Temporary Shutdown Research Articles

Paramedic educational programs maintain entry level competency throughout the COVID-19 pandemic.

The COVID-19 pandemic required unprecedented changes to emergency medical services (EMS) educational frameworks in the United States. It is unclear if pandemic-related changes impacted paramedic educational outcomes. We aimed to evaluate curricular and performance changes resulting from the initial COVID-19 pandemic on paramedic educational programs. We performed a retrospective cross-sectional evaluation of paramedic educational programs in 2019 and 2020 using the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions annual reports. These reports contain detailed program components and measures of program success. We included programs reporting at least one graduate in the study period. Descriptive statistics (proportions [%], median [interquartile range, IQR]) were calculated for paramedic program characteristics in 2019 and 2020, as well as pandemic specific curriculum changes. Wilcoxon rank-sum and Fisher's exact tests were used to evaluate differences in characteristics by year. The number of paramedic educational programs in our population decreased from 640 programs in 2019 to 612 in 2020, with a statistically significant decrease in clinical hours (2019: 219 [IQR 168‒272]; 2020: 200.5 [IQR 157‒261]). There was no difference in first or third-attempt certification examination success between years. Temporary shutdown was experienced in 34% of programs (duration: 3weeks [2‒7]) and 72% of required curricular changes. Curricular changes commonly included decreased in-person education (86%), traditional classroom lectures (78%), number of clinical sites (78%), and increased online didactic education (92%). Only 20% of programs decreased laboratory simulation or total training hours. During the pandemic, paramedic educational programs changed educational delivery with no observed differences on overall program performance. Identifying key curricular changes and best practices for implementation may be necessary to better optimize future educational delivery.

Low-disturbance land remediation using vertical groundwater circulation well technology: The first commercial deployment in an operational chemical plant

Soil and groundwater contamination by organic pollutants from chemical plants presents significant risks to both environmental and human health. We report a significant field trial where a chemical plant in operation showed soil and groundwater pollution, as verified by sampling and laboratory tests. While many remediation methods are effective, they often require the temporary shutdown of plant operations to install necessary equipment. This paper introduces a novel combination of low-disturbance contaminant remediation technologies, including groundwater circulation well (GCW), pump and treat (P&T), and in-situ chemical oxidation (ISCO) technologies, that can be applied on the premises of an active plant without halting production. The groundwater with dissolved contaminants is removed through P&T and GCW, while GCW enhances ISCO that focus on eliminating the remaining hard-to-pump contaminants. Results show: (1) after two years of remediation effort, the contaminant levels in soil and groundwater were significantly reduced; (2) the average concentration reduction rate of four contaminants, including 1,2-dichloroethane, methylbenzene, ethylbenzene, and M&P-xylene, exceeds 98 %; (3) the presented remediation strategy results in the improvement of remediation efficiency. Specifically, the concentration of 1,2-dichloroethane in observation wells dropped from 40,550.7 μg/L to 44.6 μg/L. This study offers a first-of-its-kind commercial deployment of a GCW-based remediation strategy in an active plant setting. Moreover, the combined remediation approach presented here can serve as a model for designing contaminant remediation projects that require minimal operational disruption.

Valuing public transit: The L‐train shutdown

AbstractIn this article, I quantify the value of access to public transit in New York using the surprise, hurricane‐related announcement of the temporary shutdown of an important piece of transportation infrastructure: the L‐train connecting Brooklyn and Manhattan. My approach allows me to measure changes in housing sales prices by using a change in public transit infrastructure, that is, (a) temporary, and (b) not an outcome of city transit planning, but rather an unexpected consequence of a natural disaster. I find that the L‐train's shutdown announcement caused a temporary decrease in sales prices for affected housing units of 6.4%. This estimate suggests a monthly capitalization rate of public transit access of around $863 for housing units where the L‐train is the nearest subway stop, demonstrating that households in NYC ascribe a high value to transit access. Using these estimates, the benefits of the repair outweigh the costs, with the benefit‐to‐cost ratio of the repairs ranging from 2.76 to 2.78.

