The Perceived Impacts of COVID-19 on Users' Acceptance of Virtual Reality Hardware: A Digital Divide Perspective

The COVID-19 pandemic has directly or indirectly impacted everyone around the globe. However, the pandemic and its long-term consequences have not been distributed evenly within societies. These disparities have in many cases intensified existing social and economic inequalities such as the uptake of novel digital technologies. This study investigates the influence of the pandemic on the acceptance of virtual reality (VR) hardware within the framework of the technology acceptance model (TAM) and the digital divide/inequality scholarship. A survey was designed to examine the perceived impact of COVID-19 on the potential adoption of VR hardware. Specifically, this study included variables related to perceived ease of using VR hardware (ease of use), perceived usefulness of VR hardware (usefulness), intention to use VR hardware (use intention), and intention to purchase VR hardware (purchase intention). The predictors included two digital divide variables (material access and VR experience) and two other variables (COVID-19 and demographic variables). A total of 298 participants were recruited from Amazon Mechanical Turk. The results suggest that the perceived impacts of COVID-19 positively predicted participants' perceived usefulness of VR hardware as well as their intention to use and purchase VR hardware. © 2023 SAGE Publications.

Virtually Transforming healthcare at scale: Implementing improved access to stroke care across regional and rural areas

Aim: The NSW Telestroke project implemented a virtual model of care to improve access to hyperacute stroke treatment across 23 hospitals. To understand and extrapolate the success factors involved in effective project implementation and sustainability. Objective: The successful implementation of large-scale service redesigns with demonstrated improvement in patient outcomes are limited. The implementation at scale to 23 hospitals with varying local contextual features including resourcing, culture, leadership and facility set up has provided insights into the key elements of successful implementation. Undertaking a systematic approach to implementation including formulating a well-developed and attainable proposal for change in practice with clear targets, assessing the performance and mapping potential barriers indicates markers for successful implementation. Lessons learned has provided a gauge of what future endeavours should consider to inform large scale system transformation. Results: The Telestroke project has been implemented across 18 hospitals to date, with a further five sites by June 30, 2022. This is within the expected timeframe despite COVID-19 outbreaks in NSW and subsequent restrictions limiting activity at crucial time periods. Discussion: Through reflective lesson learned discussions at a program, hospital and individual level key drivers for successful implementation and sustainability of the project were highlighted. They include: 1. A clear roadmap, detailing the implementation approach with matching resources and education packages, have allowed expedited delivery of the program at a site level 2. Skilled, dedicated and consistent staffing in program implementation lead roles has enabled stability in coordination and knowledge management. This supports key learnings being adapted and utilised for future go-lives. 3. Leveraging skill mix at each site to fill knowledge/experience gaps to support and embed Telestroke. 4. A supportive executive team and clearly identified key champions in each department to drive the change forward. 5. Adapting training to suit the local environment including resources and COVID-19 restrictions was crucial during implementation.

Infectious bronchitis virus infection in chicken: viral load and immune responses in Harderian gland, choanal cleft and turbinate tissues compared to trachea.

1. The role of the Harderian gland (HG), choanal cleft (CC) and turbinate in terms of IBV M41 viral load compared to the trachea, and immune (innate, cellular and mucosal) responses were studied in 21-day-old commercial broiler chickens.2. After virulent IBV M41 challenge, the antigen concentration detected either by quantitative RT-PCR or immunohistochemistry peaked at 2-3 days post challenge (dpc) in all tissues. Significant increases of lachrymal IBV-specific IgA and IgY levels were found at 4-5 dpc.3. Gene transcription showed a significant up-regulation of TLR3, MDA5, IL-6, IFN-α and IFN-ß, where patterns and magnitude fold-change of mRNA transcription were dependent on the gene and tissue type.4. The results demonstrated active IBV M41 replication in the HG, CC and turbinate, comparable to levels of replication found in the trachea. Data on immune-related genes in head-associated tissues provide further understanding on the immunobiology of IBV and offer opportunities to identify their use as quantitative biomarkers in pathogenicity and vaccination-challenge studies.

