Estimating the effect of mobility on SARS-CoV-2 transmission during the first and second wave of the COVID-19 epidemic,Switzerland, March to December 2020

IntroductionHuman mobility was considerably reduced during the COVID-19 pandemic. To support disease surveillance, it is important to understand the effect of mobility on transmission.AimWe compared the role of mobility during the first and second COVID-19 wave in Switzerland by studying the link between daily travel distances and the effective reproduction number (R_t ) of SARS-CoV-2.MethodsWe used aggregated mobile phone data from a representative panel survey of the Swiss population to measure human mobility. We estimated the effects of reductions in daily travel distance on R_t via a regression model. We compared mobility effects between the first (2 March–7 April 2020) and second wave (1 October–10 December 2020).ResultsDaily travel distances decreased by 73% in the first and by 44% in the second wave (relative to February 2020). For a 1% reduction in average daily travel distance, R_t was estimated to decline by 0.73% (95% credible interval (CrI): 0.34–1.03) in the first wave and by 1.04% (95% CrI: 0.66–1.42) in the second wave. The estimated mobility effects were similar in both waves for all modes of transport, travel purposes and sociodemographic subgroups but differed for movement radius.ConclusionMobility was associated with SARS-CoV-2 R_t during the first two epidemic waves in Switzerland. The relative effect of mobility was similar in both waves, but smaller mobility reductions in the second wave corresponded to smaller overall reductions in R_t . Mobility data from mobile phones have a continued potential to support real-time surveillance of COVID-19.     

Tracking Demographic Movements and Immunization Status to Improve Children’s Access to Immunization: Field-Based Randomized Controlled Trial

BackgroundCountries’ Expanded Program on Immunization (EPI) contribute to the reduction of mortality and morbidity, but access to these vaccines remains limited in most low-income countries.ObjectiveWe aim to assess whether involving community volunteers (CVs) to track children’s vaccination status and demographic movements and using recorded data to plan catch-up immunization sessions can improve children’s vaccination timeliness, completeness, and coverage.MethodsThis was a field-based randomized controlled trial and communities of the Foumban health district in West Cameroon were allocated to intervention or control groups. In the intervention group, a CV per community was trained to visit households monthly for a year to assess and record in a register, details of EPI-targeted children, their demographic movements and immunization status. The scanned recorded pages were sent to the health center immunization team through WhatsApp and used to organize monthly community catch-up immunization sessions. In the control group, EPI vaccination sessions were routinely conducted. Surveys were conducted at 6 and 12 months from the beginning of the intervention in both study groups to assess and compare immunization timeliness, coverage, and completeness.ResultsOverall, 30 buildings per cluster were surveyed at midline and endline. Of the 633 and 729 visited households in the intervention group at midline and endline, 630 (99.5%) and 718 (98.4%), respectively, consented to participate. In the control group, 507 and 651 households were visited and 505 (99.6%) and 636 (97.7%), respectively, consented to participate. At 12 months intervention, the month one timeliness of bacille Calmette–Guerin (BCG) vaccine did not increase in the intervention group compared with the control group for the age groups 0-11 months (adjusted odds ratio [aOR] 1.1, 95% CI 0.7-1.8) and 0-59 months (aOR 1.1, 95% CI 0.9-1.4), and significantly increased for the first-year BCG vaccine administration for the age group 0-23 months (aOR 1.5, 95% CI 1.1-2.2). The coverage of diphtheria-pertussis-tetanus and hepatitis B+Hemophilus influenzae type B (DPT-Hi +Hb) dose 3 (aOR 2.0, 95% CI 1.5-2.7) and of DPT-Hi+Hb dose 1 (aOR 1.8, 95% CI 1.4-2.4) vaccines increased significantly in the intervention group compared with the control group in the age groups 12-59 months and 12-23 months, respectively. Specific (DPT-Hi+Hb dose 1 to DPT-Hi+Hb dose 3: aOR 1.9, 95% CI 1.4-2.6) and general (BCG to measles: aOR 1.5, 95% CI 1.1-2.1) vaccine completeness increased significantly in the intervention group compared with the control group.ConclusionsFindings support that involving CVs to track children’s vaccination status and demographic movements and using recorded data to plan catch-up immunization sessions improve children’s vaccination timeliness, completeness, and coverage. This strategy should be adopted to improve access to vaccination for EPI target populations and the consistency verified in other contexts.Trial RegistrationPan African Clinical Trials Registry PACTR201808527428720; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3548     

