A Multimodal Framework for the Identification of Vaccine Critical Memes on Twitter

Memes can be a useful way to spread information because they are funny, easy to share, and can spread quickly and reach further than other forms. With increased interest in COVID-19 vaccines, vaccination-related memes have grown in number and reach. Memes analysis can be difficult because they use sarcasm and often require contextual understanding. Previous research has shown promising results but could be improved by capturing global and local representations within memes to model contextual information. Further, the limited public availability of annotated vaccine critical memes datasets limit our ability to design computational methods to help design targeted interventions and boost vaccine uptake. To address these gaps, we present VaxMeme, which consists of 10,244 manually labelled memes. With VaxMeme, we propose a new multimodal framework designed to improve the memes' representation by learning the global and local representations of memes. The improved memes' representations are then fed to an attentive representation learning module to capture contextual information for classification using an optimised loss function. Experimental results show that our framework outperformed state-of-the-art methods with an F1-Score of 84.2%. We further analyse the transferability and generalisability of our framework and show that understanding both modalities is important to identify vaccine critical memes on Twitter. Finally, we discuss how understanding memes can be useful in designing shareable vaccination promotion, myth debunking memes and monitoring their uptake on social media platforms. © 2023 ACM.

Teaching From the Guest Room, Learning at the Kitchen Table: Online Equity Courses in a Pandemic

In this piece, I use a series of "found poems" created from my notes and memos taken while teaching, first curating them into thematic poems and then reflecting on what those poems say about the affordances and constraints of teaching courses-especially those focused on equity and justice-in an online format during the COVID-19 pandemic. I also describe pedagogical moves made during this transition.

Drive-through anticoagulation clinic during COVID-19 pandemic

Background: Dedicated anticoagulation clinics have demonstrated superior patient outcomes. The COVID-19 pandemic created challenges for patient care including fear of medical appointments due to potential risk of exposure. An innovative approach to anticoagulation management was developed at our center that allows the patient to stay in their vehicle while our anticoagulation advanced practice nurse obtains blood for point-of- care/ INR testing, education and counseling. Objectives: 1. To assess degree of compliance to anticoagulation management pre vs. post drive-through clinic. 2. Assess percentage and time to therapeutic range (TTR), percentage within therapeutic (TR), subtherapeutic, and supratherapeutic INR pre vs. post drive-through clinic. 3. Evaluate bleeding and thrombosis complications during study period. 4. Assess patient/family satisfaction. Methods: Retrospective chart review of patients on warfarin therapy who used the drive-through clinic between April 1 and August 31, 2020. Patient demographics, underlying diagnosis, and target INR range were reviewed. Dates and values for INR, percentage of therapeutic (TR), subtherapeutic, and supratherapeutic INR and degree of compliance (≥1 INR determination per month) were collected for 6 months prior to April 1 and compared to results obtained during drive-through clinic implementation. Data were summarized descriptively and compared using nonparametric statistical methods. Results: A total of 17 patients were evaluated in our drive-through clinic during the study period. Fifty-eight percent were males (n = 10) with a median age of 15 years (range: 3-54). Primary indication for warfarin therapy included: tricuspid valve replacement (n = 1), mitral valve (n = 5), aortic valve (n = 4), Fontan (n = 5), atrial fibrillation (n = 1), and deep vein thrombosis (n = 1). Median TTR was 60.1% (range: 21.1-89.2) with a median cumulative time of anticoagulation of 3.3 years (range: 0.2-6.1 years). Overall compliance pre vs. post drive-through clinic implementation was similar (median pre compliance 100% (95% CI: 83%-100%) vs. 100% post (95% CI: 100%-100%);p = 0.16;Figure 1). Five of six patients who had compliance less than 90% achieved an improvement with the drive-through clinic. The median percentage of INR within TR improved significantly with the drive-through clinic (median pre 50% (95% CI: 33%-67%) vs. median post 80% (95% CI: 57%-100%);p = 0.0103;Figure 2). No bleeding or thrombotic complications were observed. Patients and families reported 100% satisfaction with the drive-through care. Conclusions: A drive-through INR clinic during COVID-19 pandemic allowed patients to access care from their vehicle. A subgroup of patients improved compliance to INR monitoring. The median percentage of INR within TR improved significantly after implementation of the drive-through clinic. Innovative approaches such as this clinic may improve patient compliance and adherence to anticoagulation. (Figure Presented).

