Self-reported Mental Health Measures among Incoming Collegiate Student-Athletes who had SARS-COVID-19.

BACKGROUND: COVID-19 survivors may experience persistent neuropsychological disruptions such as lower satisfaction with life (SWLS), depression, and anxiety. While student-athletes are at low risk for severe COVID complications, the effect of COVID on mental health remains to be elucidated. OBJECTIVE: Compare patient-reported mental health outcomes for incoming collegiate athletes who did (COVID+) and did not (COVID-) have COVID-19. METHODS: 79 COVID+ (79/178, 44.4%, 18.90±0.16 years) and 99 COVID- (99/178, 55.6%,18.95±0.16 years) completed SWLS, anxiety (HADS anxiety, STAI), depression (HADS depression). Unadjusted One-way ANOVAs were conducted across all patient-reported outcomes. ANCOVAs were conducted to determine the interaction of COVID history, sex, and race/ethnicity on outcomes. Post-hoc Bonferroni testing was performed to determine specific differences between groups. Chi-square analyses were used to compare the number of athletes who met the standard of clinical cut points for both groups. RESULTS: We observed a significant difference between groups for HADS depression (p=0.047), whereby athletes in the COVID+ group had significantly higher depression ratings (2.9±0.3). There was a significant group difference for SWLS (p=0.019), HADS anxiety (p=0.003), and STAI state anxiety (p=0.014) such that SWLS, HADS anxiety, and trait anxiety was higher for the COVID+ group in the adjusted model. Post-hoc testing revealed that COVID+ females had significantly worse HADS anxiety (p=0.011) and STAI trait anxiety (p=0.002). There were no significant differences in the percentage of responses below established diagnostic thresholds between groups. CONCLUSIONS: Incoming collegiate student-athletes who reported prior COVID diagnosis reported significantly higher depression scores suggesting clinicians may need to be aware of the potential need to intervene with appropriate mental health identification and referral. However, it was encouraging that most participants, regardless of prior COVID diagnosis, had mental health scores that did not exceed established diagnostic threshold values.

IMMUNOGENICITY OF SARS-CoV-2 mRNA VACCINATION IN IDIOPATHIC CD4 LYMPHOPENIA

Background: The rapid development of SARS-CoV-2 mRNA vaccines has been a remarkable success of the COVID-19 pandemic, but vaccine-induced immunity is heterogeneous in immunocompromised populations. We sought to determine the immunogenicity of SARS-CoV-2 mRNA vaccines in a cohort of people with idiopathic CD4 lymphopenia (ICL). Method(s): 25-patients with ICL followed at the National Institutes of Health on a natural history protocol were evaluated between 2020-2022. Blood and serum was collected within 4-12 weeks after their second and/or third SARS-CoV-2 mRNA vaccine dose. Twenty-three matched healthy volunteers (HVs) provided blood samples at similar timepoints post-mRNA vaccination on a separate clinical protocol. Pre-vaccine blood samples were also used when available. Anti-spike and anti-receptor binding domain antibodies were measured. T-cell stimulation assays were performed to quantify SARS-CoV-2 specific T-cell responses. Comparisons were made with Wilcoxon test. Result(s): Twenty-participants with ICL had samples collected after their second mRNA vaccine and 7-individuals after the third dose. Median age at vaccination was 51-years (IQR: 44-62) and 12 were women (48%). Median CD4 T-cell count was 150 cells/muL (IQR: 85-188) at the time of vaccination, and 11-individuals (44%) had a baseline CD4 count <=100 cells/muL. HVs had a median age of 54-years (IQR: 43-60) with 13-women (56.5%). Anti-spike IgG antibody levels were significantly greater in HVs than those with ICL after 2-doses. Lower SARS-CoV-2 IgG antibody production was primarily observed in those with baseline CD4 T-cells <=100 cells/mul (Figure-1A). The decreased production in ICL remained after a third vaccine dose (Figure-1B). There was a significant correlation between anti-spike IgG and baseline CD4 count. Spike-specific CD4 T-cell responses in volunteers compared to those with ICL demonstrated similar levels of activation induced markers (CD154+CD69+) and cytokine production (IFNgamma+, TNFalpha+, IL2+) after two or three mRNA vaccine doses. Quantitatively the smallest responses were observed in those with lower baseline CD4 T-cells (Figure 1C-D). Minimal SARS-CoV-2 CD8 T-cell responses were detected in both groups. Conclusion(s): Patients with ICL and baseline CD4 T-cells >100 mount similar humoral and cellular immune responses to SARS-CoV-2 vaccination as healthy volunteers. Those with baseline CD4 T-cells <=100 have impaired vaccine- induced immunity and should be prioritized to additional boosters and continue other risk mitigation strategies. (Figure Presented).

