Comparison of COVID-19 and Influenza-Related Outcomes in the United States during Fall-Winter 2022-2023: A Cross-Sectional Retrospective Study

Influenza and COVID-19 contribute significantly to the infectious disease burden during the respiratory season, but their relative burden remains unknown. This study characterizes the frequency and severity of medically attended COVID-19 and influenza during the peak of the 2022-2023 influenza season in the pediatric, adult, and older adult populations and characterizes the prevalence of underlying conditions among patients hospitalized with COVID-19. This cross-sectional analysis included individuals in the Veradigm EHR Database linked to Komodo claims data with a medical encounter between 1 October 2022 and 31 March 2023 (study period). Patients with medical encounters were identified with a diagnosis of COVID-19 or influenza during the study period and stratified based on the highest level of care received with that diagnosis. Among 23,526,196 individuals, there were more COVID-19-related medical encounters than influenza-related encounters, overall and by outcome. Hospitalizations with COVID-19 were more common than hospitalizations with influenza overall (incidence ratio = 4.6) and in all age groups. Nearly all adults hospitalized with COVID-19 had at least one underlying medical condition, but 37.1% of 0-5-year-olds and 25.0% of 6-17-year-olds had no underlying medical conditions. COVID-19 was associated greater burden than influenza during the peak of the 2022-2023 influenza season.

Comparative Effectiveness of Bivalent (Original/Omicron BA.4/BA.5) COVID-19 Vaccines in Adults

The emergence of Omicron variants coincided with declining vaccine-induced protection against SARS-CoV-2. Two bivalent mRNA vaccines, mRNA-1273.222 (Moderna) and BNT162b2 Bivalent (Pfizer-BioNTech), were developed to provide greater protection against the predominate circulating variants by including mRNA that encodes both the ancestral (original) strain and BA.4/BA.5. We estimated their relative vaccine effectiveness (rVE) in preventing COVID-19-related outcomes in the US using a nationwide dataset linking primary care electronic health records and pharmacy/medical claims data. The study population (aged ≥18 years) received either vaccine between 31 August 2022 and 28 February 2023. We used propensity score weighting to adjust for baseline differences between groups. We estimated the rVE against COVID-19-related hospitalizations (primary outcome) and outpatient visits (secondary) for 1,034,538 mRNA-1273.222 and 1,670,666 BNT162b2 Bivalent vaccine recipients, with an adjusted rVE of 9.8% (95% confidence interval: 2.6-16.4%) and 5.1% (95% CI: 3.2-6.9%), respectively, for mRNA-1273.222 versus BNT162b2 Bivalent. The incremental relative effectiveness was greater among adults ≥ 65; the rVE against COVID-19-related hospitalizations and outpatient visits in these patients was 13.5% (95% CI: 5.5-20.8%) and 10.7% (8.2-13.1%), respectively. Overall, we found greater effectiveness of mRNA-1273.222 compared with the BNT162b2 Bivalent vaccine in preventing COVID-19-related hospitalizations and outpatient visits, with increased benefits in older adults.

The impact of a Facebook campaign among mothers on HPV vaccine uptake among their daughters: A randomized field study

OBJECTIVE

The popularity of social networks provide an incredible opportunity to enhance the impact of preventive medicine programs. We aimed to assess whether a targeted Facebook campaign among mothers may increase the uptake of human Papilloma virus (HPV) immunization among their 8th-grade daughters.

METHODS

This field study was conducted among the members of a state-mandated health organization in Israel. Included were all 21,592 members who were mothers to 14 year-old daughters in the 2018-19 school-year. A total of 17,271 (80%) were randomly allocated to the campaign arm and the rest (n=4,321) were selected as a reference group. The Facebook ads addressed issues and concerns regarding HPV-related diseases and HPV vaccine. Main outcome measures were Facebook metrics on exposure to campaign and HPV immunization among eighth grade daughters of the study participants.

RESULTS

Between 8/2018-10/2018, Facebook ads were shown 1.8-million times (a reach of 88%). The uptake of HPV vaccine among daughters of women allocated to the campaign arm (55.3%) was similar (p = 0.749) to 55.0% in the control group. The only significant differences between study groups were observed when stratifying by SES level. In the lowest SES quartile, Facebook campaign significantly (p = .02) reduced vaccine uptake (35% vs. 39.0%), with a relative risk of 0.90 (95%CI: 0.82-0.98), while in the second SES quartile, Facebook campaign increased vaccine uptake from 52.6% to 55.8%, with a RR of 1.06 (95%CI,1.00-1.12). Among mothers in higher SES levels, daughters of exposed and unexposed mothers had similar immunization rates.

CONCLUSIONS

Facebook campaign may increase the uptake of HPV vaccine among daughters to mothers of medium-to-low SES level, but it may reduce vaccination among lower SES groups.

