Training Experience and Outcomes of the First Cohort of the ASGE Diagnostic EUS Training Program

Introduction: Despite the expanding role and need for endoscopic ultrasound, training opportunities for established endoscopists in the USA are limited. ASGE launched a novel competency-based program to address this training need in 2019. It includes an online learning modules, live webinars, a hands-on weekend course, a summative knowledge exam, followed by a customizable preceptorship with an EUS expert. Aim(s): To describe the training experience of a sample from the first cohort of the ASGE Diagnostic EUS training program. Method(s): A total of 26 applicants were chosen for the first cohort of the training program in 2019. We describe the experience of 3 endoscopists (ST at the Swedish Digestive Health Institute, Seattle, WA;BM at the Borland Groover Clinic, Jacksonville, FL and JH at Guthrie, Sayre, PA) who completed their hands-on training. Their case volumes were 160 (4 mentors), 185 (2 mentors) and 185 (3 mentors) respectively over a total of 12 weeks each. While 1 trainee (JH) was able to get trained at the same institute where he was employed, the other 2 (ST, JH) had to seek training in another state due to lack of preceptorship sites within their states of employment. One center tracked TEESAT scores (The EUS and ERCP Skills Assessment Tool) for every 5 procedures for their trainee (ST), and he was noted achieved a global score of 4 by the 150 th procedure. Result(s): All 3 trainees have been credentialed for EUS privileges at their respective institutes, and are performing EUS independently. Conclusion(s): The ASGE EUS diagnostic training program was able to fulfil the training needs of motivated established clinicians in full time practice. The main challenges encountered were identifying willing institutes and expert EUS preceptors, and institutional administrative barriers. COVID restrictions were a unique hurdle to the timely completion of preceptorship. This program's success in the future depends on buy in from EUS experts in the community and their respective institutions.

COVID-19 Vaccine Hesitancy among the Population of Quetta-Associated Beliefs and Barriers

Objectives: This study aimed to determine the prevalence of hesitancy towards COVID-19 vaccination among the adult population of Quetta and the likelihood predictors of hesitancy towards COVID-19 vaccination. Study Design: Analytical cross-sectional study. Place and Duration of Study: Study was conducted at Quetta, from Nov 2021 to May 2022. Methodology: A total of 396 individuals participated in the study. Along with socio-demographic details, participants responded to the COVID-VAX scale and questions from WHO determinants of vaccine-hesitancy. A relationship was modelled between WHO determinants of vaccine-hesitancy, socio-demographic characteristics and vaccine-hesitancy using logistic regression. Results: Results showed that majority of individuals were vaccine-hesitant (67.2%). The final model obtained significant predictors among contextual influences as demonstrated past bad experiences on vaccination, non-belief in risking their own and family's health for being non-vaccinated and negative influences by an influential person. Among individual influences, knowledge about someone having bad experiences to vaccines, confusion about scheduling of vaccines, lack of trust in the healthcare system and provider, disbelieving in immunization as a social norm and concerns regarding vaccine. Among factors directly related to vaccine/vaccination, difficult vaccination schedule, fear of pain/needles, and non-willingness to pay for vaccination were found as significant predictors of the COVID-19 vaccine-hesitancy (p-value <0.05). Conclusions: More than half of the participants showed hesitancy towards COVID-19 vaccine. Factors contributing to vaccine-hesitancy must be addressed to build confidence regarding COVID-19 vaccines among the people to attain the goal of herd immunization against COVID-19. © 2022, Army Medical College. All rights reserved.