The Association between Diet Quality and Health Status in Mobile Food Pantry Users in Northeastern Connecticut

Low-income Americans tend to have poor diet quality and disease prevalence overall. Mobile food pantries aim to improve these outcomes, and have rarely been studied. This cross-sectional study aimed to evaluate the association between diet quality and health status in mobile food pantry users. Data were collected from two mobile food pantry sites in Northeastern Connecticut (n = 83). Sociodemographic food security and diet quality data were collected. Overall, diet quality was low among all participants with intakes of fruits, vegetables, and whole grains of concern. Participant adherence to the 2020–2025 US Dietary Guidelines were low, with no participants meeting recommendations for whole grains. Obesity, diabetes, and hypertension prevalence in this population exceeded national averages. After adjusting for covariates, hypertension was associated with higher dairy and added sugar intake, as well as a greater intake of added sugar from sugar-sweetened beverages (p < 0.05). Although results were not statistically significant, participants with obesity, diabetes, and hypertension showed a trend of having lower adherence to the guidelines than those without these chronic diseases. Questions assessing participant interest in changing their diets were also posed, indicating overall high interest in learning about current diet quality and weight improvement.     

Can a Patient use an App at Home to Measure Knee Range of Motion? Utilizing a Mobile App,Curovate, to Improve Access and Adherence to Knee Range of Motion Measurements

IntroductionKnee range of motion is a critical measure of progress after knee injury and knee surgery. However, many patients do not understand the importance of knee range of motion and most do not have a way to self-monitor their knee range of motion at home. The patient being able to measure their own range of motion can provide improved access to this critical health metric, and could improve adherence with their daily knee range of motion exercises. The purpose of this technical report is to determine if a mobile app, Curovate, can provide reliable measures of knee range of motion compared to standard goniometric measurements.ProceduresThere were four positions of knee flexion and four positions of knee extension each measured twice with a standard goniometer and four different mobile devices with the app Curovate. The reliability and validity of the Curovate app was tested across mobile devices and operating systems and compare to goniometric knee range of motion measurements. A total of 80 measurements were taken. All testing was completed on a healthy 23-year-old male with no knee pathology.ResultsA strong positive correlation, Pearson’s r > = 0.9985, for all positions of knee flexion and extension across all four mobile devices as well as each mobile device compared to standard goniometric measurements.ConclusionsThis article presents a unique method for patients to measure their knee range of motion using the mobile app Curovate. Overall, the mobile app, Curovate, was found to have a strong positive correlation across four mobile devices with varying operating systems and compared to goniometric measurements.Level of evidence4     

门诊移动医疗系统设计实施和发展探讨

以南京市第二医院为例,从设计目标、流程架构、具体功能3方面阐述门诊移动医疗系统设计,介绍系统实施应用效果。分析移动医疗发展前景,包括基础功能拓展、移动医疗物联网应用等方面,为相关研究提供参考。     

学术图书馆移动身份认证服务效果分析

阐述移动身份认证技术路径实现原理,以中国医学科学院图书馆虚拟专用网络（VPN）使用数据为参照,重点以2020年2月日志数据为样本,对比分析协和移动身份认证（PUMC ID）和WebVPN的用户访问和数据库利用情况,结合服务效果探讨图书馆建设移动身份认证系统时应考虑的问题,以期为学术型图书馆开展移动访问服务提供参考。     

移动医生查房系统临床实施应用研究

结合陆军军医大学第一附属医院移动医护信息化建设实践,介绍移动查房系统软件架构、网络架构、具体功能及应用优势,指出该系统可实现患者临床信息实时更新和共享,有助于提高医护人员临床决策响应能力和工作效率。     

医学生对移动医疗APP认知和使用情况调查

以重庆医科大学本科生和研究生作为研究对象,调查其对移动医疗APP的认知和使用情况,包括上网设备与时长、知晓率与知晓途径、安装率与安装数量、使用率与频率、安装目的等方面。结果显示医学生对移动医疗APP知晓度高但使用率不高,不同教育层次和不同专业学生对移动医疗APP需求存在差异。     

信息不对称视角下移动医疗APP发展竞争力分析

阐述移动医疗APP内涵与发展,对比分析春雨医生较传统医疗服务模式在诊前、诊时、诊后3个阶段为缓解医疗市场信息不对称所采取的有效措施,探讨其竞争优势及发展劣势并提出建议。