Infectious disease Roundup 2022

This paper describes the epidemiology, prevalence, transmission, prevention and control of some infectious diseases in companion animals, livestock, wild animals and humans in Ontario, Canada, in 2022, including SARS-CoV-2;Echinococcus multilocularis, Leishmania spp. and SARS-CoV-2;antimicrobial stewardship resources;2 cases of rabid dogs imported from Iran (July 2021 and January 2022);prevalence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriacea, Dirofilaria immitis, Brucella canis, canine parainfluenza and adeno- and herpes viruses in dogs recently imported from Asia;Paragonimus kellicotti lung flukes and Streptococcus equi subsp. zooepidemicus in dogs;African swine fever in pet pigs, backyard pigs and wild pigs and blastomycosis in dogs and humans.

In-person learning low risk for COVID-19 acquisition: findings from a population-based analysis of the 2020-2021 school year in Saskatchewan, Canada

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused substantial disruption to in-person learning, often interfering with the social and educational experience of children and youth across North America, and frequently impacting the greater community by limiting the ability of parents and caregivers to work outside the home. Real-world evidence related to the risk of COVID-19 transmission in school settings can help inform decisions around initiating, continuing, or suspending in-person learning. Methods: We analyzed routinely collected case-based surveillance data from Saskatchewan's electronic integrated public health system, Panorama, from the 2020-2021 school year, spanning various phases of the pandemic (including the Alpha variant wave), to better understand the risk of in-school transmission of COVID-19 in Saskatchewan schools. Results: The majority (over 80%) of school-associated COVID-19 infections were acquired outside the school setting. This finding suggests that the non-pharmaceutical measures in place (including masking, distancing, enhanced hygiene, and cohorting) worked to limit viral spread in schools. Conclusion: Implementation of such control measures may play an essential role in allowing children and youth to safely maintain in-person learning during the pandemic.

Implantation from Short Term MCS to Durable VAD: Single Center Experience

The rising use of temporary mechanical circulatory support (tMCS) to stabilize patients with acute cardiogenic shock has resulted in an increased number of these patients being bridged to advanced therapies. While heart transplantation has become the favored path for these patients, durable VAD can be a safe option to recover these Intermacs I patients. All patients implanted with durable VAD at our center from 2017-2021 were reviewed retrospectively and included in this series. Thirty-three patients underwent VAD implantation during the study period. At the time of implant, 78.8% were INTERMACS 1 on tMCS (N=26) and 92.3% (N=24) were stabilized on an Impella (Abiomed, Danvers, MA), 3.8% (N=1) required Centrimag and 3.8% (N=1) required combined VA-ECMO and Impella. Mean age was 65.3 years, 88.4% were male and 39% (N=13) had nonischemic cardiomyopathy. Six patients were implanted with Heartmate II LVAD, while 27 received Heartmate 3 (Abbott, Abbott Park, IL). At the time of VAD implantation, 19% (n=5) of patients required RV mechanical support. Ninety-two percent of patients survived to discharge with a mean total length of stay of 56.23 days and mean post VAD length of stay 34.2 days. Sixty percent of these patients (N=15) survived at least 1-year, with 12 of the patients alive at 2 years. Of the early expirations, 80% died within the first 6 months post implant. Etiology of mortality included RV failure in 50% of patients, COVID-19 infection in 17% , and sepsis in 25%. Despite the high-risk of mortality in the cardiogenic shock population, those patients who can be stabilized with tMCS can have reasonable survival following durable VAD implantation. Following implant, the highest risk for mortality is within the first 6 months and is primarily related to worsening RV dysfunction. With recent data also showing that HM3 can extend life by 5 years, the concept of bridge to transplant LVAD should also be reconsidered for this very sick patient population. [ABSTRACT FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

