cognitive Biases, and the COVID-19 Pandemic date = 2020-08-27 keywords = COVID-19; evidence summary = A subsequent high-profile paper associating the use of hydroxychloroquine with increased mortality in the treatment of COVID-19 had to be retracted 2 after scientists pointed out issues such as mismatched mortality rates when compared to Australian official reports, no release of the dataset for independent analysis, and lack of thorough ethical review. The term "flexibilization" here refers to a loosening of methodological standards and the development of low-quality studies, leading to the creation of unreliable data and, later in the cycle, of anecdotal evidence. Within this context, science and clinical research have been creating rigorous methodological standards in order to produce high-quality studies that allow us to have greater confidence in the evidence while mitigating unnecessary damage. During the COVID-19 pandemic, the early adoption of new interventions by clinicians and policy makers based on promising but often low-quality data is creating a scenario from which anecdotal evidence may emerge. doi = 10.1016/j.mayocp.2020.06.037 id = cord-318205-qxkel0ww author = Parkulo, Mark A. title = Risk of SARS-CoV-2 Transmission Among Coworkers in a Surgical Environment date = 2020-10-22 keywords = SARS summary = This was an observational study of 394 health care workers in a surgical environment who were exposed to 2 known SARS-CoV-2–positive coworkers. Infections of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) among health care workers is a serious consequence of the coronavirus disease 2019 (COVID-19) pandemic. Of the COVID-19 cases reported to the US Centers for Disease Control and Prevention (CDC) between February 12 and April 9, 2020, that contained information about workers, 19% were identified as health care personnel. 2, 3 Here we report the outcome of a widespread surveillance program in a surgical area which was implemented as a result of health care workers testing positive for SARS-CoV-2 at Mayo Clinic, Jacksonville, Florida. Employee Health determined that 394 other employees worked in the surgical area at the same time as the index cases, and all were recommended to undergo SARS-CoV-2 PCR testing as surveillance. doi = 10.1016/j.mayocp.2020.10.016 id = cord-334708-lbmktall author = Putman, Michael S. title = Publication Rate and Journal Review Time of COVID-19 Related Research date = 2020-08-31 keywords = COVID-19 summary = doi = 10.1016/j.mayocp.2020.08.017 id = cord-255389-2fufd0ba author = Razonable, Raymund R. title = Mayo Clinic Strategies for COVID-19 Clinical Guidance and the Delivery of Care for Patients With Coronavirus Disease 2019 date = 2020-06-23 keywords = COVID-19 summary = title: Mayo Clinic Strategies for COVID-19 Clinical Guidance and the Delivery of Care for Patients With Coronavirus Disease 2019 Herein, we describe our strategies for developing and successfully implementing a clinical guidance that assists our health care providers in caring for patients with SARS-CoV-2 infection. Likewise, we developed a COVID-19 Treatment Registry that allows us to monitor our clinical practice and optimize our management guidance on the basis of our evolving clinical experience. The clinical guidance has been continually updated and made available to health care providers on a dedicated institutional COVID-19 webpage. This clinical team rapidly developed expertise in COVID-19 care because they served as consultants to frontline health care providers. The COVID-19 clinical guidance continues to evolve as new information is gathered from our clinical experience and as updated management strategies are published in the literature. doi = 10.1016/j.mayocp.2020.05.037 id = cord-007864-kxyu5nzp author = Sampathkumar, Priya title = Dealing With Threat of Drug-Resistant Tuberculosis: Background Information for Interpreting the Andrew Speaker and Related Cases date = 2011-10-20 keywords = MDR summary = Transmission of TB on board a commercial aircraft during long-distance flights has been reported several times, [19] [20] [21] [22] but no case of active TB disease resulting from exposure on board has been identified subsequently. The WHO first published guidelines regarding TB and air travel in 1998 and revised them in 2006 in response to increased concerns about resistant forms of TB and improved international collaboration in dealing with infectious disease risks. Epidemiologic notes and reports nosocomial transmission of multidrug-resistant tuberculosis among HIV-infected persons-Florida Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa Gerberding, MD, MPH, on recent case of extensively drug resistant TB: CDC''s public health response. CDC investigation of traveler with extensively drug-resistant tuberculosis (XDR TB): questions and answers for passengers and flight crew on affected flights doi = 10.4065/82.7.799 id = cord-329779-5sauq4gp author = Sanchis-Gomar, Fabian title = In Reply – Association of Renin Angiotensin System Blockers with Outcomes in Patients With COVID-19 date = 2020-09-14 keywords = COVID-19 summary = doi = 10.1016/j.mayocp.2020.09.011 id = cord-285569-ei9w19i7 author = Shah, Aditya title = Guide to Understanding the 2019 Novel Coronavirus date = 2020-02-28 keywords = China; SARS summary = A cluster of cases of pneumonia caused by a novel coronavirus, COVID-19, was first reported in Wuhan in the Hubei province in China in late December 2019. 