Assessing Foundation Students' Acceptance in Using Video Conferencing Technologies (VCTs) as Online Learning Platforms during the Pandemic

The COVID-19 pandemic has significantly affected Higher Education Institutions (HEIs) in Malaysian education system. Due to this, the HEIs have implemented online learning to be replaced with physical classrooms to ensure that all students able to reach their learning potentials. As such, video conferencing technologies (VCTs) have been employed nationwide for effective learning activities. Previous research have shown that teaching and learning using VCTs are beneficial for online learning, however, not many studies focused on the student's acceptance of VCTs during unforeseen situations. This study intends to overcome this research gap by investigating the factors influencing the foundation students' acceptance of VCTs during the outbreak. Therefore, the facilitating conditions and computer self-efficacy factors are integrated into the Technology Acceptance Model (TAM) for analysis. For this purpose, the PLS-SEM was used to analyze the data collected from 231 participants of selected higher education institutions in Malaysia. The finding revealed that ‘attitude towards use' and ‘intention to use' VCTS have a positive relationship with the actual use of VCTs. Furthermore, the result indicated that facilitating condition has significantly impacted the ‘perceived ease of use' of the VCTs. However, ‘computer self-efficacy' has no significant impact on the ‘perceived usefulness' of the VCTs. It is also learned that using VCTs is acceptable for remote and online learning mode, particularly amid the current COVID-19 pandemic. The outcomes of this study are able to improve the existing knowledge on the student's acceptance of VCTs and provide useful insights into the curriculum designated for the HEIs. Hence, it can be concluded that our findings validated the model used in this study and offered valuable guidelines in developing online learning approaches that promote learning through varied platforms. © 2023,International Journal of Emerging Technologies in Learning. All Rights Reserved.

Development, validation and forced degradation studies of green liquid chromatographic method for determination of remdesivir in bulk drug and pharmaceutical formulation

Remdesivir was recently approved by Food and Drug Administration (FDA) to treat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease. In this study, we report development of the green and reversed-phase liquid chromatographic method for quantitative determination of remdesivir in pharmaceutical formulations in forced degradation studies using mobile phase consisting of 0.4% trifluoroacetic acid: Acetonitrile with flow rate of 1.0mL min-1. High performance liquid chromatographic stability-indicating procedure was evaluated and impurities were profiled by subjecting the remdesivir under stress conditions i.e. acidic and alkaline hydrolysis, oxidative and thermal degradation. The developed method effectively separated the parent drug response from that of degradation products and it was validated following ICH guidelines within linearity range of 5-50 mu g mL-1 exhibiting correlation coefficient greater than 0.997. At all levels, the %RSD values were less than 2.0 indicating satisfactory precision. Green profile of developed method was evaluated by NEMI and AGREE tools. Comparison of proposed method with already existing chromatographic method was established using analytical eco-scale. The proposed method is eco-friendly and resulted in reliable quantification of remdesivir in dosage formulation and impurity profiling.

Viral and Bacterial Causes of Labyrinthitis

Labyrinthitis is a known inflammation of the membranous structure of the inner ear. Affected patients usually present with nausea and vomiting, vertigo, hearing loss/impairment, and tinnitus. Many etiologies have been proposed to lead to the development of labyrinthitis, including bacterial, viral, systemic, and iatrogenic causes and the most commonly reported causes include viral and bacterial infections. Not many investigations have elaborated on the viral and bacterial etiologies, and the evidence seems to be scattered across the different studies. In the present study, we have reviewed the literature to discuss the current evidence regarding the viral and bacterial causes of labyrinthitis. Many viruses and bacteria were reported in the literature to cause the condition. However, the most common pathogen includes cytomegalovirus and maternal rubella infections, leading to congenital hearing loss. Other viruses as measles and mumps might also lead to developing post-natal labyrinthitis. Studies also indicates that COVID-19 can be a recent cause of the disease. However, evidence regarding this information, similar to the case with other viral and bacterial etiologies, still needs further validation and reporting before making solid conclusions. Accordingly, we encourage researchers to furtherly report about similar cases and conduct epidemiological investigations to better understand the etiology of the disease.