EdTech, Market Logics, and Pedagogic Containment: Critical Pedagogies for a Critical Moment

While questions surrounding the relationship between education and technology have captured the attention of critical educational scholars in recent decades, such concerns have taken on new import. Although technology had become a progressively pervasive feature of schooling in the years preceding COVID-19, the swift shift to remote and hybrid forms of instruction rendered necessary by the ongoing pandemic has restructured higher education in ways that are likely to last beyond the current crisis. In light of the corporate interests at stake in the EdTech market, such developments warrant attentive scrutiny. In addition to the ways in which COVID-19 has opened up opportunities for technology companies to financially capitalize on the ongoing crisis, I argue that this moment has, perhaps more importantly, laid the groundwork for ideological capitalization that will likely accelerate market orientations toward education that risk foreclosing possibilities for critical pedagogies. Drawing on the work of Herbert Marcuse and Paulo Freire, I argue that EdTech reifies market logics in higher education and renders teaching increasingly vulnerable to mechanisms of standardization, surveillance, and the logics of neoliberal techno-rationality that foreclose possibilities for pedagogic autonomy. I then explore Freire's theorizing on the roles of freedom and autonomy in a critical educational paradigm to argue that the tradition of critical pedagogy offers important insights for challenging the creeping digital hegemony in higher education. © 2022 selection and editorial matter, Kenneth J. Saltman and Nicole Nguyen;individual chapters, the contributors.

Reduction in final year medical students’ knowledge during the COVID-19 pandemic: Insights from an interinstitutional progress test

There has been little information about how the COVID-19 pandemic has impacted medical students’ knowledge acquisition. The aim of the study was to identify the impact of the COVID-19 pandemic on medical students’ knowledge acquisition by comparing the students’ performance on two Progress Test exams administered in 2019 (pre-pandemic) and 2020 (during the pandemic). We included data from 1,491 students at two medical schools in Brazil. Both schools had experienced interrupted preclinical classes and clinical clerkship rotations in March 2020 but had resumed remote preclinical classes with online activities within 1 month after the interruption and clerkship rotations within five to 6 months after the interruption. We analyzed the data with the Rasch model from Item Response Theory to calibrate the difficulty of the two exams and calculated the performance of the students, with comparison of the differences of mean knowledge for each year and between the two cohorts. We found that the students’ knowledge in the cohort of 2019 was higher than those in the cohort of 2020, except in the second year. Also, the students did not show any increase in knowledge between 2019 and 2020 in the clerkship years. It appears that the pandemic significantly impaired the knowledge acquisition of medical students, mainly in the clerkship years, where practical activities are the central part of training. This is of special concern in low- and middle-income countries where graduated medical doctors are allowed to practice without further training or are required to have continuing professional development. Copyright © 2022 Hamamoto Filho, Cecilio-Fernandes, Norcia, Sandars, Anderson and Bicudo.

