Promoting the key moments of hand hygiene in a Targeted Hygiene intervention at COP26 : Lisa Ackerley

The COP26 conference in Glasgow, November 2021 presented a unique public health challenge in the midst of the COVID-19 pandemic. With 38,457 delegates attending, this international event posed a risk for SARS-CoV-2 infection. We used Targeted Hygiene theory to carry out a large event risk assessment process that focused on how spaces were used, referred to evidence from scientific literature, and identified key moments for surface and hand hygiene interventions. We relied on behavioural science evidence to optimize hand hygiene compliance at the event. To do so, we secured the opportunity to use hand sanitizer by determining the most suitable locations for over 500 hand sanitizing stations. To further motivate uptake of personal hygiene, kits were provided for each delegate with hygiene messaging to improve knowledge of the importance of hand hygiene in breaking the chain of infection. A COP26-branded face covering, personal hand gel and wipes were provided in the pack. Training and cleaning protocols centred on Targeted Hygiene were developed for cleaning teams to implement. Compliance monitoring through observation and daily real-time reporting of over 250 adenosine triphosphate (ATP) checks on just-cleaned surfaces provided reassurance for public health agencies that our Targeted Hygiene approach was effective. The messaging and cleaning interventions were carried out for the duration of the COP26 conference. The number of individuals officially affiliated with COP26 that tested positive was ∼2 in 1,000 as compared to ∼11-12 in 1,000 individuals in Scotland during the same period (6-13 November 2021 as reported by Public Health Scotland). Whilst no single control can be attributed to this achievement, effective hand and surface hygiene interventions contributed by helping to break the chain of infection. This risk-based approach to Targeted Hygiene serves as a blueprint for effective, sustainable and measurable nonpharmaceutical interventions at large scale events. Key messages • To mitigate risk of infection at COP26, key moments for surface and hand hygiene were identified and emphasized in cleaning protocols and education. • Using a risk-based approach to Targeted Hygiene serves as a blueprint for effective, sustainable and measurable nonpharmaceutical interventions at large scale events such as COP26.

Cystic fibrosis, lockdown and CFTR modulators - a perfect storm

The COVID-19 pandemic has had a significant impact on the mental health and well-being of children and young people. A large scale survey undertaken by the NHS in July 2020 showed 1 in 6 children aged 5–16 had a probable mental health disorder compared to 1 in 9 in 2017. The TIDES study showed that young people with cystic fibrosis have a 2–3 times higher risk for anxiety and depression than the general population. There are also increasing reports of adverse mental health effects with CFTR modulators. We present the case of an adolescent girl with cystic fibrosiswho struggled with mental health issues since the start of the COVID-19 pandemic. This escalated during repeated lockdowns and on starting Kaftrio® in late 2020. Despite a beneficial effect initially on her lung function, her mental health deteriorated further and she was acutely admitted to a medical ward in spring 2021 with significant depression and passive suicidal ideation. She had lost 10% of her body weight in 3 months and had a nearly 20% drop in FEV1 in 5 months. Her escalating mental health condition lead to her being sectioned under the mental health act. We discuss the complexities of this case, managing a joint psychiatric and medical patient on an acute medical ward and the legalities of trying to ensure she had good cystic fibrosis care while under a mental health act section. Legally, the mental health act only covers treatment for mental health conditions but she was using non-compliance with CF care as a method of self-harming. We discuss the potential negative impact of Kaftrio® on her mental health and how we stopped and then slowly increased her dose using sweat tests and monitoring her mental health. Despite the challenges involved, her mental and physical health improved through coordinated working with all the teams involved in her care.

