SeroNet Pooling Project of immunocompromised populations

Introduction: COVID-19 vaccination substantially reduces morbidity and mortality associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severe illness. However, despite effective COVID-19 vaccines many questions remain about the efficacy of vaccines and the durability and robustness of immune responses, especially in immunocompromised persons. The NCI-funded Serological Sciences Network (SeroNet) is a coordinated effort including 11 sites to advance research on the immune response to SARS-CoV-2 infection and COVID-19 vaccination among diverse and vulnerable populations. The goals of the Pooling Project are: (1) to conduct real-world data (RWD) analyses using electronic medical records (EMR) data from four health care systems (Kaiser Permanente Northern California, Northwell Health, Veterans Affairs-Case Western, and Cedars-Sinai) to determine vaccine effectiveness in (a) cancer patients;(b) autoimmune diseases and (c) solid organ transplant recipients (SOTR);(2) to conduct meta-analyses of prospective cohort studies from eight SeroNet institutions (Cedars-Sinai, Johns Hopkins, Northwell Health, Emory University, University of Minnesota, Mount Sinai, Yale University) to determine post-vaccine immune responses in (a) lung cancer patients;(b) hematologic cancers/hematopoietic stem cell transplant (HSCT) recipients;(c) SOTR;(d) lupus. Method(s): For our RWD analyses, data is extracted from EMR using standardized algorithms using ICD-10 codes to identify immunocompromised persons (hematologic and solid organ malignancy;SOTR;autoimmune disease, including inflammatory bowel disease, rheumatoid arthritis, and SLE). We use common case definitions to extract data on demographic, laboratory values, clinical co morbidity, COVID-19 vaccination, SARS-CoV-2 infection and severe COVID-19, and diseasespecific variables. In addition, we pool individual-level data from prospective cohorts enrolling patients with cancer and other immunosuppressed conditions from across network. Surveys and biospecimens from serology and immune profiling are collected at pre-specified timepoints across longitudinal cohorts. Result(s): Currently, we have EMR data extracted from 4 health systems including >715,000 cancer patients, >9,500 SOTR and >180,000 with autoimmune conditions. Prospective cohorts across the network have longitudinal data on >450 patients with lung cancer, >1,200 patients with hematologic malignancies, >400 SOTR and >400 patients with lupus. We will report results examining vaccine effectiveness for prevention of SARS-CoV-2 infection, severe COVID-19 and post-acute sequelae of COVID-19 (PAS-C or long COVID) in cancer patients compared to other immunocompromised conditions. Conclusion(s): Our goal is to inform public health guidelines on COVID-19 vaccine and boosters to reduce SARS-CoV-2 infection and severe illness in immunocompromised populations.

Perceived quality of online learning during COVID-19 in higher education in Singapore: perspectives from students, lecturers, and academic leaders

The COVID-19 pandemic has significantly affected the higher education sector in Singapore. Existing tertiary studies seeking to understand the intraperiod response to COVID-19 often focus on single institutions, jurisdictions or stakeholder groups. This study is the first in-depth qualitative multi-stakeholder examination of the higher education environment in Singapore during the COVID-19 pandemic. It explored the perceptions of the quality of digital pedagogy during COVID-19, how universities have adapted because of the pandemic, and how leaders, teaching staff and students have been affected by the management and educational changes via 13 semi-structured interviews across six Singapore higher education institutions. Through purposive sampling, we explore current stakeholder perceptions, structural education changes, and personal learning and teaching impacts of COVID-19. Applying Braun and Clarke's approach to thematic analysis, we inductively uncovered four major themes: the Singapore government's approach to COVID-19 and its effects on delivery;academic leadership approaches;education technology;and well-being. This article is critical as a key foundation to understand how Singapore is responding with unique geopolitical differences. We discuss the practical implications of our research for current university faculty and students during and beyond the pandemic, and outline opportunities for future research. © 2022, The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd.

Social media usage and acceptance in higher education: A structural equation model

The adoption and use of social media as an educational technology in higher education has been exacerbated during the COVID-19 pandemic. As a result, this study applied the unified theory of usage and acceptance of technology theory and the technology acceptance model as predictors of behavioral intention to use social media and actual social media use. These, as posited by the model, affect the performance impact of social media usage. This study involved a quantitative survey with 312 undergraduate university students in Malaysia. Using structural equation modeling, this study identified that unified theory of usage and acceptance of technology theory and the technology acceptance model influence behavioral intentions to use and actual use of social media, resulting in an improved performance impact. That is, when students see the value in particular technologies, feel their performance (e.g., passing their studies) will be improved by using that technology, offers behavioral nudges toward adoption and use. Copyright © 2022 Al-Rahmi, Shamsuddin, Wahab, Al-Rahmi, Alismaiel and Crawford.