United Kingdom: health system review 2022

The separate governments in England, Scotland, Wales, and Northern Ireland have been in charge of planning and executing health care services since devolution in the late 1990s. Residents of the UK have access to a National Health Service (NHS) based on clinical need, not financial capacity. Contrarily, free access to social care services is means-tested and subject to a variety of eligibility requirements depending on the United Kingdom country. In comparison to the majority of other high-income nations, the UK has significantly lower levels of physicians and nurses, hospital beds, and diagnostic tools. Due to these deficiencies, the nation has minimal capacity to absorb sudden shocks like the COVID-19 pandemic. Additionally, they have caused an increase in the number of people on waiting lists for elective care, with over 6 million people in England alone in 2022. In the past, the UK's health spending has seen periods of both continuous expansion and austerity. Nevertheless, over the past ten years, total health spending has grown, reaching just over 10% of GDP in 2019. Around 80% of all health spending is public money, which is a significant share and has been stable over the past 20 years. As a result, UK people have little out-of-pocket spending and high levels of protection from the financial effects of illness. To enable real integration amongst health care providers, a number of obstacles still exist in all four countries, including disconnected health information technology systems, duplicate governance structures, and a dearth of strategic planning. Although efforts to encourage such integration through cross-sectoral partnerships have advanced in England, Scotland, and Wales in recent years, Northern Ireland remains the only United Kingdom component county where the NHS and social care are completely organisationally linked.

Characteristics and Outcomes of Patients Admitted for Acute Alcoholic Hepatitis Before and During the COVID-19 Pandemic

Purpose: Despite known increases in alcohol use, changes in alcohol-associated liver disease rates during COVID-19 have not been well characterized. We compared the incidence and outcomes of hospitalized patients with acute alcoholic hepatitis (AH) before and during COVID-19. Method(s): We identified patients admitted with AH at two tertiary care centers by retrospective chart review in pre-COVID-19 (4/1-6/31/2019) and during COVID-19 (4/1-6/31/2020) time periods using strict criteria (total bilirubin>3.0, AST 35-500, ALT 49-500, and heavy drinking within 60 days of admission). Severe AH was defined as Maddrey's discriminant function (MDF) >= 32. Univariable comparisons were performed using Chi-square and Wilcoxon rank sum tests as appropriate. Result(s): Inpatient admissions for AH increased from 0.13% (90 of 69610) pre- COVID-19 to 0.25% (160 of 63021) during COVID-19 (P<.001). During COVID-19, AH patients had lower rates of polysubstance abuse (40% vs 18%, P<.001) compared to pre-COVID-19 (Table 1). Mental health and substance abuse (MHSA) consult rate was 52% pre- and during COVID-19. Relapse medication use rate was 8% and did not differ significantly between time periods. In severe AH (N=127) frequency of steroid treatment (39% vs 48%, P=0.31), evaluation for (12% vs 16%, P=0.61) or receipt of liver transplant (2% vs 4%, P=1.00) were similar pre- and during COVID-19. Compared to pre-COVID-19, AH patients during COVID-19 had significantly lower rates of all-cause 90-day readmission (59% vs 42%, P=0.02), but there was no difference in rates of 90-day readmission for AH (27% vs 22%, P=0.47), inpatient mortality (11% vs 9%, P=0.66) and 12-month mortality (30% vs 23%, P=0.23). Conclusion(s): Inpatient admission rates for AH nearly doubled during COVID-19. Polysubstance abuse was less common among patients with AH during COVID-19, but 90-day readmission rates remained high pre- and during COVID-19. Low rates of both MHSA consult and relapse medication use indicate a need for greater attention to inpatient alcohol treatment. (Table Presented).

Examining the Impact of COVID-19 on Ridership for an Agency Running a Demand Response System

COVID-19 emerged in December 2019 and changed transportation across the United States, especially for people dependent on transit buses to make trips. Most transit agencies saw a significant decrease in ridership;however, the impact on travel for agencies that offer demand-response transit hasn't been examined completely. This paper examines ridership for a demand-response rural transit system from three perspectives: Pre-pandemic, mid-pandemic, and pandemic-recovery. The paper examines total trips, origin locations, and destination locations at the three time intervals. In addition, the paper develops a transit social vulnerability index (SVI) to evaluate which riders continued to use the service and what factor or factors lead to those decisions. The results of the paper show that transit trip making and passengers of the system were not all affected uniformly. © ASCE. All rights reserved.