Three-dimensional distribution patterns of newborn neurons in the adult olfactory bulb

We present a new method to study the three-dimensional (3D) spatial distribution patterns of newborn neurons in the mouse olfactory bulb (OB). Newborn neurons were transduced, in vivo, using lentiviruses to express green fluorescent protein (GFP). Two-photon (2P) microscopy was used to image thick OB slices (approximately 250 microm) at single cell resolution. Image-stacks were captured semi-automatically, and concatenated offline, to create larger image-stacks containing the positional information of all the labeled neurons. Serial reconstruction of the large image-stacks resulted in a three-dimensional virtual model, containing the exact position of all the labeled newborn neurons within large volumes of the OB. The feasibility of this method was demonstrated by analyzing the cell distributions of thousands of GFP labeled newborn neurons. This analysis identified 3D clusters in which the newborn cells' density is significantly higher than the mean density. We show that our method reveals information that is overlooked when sampling only a small fraction of the tissue in 2D. This method may serve as a valuable tool, not only for analyzing newborn neurons in the OB, but also for other neuronal types as well as for other brain regions.

Evaluating satisfaction with a child and adolescent psychological telemedicine outreach service

A child and adolescent telepsychiatry service in rural New South Wales was evaluated. Part of the evaluation was to assess whether rural mental health workers and patients were satisfied with the videoconferencing services provided by child psychiatrists from the Children's Hospital at Westmead. During a 12-month study, information was collected using questionnaires on a total of 136 new patients who had been interviewed via videoconferencing. Satisfaction questionnaires were completed by 100 rural mental health workers, and 82 patients and their families/carers. Questionnaires about satisfaction with the technology were completed by 136 child psychiatrists, 101 rural mental health workers and 79 patients. Patients and their families/carers, as well as rural clinicians, expressed high overall satisfaction with the telepsychiatry service. The evaluation suggested that videoconferencing is a good method of providing child and adolescent psychiatry services to remote and rural communities.

Technique sensitivity: biological factors contributing to clinical success with various restorative materials

Since the 1950s, clinicians have relied on various formulations of Ca(OH)2 to stimulate dentin bridge formation. Various studies (Kozlov and Massler, 1966; Massler, 1967; Brännström, 1978; Cox et al., 1987; Snuggs et al., 1993) have demonstrated that pulp healing and dentin bridging can occur against a pH spectrum of materials. Recent studies (Akimoto et al., 1998; Cox et al., 1998, 1999; Tarim et al., 1998; Kitasako et al., 1999; Hafez et al., 2000) have reported successful pulp healing and dentin bridging using adhesives for direct capping of exposed pulps. However, others (Costa et al., 1997; Stanley and Pameijer, 1997; Pameijer, 1998; Hebling et al., 1999; Carvalho et al., 2000) have reported unsatisfactory results when exposures were direct-capped with adhesives. Biological and technical factors, or a combination of both, might be postulated to explain these differences. Recent studies have demonstrated that biological success is dependent upon proper hemorrhage control at the exposure site. This review explores the differences and common factors influencing successful dentin bridging, focusing on data derived from animal studies conducted according to ISO usage guidelines for cavity preparation and material placement. In the past, there has been concern that etching of vital dentin leads to immediate pulp death due to low pH. Recent studies have reported that acidic cements cause breakdown of only the smear layer and fail to seal the restoration interface, leading to inflammation and necrosis. A properly hybridized dentinadhesive interface provides a "bacteriometic" seal to both dentin and pulp tissues. Recent ISO usage studies have shown a high incidence of dentin bridging with adhesives following proper hemorrhage control and removal of both operative debris and biofilm at the dentin-pulp interface by agents such as NaOCl. These are important technique-sensitivity factors to be considered for pulp healing and dentin bridge formation.

Posttraumatic symptoms in South African police exposed to violence

A study was undertaken with 55 Internal Stability Unit (ISU) members of the South African Police (SAP) to establish whether the situations under which they work, continuous and current, as opposed to prior, traumatic exposure, would result in a particular type of traumatic symptom constellation. The results indicated that the traumatic stressor of witnessing a traumatic event was predictive of the symptoms of intrusion. However, symptoms of intrusion were correlated with symptoms of avoidance, suggesting that avoidance may be a defensive response to intrusive phenomena which are a direct effect of exposure to violence. Various hypotheses were suggested to explain this phenomenon, focusing on the need for denial within a macho police culture and the particular features of the South African scenario.

Moisture susceptibility of resin-modified glass-ionomer materials

The purposes of this experiment were to determine if resin-modified glass-ionomer cements are less sensitive to moisture than are conventional glass-ionomer cements, to investigate the effects of barrier coatings, and to study the effects of different setting environments. Discoid specimens of a variety of resin-modified glass-ionomer materials and a conventional glass-ionomer cement control were stored in different environments and were protected with different barrier coatings. The diametral tensile strengths of the specimens were determined and analyzed with three-way analysis of variance. Resin-modified glass-ionomer cements are less sensitive to moisture than is the conventional glass-ionomer cement control. Drier environments produced stronger resin-modified glass-ionomer specimens. Use of a fissure sealant as a barrier coating increased overall specimen strength, and the individual materials differed in strength.