Can You Smell Me Now: Towards a Remote Olfactory Study

The sense of smell-olfaction involves the natural processing of ambient information in real-time. This process allows humans to detect danger, identify familiarities, and form lasting memories. During the COVID-19 pandemic, researchers were presented with challenges related to conducting in-person olfactory-based user studies. In this paper, we explore user experience and perception during olfactory-based interactions (OBI). Based upon previous literature, we propose an approach to offer future researchers a methodology for conducting olfactory-based user studies remotely. In particular, we explored a paper prototyping medium as an olfactory display. This experiment demonstrates the remote investigation of a complex sensory functionality during high mental work-load levels while participants (N=12) engage in an online memory game. Furthermore, this work seeks to inspire further discussion of olfactory-based user studies that explore functions related to human moods, memory, and behavior.

Erythroderma and Eosinophilia with Multi-System Involvement, a Case of Vress

Introduction: Resembling Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), Virus Reactivation with Eosinophilia and Systemic Symptoms (VRESS) occurs triggered by members of Herpesviridae family viruses. Case Description: A 12-year-old male was hospitalized with a 5-day history of fever, pruritic erythematous rash on the trunk and extremities, and facial edema. The patient was exposed to a cousin diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C) 10 days prior. No history of traveling, unusual food intake, URI, drug ingestion during the prior 3 months. Patient was treated with clindamycin x 10 days for possible Staphylococcal Scalded Skin Syndrome. Patient was noted to have eosinophilia of >2000 that persisted through the hospital course and thereafter, transaminitis with direct bilirubinemia, transient microscopic hematuria, elevated CRP and C3, normal EKG and chest radiograph, normal T/B/NKC counts, normal levels of immunoglobulins and elevated IgE (2163>1579IU/mL). IgG and IgM were negative for: CMV, adenovirus, strongyloidces, HAV, HBV, and HIV. IgG positive to: EBV, HHV-6, mycoplasma, HHV-6, HSV1, and parvovirus. Negative cultures for MRSA and group A Streptococcus. Negative PCRs for COVID -19. At 8 week follow up, skin erythema evolved into desquamation in the fingers and eosinophilia persisted. Discussion(s): VRESS should be on the differential for patients presenting with a DRESS-like symptoms in the absence of drug exposures. VRESS is often triggered by members of the Herpesviridae family of viruses including EBV and HHV-6, to both of which this patient was exposed to in the past. While diagnosis is one of exclusion, early identification can guide appropriate management. Copyright © 2022

The Unexpected Online Learning Pivot: Faculty Persistence Through the Swerve and Dangle

The COVID-19 pandemic that swelled into an economic maelstrom during the year 2020 also focused a direct hit on higher education. As faculty and students were heading into spring break, the seismic impact of impending changes were realized. Within the digital age, the technology has raised an everincreasing recognition of differentiated styles of teaching and learning, yet so many faculty held tightly to the traditional face-to-face instructional environments. Yet faculty persistence won the day, reflecting the ability of higher education faculty to succeed through the swerving road of the unknown, the tightrope that they walked dangling daringly over the online chasm of understanding. This chapter focuses on the initial foray into the principles of instruction, followed by an understanding of the differentiation between optics and outcomes, developing strategic priorities, an understanding of nuanced teaching and learning, and the gratitude and understanding conceived through critically reflective pedagogy and journaling.

UTILIZING INPATIENT ADMISSIONS TO INCREASE UNIVERSAL HIV SCREENING DURING THE COVID-19 PANDEMIC AND BEYOND

STATEMENT OF PROBLEM/QUESTION: Individuals at risk for HIV often face barriers to routine outpatient care which were exacerbated during the COVID-19 pandemic, creating a need and an opportunity to leverage hospital admissions for HIV screening. DESCRIPTION OF PROGRAM/INTERVENTION: This resident-led quality improvement project ran from 10/01/2020 to 6/30/2021 and aimed to increase rates of HIV screening among inpatients on the Medicine service at Zuckerberg San Francisco General Hospital (ZSFG), an urban safety net hospital. The QI intervention was informed by an initial gap analysis and consisted of three components: provider education, targeted outreach including biweekly performance metrics with peer comparisons, and electronic health record (EHR) optimizations. A pre-existing multidisciplinary care team was available to provide follow-up for positive test results, facilitating rapid linkage to HIV care. MEASURES OF SUCCESS: Given the high prevalence of HIV risk factors in this population, appropriate screening was defined as having an HIV test within the past 6 months. Our target for appropriate HIV screening was 55% of hospitalized patients on the Medicine service without a known HIV diagnosis, an increase of 10% from baseline. As a secondary goal, we sought to increase resident education about HIV as measured by pre- and post- intervention surveys. FINDINGS TO DATE: Among patients admitted during the intervention period (N = 1701), there was a 17.6% absolute increase in HIV screening rates compared to baseline (N = 885) (45.3% v. 62.9%, p < 0.001). To assess the impact of our intervention on previously identified differences in screening rates by gender, race, and language, we conducted post-intervention subgroup analyses. These results demonstrated persistently lower screening rates among females (59.6% v. 64.6%, p = 0.044), Asians (55.0% v. 64.5, p < 0.01), and patients speaking Chinese-based languages (53.5% v. 63.8, p = 0.01). Comparisons of pre- and post-intervention survey data showed an increase in provider comfort and knowledge across all domains assessed. KEY LESSONS FOR DISSEMINATION: Quality improvement interventions including education, targeted outreach, and EHR optimization can increase HIV screening rates of hospitalized patients. We found that despite improvement in overall screening rates, disparities persisted for women, Asians, and non-English speaking patients. Targeted interventions to address these disparities in HIV screening are needed. Inpatient providers are well-poised to help address HIV screening gaps, particularly for underserved patient populations who may face increased barriers to routine HIV prevention services.

