The Risks and Harms Associated with Modern Slavery during the COVID-19 Pandemic in the United Kingdom: A Multi-Method Study

The COVID-19 pandemic has considerably affected global economies and societies, exacerbating existing social inequalities. This "syndemic” pandemic has placed people and communities affected by modern slavery and human trafficking at elevated risk of multiple harms. This paper uses a mix of methods–an evidence synthesis, a survivor survey, web-monitoring, and dialogue events–to explore how COVID-19 has affected the risks and pathways to harm associated with modern slavery/human trafficking in the UK and U.S. We use concepts of hazard, risk, exposure, and harm and the tools of public health risk and resilience assessment to examine how COVID-19 has amplified existing risks of harm and generated new pathways to further harm. We also use a novel complex systems approach to represent risk relationships and demonstrate how the economic shock of COVID-19 and mandated social isolation have led to negative outcomes for affected people. The paper provides policy and practice insight into interventions can be implemented across systems to minimize exploitation and how locally led intervention can offset the damaging effects of the pandemic (SDGs 5 & 16). © 2023 The Author(s). Published with license by Taylor & Francis Group, LLC.

Dividends and share repurchases during the COVID-19 economic crisis

In this article, we examine dividends and share repurchases of S&P 1500 firms during the COVID-19 crisis characterized by the stock market crash and a relatively quick stock price recovery propelled by technology stocks. We find that the great majority of firms either maintain or increase the level of dividends during the crisis period. Yet, the relation between the dividend payout and reported earnings is negative and significant. This relation also holds for other types of payouts, including share repurchases and special dividends. Moreover, we find that both forecasted and realized earnings of up to 1 year into the future are negatively associated with current dividends, implying that existing payout policies are unsustainable in the longer term. Surprisingly, the difference-in-differences test shows that firms strongly affected by the COVID-19 crisis have higher dividend payouts (relative to net earnings) compared to unaffected firms. The same test indicates that strongly affected firms significantly reduce repurchases. © 2023 The Authors. Journal of Financial Research published by Wiley Periodicals LLC on behalf of The Southern Finance Association and the Southwestern Finance Association.

Usefulness of day-one chest X-ray score for predicting mortality and ICU admission in COVID-19 patients

We aimed to investigate the performance of a chest X-ray (CXR) scoring scale of lung injury in prediction of death and ICU admission among patients with COVID-19 admitted at Vinmec Central Park hospital (HCM City, VN) during the peak epidemic in 2021. X-ray images and clinical data were collected from patients with SARS-CoV-2 PCR positive from July to September 2021. Three radiologists independently assessed the CXR score at admission which is the sum of severity and extent of lung injuries on four lung quadrants (maximum score = 24). Among 219 patients included, 28 died including 25 from 34 patients admitted to the ICU. There was a high consensus for CXR scoring among radiologists (kappa = 0.90;CI95%: 0.89-0.92). CXR score was the strongest predictor of mortality (tdAUC 0.85;CI95%: 0.69-1) within the first 3 weeks after admission. Multivariate model with adjustment for age confirmed a significant effect of increased CXR score on mortality risk (HR = 1.33, CI95%: 1.10 to 1.62). At a threshold of 16 points, the CXR score allows predicting in-hospital mortality and ICU admission with good sensitivity (0.82 (CI95%: 0.78 to 0.87) and 0.86 (CI95%: 0.81 to 0.90)) and specificity (0.89 (CI95%: 0.88 to 0.90) and 0.87 (CI95%: 0.86 to 0.89), respectively). The day-one CXR score is a reliable predictor of the risk of death and ICU admission and could be used to identify high-risk patients in needy countries like Vietnam.

The Impact of the Coronavirus (COVID-19) Pandemic on Education: A Model Toward Technology-Supported Synchronous Remote Learning

During the COVID-19 pandemic, many universities have moved a large portion of their classes online. To better support students' online learning activities and to best resemble the face-to-face setting, the technology-supported, synchronous remote learning platform was adopted in most cases. In this study, the authors aim to investigate factors that could influence students' learning in this new environment during the COVID-19 pandemic. Specifically, a research model was developed and tested with 428 students. The result showed that students' IT competence had a significant impact on their learning satisfaction, while social influence had a significant impact on their intention to use the remote learning technology in future classes. As to technology-facilitating conditions, significant impacts were found from it (at both institution and student levels) to learning satisfaction. They also found that COVID-19-related mental impacts could influence student satisfaction on and intention to use the remote learning technology.