Innovative University-Based Regional Workforce Development Experience

Stemming from requests from regional industrial employers primarily in the manufacturing field, an innovative, state-funded workforce development summer camp and related dual-enrollment course was developed at Austin Peay State University. The focus of the camp and course was to prepare students in their junior and senior years of secondary education for entry-level employment in regional manufacturing facilities. The five-week summer camp included an opportunity to gain OSHA-10 online training, basic theoretical and applied knowledge in engineering technology-related areas pertinent to entry-level manufacturing jobs, and the necessary soft skills needed to meet regional employers' demand. Ten students that were assessed from school districts surrounding the hosting institution participated in the first offering of the camp in the summer of 2021. Topics customized for the potential trained, operator-level employee included industrial safety;basic industrial electrical distribution and motor theory;basic mechanical drive theory;and basic industrial automation theory, including industrial robotics and programmable logic controller theory. All technical content theory was accompanied by a related lab that allowed for the application of the learned theory. Additionally, soft-skills training was provided via online vendors. Assessment of student progress was accomplished through a university-held dual-enrollment course in the form of exams and participation grades. The students enrolled in the course received both secondary and university level academic credit that could be transferred into the university's engineering technology associate's or bachelor's degree programs. While fulfilling the need of regional industrial employers, the summer camp and dual enrollment course provided a university-based learning experience that would better inform the student of future career path opportunities. Due to COVID-19 complications in recruiting targeted students, many of the 10 students participating in the camp did not intend to follow the manufacturing employee career pathway, although all 10 students passed the course with above-average grades. Funding for the camp, which includes scientific and safety demonstrations, is secured for the 2022 summer term, during which a more engineering-focused cohort of students will be an enrollment goal. © American Society for Engineering Education, 2022

Features of hospitalized pediatric patients with seizures and respiratory viruses: a comparison of SARS-CoV2, other corona viruses, and influenza

Objective: To compare features of hospitalized pediatric patients with seizures and respiratory viruses. Background: Neurological symptoms are reported in children with COVID-19, caused by SARS-CoV2. Limited data is available on neurological symptoms in other respiratory viruses, including influenza and other coronaviruses. Design/Methods: Retrospective data was extracted from EPIC on all children between 0-21 years old admitted to Children's Hospital of Atlanta from January 1, 2014 to June 1, 2021 for seizures and had positive PCR for SARS-CoV-2, other coronaviruses (Coronavirus NL63 and Coronavirus OC34) and influenza (A and B). Patient characteristics including age, race, sex, ethnicity, hospital length of stay, intensive care unit admission, intubation, chest x ray, MRI, and disposition were included. Comparison of patient characteristics between children with COVID-19 and the two other groups were conducted respectively. Results: A total of 487 pediatric patients were included: 68 COVID-19, 232 influenza, and 187 with other coronaviruses (OC), with median age of 6.2 (interquartile range (IQR): [3.1,11.2]). COVID-19 patients had higher ICU admission rates (50% versus 31%, p = 0.008) but lower intubation rates than OC (19% versus 35%, p = 0.021). Stroke rates were higher in COVID-19 versus OC (6% versus 0.5%, p= 0.019). Initial white blood cell counts were lower in the COVID-19 (median 7.32[6.05, 11.07]) than OC (median 10.66[ 7.61, 14.26];p = 0.001). The rate of abnormal MRI was lower among COVID-19 patients, compared to OC patients (57% versus 82%) with a medium to large effect size (standard mean difference) of 0.55. However, no differences were observed between COVID-19 and influenza cohorts. Conclusions: Differences in patients with COVID-19 versus other coronaviruses were observed, whereas no differences were observed in COVID-19 versus influenza patients. Vigilance should be undertaken in treatment of children presenting with all respiratory illnesses.