Emergency remote teaching or andragogical innovation? Higher education in Singapore during the COVID-19 pandemic

Singapore higher education’s intraperiod response to the novel coronavirus (COVID-19) pandemic was unique compared to other countries, being praised by the World Health Organisation (WHO) for its early response. Like many other countries, alarming growth in cases appeared, and careful strategies for the continuation of learning were implemented. This paper provides a critical case study and reflection-in-action (Green et al., 2020) of the Singaporean intraperiod response, exploring individual responses from a sample of six autonomous universities, two international universities with campuses in Singapore, and four Private Education Institutions. Through a defined qualitative content analysis of university documentation, scant academic literature, and government and media sources, an understanding of the pandemic response in Singapore was possible. We chose to ensure full coverage of the city-state to enable a comprehensive country analysis in contrast to the growing volume of single-institution pandemic and emergency remote teaching case studies applying a sociotechnical theoretical framework to guide an analysis between educational technology systems and the people using it to teach, work, and learn. This study identified that while tasks and technology were presented with depth, the social elements – people and systems – were often lacking accurate description. We discuss how this technical focus has practical and research implications, and how future research and university teaching and learning practice can better respond to future challenges through reflection of the sociotechnical perspective. © 2022, Kaplan Singapore. All rights reserved.

CEREBRAL VENOUS SINUS THROMBOSIS AND COVID-19: CAUSATION OR COINCIDENCE?

Since early in the pandemic, it has been recognised that coronavirus disease 2019 (COVID-19) is associ-ated with an increased risk of thromboembolic complications. Several recent case reports have identified cases of cerebral venous sinus thrombosis (CVST) occurring in conjunction with COVID-19. Given these patients' increased risk of thromboembolic events, some authors have hypothesised that there may be a causative association between the two conditions. To examine this hypothesis, we collected a retrospective case series of patients with CVST presenting to a large tertiary neurology centre and surrounding trusts in the North West of England between January 2019 and December 2020. The catchment area serves approximately 3.2 million people, of which all confirmed cases of CVST are discussed with tertiary services. We identified 46 cases of CVST during 2020, 5 of which were identified as having been positive for COVID-19 RNA or antibodies at the time of CVST diagnosis (10.87%). A comparative 52 cases of CVST were identified during 2019. We suggest our findings do not provide evidence for an association between CVST and COVID-19 based on overall incidence trends. However, we also suggest that further research should be undertaken regarding this potential association, with particular emphasis on COVID-19 antibody testing.

The EdTech difference: Digitalisation, digital pedagogy, and technology enhanced learning

This editorial is in support of an issue of the Journal that has a focus on educational technology (EdTech). With this in mind, this editorial will provide advice on how the editorial team for this section feels that educational technology will evolve into the latter part of the 2020’s, especially given the disruption caused by the COVID-19 pandemic. Examples are given of how writing in this space has changed over the years of the pandemic, with a history of EdTech given, followed by an argument for the need for technology to be used in context. This is followed by descriptions of good practice around theoretical framing, methodology rigour, inclusion of the people element, and the need for the technology to serve a purpose. The piece concludes with a summary of where the editorial teams feels the field will go from here into the future. Throughout, practical examples of submissions made over the last few years are given to help illustrate a coherent direction. It is anticipated that this editorial will serve as a guide for future authors to use in service of better educational technology outputs in the future. Practitioner Notes 1. The use of technology in education needs to serve a purpose. 2. Theoretical framing is an essential underpinning of any EdTech practice. 3. EdTech research needs to ensure it embodies valid and reliable research methods and measures for evaluation. 4. Technology needs to enhance learning in all contexts, regardless of mode of learning. 5. EdTech researchers need to ensure that people and their behaviours are reflected in the technology-based processes. © 2022, University of Wollongong. All rights reserved.