HIV and SARS-CoV-2 INFECTION and OUTCOMES in the MID-ATLANTIC US

Background: Reports of severity of illness and outcomes of SARS-CoV-2 infection in persons living with HIV (PLWH) vary across cohorts. Limited data exists regarding post-infection complications among PLWH. Methods: We examined the clinical characteristics and outcomes among PLWH infected with SARS-CoV-2 compared to an age and race matched cohort in a healthcare system composed of ten academic and community-based hospitals in the mid-Atlantic United States. Descriptive statistics were used and multivariate logistic regression analyses were performed to explore factors associated with incident hospitalization and death/mechanical ventilation among PLWH. Results: Between March 2020 and November 2020, 281 d PLWH were diagnosed with SARS-CoV-2 infection among 1632 tested. The mean age was 51.5 years (SD: 12.74), 63% (n=177) were male, and 86% (n=237) were African-American/Black. The median CD4+ T lymphocyte count was 623 cells/mm3 [383, 938] and 87% had a HIV viral load <200 copies/mL. More PLWH were hospitalized than age/sex matched HIV-seronegative controls, 47% (n=132/281) versus 24% (n=269/1124), (p<0.001). Rates of post-Coronavirus Disease 2019 (COVID-19) cardiovascular, thrombotic, acute kidney injury, and concurrent infections were similar between PLWH and HIV-seronegative individuals. All cause mortality was similar between PLWH and HIV-seronegative individuals, 14% versus 13% (p=0.75). In adjusted analyses, hospitalization among PLWH with COVID-19 was associated with older age aOR 1.03 (95% CI 1.03, 1.06, p=0.022) and Medicaid insurance aOR 2.87 (95% CI 1.45, 5.78, p=0.003). Conclusion: In an age/sex matched cohort, PLWH with well-controlled HIV and SARS-CoV-2 infection had higher rates of hospitalization but similar mortality rates compared with HIV-seronegative individuals. Despite higher rates of hospitalization and higher comorbidity burden, rates of post-COVID-19 events were similar. However, older age and Medicaid insurance status associated with more severe disease among PLWH suggesting the importance of targeted interventions to mitigate the effects of modifiable inequities.

Adults' views and experiences of vaccines developed in response to the COVID-19 pandemic: a qualitative evidence synthesis

Objectives: This is a protocol for a Cochrane Review (qualitative). The objectives are as follows:. Objectives The objective of this review is to identify, appraise and synthesise qualitative studies that explored adults’ views and experiences towards vaccination in the context of the COVID-19 pandemic. A secondary objective is to compare this evidence with qualitative evidence that explores people’s perspectives of vaccines developed in response to Ebola, Hong Kong flu and Swine flu. Copyright © 2022 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Ear Recognition In The Wild with Convolutional Neural Networks

Ear recognition has gained attention in recent years. The possibility of being captured from a distance, contactless, without the cooperation of the subject and not be affected by facial expressions makes ear recognition a captivating choice for surveillance and security applications, and even more in the current COVID-19 pandemic context where modalities like face recognition fail due to mouth and facial covering masks usage. Applying any deep learning (DL) algorithm usually demands a large amount of training data and appropriate network architectures, therefore we introduce a large-scale database and explore fine-tuning pre-trained convolutional neural networks (CNNs) looking for a robust representation of ear images taken under uncontrolled conditions. Taking advantage of the face recognition field, we built an ear dataset based on the VGGFace dataset and use the Mask-RCNN for ear detection. Besides, adapting the VGGFace model to the ear domain leads to a better performance than using a model trained for general image recognition. Experiments on the UERC dataset have shown that fine-tuning from a face recognition model and using a larger dataset leads to a significant improvement of around 9% compared to state-of-the-art methods on the ear recognition field. In addition, we have explored score-level fusion by combining matching scores of the fine-tuning models which leads to an improvement of around 4% more. Open-set and close-set experiments have been performed and evaluated using Rank-1 and Rank-5 recognition rate metrics. © 2021 IEEE

Experiences in the Training Program to Strengthen Technology-based Entrepreneurship through Specialized Tools, during COVID-19

Currently, because of the global health emergency, various difficulties have arisen in education. Specifically, in the field of Innovation and Entrepreneurship, the virtualization of training and networking programs, considered as the basis of any Entrepreneurship, has been evidenced as the main problem. This article explains a virtualization proposal through the use of digital tools such as social networks, videoconferences, and virtual rooms (Habbo), achieving a great reception by students of the various professional careers of the University. Likewise, it is explained how the interaction, synergy, and development of soft skills, aroused among the participants of the different specialties, allowed outstanding achievements at the national level. © 2021 Latin American and Caribbean Consortium of Engineering Institutions. All rights reserved.