Lessons Learned from Teaching in Person Cadaveric Anatomy During the COVID19 Pandemic

In March 2020, TTUHSC opened a new 20,000sf Institute of Anatomical Sciences for human gross anatomy. When the COVID-19 pandemic struck and many schools shifted from in person to online teaching, we hypothesized that if safety measures were used, in person cadaveric anatomy could be safely taught without a decrease in student performance. To test this, we reduced onsite attendance to less than 25% of room capacity. Masks were required at all times and students were instructed to social distance. Six students were assigned per cadaver, but only two students dissected at a time. The other four students reviewed and completed dissections and/or reviewed in groups of two at other allotted times. Thus, students dissected only every third lab. Dissection and lab review attendance was mandatory and students were nearly 100% compliant. Teaching assistants recorded dissected prosections reviews, and these videos were uploaded to password protected course files for independent learning. Students were provided iPads in the laboratory and access to three software packages for use on and off site. All students had access to multiple formative quizzes and exams, and three new online practice practical exams were created. To help reduce testing anxiety, a pass/fail system replaced categorical grading. However, all written and practical exams were conducted on site and in person. At TTUHSC, we have developed an exam question database to track historical student performance including a 25-question optional pre-block practice exam used to assess incoming student anatomical aptitude. In 2020, 90% of incoming students (93% in 2019) took the pre-block exam and scored an average of 28% (24% in 2019). In 2020, despite vastly different content delivery approaches (>80% of lectures were on Zoom) and reduced in-person dissection requirements, students modestly outperformed their 2019 counterparts. Overall exam averages were 89% in 2020 compared to 87% in 2019. If a categorical system was in place, 66% of students would have earned Honors or High Pass in 2020 compared to 61% in 2019. Our formative assessments were highly predictive of summative exam performance, and students reported that they reduced exam stress. Furthermore, summative exam averages correlated strongly with NBME performance (p<0.0001, r =0.63). TTUHSC medical students estimated that a majority of their peers at other medical schools did not have any in person dissection in 2020. Our students ranked in person laboratory dissection as the most useful learning activity, 88% reported that our COVID-19 preparations were very good to outstanding, and 97% were satisfied with the quality of their anatomy education. We conclude that 1) When using appropriate precautions, in person cadaveric anatomy can be taught safely during a pandemic;2) cadaveric dissection is essential for mastery of anatomical concepts;and 3) coupling online learning modalities with rigorous formative assessments prevented a modest reduction in cadaveric dissection opportunities from negatively impacting student performance. 2.

European Association of Urology COVID intermediate prioritisation group is poorly predictive of pathological high-risk among patients with renal tumours

Introduction & Objectives: The purpose of prioritisation is to minimise harm while safeguarding access to health care in times of reduced clinical resources. The EAU Guideline Office Rapid Reaction Group (GORRG) issued priority recommendations for use during the COVID-19 pandemic. We evaluated if the clinical prioritisation for suspected renal cell carcinoma (RCC) planned for surgery matched final pathological risk. Materials & Methods: From 23 March 2020 at the beginning of the first lock-down in the UK, patients with suspected RCC were prioritised according to GORRG recommendations until 10 October 2020. To increase statistical power, GORRG prioritisation was also retrospectively assigned to pre-lockdown RCC surgical cases, dating back to April 5 2019. Patient and tumour characteristics were assessed, as was priority group according to GORRG, TNM, and postoperative risk according to 2003 Leibovich scores. We assessed concordance between pre-operative GORGG prioritisation group and post-operative risk, and if stratification could be further improved by subgrouping of size. Results: 351 patients with suspected RCC were prioritised and underwent surgery, of which 16 were benign and 335 were RCC after specimen analysis. The intermediate priority group did not match the pathological risk group in 47.7%, with 25.7% and 16.4% of the group being pathological low and high risk, respectively. The low GORRG priority group harboured 14.9% intermediate and 1.06% high risk RCC, and the high GORRG priority group 27.9% intermediate and no low risk RCC respectively. Within the GORRG intermediate group, 34.2% of cT1b tumours were low risk, and 32.3% of cT2a tumours high risk. Analysing at 1 cm increments, 45.1% of 4-5cm tumours were low risk. The area under the receiver operating characteristics curve for priority groups in predicting matched postoperative risk group was 0.60 (95% CI 0.55-0.65). The sankey diagram shows patients categorised according to EAU GORGG guidelines (left) and pathological risk (right).(Figure Presented)Conclusions: The recommended prioritisation system can be error prone and should be prudently applied based on the centre’s needs. Particularly amongst the intermediate group, centres with clinical capacity should not defer intervention of cT2a tumours for longer than absolutely necessary and in severely limited resources may consider intermediate priority tumours <5cm as low priority.