Spatio-temporal air quality assessment in Tehran, Iran, during the COVID-19 lockdown periods

Based on ground-based and satellite-based data, spatio-temporal analyses of air quality in Tehran were carried out during the lockdown periods (February-April) in 2020 and 2021. We evaluated the differences in temporal emissions of six air pollutants (NO2, CO, SO2, O3, PM2.5, and PM10) at various time scales, including diurnal, monthly, and relative changes. The results of ground-based measurements indicated that for all pollutants except O3, the magnitude decreased in 2020 (11-42%) compared to the baseline period (2015-2021). As a result of eased restrictions and unfavorable meteorological conditions, the reduction in air pollutants was lower in 2021 (5-32%), and PM2.5 and PM10 levels increased (3.75 and 11.22%). Satellite-based concentrations (NO2, CO, SO2, and AOD) varied from −8 to 54% in 2020 and from −41 to 60% in 2021 compared to 2019 as the pre-lockdown year. Concerning AOD, the trend is consistent with dust events during March and April in our region. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

In silico study to find a potent inhibitor, Vilazodone, to cure COVID-19 using molecular docking

The pandemic caused by the coronavirus SARS-COVID-2 has had devastating impact on the world. It has caused a significant number of deaths across the world. Fast spread and lack of vaccine prompted academia to adopt new, fast and reliable methodologies to design new drugs. A combined approach of direct drug design and indirect drug design has been used for molecular docking. In the study, we found a compound, Vilazodone, with a binding energy of -8.40 kcal/mol. The druglikeness properties of this compound are investigated through SWISS ADMET analysis. In this in-silico study, we confirmed this compound is a potential drug candidate against SARS-CoV-2.However, in-vitro and in-vivo studies are required to prove its efficacy. © 2022 IEEE.

Drug Repurposing for CoVID-19 Spike Protein through Molecular Docking

Drug repurposing is the technique of finding new uses for currently used or under-researched drugs. Because this strategy requires less time and money, it is thought to be a particularly effective drug development strategy. Due to current technological breakthroughs, the accessibility of vast and reliable database resources, as well as data accessibility from genomes, proteomics, transcriptomics, etc., there are numerous opportunities to identify drugs by drug repurposing. The recent SARS-COV-2 epidemic, which has so far claimed 6,245,750 lives, has significantly increased the use of bioinformatics techniques in deciphering the characteristics of viral diseases. Using FDA-approved antiviral drugs that target the COVID-19 spike protein, we have used a bioinformatics approach to drug repurposing to find possible effective inhibitors against the Coronavirus (COVID-19). We used a variety of bioinformatics tools in this study, including AutoDock-Vina, PyMol, and Discovery Studio, to identify a promising drug called Cepharanthine (CEP), which demonstrates successful outcomes and efficacy compared to recently used antiviral drug candidates like arbidol, talampicillin, bromhexine, chloroquine, lycorine, bruceine A, reserpine, indinavir, galidesiver, doxycycline, methisazone, flupentixol, trifluoperazine and fluoxetine. The potential therapeutic value of cepharanthine as a drug for treating COVID-19 has been investigated in this study. It is expected that the proposed study will help medical professionals and researchers cure disorders linked to Severe acute respiratory and variations of it. © 2022 IEEE.