Impact of COVID-19 on paratransit operators and riders: A case of central Alabama

Paratransit plays an important role in offering mobility and accessibility in local communities, especially for mobility disadvantaged group such as seniors, persons with disabilities, and persons with medical conditions. This study comprehensively evaluates the impacts of COVID-19 on paratransit services from paratransit operator and individual rider perspectives. In particular, we mine a paratransit dataset that covers trip logs of more than 800 unique riders over a seven month period in order to understand how the pandemic impacted service and influenced trip purposes of individual riders. For service providers, our analyses show that a significant loss in paratransit ridership was accompanied by drastic changes in travel behavior among paratransit riders. Results indicate that the operator was able to deliver safe and efficient mobility services during COVID-19, but at a 60% higher cost per rider than under pre-pandemic conditions. The results also reveal a varying level of impacts for individual riders given heterogeneity among trip purposes and demographic profiles. Moreover, similarities are identified across a range of individual riders, depending on specific trip purposes and the availability of alternative travel options. This study is among the first to investigate paratransit operations during COVID-19 in terms of impacts to both operators and individual riders. The lessons learned and policy insights should be useful to other paratransit operators and policymakers in preparing for current and future pandemics.

LOCAL-SCALE SPATIAL VARIABILITY in SARS-CoV-2 SEROPREVALENCE in AN INDIAN MEGACITY

Background: While the diversity in SARS-CoV-2 transmission across geographies and risk groups is well recognized, there has been limited investigation into spatial heterogeneity at a local scale, that is variability across a single city. Identifying patterns and factors associated with spatial variability requires population representative samples which are challenging to obtain but critical for mitigation strategies including vaccine distribution. Methods: From Jan to May 2021, we sampled 4,828 participants from 2,723 unique households across 100 spatial locations in Chennai, India using a probability proportional to population density sampling approach. All participants provided a blood sample and underwent a household and individual survey. 4,712 samples were tested for antibodies to the Spike protein (anti-Spike IgG) by the Abbott ARCHITECT. SARS-CoV-2 prevalence by spatial location was plotted using splines estimated by generalized additive models. Associations between seroprevalence and spatial attributes (zone, population density), study characteristics (date of sampling), household and individual-level covariates were estimated using Bayesian mixed effects logistic regression accounting for clustering within households and locations. Results: The median age was 38 and 49% self-identified as female. Overall, anti-S IgG prevalence was 61.9% (95% confidence interval [CI]: 60.5-63.3%) but ranged from 41.5% to 73.1% across the 12 zones. Splines indicated statistically significant variation in seroprevalence across the city (Panel A). Mixed effects regression including location and household effects indicated 31% of variance was attributable to location. In adjusted analysis, seroprevalence was significantly associated with population density (OR=1.46 per 100 people/100 sq meter [95%CI: 1.08-1.97];Panel B), age (OR=1.004 [95%CI: 1.0002-1.005]), having an air conditioner (OR=0.65 [95%CI: 0.43-0.98]) and sample timing but not with household crowding (OR=0.97 per person/room [95%CI: 0.75-1.26];Panel C). Significant spatial variation across locations remained after adjustment for these variables, accounting for 28% of variance. Conclusion: We observed substantial spatial heterogeneity of SARS-CoV-2 burden in this high prevalence setting not fully explained by individual, household or population factors. Such local variability in prevalence has implications not only for transmission but for scale-up of vaccines which remain in limited supply in low-and middle-income countries.