Structural basis of anti-SARS-CoV-2 activity of HCQ: Specific binding to N protein to disrupt its interaction with nucleic acids and LLPS

SARS-CoV-2 nucleocapsid (N) protein plays the essential roles in key steps of the viral life cycle, thus representing a top drug target. Functionality of N protein including liquid-liquid phase separation (LLPS) depends on its interaction with nucleic acids. Only the variants with N proteins functional in binding nucleic acids might survive and spread in evolution and indeed, the residues critical for binding nucleic acids are highly conserved. Hydroxychloroquine (HCQ) was shown to prevent the transmission in a large-scale clinical study in Singapore but so far, no specific SARS-CoV-2 protein was experimentally identified to be targeted by HCQ. Here by NMR, we unambiguously decode that HCQ specifically binds NTD and CTD of N protein with Kd of 112.1 and 57.1 ?M respectively to inhibit their interaction with nucleic acid, as well as to disrupt LLPS. Most importantly, HCQ-binding residues are identical in SARS-CoV-2 variants and therefore HCQ is likely effective to different variants. The results not only provide a structural basis for the anti-SARS-CoV-2 activity of HCQ, but also renders HCQ to be the first known drug capable of targeting LLPS. Furthermore, the unique structure of the HCQ-CTD complex suggests a promising strategy for design of better anti-SARS-CoV-2 drugs from HCQ. Copyright © 2021 The Author(s). Published by Cambridge University Press.

EXAMINING GENDER DIFFERENCES IN STUDENT LEARNING DURING THE COVID-19 PANDEMIC: A MODEL FROM THE SWITCHING COSTS AND QUALITY- RELATED PERSPECTIVES

Aim/Purpose The aim of this study is to address the research questions on: (1) what factors can significantly influence student learning in remote classes during the COVID-19 pandemic? and (2) what are the gender differences, if any, in this context? To do this, the authors developed a research model from the switch ing costs (defined as the time and effort students have been put to change from one learning platform to another) and quality-related perspectives. In addition, gender differences are examined and identified by testing the proposed research model on male and female students, respectively. Background The recent worldwide outbreak of COVID-19 has changed many aspects of people's lives, including higher education. To better protect students and faculty, many universities have moved most of their classes online. Such a sudden change could make significant impacts on student learning. Thus, this study aims to empirically examine factors that can influence student learning in remote classes during the COVID-19 pandemic, and to investigate potential gender differences in such a context. Methodology The survey method is used in this study. The survey invitation was sent to students in multiple classes that had switched from in-person learning to remote learning during the COVID-19 pandemic. The survey was distributed in the online format. In total, 428 students completed the survey, with 202 being males and 226 being females. Contribution This study contributes to the current literature on student learning during emergency situations such as COVID-19 by developing a research model to systematically investigate potential factors that could influence their perceptions of academic performance and learning enjoyment. A second contribution is the integration of theoretical perspectives of switching costs and three types of quality-related constructs in the proposed research model. In addition, the authors also investigate gender differences based on the proposed research model, and some interesting differences have been found and reported in this study. Findings Data analysis indicates that perceived value has a significant impact on perceived academic performance for female but not male students. In addition, male students find information quality to be a significant factor in perceived academic performance, but not perceived learning enjoyment;on the contrary, their female counterparts find it to be significant in influencing perceived learning enjoyment, but not perceived academic performance. Also, female students perceive system quality to be influential on their learning enjoyment and support service quality to be influential on their academic performance, but no such significant perceptions are found among male students. Recommendations for Practitioners The results of this study could help bring some insights to educators on teaching remote classes during the COVID-19 pandemic (or potentially in other similar emergency situations). For example, when moving classes to the remote platform because of an emergency situation, in order to make sure a smooth transition and achieve a higher rate of student learning success, educators, as well as the institution, need to focus on reducing the costs and, in the meanwhile, increasing the benefits associated with such a change from the students' perspective. In addition, educators may need to keep in mind the gender differences identified in this study, which may help them better understand the learning needs of different gender groups. Recommendation for Researchers Researchers could validate and apply the proposed research model on students from different types of institutions (such as public universities vs. private universities) and students at different levels (such as undergraduate vs. graduate students). It could also be valuable to apply and extend the current model on students from other nations who have different cultural backgrounds. Impact on Society Understanding influential factors on student learning during the COVID-19 pandemic, as well as gender differences in this context, could help educators better adjust their teaching of remote classes in such an emergency situation, thus meeting the learning needs of students in both gender groups. Future Research Future research could further validate the research model proposed in this study by applying it to students in other institutions and other nations. Also, in addition to perceived academic performance and learning enjoyment, future research may expand the current model or create new models on other student learning-related dependent variables.