BIOMEDICAL DEGREE IN PAKISTAN: AN INSIGHT

Among all the multidisciplinary fields, biomedical is the fastest growing. Its diversified skills in biological as well as engineering sciences makes it a unique pillar of the any healthcare unit to create unique solutions while pertaining to healthcare standards. However, in Pakistan, the importance of biomedical field was recognized later.1 Here are several causes for this. First, we mix biomedical degree with pure medical science, and second, all relevant vacancies in Pakistan are filled by electronics and electrical engineers. It would be difficult to underline the importance of biomedical graduates in Pakistan without defining their employment positions and duties. Many companies who are working with biomedical equipment, in particular, have begun to provide special vacancies and quotas for biomedical graduates to emphasize the importance of biomedical field and to give it equal merit like all other fields. Many HEIs have started offering bachelors program in the biomedical field. Currently, the bachelor degree in Biomedical Engineering is offered by the University of Engineering & Technology, Lahore (KCK Campus), Riphah University, Lahore, Sir Syed University of Engineering & Technology, Karachi, Hamdard University, Karachi, NED University of Engineering and Technology, Karachi, Ziauddin University, Karachi, Salim Habib University, Karachi, Liaquat University of Medical and Health Sciences, Jamshoro, and Mehran University of Engineering and Technology, Jamshoro.2 Bachelor degrees in biomedical technology is offered by The University of Lahore, Lahore, University of Engineering & Technology, Lahore (KSK Campus), Foundation University, Rawalpindi Campus, Islamia University of Bahawalpur, Bahawalpur, NFC Institute of Engineering & Technology, Multan, Superior University, Lahore, Ziauddin University, Karachi, University of Engineering and Technology, Taxila, Punjab Tianjin University of Engineering & Technology, Lahore, and National University of Technology, Islamabad.3 Defining the role of biomedical personnel in health-care enables them to serve for hospitals, firms working with equipment as well as in research and development and regulatory agencies. Biomedical personnel have a broad spectrum for their career prospect, and they have greater opportunities to pursue postgraduate studies in different countries around the globe. Their importance cannot be denied since they are a crucial pillar in healthcare in times of need, such as in times of COVID-19 when society as a whole went in recession and fell under the need for more biomedical personnel. The difference between biomedical engineering and biomedical technology is always a source of debate for students and parents. A student who graduates in biomedical engineering will receive a Pakistan Engineering Council (PEC) registration number, whereas a biomedical technologist will receive a National Technology Council (NTC) registration number.2,3 Both PEC and the NTC are accreditation bodies in Pakistan that seek to ensure the quality of education and make it comparable to worldwide educational standards in higher education institutions. © 2022. Maria Shahzadi, et al.

COVID-19 Vaccination and Mental Stress within Diverse Sociodemographic Groups.

In this study, we surveyed 635 participants to determine: (a) major causes of mental stress during the pandemic and its future impacts, and (b) diversity in public perception of the COVID-19 vaccination and its acceptance (specifically for children). Statistical results and intelligent clustering outcomes indicate significant associations between sociodemographic diversity, mental stress causes, and vaccination perception. For instance, statistical results indicate significant dependence between gender (we will use term 'sex' in the rest of the manuscript) and mental stress due to COVID-19 infection (p = 1.7 × 10-5). Over 25% of males indicated work-related stress compared to 35% in females, however, females indicated that they were more stressed (17%) due to relationships compared to males (12%). Around 30% of Asian/Arabic participants do not feel that the vaccination is safe as compared to 8% of white British and 22% of white Europeans, indicating significant dependence (p = 1.8 × 10-8) with ethnicity. More specifically, vaccination acceptance for children is significantly dependent with ethnicity (p = 3.7 × 10-5) where only 47% participants show willingness towards children's vaccination. The primary dataset in this study along with experimental outcomes identifying sociodemographic information diversity with respect to public perception and acceptance of vaccination in children and potential stress factors might be useful for the public and policymakers to help them be better prepared for future epidemics, as well as working globally to combat mental health issues.

Assessment of Critical Challenges Faced by Students and Significance of Cutting Edge Technologies in Pakistan Education during COVID-19 Pandemic

The educational system in Pakistan relies on traditional methods of learning. Notably, only few institutions are prioritizing technological advancements and its implementation in education system. However, majority of the institutions adhere to conventional methods and ignoring its negative impacts. A sudden outbreak of the Covid-19 pandemic is challenging for everyone. Specifically, the fear of pandemic particularly affected those students who were indulged in physical classes. This study presents a comprehensive analysis of already available studies discussing the challenges and role of Information Technology (IT) in the educational domain. The study mainly incorporated an online questionnaire-based survey among 400 university-going students of Punjab, Pakistan. Additionally, the study highlights the key challenges and essential IT platforms that helped students continue their education. Moreover, we analyzed the incorporated constructs with the assistance of using SPSS and AMOS. Besides, our results confirm that Information Technology (IT) played an essential role in students' lives in their education. Our research shows that the role of IT in our education system is highly essential to be implemented. Although there are innumerable challenges, yet IT has core importance in the education sector during the pandemic. Moreover, the research intends to safeguard the education budget for better learning outcomes in Pakistan Punjab's educational level COVID-19 pandemic. Institutions and students are encouraged to adopt IT, seeing its inevitable role in education.