CovTANet: A Hybrid Tri-Level Attention-Based Network for Lesion Segmentation, Diagnosis, and Severity Prediction of COVID-19 Chest CT Scans

Rapid and precise diagnosis of COVID-19 is one of the major challenges faced by the global community to control the spread of this overgrowing pandemic. In this article, a hybrid neural network is proposed, named CovTANet, to provide an end-to-end clinical diagnostic tool for early diagnosis, lesion segmentation, and severity prediction of COVID-19 utilizing chest computer tomography (CT) scans. A multiphase optimization strategy is introduced for solving the challenges of complicated diagnosis at a very early stage of infection, where an efficient lesion segmentation network is optimized initially, which is later integrated into a joint optimization framework for the diagnosis and severity prediction tasks providing feature enhancement of the infected regions. Moreover, for overcoming the challenges with diffused, blurred, and varying shaped edges of COVID lesions with novel and diverse characteristics, a novel segmentation network is introduced, namely tri-level attention-based segmentation network. This network has significantly reduced semantic gaps in subsequent encoding-decoding stages, with immense parallelization of multiscale features for faster convergence providing considerable performance improvement over traditional networks. Furthermore, a novel tri-level attention mechanism has been introduced, which is repeatedly utilized over the network, combining channel, spatial, and pixel attention schemes for faster and efficient generalization of contextual information embedded in the feature map through feature recalibration and enhancement operations. Outstanding performances have been achieved in all three tasks through extensive experimentation on a large publicly available dataset containing 1110 chest CT-volumes, which signifies the effectiveness of the proposed scheme at the current stage of the pandemic.

Celebrating talents of the type 1 diabetes community during covid-19 pandemic

Background: 'ArT1st' was created (11/2019) by Professor Kar, bringing 9 artistic people with type 1 diabetes (PWDs) and diabetes healthcare professionals (HCPs). The aim for ArT1st was to provide peer support within type 1 diabetes community via art, and to showcase the community's artistic talents through a live event in 2020. With covid-19 pandemic, lockdown became a time of anxiety and loneliness, affecting mental health. With the live ArT1st event postponed, to help uplift the mood and reduce social isolation, the ArT1st team created an online project for the type 1 diabetes community. Methods: • ArT1st email address and website created to receive/house contributions • Social media accounts created • Daily posts across social media -artistic contributions + summary about artist (diabetes journey/ community involvement, how art helped with diabetes/mental health/pandemic) Results: 167 contributions of music, fashion, photography, craft, poetry, dance, drama, painting received worldwide over 2/12: all ages, PWDs, HCPs, carers, professional/amateur artists. • Social media data: Twitter-498 followers/447 tweets, Facebook-1358 friends, Instagram-365 followers/273 posts • Twitter activity: 371.3k impressions over 77 days-average 4.8k impressions/day. Average-11 retweets/day, 38 likes/ day, 3 comments/day. Interest extended beyond community, highlighting issues PWD face daily. Many positive comments about uplifting mood, great support network. Friendships and art collaborations developed between PWDs, and between PWDs and HCPs. Conclusion: ArT1st is first of its kind as a form of peer support for the type 1 diabetes community and celebrating artistic talents. ArT1st promoted new online peer support & friendships for the community, through the power of art;and provided an innovative outlet during the pandemic.

Clinical impact of tocilizumab therapy in SARS-CoV-2 respiratory infections in ICU and non-ICU patients

Background: Tocilizumab (TCZ) is a monoclonal antibody against the interleuikin- 6 receptor which is potentially beneficial in COVID-19 induced cytokine release syndrome (CRS). However, there are limited studies showing anti-inflammatory effect and clinical benefit of TCZ in COVID-19 patients. This retrospective study examines treatment responses of criteria based TCZ therapy for SARS-CoV-2 respiratory infection for ICU vs. non-ICU patients. Methods: We established institutional criteria to identify patients at risk of CRS from COVID-19. Patients were included if they received at least 1 dose of TCZ and were admitted for at least 72 hours. Primary endpoint was to assess clinical improvement (CI) at the end of admission. CI was defined by extubation, downgrade from ICU, discharged or improvement in Clinical Ordinal Scale by 2. Secondary endpoint of the study was to assess inpatient mortality (IM) and risk factors associated with IM. Subgroup analysis included impact of early (< 96 hours) vs late (≥ 96 hours) TCZ therapy on IM. Results: Between March 25 to May 6, 2020, 170 patients met criteria and received TCZ. There were 83 non-ICU patients and 87 in the ICU. Forty five patients needed invasive mechanical ventilation (IMV). ICU patients tended to be obese, receive 2 doses of TCZ and have longer length of stay. Overall CI was seen in 71% of patients. CI was higher in non-ICU vs ICU patients (85.5% vs 57.5%, P=0.002). Overall IM was 18.8%;however, IM was lower in non-ICU vs ICU patients (8.4% vs 28.7%, P=0.0014). IM was higher in patients on IMV vs. non-IMV (30% vs 15.4%, P=0.03). Risk factors of ICU admission, BMI ≥ 30 kg/m2 and AKI were associated with higher risk of IM. Many IM patients were made comfort care. No differences were observed in early vs late TCZ therapy on inpatient mortality, but there was a trend toward lower mortality with early TCZ. COS Review of Tocilizumab Patients Conclusion: TCZ is an effective treatment option in patients with SARS-CoV-2 patients at risk of CRS. Patients receiving TCZ in non-ICU setting had a better response to treatment compared to ICU patients. Obesity and AKI were associated with higher risk of mortality, but there was no statistical difference in early vs late therapy. Further studies with control group and larger sample size are warranted.