DERIVATION OF A RISK SCORE TO PREDICT SEVERE COVID-19 PNEUMONIA IN HOSPITALIZED PATIENTS WITH OVERWEIGHT OR OBESITY

Background Although a higher body mass index (BMI) has been reported to be associated with severe COVID-19 pneumonia (severe disease), it is unclear if metabolic status plays a role. Being metabolically unhealthy (MU) is defined as having either hypertension, hyperlipidemia, type 2 diabetes mellitus/pre-diabetes, or non-alcoholic fatty liver disease. We aimed to derive a risk score to predict severe disease in patients with obesity or overweight according to metabolic status. Methods A retrospective study was performed for patients hospitalized with COVID-19 pneumonia between March 2020 and August 2021 at a single tertiary center. Patients were excluded if they were immunocompromised or had a BMI < 25.0. Wilcoxon rank sum test or Fisher's Exact test were performed. Univariate logistic regression was performed followed by multivariate logistic regression to derive a risk score to predict severe disease. Variables with the highest p-values were sequentially removed until removal led to less than a 1-point reduction (improvement) in the Akaike information criterion. Accuracy of the model was calculated using bootstrap resampling estimates of the area under the receiver operating characteristic curve (AUROCC). Results 334 of 450 patients hospitalized with COVID-19 pneumonia (74.2%) were MU. Older age, higher BMI, being a former smoker, and having been vaccinated for SARS-CoV-2 were associated with being MU. There was no difference in treatments for COVID-19 pneumonia according to metabolic status. Patients who were MU had a higher death rate (10.5% vs. 2.6%) and longer total length of stay (median 6 vs. 5 days). Figure 1. On univariate analysis, age at admission, male gender, Asian race, hypertension, and type 2 diabetes mellitus were significant predictors of severe disease, whereas being MU was not, p=0.27. On multivariate logistic regression, older age, male gender, and Asian race were associated with having severe disease. Not being vaccinated was associated with a doubled odds of severe disease (OR 2.24, 95% CI: 1.07, 4.59). Figure 2. The AUROCC of the final model was 0.66 (95% CI: 0.60 to 0.71). The risk score at the lowest quintile had a 33.1% to 65.5% predicted risk and a 58.7% observed risk of severe disease, whereas at the highest quintile there was an 85.7% to 97.7% predicted risk and an 89.7% observed risk of severe disease in our cohort. Conclusion In this retrospective study of hospitalized patients with COVID-19 pneumonia, being MU was not a predictor of severe disease, even though mortality rate and total length of stay were higher in this group despite having higher rates of vaccination. Older age at admission, male gender, Asian race, and being unvaccinated were associated with severe disease. Using this risk score may help to predict severe disease in hospitalized patients with obesity or overweight. External validation is recommended (Table Presented)(Table Presented)

Immunopathogenesis of infectious bronchitis virus Q1 in specific pathogen free chicks.

The immunopathogenesis of avian coronavirus, infectious bronchitis virus (IBV) Q1, was investigated in specific pathogen free chicks. Following infection, chicks exhibited respiratory clinical signs and reduced body weight. Oropharyngeal (OP) and cloacal (CL) swabs were collected at intervals and found to be RT-PCR positive, with a greater number of partial-S1 amino acid changes noted in CL swabs compared to OP swabs. In tissue samples, IBV viral load peaked 9 days post infection (dpi) in the trachea and kidneys, and 14 dpi in the proventriculus. At 28 dpi, ELISA data showed that 63% of infected chicks seroconverted. There was significantly higher mRNA up-regulation of IFN-α, TLR3, MDA5, LITAF, IL-1ß and IL-6 in the trachea compared to the kidneys. Findings presented here demonstrate that this Q1 isolate induces greater lesions and host innate immune responses in chickens' tracheas compared to the kidneys.