Nanoarchitectonics: role of nanomaterials in vaccination strategies for curbing SARs-CoV-2/COVID-19

With the exponential rise in infections by CoV-2 and the scarcity of antiviral therapeutics, the development of an effective vaccine for the SARS CoV-2 is critical. The emerging pandemic has prompted the international science community to seek answers in therapeutic agents, including vaccines, to battle the SARS CoV-2. The various scientific literature on SARS CoV, to a lesser degree, MERS (Middle East Respiratory Syndrome), has mentored vaccine techniques for the unique Coronavirus. This disease, COVID-19, is triggered by SARS-CoV-2 virus that causes COVID-19 that needs vaccine protection. Vaccines producing significant amounts of virus-neutralizing antibodies with high affinity may be the only way to combat infection while avoiding negative consequences. There is a summary of numerous vaccine contenders in the review, including nucleotide, vector-based vaccines, & subunit, and attenuated & killed types. That has previously shown preventive effects against the MERS-CoV & SARS-CoV, while suggesting that these candidates may yield a safe and efficient vaccine for SARS-CoV-2. Vector-based vaccines, monoclonal antibodies, genetic vaccines, and protein subunit types for passive immunization are among the vaccination platforms currently being evaluated for the CoV-2 virus;each has its own set of benefits and drawbacks. The clinical safety and effectiveness evidence is the main challenging research task for this possible vaccine developed in the lab. The most challenging aspect of production is constructing and validating distribution platforms worthy of mass-producing the vaccine on a larger scale. Since target vaccine groups include high-risk people above the age of 60, including severe co-morbid diseases, the healthcare staff, and those engaged in vital industries, an effective COVID-19 vaccine would need a careful confirmation of effectiveness and detrimental reactivity. The study summarises efforts devoted to developing an efficient vaccine for the new Coronavirus that devastated the global economy, people's health, and even their lives.

Covid-19 Vaccination and Mental Stress within Diverse Socio-demographic Groups (preprint)

In this study, we surveyed over 600 participants to determine: a) major causes to mental stress during the pandemic and its future impacts, and b) diversity in public perception and acceptance (specifically for children) of Covid-19 vaccination. Statistical results and intelligent clustering outcomes indicate significant relationships between sociodemographic diversity, mental stress causes, vaccination perception, and Covid-19 infections. For instance, statistical results indicate significant dependence between mental stress due to Covid-19 and gender (p = 1.7e-05). Over 25% of males indicated work related stress comparing 35% in females however, females indicated more stressed (17%) due to relationships comparing to males (12%). Around 30% of Asian/Arabic participants don’t feel vaccination being safe as compared to 8% of white-British and 22% of white-European indicating significant dependence (p = 1.8e-08) with ethnicity. More specifically, vaccination acceptance for children is significantly dependent to ethnicity (p = 3.7e-05) where only 47% participants show willingness towards children’s vaccination. Primary dataset in this study along with experimental outcomes identifying sociodemographic information diversity with respect to public perception and acceptance of vaccination to children and potential stress factors might be useful for public and policy makers to be better prepared for future epidemics as well as working globally to combat mental health issues and running more effective vaccination campaigns.