Allelic variation in class I HLA determines CD8(+) T cell repertoire shape and cross-reactive memory responses to SARS-CoV-2

[Figure: see text].

Viewing Emerging Human Infectious Epidemics through the Lens of Invasion Biology

Invasion biology examines species originated elsewhere and moved with the help of humans, and those species' impacts on biodiversity, ecosystem services, and human well-being. In a globalized world, the emergence and spread of many human infectious pathogens are quintessential biological invasion events. Some macroscopic invasive species themselves contribute to the emergence and transmission of human infectious agents. We review conceptual parallels and differences between human epidemics and biological invasions by animals and plants. Fundamental concepts in invasion biology regarding the interplay of propagule pressure, species traits, biotic interactions, eco-evolutionary experience, and ecosystem disturbances can help to explain transitions between stages of epidemic spread. As a result, many forecasting and management tools used to address epidemics could be applied to biological invasions and vice versa. Therefore, we advocate for increasing cross-fertilization between the two disciplines to improve prediction, prevention, treatment, and mitigation of invasive species and infectious disease outbreaks, including pandemics.

Cardiovascular disease and severe hypoxemia are associated with higher rates of non-invasive respiratory support failure in COVID-19 pneumonia

RATIONALE Acute hypoxemic respiratory failure (AHRF) is the major complication of coronavirus disease 2019 (COVID-19), yet optimal respiratory support strategies are uncertain. We aimed to describe outcomes with highflow oxygen delivered through nasal cannula (HFNC) and non-invasive positive pressure ventilation (NIPPV) in COVID-19 AHRF and identify individual factors associated with non-invasive respiratory support failure. METHODS We conducted a retrospective cohort study of hospitalized adults with COVID-19 within a large academic health system in New York City early in the pandemic to describe outcomes with HFNC and NIPPV. Patients were categorized into the HFNC cohort if they received HFNC but not NIPPV, whereas the NIPPV cohort included patients who received NIPPV with or without HFNC. We described rates of HFNC and NIPPV success, defined as live discharge without endotracheal intubation (ETI). Further, using Fine-Gray sub-distribution hazard models, we identified demographic and patient characteristics associated with HFNC and NIPPV failure, defined as the need for ETI and/or in-hospital mortality. RESULTS Of the 331 patients in the HFNC cohort, 154 (46.5%) patients were successfully discharged without requiring ETI. Of the 177 (53.5%) who experienced HFNC failure, 100 (56.5%) required ETI and 135 (76.3%) patients ultimately died. Among the 747 patients in the NIPPV cohort, 167 (22.4%) patients were successfully discharged without requiring ETI, and 8 (1.1%) were censored. Of the 572 (76.6%) patients who failed NIPPV, 338 (59.1%) required ETI and 497 (86.9%) ultimately died. In adjusted models, significantly increased risk of HFNC and NIPPV failure was observed among patients with co-morbid cardiovascular disease (sub-distribution hazard ratio (sHR) 1.82;95% confidence interval (CI), 1.17-2.83 and sHR 1.40;95% CI 1.06-1.84, respectively). Conversely, a higher oxygen saturation to fraction of inspired oxygen ratio (SpO2/FiO2) at HFNC and NIPPV initiation was associated with reduced risk of failure (sHR, 0.32;95% CI 0.19-0.54, and sHR 0.34;95% CI 0.21-0.55, respectively). CONCLUSIONS A subset of patients with COVID-19 AHRF was effectively managed with non-invasive respiratory modalities and achieved successful hospital discharge without requiring ETI. Notably, patients with co-morbid cardiovascular disease and more severe hypoxemia experienced lower success rates with both HFNC and NIPPV. Identification of specific patient factors may help inform more selective use of non-invasive respiratory strategies, and allow for a more personalized approach to the management of COVID-19 AHRF in pandemic settings.