The new normal in the post-pandemic world: Our experience of organising a three-part webinar series for the CST 2022 Applicants

Introduction: In The time of COVID-19, The influx in The use of The online platform has been paramount. The Surgical world is no exception with The first virtual selection process for Core Surgical Training (CST) 2021 applicants. We, The current core trainees from The Kent, Surrey and Sussex (KSS) deanery organised this three-part webinar series for CST 2022 applicants to aid our future colleagues. Material(s) and Method(s): The event poster was circulated among The Surgical tutors, medical education Department across The KSS region, all The foundation schools and to Foundation Trainees Surgical Societies (FTSS) across The UK. It was advertised on Facebook, Twitter, WhatsApp and Eventbrite. Google Workspace was used to manage registered participants and Microsoft Teams were used for The webinars. Discussion(s): A total of 526 participants registered. 69.9% of them registered through social media whereas 16.4% and 9.8% through The medical education Department and word of mouth respectively. The first part covering The CST program overview and self-assessment guidance was attended by 96 of them on 16 November 2021. The second part covering interview stations was attended by 29 participants on 14 December 2021. We received positive feedback from 42 and 8 participants following each webinar respectively. We currently have 88 participants registered for our mock interview sessions planned for late January 2022. Conclusion(s): The virtual selection process is here to stay. Well-organised events like this will help The candidates prepare well for their interview as well as helping The current trainees with their teamwork, leadership and organisation skills.

Implementing Simulation Based Learning (SBL) to Reduce the Gap in Surgical Training, A Theoretical Evaluation Approach

Background: The current Surgical training is severely affected by COVID-19 pandemic with redeployment and reduced number of elective procedure across NHS hospitals, this has affected both core and higher Surgical trainees, rendering The traditional apprenticeship model obsolete. It became evident that The future of Surgical training and innovation will require a combination of simulation and operative exposure to overcome The obstacle of reduced exposure in Surgical education and operative training. Discussion(s): In our theoretical analysis, we will discuss The efficacy, safety and impact of relying on SBL to fill The gaps in Surgical training. Clinical exposure alone will not be sufficient to train procedure based speciality trainees to their highest proficiency. SBL is one design that is supported by learning theories such as Transformational Learning and Experiential Learning Theory. Ina highfidelity simulation, such as laparoscopic simulation courses, all concepts of facilitated learning are fulfilled which strongly supports our hypothesis. on balance, given The complexity of skills learnt, it remains difficult to measure The efficacy of transferring The learnt capabilities into practice and standardise this among learners. SBL also leaves non-technical skills un-assessed in depth. Conclusion(s): The disruption of training due to COVID-19 affected our procedure based learning, this leaves us with a dilemma to catch-up with these unmet training needs. SBL could be one of The adjuncts that fill in The gaps on The short and medium term. Implementing SBL in Surgical training curriculum, should be evaluated for efficacy and cost effectiveness.

Implementing simulation based learning (SBL) to reduce the gap in surgical training, a theoretical evaluation approach

Background: The current surgical training is severely affected by COVID-19 pandemic with redeployment and reduced number of elective procedure across NHS hospitals, this has affected both core and higher surgical trainees, rendering the traditional apprenticeship model obsolete. It became evident that the future of Surgical training and innovation will require a combination of simulation and operative exposure to overcome the obstacle of reduced exposure in surgical education and operative training. Discussion(s): In our theoretical analysis, we will discuss the efficacy, safety and impact of relying on SBL to fill the gaps in surgical training. Clinical exposure alone will not be sufficient to train procedure based speciality trainees to their highest proficiency. SBL is one design that is supported by learning theories such as Transformational Learning and Experiential Learning Theory. In a high fidelity simulation, such as laparoscopic simulation courses, all concepts of facilitated learning are fulfilled which strongly supports our hypothesis. On balance, given the complexity of skills learnt, it remains difficult to measure the efficacy of transferring the learnt capabilities into practice and standardise this among learners. SBL also leaves non-technical skills un-assessed in depth. Conclusion(s): The disruption of training due to COVID-19 affected our procedure based learning, this leaves us with a dilemma to catch-up with these unmet training needs. SBL could be one of the adjuncts that fill in the gaps on the short and medium term. Implementing SBL in surgical training curriculum, should be evaluated for efficacy and cost effectiveness.