CHRONIC PANCREATITIS AND COVID-19: INCIDENCE AND OUTCOMES. A MULTICENTER RESEARCH NETWORK ANALYSIS

Introduction: SARS-CoV-2, the causative organism for COVID-19, uses ACE2 to enter human cells. Pancreatic ductal, acinar and islet cells also express ACE-2;therefore, involvement of the pancreas is plausible. Elevated lipase and cases of acute pancreatitis related to COVID-19 have been reported in previous studies. Patients with chronic pancreatitis (CP) have a low-grade inflammatory state and pancreatic parenchymal fibrosis, which may predispose them to pancreatic injury and worse COVID-19 outcomes. However, large studies reporting the incidence and outcomes of COVID-19 in patients with chronic pancreatitis are lacking. Methods: A retrospective cohort study was performed using TriNetX (a multiinstitutional research network). Prevalence and Incidence Rate Ratio (IRR) (cases/ personday) of COVID-19 were charted for patients with CP between January 2020 and July 2021. Patients diagnosed with COVID-19 during this period were stratified into two groups based on the presence of CP (CP cohort and non-CP cohort). Outcomes of COVID-19 in the CP cohort were compared to the non-CP cohort after 1:1 propensity score matching (PSM) for age, gender, race, diabetes, ischemic heart disease, hypertension, lung disease, cirrhosis, smoking, and alcohol abuse. Results: A total of 4420 patients with CP diagnosed with COVID-19 were identified and compared to 1,169,773 patients without CP. A large proportion of patients with CP were diagnosed with COVID-19 and the IRR peaked between December 2020-January 2021 and then declined subsequently (Figure 1). Patients in the CP cohort were older and had a higher prevalence of multiple comorbidities (Table 1). In crude, unmatched analysis, COVID-19 patients with CP had higher mortality (4.96% vs 2.16%;RR: 2.29, 95% CI:2.02-2.61), need for hospitalization (RR: 3.64, 95% CI:3.47-3.83), critical care need (RR: 3.16, 95% CI:2.86-3.50), and acute kidney injury (AKI) (RR: 3.96, 95% CI:3.71-4.24) compared to patients without CP (Table 1). No residual imbalance was noted (SMD <0.1 for all covariates) after PSM. After PSM, no difference in mortality or rate of mechanical ventilation was noted, however, patients with CP had a significantly higher risk of hospitalizations (RR: 1.51, 95% CI:1.39-1.64) and AKI (RR: 1.28, 95% CI:1.16-1.42) (Table 1). No difference in mortality, hospitalization, and critical care was noted for patients with alcohol-induced CP vs other etiologies. Conclusion: Patients with CP have high mortality and risk of poor outcomes after COVID-19 due to the presence of a significant burden of comorbidities and risk factors for severe COVID-19. In addition, CP is independently associated with higher healthcare utilization and complications such as AKI in patients with COVID-19. (Figure Presented) Figure 1: Prevalence and Incidence rate (cases/person-day) of COVID-19 in patients with chronic pancreatitis (Table Presented) Table 1. Characteristics and outcomes of patients with COVID-19 in matched and unmatched Chronic Pancreatitis (CP) and non-CP cohorts

A portable light scattering system for detecting expelled droplets to assess Covid-19 transmission risk

The COVID-19 pandemic has caused a marked disruption in the delivery of medical care, resulting in significant negative consequences for patients. Considering Covid-19 spreads primarily through expelled respiratory droplets, the ability to detect and measure droplets is critical to the development of clinical protective practices. However, most available methods are either unsuitable for the clinical setting, or cannot distinguish solid particles from liquid droplets. We developed a robust and portable optical instrument capable of measuring the size and quantity of droplets generated during medical procedures. Here we outline the system design and describe our preclinical measurements, which showed that surgical masks significantly reduce the number of expelled speech droplets. Copyright © 2022 SPIE.

Spatio-Temporal Characteristics of Air Quality Index (AQI) over Northwest China

In recent years, air pollution has become a serious threat, causing adverse health effects and millions of premature deaths in China. This study examines the spatial-temporal characteristics of ambient air quality in five provinces (Shaanxi (SN), Xinjiang (XJ), Gansu (GS), Ningxia (NX), and Qinghai (QH)) of northwest China (NWC) from January 2015 to December 2018. For this purpose, surface-level aerosol pollutants, including particulate matter (PMx, x = 2.5 and 10) and gaseous pollutants (sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O-3)) were obtained from China National Environmental Monitoring Center (CNEMC). The results showed that fine particulate matter (PM2.5), coarse particulate matter (PM10), SO2, NO2, and CO decreased by 28.2%, 32.7%, 41.9%, 6.2%, and 27.3%, respectively, while O-3 increased by 3.96% in NWC during 2018 as compared with 2015. The particulate matter (PM2.5 and PM10) levels exceeded the Chinese Ambient Air Quality Standards (CAAQS) Grade II standards as well as the WHO recommended Air Quality Guidelines, while SO2 and NO2 complied with the CAAQS Grade II standards in NWC. In addition, the average air quality index (AQI), calculated from ground-based data, improved by 21.3%, the proportion of air quality Class I (0-50) improved by 114.1%, and the number of pollution days decreased by 61.8% in NWC. All the pollutants' (except ozone) AQI and PM2.5/PM10 ratios showed the highest pollution levels in winter and lowest in summer. AQI was strongly positively correlated with PM2.5, PM10, SO2, NO2, and CO, while negatively correlated with O-3. PM10 was the primary pollutant, followed by O-3, PM2.5, NO2, CO, and SO2, with different spatial and temporal variations. The proportion of days with PM2.5, PM10, SO2, and CO as the primary pollutants decreased but increased for NO2 and O-3. This study provides useful information and a valuable reference for future research on air quality in northwest China.