Molecular SARS-CoV-2 testing during the COVID-19 outbreak: Experiences of a hospital in Southeast Michigan, USA

Background: The novel Coronavirus SARS CoV-2 (COVID-19) outbreak was complicated by the lack of diagnostic testing kits. In early March 2020, leadership at Beaumont Hospital, Royal Oak Michigan (Beaumont) identified the need to develop high capacity testing modalities with appropriate sensitivity and specificity and rapid turnaround time. We describe the molecular diagnostic testing experience since initial rollout on March 16, 2020 at Beaumont, and results of repeat testing during the peak of the COVID-19 pandemic in MI. Methods: Beaumont is an 1100 bed hospital in Southeast MI. In March, testing was initially performed with the EUA Luminex NxTAG CoV Extended Panel until March 28, 2020 when testing was converted to the EUA Cepheid Xpert Xpress SARSCoV- 2 for quicker turnaround times. Each assay was validated with a combination of patient samples and contrived specimens. Results: During the initial week of testing there was > 20 % specimen positivity. As the prevalence grew the positivity rate reached 68% by the end of March (Figure 1). Many state and hospital initiatives were implemented during the outbreak, including social distancing and screening of asymptomatic patients to increase case-finding and prevent transmission. We also adopted a process for clinical review of symptomatic patients who initially tested negative for SARS-CoV-2 by a group of infectious disease physicians (Figure 2). This process was expanded to include other trained clinicians who were redeployed from other departments in the hospital. Repeat testing was performed to allow consideration of discontinuation of isolation precautions. During the surge of community cases from March 16 to April 30, 2020, we identified patients with negative PCR tests who subsequently had repeat testing based on clinical evaluation, with 7.1% (39/551) returning positive for SARS- CoV2. Of the patients who expired due to COVID-19 during this period, 4.3% (9/206) initially tested negative before ultimately testing positive. Conclusion: Many state and hospital initiatives helped us flatten the curve for COVID-19. Our hospital testing experience indicate that repeat testing may be warranted for those patients with clinical features suggestive of COVID-19. We will further analyze these cases and clinical features that prompted repeat testing. (Figure Presented).

Managing People with Diabetes Fasting for Ramadan During the COVID-19 Pandemic: A South Asian Health Foundation Update.

The month of Ramadan forms one of the five pillars of the Muslim faith. Adult Muslims are obligated to keep daily fasts from dawn to sunset, with exceptions. This year Ramadan is due to begin on 23 April 2020 and the longest fast in the UK will be approximately 18 hours in length. In addition, due to the often high-calorie meals eaten to break the fast, Ramadan should be seen as a cycle of fasting and feasting. Ramadan fasting can impact those with diabetes, increasing the risk of hypoglycaemia, hyperglycaemia and dehydration. This year, Ramadan will occur during the global COVID-19 pandemic. Reports show that diabetes appears to be a risk factor for more severe disease with COVID-19. In addition, the UK experience has shown diabetes and COVID-19 is associated with dehydration, starvation ketosis, diabetic ketoacidosis and hyperosmolar hyperglycaemic state. This makes fasting in Ramadan particularly challenging for those Muslims with diabetes. Here, we discuss the implications of fasting in Ramadan during the COVID-19 pandemic and make recommendations for those with diabetes who wish to fast.