The impact of COVID-19 on the disease activity of multiple sclerosis: A Retrospective cohort study

Objective: To understand the impact of COVID-19 on the disease activities of multiple sclerosis. Background: COVID-19 pandemic is thought to influence the natural history of immune disorders, but its effect on multiple sclerosis (MS) is not fully understood Design/Methods: We studied all patients with MS seen in our hospital between March 2020 and August 20201. We identified patients infected with COVID-19, who had 4 at least 4-6 months follow up afterwards. We determined clinical and radiological evidence of disease activities in all patients by the end of the study period. Results: We studied 301 patients;216 (72 %) were women, the mean age was 38 years (range;16, 73 years), and the mean disease duration was 10 years (range;1, 36 years). The median EDSS score was 0.5 (range;0, 8). RRMS accounted for most of cases (270 patients). Thirty (10 %) patients were infected with COVID-19 (table 1). All patients reported mild symptoms, and none required hospitalization. None of our patients were fully vaccinated during the study. COVID-19 was prevalent among younger patients with RRMS, who were mobilizing, irrespective of DMTs they received (figure 1). Twenty-five patients had clinical relapses, but only one patient had COVID-19 preceding the relapse. Similarly, 73 patients had MRI disease activities, 8 of those had COVID-19 positive PCR prior to MRI changes. Disease activities were dependent on DMT use, but not COVID-19 status (figure 2 and 3). The later observation was also supported by multiple logistic regression analyses (adjusted odds ratio for MRI and clinical changes were 1.39 and 0.35 respectively, p = 0.4 and 0.3 respectively). Conclusions: Despite its high prevalence in our patients, COVID-19 didn't appear to influence the disease activities in our patients with MS. Standard precautions to reduce the risk of COVID-19 transmission must be applied, particularly in young patients with minimal or no disabilities.

Investigating the Electronic Examinations' Quality from Faculty Members' and Students' Experiences and Perspective

The current qualitative and quantitative study methods intend to investigate the quality of electronic examinations and the obstacles of changing the examinations' process from the participants' experiences and perspectives. The study generates feedback to enhance the adoption and improvement of the e. examination process. Due to the COVID-19 pandemic, electronic exams help much during the education interruption. The study employed two tools to answer the study'scentraln question: "To what extent did teachers and students reflect on the quality of electronic examinations' criteria? They Were distributed among (n=165) undergraduates and (n=24) faculty members during 2020/2021. Findings from the e. questionnaire's SPSS and interview's content analyses indicated that most participants were satisfied with the e. exams' flexibility, ease of use, clarity, fairness in grading, and feasibility in time, efforts, and money. Concerning challenges, few undergraduates complained about the Network problems, e. cheating, and the number of attempts to answer e. exams. Few faculty members have complained that some questions require different preparation methods, e. exams increase students' scores without much effort. On the other hand, it opened the door for malpractices. To conclude, the results revealed that E. examinations are of high quality;they were responsible for undergraduates' high performance, saved effort and time more than the in-class exams. The study recommends future research exploring families, especially parents, about their experience with kids regarding the quality of online examinations during the COVID-19 pandemic. Moreover, research is needed to address how teachers deal with the validity and reliability of the electronic exams

Nigella Sativa Supplementation Accelerates Recovery from Mild COVID-19: First Randomized Controlled Trial