ESTIMATION of SARS-CoV-2 CUMULATIVE INCIDENCE: AN APPLICATION of MIXTURE MODELING

Background: With global vaccine scale-up, the utility of the more stable anti-S IgG assay in seroprevalence studies is limited. P population prevalence estimates of anti-N IgG SARS-CoV-2 using alternate targets (eg, anti-N IgG) will be critical for monitoring cumulative SARS-CoV-2 incidence., We demonstrate the utility of a Bayesian approach that accounts for heterogeneities in SARS-CoV-2 seroresponse (eg, must consider mild infections and/or antibody waning) to ensure anti-N IgG prevalence is not underestimated and correlates not misinterpreted. Methods: We sampled 4,828 participants from 2,723 households across 100 unique geospatial locations in Chennai, India, from Jan-May, 2021 when <1% of the general population was vaccinated. All samples were tested for SARS-CoV-2 IgG antibodies to S and N using the Abbott ARCHITECT. We calculated prevalence using manufacturer cut-offs and applied a Bayesian mixture model. In the mixture model, individuals were assigned a probability of being seropositive or seronegative based on their normalized index value, accounting for differential immune response by age and antibody waning. Regression analyses to identify correlates of infection defined seropositivity by manufacturer cut-offs and the mixture model. Results: The raw SARS-CoV-2 seroprevalence using IgG to S (cutoff=50) and N (cutoff=1.4) were 61.9% (95% confidence interval [CI]: 60.5-63.3%) and 13.7% (CI: 12.8-14.7%), respectively with a correlation of 0.33. With the mixture model, anti-N IgG prevalence was 65.4% (95% credible interval [CrI]: 61.8-68.9). Correlates of anti-N IgG positivity differed qualitatively by the two approaches (Table). Using the manufacturer cut-off, income loss during the pandemic, household crowding and lack of air conditioning were associated with significantly lower anti-N prevalence. By contrast, in the mixture model, many measures of lower socioeconomic status were associated with higher prevalence, associations that were comparable when anti-S was the outcome. The age pattern differed between approaches: the mixture model identified that individuals aged >50 had the lowest seroprevalence, but the highest immune response to infection. Conclusion: With global vaccine scale-up, population prevalence estimates of anti-N IgG will be critical for monitoring cumulative SARS-CoV-2 incidence. We demonstrate the utility of a Bayesian approach that accounts for heterogeneities in SARS-CoV-2 seroresponse to improve accuracy of anti-N IgG prevalence estimates and associated correlates.

Impact of COVID-19 on CT-diagnosed acute appendicitis and diverticulitis: was there collateral damage?

AIM: To evaluate the change in diagnosis rates, disease severity at presentation, and treatment of acute appendicitis and diverticulitis during the COVID-19 shutdown. MATERIALS AND METHODS: Following institutional review board approval, 6,002 CT examinations performed at five hospitals for suspected acute appendicitis and/or diverticulitis over the 12 weeks preceding and following the shutdown were reviewed retrospectively. Semi-automated language analysis (SALA) of the report classified 3,676 CT examinations as negative. Images of the remaining 2,326 CT examinations were reviewed manually and classified as positive or negative. Positive cases were graded as non-perforated; perforated, contained; and perforated, free. RESULTS: CT examinations performed for suspected appendicitis and/or diverticulitis decreased from 3,558 to 2,200 following the shutdown. The rates of positive diagnoses before and after shutdown were 4% (144) and 4% (100) for appendicitis and 8% (284) and 7% (159) for diverticulitis (p>0.2 for both). For positive CT examinations, the rates of perforation, hospitalisation, surgery, and catheter drainage changed by -2%, -3%, -2%, and -3% for appendicitis (n=244, p>0.3 for all) and +6% (p=0.2) +9% (p=0.06), +4% (p=0.01) and +1% (p=0.6) for diverticulitis (n=443). CONCLUSION: CT examinations performed for suspected appendicitis or diverticulitis declined after the shutdown, likely reflecting patients leaving urban centres and altered triage of non-COVID-19 patients. The diagnosis rates, disease severity at presentation, and treatment approach otherwise remained mostly unchanged.

Systemic Challenges in Internship Training for Health-Service Psychology: A Call to Action From Trainee Stakeholders.

The challenges observed in health service psychology (HSP) training during COVID-19 revealed systemic and philosophical issues that preexisted the pandemic, but became more visible during the global health crisis. In a position paper written by 23 trainees across different sites and training specializations, the authors use lessons learned from COVID-19 as a touchstone for a call to action in HSP training. Historically, trainee voices have been conspicuously absent from literature about clinical training. We describe longstanding dilemmas in HSP training that were exacerbated by the pandemic and will continue to require resolution after the pandemic has subsided. The authors make recommendations for systems-level changes that would advance equity and sustainability in HSP training. This article advances the conversation about HSP training by including the perspective of trainees as essential stakeholders.