Predictive maintenance system for high-end equipment in nuclear power plant under limited degradation knowledge

To ensure the safe operation of high-end equipment, the three-stage maintenance strategy comprising unplanned shutdown, temporary shutdown, and scheduled shutdown is currently employed in nuclear power plants. However, this strategy hinders the acquisition of degradation knowledge (run-to-failure data or degradation mechanism), thereby impeding the application of traditional predictive maintenance systems. Hence, the responsibility for determining the maintenance stage primarily lies with experienced field engineers, and an incorrect decision could potentially result in an unplanned shutdown. To this challenge, we integrate the three-stage maintenance strategy and prognosis methods to form a predictive maintenance system for nuclear power plants. The system framework is first established, and prognosis methods, including sensor selection, degradation trend prediction for short-term prognosis, and remaining useful life (RUL) prediction for long-term prognosis, are then developed under limited degradation knowledge. Finally, the system is deployed in the circulating water pump of a nuclear power plant utilizing an Internet of Things (IoT) architecture. An industry case study verifies that the proposed system can provide decision-making support and further achieve predictive maintenance for high-end equipment in nuclear power plants.

Economic flexibilities and opportunities for sugar cane plants: A real options valuation case

The goal of this paper is to investigate the effect of production flexibility in decision making in a sugar cane plant under the Real Options theory approach. It was considered a sugar cane plant with the option to switch output and with the option to temporary shutdown. Under these conditions, we sought to quantify the marginal effect of such flexibilities on the decision-making. The methodology employs Monte Carlo simulations to estimate the effect of options in the investment's value. The results obtained indicate that decision-making models with flexibilities can increase the expected value of the Net Present Value by up to 88.14 % and reduce the risk of Net Present Value being negative, especially when considering the temporary shutdown option. Finally, this paper proposes that flexibilities bring greater returns to sugar cane plants, allowing to mitigate the effects of crises in the sector.

Reinitiation of modern-style plate tectonics in the Early Neoproterozoic: Evidence from a ∼930 Ma blueschist-facies terrane in South China

When and how plate tectonics operated throughout Earth’s history remain a matter of debate. The absence of low-temperature/high-pressure metamorphic rocks during Earth’s middle age (∼1.8–0.8 Ga) leads to some arguing for a temporary shutdown or change of modern-style plate tectonics throughout the Mesoproterozoic and Early Neoproterozoic. Here we report the first discovery of ∼930 Ma blueschist-facies metamorphic rocks (Tianli Schist) from the Jiangnan Orogen, South China. Peak pressure–temperature conditions of ∼425–475 ℃ and ∼0.8–1.1 GPa recorded by these units represent an average geothermal gradient of ∼14 ℃/km, characteristic of cold subduction zones. Available geologic and geochronologic constraints indicate that the Tianli Schist protolith was deposited in the southeast margin of the Yangtze Block and subsequently experienced blueschist-facies metamorphism during ocean closure at ∼930 Ma. Combined with the global metamorphic record, our results suggest that modern-style plate tectonics did not operate continuously since initiation in the Early Paleoproterozoic, but was inhibited in the Mesoproterozoic and restarted again at the end of Earth’s middle age.

THE DICHOTOMY OF DOORS: AN ANALYSIS OF “C U SOON”

Media and Entertainment Industry (M&E) has numerous slices that combine into one whole. The M&E industry consists of movies, radio, music, advertising, artificial intelligence, internet, gaming etc.... It is one of the fastest-growing industries in India and the World in general. It is an industry shaped according to the needs and demands of the viewers or consumers. A contemporary consumer not only checks on their demand fulfilment but also keenly looks upon the layout in which the media presents itself to suit their tastes and preferences. This industry is also heavily weighed upon for its quality, culture, markets, and emotional and cognitive approaches.The COVID-19 Pandemic impacted the media and entertainment industry in multiple ways. The pandemic led to the temporary shutdown of movie theatres and production houses that in turn affected their box office collection. The pandemic led to the emergence of video entertainment platforms such as Amazon Prime, Netflix, Hulu etc…The paper highlights how the pandemic opened doors for experimentation in film production and making in Kerala. It analyses the Malayalam Film Industry‟s first computer screen film “C U SOON” directed by editor-turned-director Mahesh Narayanan.

