Lessons Learned from the COVID-19 Pandemic: A Multigroup Structural Equation Modelling of Underground Space Environment and Users' Health

Due to the inherent limitations of underground spaces, such as the lack of natural ventilation and sunlight, underground space users tend to face more health risks compared with their aboveground counterparts. However, little is known about how the underground environment, users' health, and their associations were impacted by the outbreak of the pandemic. In this study, we investigated and compared the impacts of the general underground environment on regular users' physical and psychological health before and after the pandemic. To achieve this aim, the data from 525 surveys were collected from eleven underground sites, followed by an objective field measurement study conducted at five underground sites in Hong Kong pre- and post-outbreak of the pandemic. The multigroup structural equation modelling results indicated that: (i) surprisingly, the users' satisfaction towards almost all underground environment factors, including greenery, connectivity with the aboveground environment, thermal comfort, ventilation, indoor air quality, acoustic comfort, and lighting, excluding wayfinding, were significantly higher in the post-outbreak period;(ii) the users' health, both physical and psychological, was significantly better in the post-outbreak period;(iii) the impacts of visual comfort on the users' physical and psychological health were significantly greater in the post-outbreak period (critical difference ratio (;CDR;) > 1.96);(iv) the impacts of wayfinding, greenery, and acoustic and thermal comfort on the users' physical or psychological health were significant only in the pre-outbreak period (;CDR;> 1.96);(v) the impacts of connectivity on the users' physical and psychological health were significant in both the pre- and post-outbreak periods (;CDR;< 1.96). The findings were further cross-validated using the objective measurement results. With an increasing need to develop healthy underground spaces, the study contributes to the development, design, and management of the underground environment to enhance the users' health in the post-outbreak era.

Robot-assisted sacrohysteropexy vs robot-assisted sacrocolpopexy in women with primary advanced apical prolapse: A retrospective cohort study.

BACKGROUND: This study aimed to evaluate the anatomic and clinical outcomes of robot-assisted sacrohysteropexy (RASH) against robot-assisted sacrocolpopexy (RASC) for the treatment of primary advanced apical prolapse. METHODS: We conducted a retrospective cohort study of all robot-assisted pelvic organ prolapse surgeries for primary advanced apical prolapse (stage ≥II) between January 2011 and May 2021 at an academic tertiary hospital. Surgical outcomes and pelvic organ function were evaluated using the Pelvic Organ Prolapse Quantitative (POP-Q) stage and validated questionnaires (POPDI-6) during preoperative and postoperative 12-month follow-up evaluations. All data were obtained from electronic medical records. RESULTS: A total of 2368 women underwent surgery for apical prolapse repair, and 18 women underwent either RASH (n = 11) or RASC (n = 7). Compared to the RASC group, the RASH group was significantly younger, premenopausal, and less parous. Preoperative prolapse stage, operative time, estimated blood loss, and hospitalization length was comparable between the groups. No intraoperative complications were observed. All women had a median follow-up duration of 24 months (range: 12-108 months). During the 12-month follow-up period, women in the RASH group reported higher satisfaction with the surgery than those in the RASC group (100% vs. 71.4%, p = 0.137). The mesh exposure rate was significantly higher in the RASC group (3/7, 42.9%) than in the RASH group (0/11, 0%) ( p = 0.043), which was found at 12 to 36 months postoperatively and was successfully managed with vaginal estrogen cream. In the RASH group, one woman required reoperation with anterior colporrhaphy for recurrent anterior prolapse at 60 months postoperatively. The apical success rate was 100% at one year postoperatively, without apical recurrence in either group during the follow-up period. CONCLUSION: RASH represents an effective and feasible option for the surgical treatment of advanced primary apical prolapse in women who desire uterine preservation and have a significantly lower risk of mesh erosion than RASC.

Telecytology Makes Significant Contribution in ROSE with Great Accuracy - Experience During the COVID-19 Pandemic at Stony Brook University Hospital

Introduction: Telecytology (TC) has been used in rapid onsite evaluation (ROSE) of touch preparations (TPs) from core biopsies and smears from fine-needle aspiration (FNA) procedures. Although TC was established at our institution in 2010, utilization has fluctuated. The COVID-19 pandemic highlighted the value of TC for maintaining high-quality patient care with the advantages of minimizing contact with hospital personnel and patients, conserving personal protective equipment (PPE), and saving cytopathologists' time. However, the accuracy of TC compared to on site evaluation by cytopathologists has been a concern. This study aimed to address this question. Material(s) and Method(s): 697 ROSEs were identified from our quality assurance (QA) data base in 2021 (Q2-Q4) including 1) TC;2) onsite cytopathologist (OC);and 3) onsite cytotechnologistonly (OCT). Discrepancy rates between ROSE and final diagnoses were compared between TC and OC groups. A student T-test was performed to determine the statistical significance of the discrepancy rate between TC and OC. Result(s): Results are summarized in Table 1. On average, there were 26% FNA and 74% Cores by TP. The difference in discrepancy rates between TC and OC during the 3 quarters in 2021 is not statistically significant (p=0.5012). The type of discrepancy for TC was all minor while 17% major and 83% minor for OC. Conclusion(s): The value of TC for ROSE was highlighted during the pandemic, allowing cytopathologists to participate in ROSE while minimizing interpersonal contact at procedures, conserving PPE, and saving cytopathologists' time. TC provides as high quality as OC for ROSE service with statistically insignificant minor discrepancies with the final diagnosis. Although pandemic-related restrictions are easing, we anticipate that TC will continue to play a major role in ROSE.