Emergent transformation of cancer center tissue biobank to a COVID-19 biospecimen processing facility: Creation of shared institutional resource

Introduction: Establishment of a COVID19 Biospecimen Processing Facility (BPF) was undertaken, leveraging an existing Northwell Health Biospecimen Repository (NHBR). The purpose was to support COVID19 clinical trials and create a resource of biospecimens with clinical metadata. This institutional resource is envisioned to have impact on scientific inquiry, including innovation in clinical care and investigation of disease mechanisms. We present our experience, challenges, and scientific opportunities. Materials/Methods: NHBR pivoted from a cancer focus to COVID19, by establishing a dedicated BPF, redeploying existing personnel, recruiting additional volunteer health care workers, and building the IT infrastructure to support clinical trials and establish a COVID19 repository. Results: COVID19 biospecimens were obtained from three tertiary care facilities within Northwell Health;with inpatient COVID19 admission peak of 550, 711 & 304. NHBR staff of 6 Research Coordinators and 4 Pathologists' Assistants was supplemented by 22 volunteers. The Regeneron-Sanofi clinical trial to evaluate the efficacy of IL-6 inhibition with Sarilumab laid the framework for biospecimen processing. Additional COVID19 clinical trials continue to be supported by the BPF/NHBR. For biospecimen accrual, system data warehouse records were mined to identify biospecimens from COVID19 inpatients. A committee consisting of clinicians and clinical researchers provided guidance in developing the COVID19 BPF. The NHBRs preexisting global IRB-approved collection protocol obviated the need for an additional COVID19 biospecimen IRB protocol, which allowed for rapid activation of sample procurement. Accrual of 40,400 aliquots (serum, plasma, and whole blood) from 3,815 unique patients, including 366 COVID19 decedents. Viral Transport Medium (VTM) remnant specimens from more than 40,000 positive patients were retained. Conclusions: A database of remnant/discarded VTMs was established secondary to the patient care. Having a robust institutional research infrastructure is critical for preparedness and rapid response to the large-scale public health threat. Our call to action, rapid deployment and repurposing of existing assets enabled our health system to establish valuable resource that may enable us to further advance COVID19 related research. Limitations in our effort were: suspension of COVID19 biospecimen operations due to a shortage of human capital and a 4- month delay in procuring funding.

Randomized controlled trial of an adherence intervention in youth living with HIV

Background: Youth living with HIV (YLWH) have low rates of viral suppression (VS). We evaluated the impact of a 12-week intervention using remote coaching, electronic dose monitoring (EDM) and tailored outreach (the Triggered Escalating Real-Time Adherence [TERA] intervention) compared to standard of care (SOC) on VS and electronic dose monitored adherence of antiretroviral therapy (ART), among viremic (HIV-1 RNA≥200 copies/ml) youth (ages 13-24 yrs) in the United States. Methods: 89 YLWH were randomized to TERA intervention versus SOC and followed for 48 weeks with study visits at weeks 0, 4, 12, 24, 36 and 48. Remote coaching sessions were delivered at Weeks 0, 4 and 12, with continuous EDM monitoring for delayed or missed ART doses and as needed outreach from coach by text and phone in the TERA arm. Primary outcome was VS at week 12 (HIV-1 RNA <200 cp/ml at 10-14 weeks). RNA ≥ 200 cp/ml (10-14 wks) or missing set to failure. Proportions with VS were compared by arm (Fisher's exact test and log binomial regression for adjusted comparisons). Secondary outcomes included EDM adherence summarized in 12-week intervals using percent days device was opened (PCT12) and incidence rates (IR) of number of ≥7-day gaps between openings (GAPIR), compared using Wilcoxon rank sum tests. Results are reported using data collected before the study paused due to COVID-19 in March 2020. Results: 88 YLWH completed study entry: 55% male, 85% Black/African American, median age 22 (range 13-24 yrs), 44% acquired HIV perinatally and 30% on ≥3rd ART regimen. VS was achieved in 15/43 (35%;95% CI: 21%, 51%) TERA arm and 16/45 (36%;95% CI: 22%, 51%) SOC arm participants;difference (TERA-SOC) was-1% (95% CI:-21%, 20%). No differences by arm were apparent at weeks 24, 36 or 48 or after adjusting for sex, age or mode of transmission. Of 54 participants with opportunity for follow-up to week 48, 14% (4/29) and 8% (2/25) in the TERA and SOC arms, respectively, achieved consistent VS (TERA-SOC: 6%;95% CI: 15%, 25%). Median (Q1, Q3) PCT12 over the first 12 weeks was 72% (47%, 89%) versus 41% (21%, 59%) in the TERA and SOC arms, respectively (p<0.001). GAPIRs were higher in the SOC arm than TERA arm with SOC/TERA IR ratio of 2.51 (95% CI: 1.90, 3.33). Conclusion: The 12-week TERA intervention improved adherence to ART but not VS among YLWH failing treatment. TERA will be further assessed for indication, timing, and outcome duration in YLWH.