Determination of escape rate coefficients of fission products from the defective fuel rod with large defects in PWR

During normal operation, some parts of the fission product in the defective fuel rods can release into the primary loops in PWR and the escape rate coefficients are widely used to assess quantitatively the release behaviors of fission products in the industry. The escape rate coefficients have been standardized and have been validated by some drilling experiments before the 1970s. In the paper, the model to determine the escape rate coefficients of fission products has been established and the typical escape rate coefficients of noble gas and iodine have been deduced based on the measured radiochemical data in one operating PWR. The result shows that the apparent escape rate coefficients vary with the release-to-birth and decay constants for different fission products of the same element. In addition, it is found that the escape rate coefficients from the defective rod with large defects are much higher than the standard escape rate coefficients, i.e., averagely 4.4 times and 1.8 times for noble gas and iodine respectively. The enhanced release of fission products from the severe secondary hydriding of several defective fuel rods in one cycle may lead to the potential risk of the temporary shutdown of the operating reactors.

Stack cooling system coupled with secondary heat pump in fuel cell electric vehicles

Fuel cell electric vehicles (FCEVs) requires proper thermal management of a proton-exchange membrane fuel cell (PEMFC) stack, but conventional thermal management systems (TMSs) cannot manage the thermal requirements of PEMFCs under high-power density at high ambient temperatures. In this study, a stack cooling system coupled with a secondary heat pump in an FCEV is suggested. The enhanced thermal flexibility of the secondary heat pump system enabled extensive cooling with various TMS configurations. The cooling performance with different TMS configurations was evaluated, considering the thermal and electrical coupling of the heat pump system and the PEMFC stack. The results show that the stack temperature was lowered up to 2.6 °C when the excessive cooling load of the stack radiator was distributed to the cabin radiator under a relatively low-power output condition. To dissipate a large amount of waste heat from the stack, TMS requires a temporary shutdown of the cabin cooling system. In this case, utilizing the inactive outdoor heat exchanger as an additional radiator decreased the temperature up to 18.4 °C by extending the heat transfer area for stack cooling. This study proposes a cooling scheme for an FCEV and suggests appropriate cooling methods and configurations under various operating conditions.

Leveraging Mathematical Models for Optimizing Filter Utility at Manufacturing Scale.

In the production of biopharmaceuticals depth filters followed by sterile filters are often employed to remove residual cell debris present in the feed stream. In the back drop of a global pandemic, supply chains associated with the production of biopharmaceuticals have been constrained. These constraints have limited the available amount of depth filters for the manufacture of biologics. This has placed manufacturing facilities in a difficult position having to choose between running processes with reduced number of depth filters and risking a failed batch or the prospect of plants going into temporary shutdown until the depth filter resources are replenished. This communication describes a modeling based method that leverages manufacturing scale filtration data to predict the depth filter performance with a reduced number of filters and an increased operational flux. This method can be used to quantify the acceptable level of area reduction before which the filtration process performance is affected. This enables facilities to manage their filter inventory avoiding potential plant shutdowns and reduces the risks of negative depth filter performance. This article is protected by copyright. All rights reserved.

Numerical Analysis of Shield Tunnelling Breakthrough Working Shaft by Artificial Ground Freezing Method under Extreme Conditions Considering Phase Change Latent Heat

The artificial ground freezing method has been widely used in shield tunneling breakthrough working shafts. The freezing effect was mainly considered in the previous research, and the heat generation of the shield machine was not considered, which has great influence in actual engineering. In this paper, a coupling calculation model, considering phase change latent heat, is establishes that by containing the freezing process and heat generation of the shield machine, the model is verified. A numerical simulation is carried out for several working conditions that may occur in actual projects, and the following conclusions are obtained. Although the heat dissipated by the normal tunneling of the shield machine will melt the frozen soil curtain that originally meets the design requirements, the thickness of the frozen soil curtain after melting cannot reach the initial design, though it is still within the safe range. In the process of a continuous rotation working condition, the bottom and sides of a cup-shaped frozen soil curtain are partially melted in the early 6 day stay of the shield machine, and the thickness is reduced to a relatively stable value of 0.8 m. In a temporary shutdown working condition, when the contact surface temperature between the shield machine shell and the frozen soil drops to −12 °C after almost 4 days of shutdown, the shield machine may not keep tunneling forward due to the freezing effect. The research results will benefit the freezing design and management of the shield tunneling breakthrough working shaft under extreme conditions.