1 Beta coronaviruses include severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and the coronavirus variant COVID-19 virus first described in Wuhan. SARS-CoV disproportionately impacted health care workers (HCWs) in countries with the most reported cases. Similar to SARS-CoV, presentation is typically fever with symptoms of lower respiratory tract infection and radiographic evidence of pneumonia or ARDS. 16 The Centers for Disease Control and Prevention (CDC) has issued interim guidance for HCWs. 17 Novel coronavirus should be suspected if patients meet the criteria described in Table 1 . Clinical features of patients infected with 2019 novel coronavirus in Wuhan Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China doi = 10.1016/j.mayocp.2020.02.003 id = cord-331754-4cssullk author = Shakshouk, Hadir title = Purple Fingers and Toes date = 2020-05-20 keywords = perniosis summary = doi = 10.1016/j.mayocp.2020.02.025 id = cord-268470-dgxn32ls author = Sharma, Abhishek title = Obesity is Associated with More Critical Illness in COVID-19 date = 2020-07-02 keywords = COVID-19 summary = To the Editor: In follow-up to recent major state-of-the-art review on Obesity and Outcomes in SARS-CoV-2 (COVID-19), 1 we have additional data regarding the relationship of obesity with outcomes in patients with COVID-19. We performed a rapid review and meta-analysis to evaluate whether obesity is associated with worse outcomes in patients with COVID-19. The following key words were used for search in different combinations: "Coronavirus 2019", "Covid-19", "SARS-CoV2", "Obesity", "Body mass index", and "Outcomes". The primary outcome was critical illness In this rapid review and meta-analysis, obesity was associated with a 39% increased risk of critical illness, defined by individual study protocol as ICU admission, need for IMV, or hospice admission or death. Despite these study limitations, however, our data of a 39% increase in worse outcomes associated with obesity strongly supports the recent paper in Mayo Clinic Proceedings. Factors associated with hospitalization and critical illness among 4,103 patients with COVID-19 disease in New York City doi = 10.1016/j.mayocp.2020.06.046 id = cord-030903-hhhjwoei author = Sinsky, Christine A. title = Implementing Telemedicine in Primary Care: Learning Lessons From Electronic Health Records date = 2020-08-27 keywords = EHR summary = title: Implementing Telemedicine in Primary Care: Learning Lessons From Electronic Health Records Inequity in payment for cognitive versus procedural care 2 ; conflating how primary care has been valued with its value; equating the payment allocated for primary care services with the difficulty in their mastery (contributing to the assumption that lesser training is of little consequence in primary care); and a shrinking scope of practice for physicians within the specialty are among the reasons our health system has not benefitted fully from what a well-supported, well-organized model of primary care has to offer. Instead, using an organized system of care, all of the patient''s annual needs for prevention and chronic illness monitoring can be arranged at a single, coordinated appointment rather than being fragmented, with the patient contacted 1 month for their mammogram, the next month for their pneumococcal vaccine, and at yet another time for their urine test for microalbumin. doi = 10.1016/j.mayocp.2020.07.017 id = cord-298368-vuxp0l50 author = Suh, Gina A. title = Mayo Clinic Strategies for COVID-19 Avoiding a Medical Education Quarantine During the Pandemic date = 2020-06-20 keywords = trainee summary = title: Mayo Clinic Strategies for COVID-19 Avoiding a Medical Education Quarantine During the Pandemic To protect everyone involved from potential exposure to COVID-19, we implemented various strategies in order to provide educational conferences, including technology-based solutions such as Zoom (Zoom Video Communications, Inc), Skype for Business (Microsoft), Webex (Cisco Systems), and Slido (Slido). Another key component of medical education for trainees is hands-on patient care supplemented by teaching rounds. 1 Mayo Clinic implemented a moratorium on bedside group-teaching rounds to limit provider exposures to potentially infected patients, as well as to adhere to an institutional mandate to preserve personal protective equipment. A similar approach was implemented in the clinics, where virtual visits using telemedicine resources, including video conferencing, and telephone visits were Besides providing continued training, it was imperative for the institution and individual training programs to provide trainees with additional support for mental and physical health during the emotionally and psychologically taxing pandemic. doi = 10.1016/j.mayocp.2020.06.011 id = cord-269568-vwkawh6x author = Ten Hulzen, Richard D. title = Impact of Hearing Loss and Universal Face Masking in the COVID-19 Era. date = 2020-08-03 keywords = SARS; mask summary = Abbreviations: COVID-19 = coronavirus disease 2019; dB = decibel; ED = Emergency Department; FFP = filtering face piece; FM = frequency modulation; Hz = Hertz; ICU = Intensive Care Unit; N95 mask = a particulate-filtering face mask that filters at least 95% of airborne particles; PPE = personal protective equipment; PSAPs -personal sound amplification products; SARS-CoV-2 = severe acute respiratory syndrome-coronavirus-2. We''d like to call attention to the negative impacts of universal masking and social distancing in both health-care and community settings for individuals with hearing loss. Social Healthcare professionals should recognize that, with the loss of visual cues (i.e., lip reading) and support systems (e.g., family members), current COVID-19 policies such as universal masking, social distancing, and unaccompanied patients may "unmask" significant hearing loss-related issues that previously had been diminished or ignored. doi = 10.1016/j.mayocp.2020.07.027 id = cord-292606-tqjmg3qb author = Testori, Alessandro title = THE “PERFECT CYTOKINE STORM” OF COVID-19 date = 2020-05-29 keywords = inflammatory summary = The vast majority of the deaths caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) are patients over the age of 55, which died of Acute Respiratory Distress Syndrome (ARDS). IL -10 is another anti-inflammatory molecule that could be tested and it could be administered via a genetherapy approach using naked plasmid DNA vectors 4 engineered to produce IL-10 inside the recipient cells, thus reducing the cost and simplifying production. Countries need to invest in technologies like DNA vaccines 5 and antiviral gene therapy strategies, like RNAi technology, which is an ideal tool for inhibiting viral replication in host cells as the siRNA can interact with certain viral genes and silence their expression. We need to develop detailed protocols now on how to quickly produce vaccines and antivirals, that can be adapted to future viral pandemics. doi = 10.1016/j.mayocp.2020.05.015 id = cord-294728-fefkvg0a author = Vick, Dan J. title = GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G6PD) DEFICIENCY AND COVID-19 INFECTION date = 2020-06-06 keywords = G6PD summary = title: GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G6PD) DEFICIENCY AND COVID-19 INFECTION 2 There is evidence to suggest an association between G6PD deficiency and increased susceptibility to, and severity of illness with, COVID-19 infection. Vascular endothelial dysfunction and coagulopathy have been suggested as complications of COVID-19, based on a report of large vessel ischemic stroke occurring in five U.S. patients under age 50, including two without preexisting conditions. However, a recent report described an acute hemolytic episode occurring in a COVID-19 patient with G6PD deficiency who was treated with hydroxychloroquine. 12 Hydroxychloroquine may increase the oxidative stress in COVID-19 patients with G6PD deficiency, thereby serving as a trigger for hemolytic anemia. Studies are needed to determine whether a positive correlation exists between G6PD deficiency and COVID-19, with respect to increased susceptibility to infection and severity of illness. Acute hemolysis by hydroxychloroquine was observed in G6PD-deficient patient with severe COVID-19 related lung injury doi = 10.1016/j.mayocp.2020.05.035 id = cord-276194-4sfc7hal author = Vijayvargiya, Prakhar title = In Reply–The “Perfect Cytokine Storm” of COVID-19 date = 2020-05-29 keywords = COVID-19 summary = To the Editor:We read with great interest the letter by Testori regarding our Review article "Treatment Considerations for COVID-19: A Critical Review of the Evidence (or Lack Thereof)," 1 Testori pointed out the important association of pro-inflammatory cytokines in the pathogenesis of Coronavirus disease 2019 , which could account for the worse outcome in older individuals. Baricitinib will be tested as one of the drugs in the National Institute of Allergy and Infectious Diseases (NIAID) Adaptive COVID-19 Treatment Trial (ACTT). Since the online publication of our review, the investigational RNA-dependent RNA inhibitor, remdesivir, has been granted emergency use authorization in United States Food and Drug Administration based on preliminary data obtained from the ACTT. Treatment Considerations for COVID-19: A Critical Review of the Evidence (or Lack Thereof) NIH Clinical Trial Shows Remdesivir Accelerates Recovery from Advanced COVID-19 doi = 10.1016/j.mayocp.2020.05.016 id = cord-317668-cc5oyiwp author = Wieland, Mark L. title = Mayo Clinic Strategies for COVID-19 Community Engagement With Vulnerable Populations date = 2020-06-22 keywords = community summary = title: Mayo Clinic Strategies for COVID-19 Community Engagement With Vulnerable Populations The coronavirus disease 2019 (COVID-19) pandemic has impacted vulnerable populations disproportionately, including those affected by socioeconomic disadvantage, racial discrimination, low health literacy, immigration status, and limited English proficiency. Preexisting disparities in chronic diseases that are associated with worse COVID-19 outcomes and less access to health care have resulted in a higher case-fatality rate. Community engagement, "the process of working collaboratively with and through groups of people… to address issues affecting the well-being of those people," 2 can help empower communities in promoting COVID-19 prevention and containment. Herein, we describe some of the CEnR approaches used at Mayo Clinic in response to the needs of medically underserved and socioeconomically disadvantaged communities. Leveraging community engaged research partnerships for crisis and emergency risk communication to vulnerable populations in the COVID-19 pandemic doi = 10.1016/j.mayocp.2020.05.041