Purpose/Objective(s)

The 2019 coronavirus pandemic (COVID-19) had a broad impact on the care of cancer patients, including the rapid adoption of telehealth video visits. On March 15, 2020, our institutional leadership recommended transition to video visits, which posed a risk of altering patients’ access to care. We assessed the impact of this rapid transition on demographic patterns in an urban academic radiation oncology department.

Materials/Methods

Consultation and follow-up visits from the pre-COVID-19 period (January 1, 2019 to March 14, 2020) and COVID-19 period (March 15, 2020 to August 31, 2020) in a single radiation oncology department were identified. Demographics and appointment data were abstracted from the institutional electronic health record. Time trends and patient and visit characteristics were compared across the pre-COVID-19 and COVID-19 periods.

Results

During the study period, 9,450 consult and follow-up visits were performed pre-COVID-19 and 3,298 visits in the COVID-19 period. The proportion of video visits increased markedly in the transition period, from 0.6% of all visits in the week of March 2, 2020, to 87% in the week of March 23, 2020. In-person visits decreased from 98% to 3%. Among all visits (in-person and telehealth), those during the COVID-19 period were less likely to be new consultations (43.1% from 60.1%; P < 0.001). There was a small and significant increase in the proportion of visits with patients who: identified as white (61.8% from 58.4%, P = 0.019), spoke English as their primary language (91.3% from 89.4%, P = 0.002), and had commercial insurance (34.1% from 32.0%; P = 0.009).

Conclusion

The overall COVID-19 clinic population retained demographic features similar to the pre-COVID-19 population despite a very rapid near-complete transition to telehealth. Nonetheless, the telehealth-predominant COVID-19 period had slightly increased visits with patients who were white or primarily English speaking or had commercial insurance. Strategies for ensuring telehealth is accessible to diverse populations should be a priority as telemedicine is integrated into long-term clinical operations.

Drinking water contamination with heavy metals, particularly lead, is a persistent problem worldwide with grave public health consequences. Existing purification methods often cannot address this problem quickly and economically. Here we report a cheap, water stable metal-organic framework/polymer composite, Fe-BTC/PDA, that exhibits rapid, selective removal of large quantities of heavy metals, such as Pb²⁺ and Hg²⁺, from real world water samples. In this work, Fe-BTC is treated with dopamine, which undergoes a spontaneous polymerization to polydopamine (PDA) within its pores via the Fe³⁺ open metal sites. The PDA, pinned on the internal MOF surface, gains extrinsic porosity, resulting in a composite that binds up to 1634 mg of Hg²⁺ and 394 mg of Pb²⁺ per gram of composite and removes more than 99.8% of these ions from a 1 ppm solution, yielding drinkable levels in seconds. Further, the composite properties are well-maintained in river and seawater samples spiked with only trace amounts of lead, illustrating unprecedented selectivity. Remarkably, no significant uptake of competing metal ions is observed even when interferents, such as Na⁺, are present at concentrations up to 14 000 times that of Pb²⁺. The material is further shown to be resistant to fouling when tested in high concentrations of common organic interferents, like humic acid, and is fully regenerable over many cycles.

Background: Despite strong evidence for the effectiveness of anti-retroviral therapy for improving the health of women living with HIV and for the prevention of mother-to-child transmission (PMTCT), HIV persists as a major maternal and child health problem