Can You Smell Me Now: Toward s a Remote Olfactory Study

The sense of smell-olfaction involves the natural processing of ambient information in real-Time. This process allows humans to detect danger, identify familiarities, and form lasting memories. During the COVID-19 pandemic, researchers were presented with challenges related to conducting in-person olfactory-based user studies. In this paper, we explore user experience and perception during olfactory-based interactions (OBI). Based upon previous literature, we propose an approach to offer future researchers a methodology for conducting olfactory-based user studies remotely. In particular, we explored a paper prototyping medium as an olfactory display. This experiment demonstrates the remote investigation of a complex sensory functionality during high mental workload levels while participants (N=12) engage in an online memory game. Furthermore, this work seeks to inspire further discussion of olfactory-based user studies that explore functions related to human moods, memory, and behavior. © 2022 ACM.

eLearning engagement in a transformative social learning environment

Distance learning and remote learning have been developing options within the eLearning and talent training realms for over two decades, yet distance learning has become a significant reality within the past few months, especially as the COVID-19 pandemic has forever impacted the K-12, higher education, and adult training and talent development workforce solutions. Within the rapid shift into remote and distance learning environments, the curricular design and instructional design are understood as necessary. However, there is a need to understand aspects around social learning within eLearning environments. It is important to understand the opportunity of moving towards transformative social learning environmental engagement and experiences within distance and remote learning environments to improve the ability to understand social learning in eLearning environments. eLearning Engagement in a Transformative Social Learning Environment focuses on supporting and enhancing remote and distance learning (eLearning) instructional experiences, discusses the strategic role of social learning within eLearning environments, and enhances levels of engagement, transformative learning, and talent attainment environments. This book provides insights and support towards policies and procedures within instructional and training decision making around social learning needs and support. The chapters will explore social learning opportunities and support, modeling social learning engagement, communities of practice, and instructional processes of eLearning. The intended audience is teachers, curriculum developers, instructional designers, professionals, researchers, practitioners, and students working in the field of teaching, training, and talent development. © 2021 by IGI Global. All rights reserved.

THE OBSERVED RISK OF RECURRENT BLEEDING AND THROMBOEMBOLIC DISEASE IN COVID-19 PATIENTS WITH GASTROINTESTINAL BLEEDING

Background: COVID-19 patients are at increased risk of venous thromboembolism (VTE) requiring the use of anticoagulation. Gastrointestinal bleeding (GIB) is increasingly being reported, complicating the decision to initiate or resume anticoagulation as providers balance the risk of thrombotic disease with the risk of bleeding. Aim: Our primary aim is to assess rebleeding rates in COVID-19 patients with GIB and determine whether endoscopic evaluation and anticoagulation use affects these rates. Our secondary aim is to determine the 30-day VTE and mortality rates in this cohort. Methods: This is a retrospective study that reviewed 56 cases of COVID-19 patients with GIB admitted to the hospital between March 4th – May 25th. All patients tested positive for COVID 19 with reverse transcriptase polymerase chain reaction nasopharyngeal swabs. The cases were reviewed for the following outcomes: rates of therapeutic intervention, 30-day rebleeding, 30-day VTE events and 30-day mortality. Results: 23/56 (41%) of COVID-19 patients with GIB rebled within 30 days. There was no reduction in rebleeding rate with endoscopic therapy compared to medical management alone (39% vs. 42%, p=0.81). There was no difference in 30 day rebleeding rate among patients restarted on anticoagulation after endoscopy compared to those that were restarted on anticoagulation after medical management alone (41% vs 29%, p = 0.47). 15/56 (27%) of the cohort had VTE during their hospitalization, 53% of which were diagnosed after anticoagulation was held due to GIB. Patients that undergone endoscopy were more likely to be initiated or resumed on anticoagulation after bleed then those that did not (87% vs 55%, p=0.02). The all-cause 30-day mortality and GI-bleeding related deaths were 32% and 9% respectively. There was no difference in 30 day mortality rate among patients that were restarted on anticoagulation after endoscopic management compared to those restarted on anticoagulation after conservative management alone (24% vs 29%, p=0.70). Conclusions: In this cohort, while there was no difference in rebleeding rate when comparing endoscopic therapy to conservative management, patients who underwent endoscopy were more likely to be restarted on anticoagulation. Given that there was no difference in rebleeding or mortality rates among those restarted on anticoagulation after endoscopy compared to patients that were restarted on anticoagulation after conservative management, it seems reasonable to re-challenge COVID-19 patients who have stopped bleeding with anticoagulation even if endoscopy cannot be performed. However, larger studies are needed to guide management of these complex patients.(Table Presented) (Table Presented)