Geomechanical analysis of the geothermal reservoir at San Emidio, Nevada

The WHOLESCALE (Water and Hole Observations Leverage Effective Stress Calculations and Lessen Expenses) project is aiming to simulate the spatial distribution and temporal evolution of stress throughout the geothermal system at San Emidio, Nevada, United States, via a thermo-hydro-mechanical reservoir model. Focal mechanisms for microseismic events during a temporary shutdown of the geothermal power plant in 2016 were analyzed through linear stress-inversion methods to infer the in-situ reservoir stress state. This analysis was supplemented by other geophysical and geological data, including focal mechanisms from regional earthquakes, slickenlines on exposed fracture surfaces, wellbore stress indicators observed in the surrounding region, and secular strain rate measurements. From the inferences of in-situ reservoir stress, 78 different realizations of stress models were generated over reasonable ranges for the values of maximum compressive horizontal stress (SHmax) azimuth and ratios of principal stress magnitudes. Evaluation of slip tendencies on fault planes determined for the microseismic events for each realization of the initial stress model suggests the reservoir stress state as transtensional with an SHmax azimuth between N and N30∘E.

Best Practice Recommendations for Stroke Vascular Imaging During Iodinated Contrast Shortage.

GE Healthcare© announced on April 19, 2022, that their main factory and distributor of iodinated contrast had experienced a temporary shutdown because of COVID-19 outbreak in Shanghai, China. This, along with other supply chain issues, led to a worldwide shortage of iodinated contrast agents, Omnipaque and Visipaque. Our Comprehensive Stroke Center was confronted with the cascading effect of this iodinated contrast material shortage. We took immediate steps to revise our protocols and processes to continue to provide high-quality care to our stroke patients. A multidisciplinary working group comprised of representatives of our stroke center, including vascular neurology, diagnostic neuroradiology, and neurovascular surgery, urgently met to brainstorm how to mitigate the shortage. We established parameters and local guidelines for the use of CT angiography, CT perfusion, and digital subtraction angiography for stroke patients. In this article, we propose "best practice" recommendations from a single Joint Commission approved Comprehensive Stroke Center that can be used as blueprint by other hospital systems when navigating potential future supply chain issues, to provide consistent high-quality stroke care.

Assessment of the Hydraulic Regime of the City Pool of the Moscow River during the High-Runoff Period during the Temporary Shutdown of the Vodootvodny Channel

Assessment of the Hydraulic Regime of the City Pool of the Moscow River during the High-Runoff Period during the Temporary Shutdown of the Vodootvodny Channel

ФОРМУВАННЯ СТІЙКОСТІ АГЛОМЕРОВАНИХ МІСЬКИХ ПОСЕЛЕНЬ ПРИБЕРЕЖНОЇ ОДЕСЬКОЇ АГЛОМЕРАЦІЇ

Modern cities and their agglomerations are experiencing significant threats related to climate change and its consequences, pandemics, wars, etc. It is difficult for large agglomerations to mitigate the consequences of such challenges in a coordinated manner. The small cities have even fewer resources to effectively respond to threats, which makes them more vulnerable and unstable to new challenges of development. Coastal agglomerations face significant challenges to resilience in the face of internal and external threats. The research purpose is to identify features, opportunities, as well as problems and potential risks of forming the resilience of agglomerated urban settlements of the coastal Odesa agglomeration. The authors' attention was focused on a comparison of the resilience potentials of two types of cities according to their socio-geographical location: coastal (Chornomorsk and Yuzhne) and internal (Biliaivka and Teplodar). The research results were formed on the basis of content analysis of municipal official documents and local mass media from January to May 2023 as well as developing a SWOT analysis determining the problems and prospects of implementing resilience mechanisms in the cities. The different components of resilience potential were analyzed for the selected cities, especially economic, social, and environmental ones. It was revealed that the level of economic and social development of agglomerated settlements in the Odesa agglomeration is uneven. Coastal cities have a higher level of economic and social development due to the presence of the largest seaports in the country. However, the dependence of the urban economy on the activities of few large enterprises does not guarantee economic resilience. At the beginning of the full-scale russian military invasion, these cities felt the greatest vulnerability due to the temporary shutdown of businesses and ports. Yuzhne and Chornomorsk require an increased level of climate change preparedness due to the vulnerability of the sea coast, so rewilding measures can improve their adaptation to climate change and natural events. The active work of local authorities and public involvement, positive migration growth, a high proportion of children and adolescents, transparent support for small businesses, and improved tourist attractiveness are beginning to form the high level for the economic and social resilience of Biliaivka. The potential for economic and social resilience in Teplodar is low due to the significant shortage of jobs and large flows of commuting labor migration to the core city, therefore it is necessary to create attractive conditions for small and medium-sized businesses in various spheres for economic diversification. The creation of an industrial park or business incubator can compensate for the absence of the city-forming enterprise. The deep research of all threats and possible challenges, as well as the integration of urban resilience instruments into official documents based on the cooperation of all stakeholders, should be a further step in the introduction of economic, social, and environmental resilience in urban management process for the cities of the coastal Odesa agglomeration.

