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Objective: Understanding variables associated with coronavirus disease 2019 (COVID-19) vaccine confidence and hesitancy may inform strategies to improve vaccine uptake in clinical settings such as the emergency department (ED). We aim to identify factors contributing to COVID-19 vaccine acceptance and to assess patient attitudes surrounding offering COVID-19 vaccines in the ED. Methods: We conducted a survey of a convenience sample of patients and patient visitors over the age 18 years, who were native English or Spanish speakers. The survey was conducted from March through August 2021 at 3 EDs in New York City. The survey was administered via an electronic format, and participants provided verbal consent. Results: Our sample size was 377. Individuals with post-graduate degrees viewed vaccines positively (Prevalence Ratio [PR], 1.63; 95% Confidence Interval [CI], 1.07-2.47).  Of the various high-risk medical conditions associated with adverse COVID-19 infection outcomes, diabetes was the only condition associated with more positive views of vaccines (PR, 1.37; CI, 1.17-1.59). Of all participants, 71.21% stated that they believed offering a COVID-19 vaccine in the ED was a good idea. Of unvaccinated participants, 21.80% stated they would get vaccinated if it were offered to them in the ED. Conclusion: EDs can serve as a safety net for vulnerable populations and can act as an access point for vaccination.

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The aim is to introduce and characterize a new experimental demonstrative model contributing to the increase of measurement accuracy, in terms of minimum detectable activity (MDA) and background reduction, for the analysis of samples having low concentrations in tritium and radiocarbon on Quantulus 1220. The clue is related to the qualitative and quantitative differences between tritium and carbon-14 inventories of the pulp used to manufacture the cups involved in noncatalytic combustion of samples by flame oxidation method. The quality of the experimental results depends on the temporal origin of the wood from which the pulp/cellulose was extracted/purified, the specific inventory contributing to the threshold level of the MDA for the beta-emitting radionuclide to be investigated. Finally, the aim is to create and to use such a 100% old cellulose combustion cups for determining low concentrations of these radionuclides. It may be obtained by an adapted technology following the literature data and may be recommended for routine analyses of environmental samples coming from areas with no nuclear or minor nuclear influences, and also for low-level biological samples. This first attempt resulted in improvement of measurement performances up to 400% for carbon-14 and by approximately 50% for tritium.

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The incidence of obstructive sleep apnea has been underestimated in morbidly obese patients who present for evaluation for weight loss surgery. This retrospective study shows that the incidence of obstructive sleep apnea in this patient population is greater than 70 per cent and increases in incidence as the body mass index increases. Obstructive sleep apnea (OSA) is a common comorbidity in obese patients who present for evaluation for gastric bypass surgery. The incidence of sleep apnea in obese patients has been reported to be as high as 40 per cent. A retrospective review of our prospectively collected database was performed. All patients being evaluated for weight loss surgery for obesity were screened preoperatively for OSA using a sleep study. The overall incidence of sleep apnea in our patients was 78 per cent (227 of 290). All 227 were diagnosed by formal sleep study. There were 63 (22%) males and 227 (78%) females. The mean age was 43 years (range, 17-75 years). The mean body mass index (BMI) was 52 kg/m2 (range, 31-94 kg/m2). The prevalence of OSA in the severely obese group (BMI 35-39.9 kg/m2) was 71 per cent. For the morbidly obese group (BMI 40-40.9 kg/m2), the prevalence was 74 per cent and for the superobese group (BMI 50-59.9 kg/m2) 77 per cent. Those with a BMI 60 kg/m2 or greater, the prevalence of OSA rose to 95 per cent. The incidence of sleep apnea in patients presenting for weight loss surgery was greater than 70 per cent in our study. Patients presenting for weight loss surgery should undergo a formal sleep study to diagnose OSA before bariatric surgery.

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BACKGROUND: Although the Medicare Coverage Advisory Committee found that significant evidence supports the safety and effectiveness of bariatric surgery, few data are available on the outcomes of bariatric procedures in patients > or =65 years. The aim of this study was to report on contemporary outcomes of Roux-en-Y gastric bypass (RYGB) in patients > or =65 years. METHODS: We reviewed prospectively collected data from all patients > or =65 years who underwent RYGB at two Florida university-based programs from 1999 to 2005. Similarly, the Florida Discharge Database was queried for patients> or =65 years who had undergone RYGB from 1999 to 2005. The data are presented as the mean +/- SEM. RESULTS: A total of 25 patients > or =65 years had undergone RYGB at our institutions (age 68 +/- 1 years, body mass index 50 +/- 3 kg/m(2)). The overall complication rate was 20%, and the length of stay was 7 +/- 3 days. One patient (4%) died 5 weeks postoperatively of septic complications. For the 13 patients with a median follow-up of 21 months (range 9-61), the percentage of excess body weight loss was 51% +/- 7%; medication use for co-morbidities decreased from 9 +/- 1 to 4 +/- 1 medications/day (P <.01). The Florida Discharge Database reported 231 patients > or =65 years who had undergone RYGB. In that group of patients, the mean age was 67 +/- 0.2 years, the length of stay was 6 +/- 1 days, in-hospital mortality rate was 1.3%, and the overall complication rate was 15%. CONCLUSION: In a small cohort of patients > or =65 years, RYGB resulted in significant weight loss and resolution of obesity-related co-morbidities. The findings from the mandatory reported Florida Discharge Database strongly confirmed the safety of RYGB in patients > or =65 years.

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