Cardiac Symptoms in Disguise;The Potential Effects of Covid-19 on Heart Tissues and the need for Warning Cardiologists

Healthcare professionals throughout the world face a brand-new issue as SARS-CoV-2, a newly discovered coronavirus, spreads around the world. The study's primary goal is to find out how COVID-19 affects cardiac patients, as well as any potential effects on heart tissue and whether cardiologists should be notified. Faisalabad Medical University conducted this descriptive investigation between September 2021 and December 2021. Google Scholar, PubMed, and Web of Science articles published up to June 20th, 2021, were used in this inquiry. Also checked for additional relevant research were referenced references from previously published articles and reviews. People with pre-existing cardiovascular disease (CVD) have a greater vulnerability to contracting COVID-19, and as a result, their condition is more severe, and their prognosis is worse. Several risk factors for cardiovascular disease (CVD) hurt the health of these individuals, but they do not appear to increase the chance of infection. The prevalence of diabetes, cardiovascular disease, and hypertension in 1527 COVID-19 patients was 9.7 percent, 16.4 percent, and 17.1 percent, respectively, according to a meta-analysis of six published studies from China. Patients with COVID-19 are more likely to have pre-existing cardiovascular disease (CVD) or develop new heart dysfunction throughout their illness, based on the illness's striking clinical presentation and its considerable burden.

IMPACT OF COVID-19 INFECTION AMONG PATIENTS WITH PRE-EXISTING GASTROINTESTINAL CANCERS IN THE UNITED STATES: A MULTICENTER RESEARCH NETWORK STUDY

Background: Patients with underlying malignancy are considered to be at a higher risk of severe illness from COVID-19. However, the data on the COVID-19 related outcomes in patients diagnosed with major gastrointestinal cancers is lacking. We aimed to investigate the patients' characteristics and outcomes of COVID-19 infection in patients with a preexisting diagnosis of GI cancer. Methods: A search query was performed to identify all adult patients (≥ 18 years) diagnosed with COVID-19 between January 15, 2020, and July 15, 2020, on TriNet Database. The search criteria to identify potential COVID-19 patients were based on specific COVID-19 diagnosis codes or positive laboratory confirmation of COVID-19. Patients with COVID-19 and a diagnosis of the malignant esophagus, gastric, pancreatobiliary, hepatocellular, and colorectal cancer ever were included in the GI cancer group. Patients with COVID-19 who never had a diagnosis of GI cancer were included in the control group. The main outcomes were the 30-day risk for mortality, mechanical ventilation, and hospitalization after adjusting for confounding factors with 1:1 propensity score matching. For each outcome, the risk ratio (RR) with a 95% confidence interval (CI) was calculated to compare the outcomes. Results: A total of 434,375 adult patients from 40 HCO’s diagnosed with major GI cancers were identified in the Research Network. We identified a total of 1043 patients in the cancer group and 111,373 patients in the control group. Baseline demographics are described in the Table. More than half of the patients (53%) had a preexisting diagnosis of colorectal cancer while 19% of the patients had liver & intrahepatic bile duct cancers, and 15% had pancreato-biliary and 13% of patients were diagnosed with esophageal or gastric cancers. In crude analysis, COVID-19 patients with pre-existing GI cancers had a significantly higher risk of hospitalization (RR 2.37, 95% CI 2.19-2.55), mechanical ventilation (RR 2.16, 95% CI 1.69-2.75) and mortality (RR 3.81, 95% 3.14-4.63) compared to the control group. After PSM, the risk of hospitalization (RR 1.25, 95% CI 1.11-1.41) and mortality (RR 1.43, 95% CI 1.06-1.93) was still higher in COVID-19 patients with pre-existing GI cancers. However, mechanical ventilation was not significantly different in the matched groups (RR 1.91, 95% CI 0.84-1.71). Conclusion: Our study found that outcomes in patients with pre-existing GI cancers who had COVID-19 infection were worse in regard to hospitalizations and mortality. This difference persisted even after robust propensity score matching. COVID-19 patients with pre-existing GI cancers should be aggressively managed with close monitoring and can be prioritized for COVID-19 vaccination programs.(table presented) Baseline patient characteristics and 30 day outcomes in patients diagnosed with major GI cancers infected with COVID-19.