REDUCING THE SHOOTING OF HYBRID PHOTOVOLTAIC PLANTS ON SCR AND LI-GRIDS

The main threat by comparable methods lately is the temporary downtime for accurate-current network dispatch errors. Throughout a temporary outage, Power Electronic based power sources stop operating, giving rise to possible security defiance towards the network, in this research, the potentially viable choice to serve continuous work temporarily for the scheme is provided with consideration of identifying upgrades to existing photovoltaic generators (photovoltaic generators discrete) and an upgrade in the separate establishment of existing “photovoltaic” and “Energy Storage Systems” discrete hybrid photovoltaics. This study aims to find a series of power sources with Power Electronic interfaces that are connected to a low “Short Circuit Ratio” network and “Low Inertia” grid to operate without a moment's stoppage.
 The proposed method was proved by adopting PSS/e on a method where power electronics-occupying assets produce the majority of energy. Inverter models along with temporary shutdown through an equal 3-period fault were advanced in PSS/e. together with increasing infiltration of “Power Electronics” established multitude and resources, progressive completion is needed to improve network stability in low a) areas and low inertia networks. The requirements for progressive solvent arose out of the steady variation in the paradigm of the power grid from the dominant systems of traditional electric machines to the high penetration of systems based on power electronics. A technical comparison was made between distinct categories of resolution (divergent photovoltaic and divergent hybrid photovoltaic) to operate a photovoltaic generator's weak “Short Circuit Ratios” also “Low Inertia” grating (grid).
 The results of this study indicate that the proposed solution is calculated nether disparate running term and error class adopting the Electromagnetic Transient model. Moreover, to analyze distinct solvents, a specialized proportion is served on discrete hybrid photovoltaic generators. The proposed solution is the development of conventional increase as well as contemporary condensers, deter capacitors, and reducers to advanced photovoltaic generators and hybrid photovoltaic generators to provide voltage support to ensure continuous working through lopsided dispatch streak disturbances, and another solution is photovoltaic-energy generation. Integrated storage system connected to High Voltage dc and high voltage ac transmission network.

COVID-19 Elective Surgery Shutdown and Operative Experience for Graduating Plastic Surgery Independent Residents.

The initial wave of the COVID-19 pandemic led to a temporary shutdown of elective procedures. The purpose of this study is to evaluate how the elective surgery shutdown impacted case log numbers for graduating plastic surgery independent residents. The Accreditation Council of Graduate Medical Education graduate self-reported case logs were retrospectively compiled for graduating independent track plastic surgery residents for the year before the pandemic (2019), 4 months into the pandemic (2020) and 16 months into the pandemic (2021). Procedures were grouped into resident review committee area and totals for each area were used for analysis. Average number of cases and standard deviations were compiled. Percent change was calculated comparing each year to the prepandemic baseline. Statistical significance was determined with Student t tests comparing average number of cases. Coefficients of variation were calculated to assess for changes in interprogram variation. Average case numbers were then compared with minimum case requirements necessary for graduation. The Accreditation Council of Graduate Medical Education graduation case log statistics were available for 238 independent residents. There were no statistically significant differences in average case number for graduating independent residents for total reconstructive breast, trunk, hand and upper extremity, or total reconstructive procedures between graduation years. The average case number of total lower extremity reconstruction increased from 2019 to 2020 (average = 83-97.4, P = 0.02). The average total number of breast aesthetic cases increased between all years (average = 92, 98, 114), with the average increase from 2019 to 2021 being statistically significant ( P = 0.02). Differences in head and neck aesthetic deformities and trunk and extremity deformities between years were not statistically significant. The average case number for all graduating plastic surgery independent residents exceeded the minimum case log requirements. The temporary hold on elective procedures during the pandemic decreased the opportunity for plastic surgery trainees to meet minimum case log requirements. Case log data for graduating plastic surgery independent residents demonstrate that despite the temporary suspension, the pandemic did not greatly impact the average resident case numbers.