Clinical characteristics of COVID-19 patients with pulmonary embolism in 1st and 2nd waves

Introduction and ObjectivesMultiple studies have demonstrated increased risk of pulmonary embolism (PE) in COVID-19. Our study at a major NHS Trust examined the clinical characteristics, attributes and outcomes of PE in COVID-19, which have infrequently been explored in literature.MethodsWe performed a retrospective cohort study of COVID-19 patients with PE diagnosed on CT pulmonary angiogram (CTPA) over 2 months in 1st and 2nd waves (April 2020 and January 2021). Data collected from electronic health and imaging records included patient demographics, D-dimers, oxygen requirements, clinical outcomes, thromboprophylaxis/treatment and PE attributes on CTPA.ResultsWe identified 76 COVID-19 patients with PE (mean age 62.2 years, 69.7% male, 40.8% Caucasian). Patients experienced prolonged periods of COVID-19 symptoms prior to PE diagnosis - 19.6 day symptoms in 1st wave (n = 16, 21.9%) compared to 15.2 days in 2nd wave (n = 57, 78.1%). Average D-dimer was highly elevated (mean = 11576 ng/mL). 43 (56.5%) patients had high oxygen requirements - 21 (27.6%) required ≥10 litres/min via mask, 13 (17.1%) required non-invasive ventilation and 9 (11.8%) were intubated and ventilated. 22 patients (28.9%) were admitted to intensive care and 11 patients (14.5%) died. On admission, 48 patients (63.2%) were started on treatment dose enoxaparin (high PE suspicion) and 12 (15.8%) had intermediate (prophylactic) dose enoxaparin. PEs were largely treated with 3–6 months of rivaroxaban (n = 43, 56.6%) or apixaban (n = 7, 9.2%). 65.5% (n = 49) of patients had bilateral PEs;largest sizes being segmental (n = 32, 42.1%), subsegmental (n = 17, 22.4%), lobar (n = 16, 21.1%), main pulmonary artery (n= 5, 6.6%) and saddle (n = 5, 6.6%). 15 patients (19.7%) had evidence of right heart strain on CTPA.ConclusionsOur study suggests that PE in COVID-19 is more common in males and in those with COVID symptoms greater than 2 weeks, high oxygen requirements and highly elevated D-dimers. There should be a low threshold for investigating such patients for PE. Moreover, we found COVID-19 patients with PE have high likelihood of having a bilateral pulmonary distribution with right heart strain.

A Survey on Transfer Learning for COVID-19 Medical Imaging Diagnosis

Corona Virus Disease 2019 (COVID-19) has greatly disrupted lives and killed massive number of people all over the world. The insufficiency of COVID-19 testing has hindered controlling the spreading of the virus. There have been attempts that use deep learning methods to automatically diagnose COVID-19 based on CT scan images, which reduce burden for medical experts and enable fast diagnosis. However, due to the lack of publicly available CT scan data for COVID-19, it is difficult to devise a good deep neural network. In this paper, a number of experiments were conducted on transfer learning methods, which have proved helpful in the situation of lacking training data, using prominent pre-trained convolutional neural networks. The results were reported and discussed which provide some useful insights into the usage of transfer learning neural networks and form a good basis for further research in COVID-19 medical imaging diagnosis. © The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2021.