IMPACT OF COVID-19 ON PANDEMIC MAJOR GASTROENTEROLOGY PROCEDURES, VISITS, AND NEW DIAGNOSIS OF GASTROINTESTINAL CANCERS

Introduction: The COVID-19 pandemic has caused an extraordinary burden on the healthcare system and has dramatically impacted the delivery of health care services including endoscopy procedures and routine gastroenterology inpatient and ambulatory care. This has led to significant concerns that major gastrointestinal cancer diagnosis can be delayed as a consequence of this pandemic. We aimed to quantify the impact of the COVID-19 pandemic on the diagnoses of major GI cancers. Methods: Search queries were performed on the TriNetX platform to estimate the number of patient encounters, procedures, and diagnoses of new GI cancers per 100,000 patients at participating HCOs in the US between March 15, 2020, and July 15, 2020, and March 15, 2019, to July 15, 2019. Differences in the number of encounters, procedure volume, and new diagnoses before and during the pandemic are compared and reported as a percentage increase or decrease. Results: During the pandemic, major declines were seen in both the inpatient (13,334.50 vs. 22,256.57;%change: -42.99% per HCO) and emergency department (21,933.06 vs.35,225.72;% change: -40.09% per HCO) in comparison to the same interval in 2019. A relatively smaller decline was seen in the ambulatory visits (130,245.84 vs. 159,996.81;% change -22.55% per HCO) during the pandemic compared to 2019. A large increase in virtual or telehealth visits (7,266 vs. 14,612.67;% change +4465.02%) was seen during the pandemic compared to 2019. The volume of the upper endoscopies per 100,000 patients had a decline of 71.84% (52.47 per 100,000 vs. 186.38 per 100,000) with 2019. Similarly, a decline of 84.66% (46.02 per 100,000 vs. 299.95 per 100,000) was seen in the volume of colonoscopies during the pandemic compared with 2019. The number of right upper quadrant abdominal ultrasounds (344.74 vs. 536.79;% change = -35.78%) decreased during the pandemic in comparison to the same duration in 2019. The new diagnoses of the liver and intrahepatic cancers declined to almost one-third (34.13%) during the pandemic while the diagnoses of colorectal cancers decreased by 30.91 % as compared to the similar duration in 2019. We also noticed a decline in the number of new diagnoses in the esophageal and gastric cancers (26.96%) followed by pancreato-biliary cancers (-22.81%). Conclusion: Our study showed that the health care encounters and major GI procedures declined during the pandemic leading to a reduction of new diagnoses GI cancer cases among the patients who had health care encounters during the pandemic that could have led to missed opportunities for a new diagnosis of cancers. Delay in diagnosis during the COVID-19 pandemic could lead to an increase in late-stage cancer cases and poor cancer outcomes. Urgent policy and practice interventions are needed to address the consequences of delays in the diagnosis of these can-cers.(Table Presented)Number of patient encounters, endoscopic procedures and new diagnoses of major GI cancers per 100,000 patients with a percentage change before and during the pandemic.