Research and Care Networks in Acute Leukemia As a Model for Global Healthcare Collaboration

Introduction: Clinicians in academia face four major career challenges: 1. Gaining clinical advice from colleagues experienced in a particular disease or treatment 2. Experiencing Life-long coaching and mentoring from senior experienced clinicians 3. Accessing high quality continuing medical education relevant for patient care 4. Support to carry out medical research All four challenges have been adversely impacted during the Covid-19 pandemic as traditional face-to-face networks have become harder to access. This is especially pertinent when treating complex or rare diseases like acute lymphoblastic leukemia (ALL). Atypical or refractory patients, and those who experience toxicities often benefit from timely input from experts with considerable experience managing ALL. Online networks offer a robust pandemic-proof source of health and care support and advice. Until recently there have been few dedicated professional networks that provide a regular online forum dedicated to research and care on specific diseases across countries and none related to ALL. Methods: We describe the Resonance ALL Research and Care Network (ALL RCaN;https://resonancehealth.org/networks/all-rcan ) which includes a network of colleagues and a weekly, multidisciplinary online forum that brings together pediatric and adult hematologists and oncologists from around the world to share data, discuss cases and support patient care. In addition, there is a monthly ‘Fellows Fourth Friday’ to help fellows build their own professional network and gain scientific and clinical advice. The network was born out of a monthly meeting of study chairs (the “Study Chair Affinity Group”) for ALL research protocols which had been running for 10 years. Results: The network launched formally in June 2020 with 30 founding members but has expanded rapidly through word of mouth. The Acute Leukemia network grew by 850% by Dec 2020 and 1460% by March 2021 and as of July 2021 has 579 members across 18 time zones. It has succeeded in 'Building ALL Bridges“ between physicians that treat adults and pediatricians for joint discussions in acute leukemia. This collaboration has been severely lacking in the past. The network also presents selected s from major national and international conferences every 4 weeks. This model has been replicated for other cancers including the Global Neuroblastoma Network (resonancehealth.org/networks/gnn) and High-dose Methotrexate Quality Improvement Network (resonancehealth.org/networks/hdmtx). Network software development, video conferencing, meeting coordination, and content hosting have been funded by volunteer network leaders, many volunteer presenters, philanthropic contributions, and unrestricted educational grants. Now that the Resonance infrastructure is fully developed (and available to all at no cost), most Networks function well without funding. Conclusions: Providing free video conferencing, content hosting, and network management tools combined with dedicated leadership and clinically relevant discussions and presentations has led to massive growth of the ALL Research and Care Network, which continues to grow. Networks for other cancers are in various stages of development since the tool set and methodology easily scales to new groups of colleagues and new diseases. [Formula presented] Disclosures: Guscott: EUSA Pharma UK Ltd: Ended employment in the past 24 months. Douer: Amgen: Consultancy, Speakers Bureau;Servier: Consultancy, Speakers Bureau;Jazz: Consultancy;Adaptive: Current holder of individual stocks in a privately-held company, Current holder of stock options in a privately-held company, Speakers Bureau. Howard: Cellworks Group Inc.: Consultancy;Sanofi: Consultancy, Other: Speaker fees;Servier: Consultancy.