Enabling cross-cultural student voice during COVID-19: A collective autoethnography

Higher education learning and teaching has faced a significant challenge in 2020. The novel coronavirus pandemic (COVID-19) has required institutions to engage in emergency response teaching and deliver distance, online, or socially distanced delivery in most jurisdictions globally. The literature to date has focused on understanding this from the perspective of the institutions and academics primarily. For example, institutional case studies and staff critical reflections. There has been literature published on student learning, student experience, and student wellbeing during COVID-19, but these are typically constructed through an academic lens (e.g. a student satisfaction survey). This research offers a co constructed account developed adopting a students as partners philosophy. Our research team includes four students from two countries (Australia and Singapore) to independently reflect on their experience and collectively consolidate their learning journey through the pandemic, and be mentored and supported by two academics. Our findings indicate that students feel generally disconnected from their experience. Students felt their agency was important, self-awareness and accountability enabled this. Students also reflected that changes to their learning environment had made it more difficult to create social connections. They also include opportunities to change our teaching practice to be more supportive of our students' collective learning during COVID-19.

Enabling cross-cultural student voice during covid-19: A collective autoethnography

Higher education learning and teaching has faced a significant challenge in 2020. The novel coronavirus pandemic (COVID-19) has required institutions to engage in emergency response teaching and deliver distance, online, or socially distanced delivery in most jurisdictions globally. The literature to date has focused on understanding this from the perspective of the institutions and academics primarily. For example, institutional case studies and staff critical reflections. There has been literature published on student learning, student experience, and student wellbeing during COVID-19, but these are typically constructed through an academic lens (e.g. a student satisfaction survey). This research offers a co-constructed account developed adopting a students as partners philosophy. Our research team includes four students from two countries (Australia and Singapore) to independently reflect on their experience and collectively consolidate their learning journey through the pandemic, and be mentored and supported by two academics. Our findings indicate that students feel generally disconnected from their experience. Students felt their agency was important, self-awareness and accountability enabled this. Students also reflected that changes to their learning environment had made it more difficult to create social connections. They also include opportunities to change our teaching practice to be more supportive of our students’ collective learning during COVID-19. © 2020, University of Wollongong. All rights reserved.

Editorial 17.5. strengthening our focus for a post-covid-19 environment: Learnings from a pandemic in higher education

The year 2020 will unlikely be one that any member of the higher education community will forget. It has posed challenges and opportunities to rethink aspects of tertiary learning and teaching, and also confirmation of some of the better practices we have engaged in. For some, the novel coronavirus pandemic has forced bad practice – such as simple and rapid digitalisation of existing curriculum – often bundled into the pedagogically-ambiguous ‘emergency remote teaching’ or ERT (Toquero, 2020). The intense pressure for academics to deliver curriculum online, typically to the exception of time for comprehensive academic development and upskilling. The practice for an overnight transition to online learning, while deemed by many to have been essential at the time, has created a myriad of future decisions to be actioned across the sector. These range from deploying future academic development workshops to transform the workforce for continued online learning to employment of educational technologists, learning designers, or similar to enable purposeful decisions of pedagogy within online learning environments. Financial constraints have tempered the deployment of additional resources, with institutions suffering from financial modelling unexpected in late-2019 budget forecasting meetings. A reduction in student enrolments from international markets offers complexity for higher education exporter nations like Australia (Marshman & Larkins, 2020). Nonetheless, there has been a resilience from the sector to ensure continuity of education under all circumstances. The role of journals like the Journal of University Teaching and Learning Practice during the pandemic has been to support timely publication of evidence-based practices for responses to COVID-19. This has included a need to balance the acceptance of manuscripts with pre-COVID-19 data and implications, and those authors contributing to the exponentially expanding knowledge base for teaching and learning during COVID-19. For the former, we have encouraged authors during final acceptance to reflect on their work’s role in enabling a positive response to the pandemic. For those in the latter, we have ensured that writers have considered the broader implications of their work beyond the pandemic. These decisions support manuscripts publishing in JUTLP to contribute to the contemporary landscape, and also beyond the pandemic. © 2020, University of Wollongong. All rights reserved.