TWITTER-BASED EDUCATIONAL ACTIVITIES #MONDAYNIGHTIBD AND #SCOPINGSUNDAYS ENHANCE ENGAGEMENT IN LEARNING, IMPROVE CLINICAL PRACTICE, AND FACILITATE NETWORKING AND COLLABORATION AMONG MEMBERS OF THE GASTROENTEROLOGY COMMUNITY

Introduction The use of social media (SM) as an educational and networking platform is rapidly growing among healthcare professionals (HCPs), with Twitter being a preferred media for gastroenterologists. This has led to the development of organized gastroenterology (GI)-focused weekly Twitter chats (GIT) to promote medical education while enhancing user engagement. Methods A survey instrument was designed to evaluate the use and effectiveness of GIT as an educational resource for HCPs and to ascertain its perceived value relative to more traditional sources of education. The survey was distributed via Twitter from the official accounts of #MondayNightIBD and #ScopingSundays. Questions regarding participant demographics, area of clinical practice, participation and effectiveness of GIT were included. Level of agreement was assessed using a 5-point Likert scale. Results Of the 237 respondents, 49.8% were GI attending physicians, and 32.5% were GI fellows/trainees;75.5% currently practice in an academic medical center/hospital and 21.9% in a community hospital/private practice. 61.4% of respondents reported actively participating in GIT while 21.2% reported leading a weekly discussion/s. Regarding the impact of GIT on practice, majority of the respondents (89.1%) agreed/strongly agreed that it has improved their understanding of evidence-based treatment strategies, and their comfort level in navigating complex cases (90.3%), managing clinical scenarios not discussed in guidelines or textbooks (91.9%), and interpreting the results of new and emerging data and their implications (86.3%;Table 1). Respondents agreed/strongly agreed that GIT enhances expertise (90.3%), promotes decision making based on others’ expertise (88.9%), while also facilitating community building and /collegiality (95.3%), and networking (92.8%). Respondents selected GI journals (61.6%), GIT (62.3%), and conferences/symposia (51.9%) as the most effective tools to help improve their practice (Table 2). They also reported increasing use of the following educational platforms during the COVID-19 pandemic: SM including GIT (84.8%), webinars (80%), virtual conferences (65.8%), journals (24.1%), and podcasts (21.5%). Conclusions Among gastroenterologists who use Twitter, organized educational Twitter chats #MondayNightIBD and #ScopingSundays, rank high or highest as compared to other educational resources for evidence-based learning and clinical practice impact, while providing opportunities for community building and networking. The success of these educational platforms is likely due in part to the interactive and open access format that facilitates effective learner engagement. The use of Twitter in medical education is an emerging field of scholarship that merits further study.(Image Presented)

Comparative pathology, molecular pathogenicity, immunological features, and genetic characterization of three highly pathogenic human coronaviruses (MERS-CoV, SARS-CoV, and SARS-CoV-2).

The last two decades have witnessed the emergence of three deadly coronaviruses (CoVs) in humans: severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There are still no reliable and efficient therapeutics to manage the devastating consequences of these CoVs. Of these, SARS-CoV-2, the cause of the currently ongoing coronavirus disease 2019 (COVID-19) pandemic, has posed great global health concerns. The COVID-19 pandemic has resulted in an unprecedented crisis with devastating socio-economic and health impacts worldwide. This highlights the fact that CoVs continue to evolve and have the genetic flexibility to become highly pathogenic in humans and other mammals. SARS-CoV-2 carries a high genetic homology to the previously identified CoV (SARS-CoV), and the immunological and pathogenic characteristics of SARS-CoV-2, SARS-CoV, and MERS contain key similarities and differences that can guide therapy and management. This review presents salient and updated information on comparative pathology, molecular pathogenicity, immunological features, and genetic characterization of SARS-CoV, MERS-CoV, and SARS-CoV-2; this can help in the design of more effective vaccines and therapeutics for countering these pathogenic CoVs.