A Whole Virion Vaccine for COVID-19 Produced via a Novel Inactivation Method and Preliminary Demonstration of Efficacy in an Animal Challenge Model

The COVID-19 pandemic has generated intense interest in the rapid development and evaluation of vaccine candidates for this disease and other emerging diseases. Several novel methods for preparing vaccine candidates are currently undergoing clinical evaluation in response to the urgent need to prevent the spread of COVID-19. In many cases, these methods rely on new approaches for vaccine production and immune stimulation. We report on the use of a novel method (SolaVAX) for production of an inactivated vaccine candidate and the testing of that candidate in a hamster animal model for its ability to prevent infection upon challenge with SARS-CoV-2 virus. The studies employed in this work included an evaluation of the levels of neutralizing antibody produced post-vaccination, levels of specific antibody sub-types to RBD and spike protein that were generated, evaluation of viral shedding post-challenge, flow cytometric and single cell sequencing data on cellular fractions and histopathological evaluation of tissues post-challenge. The results from this preliminary evaluation provide insight into the immunological responses occurring as a result of vaccination with the proposed vaccine candidate and the impact that adjuvant formulations, specifically developed to promote Th1 type immune responses, have on vaccine efficacy and protection against infection following challenge with live SARS-CoV-2. This data may have utility in the development of effective vaccine candidates broadly. Furthermore, the results of this preliminary evaluation suggest that preparation of a whole virion vaccine for COVID-19 using this specific photochemical method may have potential utility in the preparation of one such vaccine candidate.

Occupational dermatoses during the COVID-19 pandemic: A multicentre audit in the U.K. and Ireland

Healthcare workers (HCWs) need to wear personal protective equipment (PPE) during the COVID-19 pandemic. Studies from China report high rates of irritant dermatitis in frontline HCWs (Pei S, Xue Y, Zhao S et al. Occupational skin conditions on the front line: a survey among 484 Chinese healthcare professionals caring for Covid-19 patients. J Eur Acad Dermatol Venereol 2020;Epub ahead of print). The British Society of Cutaneous Allergy conducted an audit of occupational dermatoses in HCWs. Eleven centres in the U.K. and Ireland organized occupational skin disease clinics to treat PPE-related dermatoses. A standardized proforma was completed, which included information about site, dermatological history, occupation, working environment, shift pattern, sick leave, PPE and handwashing practices. Diagnosis and treatment were advised during a virtual consultation. Each participating unit entered anonymized audit data into a spreadsheet. Data from 200 HCWs were collected in May and June 2020. Forty-three per cent (n = 86) worked in England;30.5% (n = 61) in Scotland, 13.5% (n = 27) in Ireland and 13.0% (n = 26) in Wales. Median age was 36 years. Ninety per cent (n = 180) were female;67.0% (n = 134) had nursing roles. The face was affected in 46.5% (n = 93) and hands in 46.0% (n = 92). In 94.0% of cases (n = 188) the clinical findings were felt to be occupational or partially occupational, with the most common diagnosis being irritant contact dermatitis: 59.0% of patients (n = 118). Seventeen per cent (n = 35) had required time off work (292.5 days in total;range 0.5-28). The mean number of hours of PPE wear per shift was 6.9 [median 7.5, interquartile range (IQR) 4-10]. Those who wore PPE for longer periods had more time off;each hour of wearing PPE during a shift increased the time off by 0.2 days [95% confidence interval (CI) 0.002-0.344;P = 0.048]. The mean number of handwashes with soap per day was 22.7 (median 20, IQR 10-30). Each handwash increased the expected number of days off by 0.03 (95% CI -0.013 to 0.069;P = 0.174). The mean number of uses of alcohol gel per day was 19.2 (median 10, IQR 5-30). There was an inverse association with use of alcohol gel and time off;each use of alcohol gel per day reduced the expected number of days off by 0.03 (95% CI 0.002-0.066;P = 0.04). These data indicate that the duration of wearing PPE, frequency of handwashing and use of alcohol gel have a significant effect on the time off work for HCWs.

COVID-19 infection in patients with intestinal failure: UK experience.