Introduction: Effective treatment for patients with the novel Coronavirus Disease (COVID-19) is desperately needed and is under rigorous research. Nigella sativa oil (NSO), a herbal medicine, that has a documented wide antiviral and immunomodulatory activities offering a therapeutic potential for COVID-19. Methods: Adult symptomatic patients with mild COVID-19 were recruited between May and August 2020 from King Abdulaziz University Hospital in Jeddah, Saudi Arabia. They were randomly assigned to receive supplementation with oral capsules of NSO (MARNYS' Cuminmar 500 mg twice daily for 10 days) plus standard of care or standard of care medications alone. The primary endpoint was the proportion of patients recovered (free of symptoms for 3 days) within 14 days after randomization. This trial was registered with clinicaltrials.gov, NCT04401202. Results: A total of 120 patients were enrolled. Their mean age was 35 (SD=11) years old and 57% of them were male. There were 60 patients in the treatment group (NSO) and 60 patients in the control group. The proportion of patients recovered in the treatment group was significantly higher than the control group, 42 (70%) versus 27 (45%) (p=0.006). Additionally, there was a significant difference in the average recovery time among both groups, 9.9 (SD=3.3) versus 11.6 (SD=3.4) days (p=0.006). Furthermore, 3 patients from the control group required hospitalization within the study period versus one in the treatment group. Adverse events were reported in 3 patients of NSO recipients as gastrointestinal symptoms. Conclusion: In this RCT of adult patients with mild COVID-19, NSO was associated with a significant increase in the likelihood of recovery and a decrease in the likelihood of hospitalization. To our knowledge, this is the first RCT that shows potential therapeutic benefits of NSO in patients with COVID-19 which requires further confirmation with larger double-blinded RCTs. Keywords: Black seed, Nigella sativa, COVID-19, SARS-CoV-2;randomized controlled trial

Efficient inactivation of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in human apheresis platelet concentrates with amotosalen and ultraviolet A light.

OBJECTIVES: The detection of SARS-CoV-2 RNA in blood and platelet concentrates from asymptomatic donors, and the detection of viral particles on the surface and inside platelets during in vitro experiments, raised concerns over the potential risk for transfusion-transmitted-infection (TTI). The objective of this study was to assess the efficacy of the amotosalen/UVA pathogen reduction technology for SARS-CoV-2 in human platelet concentrates to mitigate such potential risk. MATERIAL AND METHODS: Five apheresis platelet units in 100% plasma were spiked with a clinical SARS-CoV-2 isolate followed by treatment with amotosalen/UVA (INTERCEPT Blood System), pre- and posttreatment samples were collected as well as untreated positive and negative controls. The infectious viral titer was assessed by plaque assay and the genomic titer by quantitative RT-PCR. To exclude the presence of infectious particles post-pathogen reduction treatment below the limit of detection, three consecutive rounds of passaging on permissive cell lines were conducted. RESULTS: SARS-CoV-2 in platelet concentrates was inactivated with amotosalen/UVA below the limit of detection with a mean log reduction of>3.31±0.23. During three consecutive rounds of passaging, no viral replication was detected. Pathogen reduction treatment also inhibited nucleic acid detection with a log reduction of>4.46±0.51 PFU equivalents. CONCLUSION: SARS-CoV-2 was efficiently inactivated in platelet concentrates by amotosalen/UVA treatment. These results are in line with previous inactivation data for SARS-CoV-2 in plasma as well as MERS-CoV and SARS-CoV-1 in platelets and plasma, demonstrating efficient inactivation of human coronaviruses.

The impact of COVID-19 pandemic on blood supplies and transfusion services in Eastern Mediterranean Region.

BACKGROUND: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has spurred a global health crisis. The safety and supply of blood during this pandemic has been a concern of blood banks and transfusion services as it is expected to adversely affect blood system activities. We aim to assess the situation in the Eastern Mediterranean Region (EMR) during the first months of the pandemic. MATERIALS AND METHODS: A survey was designed to address blood supply, transfusion demand, and donor management during the coronavirus disease-19 (COVID-19) pandemic. Medical directors of different blood banks were invited to participate. RESULTS: A total of 16 centers participated with representation from 15/19 countries in the region. In total, 75% were from national blood banks. Most centres had a decrease in the blood supply, ranging from 26-50%. Representatives from 14 countries (93.3%) believed that public fear has contributed to a decrease in donations. Most centres (n=12, 75%) had a reduction in transfusion demand, while those who did not, reported heavy involvement in treating patients with underlying haemoglobinopathies and haematological malignancies. Half of the centres activated their contingency plans. Four centres had to alter the blood donor eligibility criteria to meet demands. All centres implemented donor deferral criteria in relation to SARS-CoV-2, but were variable in measures to mitigate the risk of donor and staff exposure. CONCLUSION: Blood services in the region faced variable degrees of blood shortages. We summarize lessons learnt during this pandemic for the blood banks to consider to plan, assess, and respond proportionately to future similar pandemics.