Impacts of the COVID-19 pandemic on scientists’ productivity in science, technology, engineering, mathematics (STEM), and medicine fields

While studies suggested adverse impacts of COVID-19 on scientific outputs and work routines for scientists, more evidence is required to understand detailed obstacles challenging scientists’ work and productivity during the pandemic, including how different people are affected (e.g., by gender). This online survey-based thematic analysis investigated how the pandemic affected scientists’ perception of scientific and academic productivity in the science, technology, engineering, and mathematics (STEM) and medicine fields. The analysis examined if inequitable changes in duties and responsibilities for caregiving for children, family, and/or households exist between scientists who are mothers compared to scientists who are fathers or non-parents. The survey collected data from 2548 survey responses in six languages across 132 countries. Results indicate that many scientists suffered from delays and restrictions on research activities and administrations due to the lockdown of institutions, as well as increased workloads from adapting to online teaching environment. Caregiving responsibility for children and family increased, which compromised time for academic efforts, especially due to the temporary shutdown of social supports. Higher percentages of female parent participants than male parent participants expressed such increased burdens indicating unequal divisions of caregiving between women and men. A range of physical and mental health issues was identified mainly due to overworking and isolation. Despite numerous obstacles, some participants reported advantages during the pandemic including the efficiency of online teaching, increased funding for COVID-related research, application of alternative research methodologies, and fluidity of the workday from not commuting. Findings imply the need for rapid institutional support to aid various academic activities and diminish gender inequity in career development among academicians, highlighting how crisis can exacerbate existing inequalities.

THE IMPACT OF THE COVID-19 PANDEMIC ON ONLINE CONSUMER BEHAVIOR FOR THE BOOK MARKET IN ROMANIA

The COVID-19 pandemic and the subsequent lockdown, along with the social distancing rules imposed by governments around the world, have caused major changes in the publishing industry and, therefore, in the book consumption patterns. The main goal of this paper is to identify the changes in the purchasing habits of book consumers within two different frameworks of motivations: utilitarian and hedonic – both studied during the COVID-19 pandemic. A model was developed to study the effects of the COVID-19 pandemic as a circumstantial impact, because it implicated the temporary shutdown of physical bookshops, the uncertainty of contracting the virus by visiting the shops once they re-opened along with the upgrades that online bookshops developed during the pandemic to attract customers. Data were gathered from 410 Romanian consumers by applying an online survey. Multivariate data analysis applied to the model showed that the COVID-19 pandemic context had a positive and significant influence on the customers’ intents of online book purchasing. Moreover, while hedonic reasons exerted a compelling influence on the customers’ intents to buy books online, the association between utilitarian reasons and online buying intents is positive, but insignificant. These results could support all stakeholders within the book market, such as publishing firms and online bookshops to strengthen their online presence – to develop their websites, their social media pages, as well as expand their advertising operations through different channels. The outcomes of this research are important and useful also for the academic environment, as the changes within the book market and the evolution of book consumption behavior influence research and academic writing overall.

Post-9/11 veterans perceptions of the pandemic: Areas of greatest impact on health and well-being.

Assess potential impacts of the COVID-19 pandemic on a subset of Post-9/11 U.S. Veterans included in a study of post-traumatic epilepsy (PTE). Two measures were added to a structured health interview for Veterans during temporary pandemic research shutdown: a validated health questionnaire [1] previously completed by survey, and a semi-structured instrument developed to assess whether pandemic conditions affected responses to the health questionnaire and identify unique impacts. Interviews were conducted between August 2020 - February 2021. Scaled items were calculated and t-tests used to compare results. Open-ended items were coded using thematic analyses. Veterans identified eight major areas of impact with negative and positive impacts: mental health, family, social, work/employment, access to resources, physical health, finances, and education. The temporary shut-down of a large health study for Post-9/11 Veterans provided an opportunity to devise an instrument to assess COVID-19's impact on health and well-being. The instrument was accepted as of the first Veteran instrument in a pandemic SDOH research repository [2], and is being used in other studies. This study highlights the need to assess and understand interrelated relationships of factors impacting health and well-being, especially as COVID-19 moves from pandemic to endemic with reverberating effects across multiple social determinants of health (SDOH).