BACKGROUND: The direct effect of the coronavirus disease 2019 (COVID-19) pandemic on patients with intestinal failure (IF) has not been described. METHODS: We conducted a nationwide study of UK IF centers to evaluate the infection rates, presentations, and outcomes in patients with types 2 and 3 IF. RESULTS: A total of 45 patients with IF contracted COVID-19 between March and August 2020; this included 26 of 2191 (1.2%) home parenteral nutrition (HPN)-dependent adults and 19 of 298 (6.4%) adults hospitalized with type 2 IF. The proportion of patients receiving nursing care for HPN administration was higher in those with community-acquired COVID-19 (66.7%) than the proportion in the entire HPN cohort (26.1%; P < .01). Two HPN-dependent and 1 hospitalized patient with type 2 IF died as a direct consequence of the virus (6.7% of 45 patients with types 2 or 3 infected). CONCLUSION: This is the first study to describe the outcomes of COVID-19 in a large cohort of patients requiring long-term PN. Methods to reduce hospital and community nosocomial spread would likely be beneficial.

High precision fully integrated airborne digital mapping systems - State of the art and performance analysis

This paper introduces the Phase One Aerial System 150, a next generation fully integrated fully digital aerial camera system with one single digital camera head and lens which almost matches the perfect geometry of a film camera for all airborne mapping applications. It is the first true replacement for the simplicity, geometry and efficiency established by film cameras for traditional airborne mapping. Several test flights were planned to be flown with the Phase One Aerial System 150 over the Greater Denver Area, Colorado, U.S.A. during the Winter of 2020. Two lenses are planned to be used, namely: 1) 50 mm lens for wide coverage and a geometry closest to that of a film camera which is suitable for most mapping applications, and 2) 90 mm lens which provides a higher resolution (smaller GSD) and a narrower field of view which is suitable for applications where less building lean might be required. Multiple flight altitudes are flown in order to end up with a GSD of 10 cm, and 20 cm, respectively. One dual-altitude flight was planned to characterize and calibrate the integrated system including camera in-flight calibration and camera/IMU boresight calibration. The remaining flights are planned to be used to validate system accuracy and productivity as well as the mapping product accuracy. Due to the Covid-19 pandemic and poor weather, only one full dual-altitude light has been flown. Therefore, system calibration, assessment, and validation are done using this single test flight. The remainder of the test flights intended for map production evaluation and accuracy assessment will be flown during the Spring of 2020, which results will be shared with the ISPRS audience during the congress presentations. © 2020 International Archives of the Photogrammetry, Remote Sensing and Spatial Information Sciences - ISPRS Archives.

Cochrane corner: Factors that influence compliance by healthcare workers with infection prevention and control guidelines for COVID-19 and other respiratory infections

As rates of novel coronavirus disease 2019 (COVID-19) continue rising in Africa, usage of infection prevention and control (IPC) strategies by healthcare workers (HCW) is critical. We highlight a Cochrane review of qualitative evidence that explored barriers and facilitators to HCW compliance with IPC recommendations for COVID-19 and other respiratory infectious diseases. The review found various individual-and organizational-level barriers and facilitators. The findings suggest that healthcare system constraints that make it difficult for healthcare workers to implement IPC guidelines require urgent prioritisation. This will help lay the foundation for addressing the more individual-level barriers potentially discouraging HCW from implementing IPC guidelines. We draw attention to pan-African initiatives for enhancing healthcare workers’ capacity to undertake IPC measures at such a critical time.

Healthcare workers' adherence to infection prevention and control guidelines for respiratory infectious diseases: A rapid qualitative evidence synthesis.

COVID-19 spreads easily between people who are in close contact, or through coughs and sneezes. As the number of cases continues to increase, healthcare workers (HCWs) are notably at risk as a result of frequency of contact with suspected cases or infected people. Use of infection prevention and control (IPC) strategies by HCWs is therefore important. We summarise the evidence from a rapid Cochrane qualitative evidence synthesis by Houghton et al. on barriers and facilitators to HCWs' adherence to IPC guidelines for respiratory infectious diseases.