The Influence of Time Orientation on Infection Risk Evaluation: Moderating Role of Public Health Crisis

The outbreak of COVID-19 has offered a painful lesson to the stakeholders of the travel and hospitality industry. To speed up the recovery of the industry, practitioners need to better understand the factors that influence potential travelers' evaluation of infection risk when traveling abroad. Hence, this study proposes time orientation (future and present orientations) as a robust determining factor. Analyzing 614 pre-pandemic and 606 mid-pandemic survey responses, this study consistently found that future and present orientations positively predict the evaluation of infection risk because of the highly perceived value of cleanliness. The presence of the pandemic amplifies the positive prediction of present orientation on the evaluation of infection risk. These findings extend the literature of time orientation by revealing its influence on travel risk and the psychological mechanisms behind it. Meaningful implications are provided for travel operators to identify the potential travelers. © The Author(s) 2023.

Fluorogenic reporter enables identification of compounds that inhibit SARS-CoV-2.

The coronavirus SARS-CoV-2 causes the severe disease COVID-19. SARS-CoV-2 infection is initiated by interaction of the viral spike protein and host receptor angiotensin-converting enzyme 2 (ACE2). We report an improved bright and reversible fluorogenic reporter, named SURF (split UnaG-based reversible and fluorogenic protein-protein interaction reporter), that we apply to monitor real-time interactions between spike and ACE2 in living cells. SURF has a large dynamic range with a dark-to-bright fluorescence signal that requires no exogenous cofactors. Utilizing this reporter, we carried out a high-throughput screening of small-molecule libraries. We identified three natural compounds that block replication of SARS-CoV-2 in both Vero cells and human primary nasal and bronchial epithelial cells. Cell biological and biochemical experiments validated all three compounds and showed that they block the early stages of viral infection. Two of the inhibitors, bruceine A and gamabufotalin, were also found to block replication of the Delta and Omicron variants of SARS-CoV-2. Both bruceine A and gamabufotalin exhibited potent antiviral activity in K18-hACE2 and wild-type C57BL6/J mice, as evidenced by reduced viral titres in the lung and brain, and protection from alveolar and peribronchial inflammation in the lung, thereby limiting disease progression. We propose that our fluorescent assay can be applied to identify antiviral compounds with potential as therapeutic treatment for COVID-19 and other respiratory diseases.

The changing role of BIM-facilitated facilities management in the post-COVID era: A systematic literature review

COVID-19 has become a long-term pandemic and pushed the re-interpretation of normality. Fighting against the pandemic and building a new normal in the post-COVID era requires constant and innovative approaches. Building information modeling (BIM) facilitated facilities management (FM) has been advocated as a powerful method to overcome the huge public health-related challenges. However, studies investigating the role of BIM-facilitated FM in the pandemic era are fragmented, and holistic knowledge is limited. Research objectives of this study are twofold: (1) to identify varying FM requirements after the outbreak of COVID-19, (2) to investigate how BIM-facilitated FM copes with changing requests in the pandemic period. To achieve the objectives, a systematic literature review was conducted. Currently, FM tends to be public health-centric, and highly emphasized requirements encompass the flexibility of space transformation for emergency purpose, effective and sufficient ventilation, reliable biosecurity, and strict anti-infection management. Based on centralized database and visualized model, BIM-facilitated FM enables space optimization, simulation and prediction of infection risk, monitoring and managing equipment operation, and effective information management, which enhances both hard and soft FM. This paper sheds light on the applications and directions of future BIM-facilitated FM research in protecting public health in the post-COVID era.

Ready to learn in an uncertain future: ways to support student engagement

Purpose: The purpose of this paper is to examine student engagement in learning amid COVID-19 and compare it with the previous cohort under face-to-face learning and propose a series of learning activities to engage students for any uncertain situations in the future. Design/methodology/approach: Two online surveys were conducted at the end of the academic years of 2018/2019 and 2019/2020 to measure student engagement under face-to-face tradition learning and emergency remote learning respectively. Findings: Student behavioural engagement was found no statistical difference between the two learning situations, whereas students having face-to-face learning demonstrated greater emotional and cognitive engagement. Social interaction is essential to drive student engagement in emergency remote learning. Practical implications: The authors intended to highlight some teaching approaches and learning activities for social interaction to engage students. Originality/value: Engaging students in remote or online learning is an educational challenge for the new reality. This paper proposed the teaching approach and learning activities to engage students in their learning in the future. © 2021, Emerald Publishing Limited.

Safe surgical tracheostomy during the COVID-19 pandemic: A protocol based on experiences with Middle East Respiratory Syndrome and COVID-19 outbreaks in South Korea.

BACKGROUND: A subset of patients with COVID-19 require intensive respiratory care and tracheostomy. Several guidelines on tracheostomy procedures and care of tracheostomized patients have been introduced. In addition to these guidelines, further details of the procedure and perioperative care would be helpful. The purpose of this study is to describe our experience and tracheostomy protocol for patients with MERS or COVID-19. MATERIALS AND METHODS: Thirteen patients with MERS were admitted to the ICU, 9 (69.2%) of whom underwent surgical tracheostomy. During the COVID-19 outbreak, surgical tracheostomy was performed in one of seven patients with COVID-19. We reviewed related documents and collected information through interviews with healthcare workers who had participated in designing a tracheostomy protocol. RESULTS: Compared with previous guidelines, our protocol consisted of enhanced PPE, simplified procedures (no limitation in the use of electrocautery and wound suction, no stay suture, and delayed cannula change) and a validated screening strategy for healthcare workers. Our protocol allowed for all associated healthcare workers to continue their routine clinical work and daily life. It guaranteed safe return to general patient care without any related complications or nosocomial transmission during the MERS and COVID-19 outbreaks. CONCLUSION: Our protocol and experience with tracheostomies for MERS and COVID-19 may be helpful to other healthcare workers in building an institutional protocol optimized for their own COVID-19 situation.