CHARACTERISTICS AND ICU OUTCOMES OF PATIENTS WITH CANCER WITH ACUTE RESPIRATORY FAILURE DUE TO COVID-19

SESSION TITLE: Lessons from the ICU: What have We Learned about the Management of COVID-19 SESSION TYPE: Original Investigations PRESENTED ON: October 18-21, 2020 PURPOSE: The purpose of this study is to describe the characteristics and outcomes of critically ill patients with cancer and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: We reviewed the clinical characteristics and outcomes of adult patients (> 18 yrs) with active or recent history of cancer and confirmed COVID-19 who developed acute hypoxemic respiratory insufficiency/failure with radiographic opacities and were consecutively admitted to two intensive care units (ICU) at Memorial Sloan Kettering Cancer Center between March 16 and May 27, 2020. The hospital adopted an early-intubation strategy during the first 4 weeks and a waiting period of 4 weeks before considering a tracheostomy. Pressure control ventilation and targeted tidal volume of 6 ml/kg predicted body weight and moderate to high PEEP was standard practice. Cases were confirmed through reverse-transcriptase–polymerase-chain-reaction assays performed on nasopharyngeal swab specimens. Data were manually abstracted from electronic health records. RESULTS: During the study period, a total of 290 patients were admitted to the two ICUs;90 (31%) patients with active (n=87) or recent (n=3) history of cancer had COVID-19 pneumonia. Mean age was 65 years;60% were male, 67% were White;49% had hypertension, 29% had diabetes mellitus;and 50% had a smoking history. 52 (63%) had solid tumors and 38 (37%) had hematologic malignancies. Advanced stage non-small cell lung carcinoma and breast carcinomas were the most frequent solid tumors and leukemia and lymphoma were the most common hematologic cancers. Vasopressors were required in 38 (42%) and CRRT in 8 (9%). In-hospital treatments for COVID-19 included remdesivir in 20%, convalescent plasma in 12%, hydroxychloroquine in 37%, azithromycin in 35%, corticosteroids in 56%, IL-6 inhibitors (tocilizumab, siltuximab) in 6% and IL-1 receptor antagonist in 1%. Acute respiratory failure (ARF) leading to invasive mechanical ventilation (MV) developed in 61 patients (68%) with a mean of 25 days on MV. Prone positioning (self or during MV) was implemented in 44 patients (49%). 18 patients (30%) were extubated after a mean of 11.5 days and 16 (26%) underwent a tracheostomy, 10 of whom (63%) were successfully liberated from MV. Thirty-six patients (40%) had a Do-Not-Resuscitate Order during their ICU stay. As of May 27, 24 (39%) of the 61 patients who required MV have died compared to 5 (17%) of the 29 non-ventilated patients. 40 patients (44%) were discharged home and 25 (28%) remain hospitalized. CONCLUSIONS: Over a third of cancer patients who developed ARF due to COVID-19 requiring MV in the ICU did not survive. CLINICAL IMPLICATIONS: Critically ill cancer patients with COVID-19 are at high risk of severe disease and mortality. DISCLOSURES: No relevant relationships by Christine Ammirati, source=Web Response No relevant relationships by Melissa Barzola, source=Web Response No relevant relationships by Sanjay Chawla, source=Web Response No relevant relationships by Michael Dang, source=Web Response Advisory Committee Member relationship with Pronia Medical Please note: $1001 - $5000 Added 06/02/2020 by Neil Halpern, source=Web Response, value=stock options Advisory Committee Member relationship with Airstrip Please note: $1-$1000 Added 06/02/2020 by Neil Halpern, source=Web Response, value=stock options No relevant relationships by James Isbell, source=Web Response Advisory Committee Member relationship with Jazz Pharmaceuticals Please note: $1-$1000 Added 07/17/2020 by Stephen Pastores, source=Web Response, value=Consulting fee Grant Support for Clinical Trial relationship with Biomerieux Please note: $5001 - $20000 Added 07/17/2020 by Stephen Pastores, source=Web Response, value=Grant/Research Support No relevant relationships by Kate Tayban, source=Web Response