Incidence and presentation of new-onset type 1 diabetes in children and adolescents from Germany during the COVID-19 pandemic 2020 and 2021: Current data from the DPV Registry.

AIMS: To determine whether the incidence of type 1 diabetes mellitus (T1D), autoantibody-negative diabetes, and diabetic ketoacidosis (DKA) at diabetes onset in 2020 and 2021 changed when compared to long-standing trends. METHODS: Our study is based on diabetes manifestation data of the 0.5-<18-year-old children/adolescents from the German multicenter Diabetes Prospective Follow-up Registry. Based on long-term pre-pandemic trends from 2011 to 2019, we estimated adjusted incidence rate ratios (IRR) for T1D and DKA, and prevalence rate ratios (PRR) regarding autoantibody status with 95 % confidence intervals (CI) for the years 2020 and 2021 (observed versus predicted rates), using multivariable negative binomial or beta-binomial regression, respectively. RESULTS: We analyzed data of 30,840 children and adolescents with new-onset T1D. The observed incidences were significantly higher than the predicted incidences (IRR2020 1.13 [1.08-1.19]; IRR2021 1.20 [1.15-1.26]). The prevalence of autoantibody-negative diabetes did not change (PRR2020 0.91 [0.75-1.10]; PRR2021 1.03 [0.86-1.24]). The incidence of DKA during the pandemic was higher than predicted (IRR2020 1.34 [1.23-1.46]; IRR2021 1.37 [1.26-1.49]). CONCLUSIONS: An increase in the incidences of T1D and DKA, but not of autoantibody-negative diabetes was observed during both pandemic years. Further monitoring and efforts for DKA prevention at onset are necessary.

Following Puck virtually in the Royal Shakespeare Company's Dream experiment: Live theatre and high-tech innovations

The thirty-minute experiment titled Dream represented a collaborative effort between the Royal Shakespeare Company and Audience of the Future. It fused live performance with motion capture technology, 3D graphics, and interactive gaming techniques, and let the audience remotely guide Puck through a virtual forest. Inspired by A Midsummer Night's Dream, it focused on Puck and the fairies. If, for online audiences, the virtual fairies moving through a digital forest suggested a video game, the eight performances were delivered live and in real time. This Dream represents a new format for Shakespeare’s performance that evolved during (rather than emerged from) the COVID-19 pandemic. © The Author(s) 2022.

Adaptation of a Transdiagnostic Cognitive-Behavioral Treatment for Adolescents with Comorbid Mental Health Conditions and High Risk Behavior

Millions of adolescents seek treatment for mental health concerns and high-risk behaviors (e.g., suicidality, non-suicidal self-injury, substance use) each year. Use of services for mental health crises have only increased since the onset of the COVID-19 pandemic. Evidence-based treatments that can be readily employed in community settings are sorely needed to address the growing adolescent mental health crisis. To be most effective, they must be able to accommodate the common comorbidity and high-risk behaviors present among the treatment-seeking adolescent population, and be designed in a manner that can be readily adopted by clinicians that serve these youth within community-based organizations. Following the Replicating Effective Programs (REP) framework, we describe the adaptation and pre-implementation process of a transdiagnostic and modular cognitive-behavioral treatment, which integrates motivational interviewing and dialectical behavior therapy techniques, to address multiple adolescent mental health conditions and high-risk behaviors. Using a mixed-methods design, we collected data from community clinicians and/or other stakeholders on perceptions of the training protocol and treatment manual, self-efficacy and knowledge in manual use, use of modules with clients, and treatment adherence, to inform our REP efforts around modifications to the training and treatment manual. We present these data and describe modifications made using the Framework for Reporting Adaptations and Modifications (FRAME) to evidence-based interventions. Overall, data support our intensive training model and transdiagnostic treatment for use by clinicians in community settings. Stakeholder engagement, adaptations to the training and treatment materials, and participation in post-training consultation, appeared to facilitate successful pre-implementation efforts. Copyright © 2022 SCCAP.

Poster: DNA-Based Molecular Communication as a Paradigm for Multi-Parameter Detection of Diseases

DNA-based molecular communication is a novel paradigm for nanoscale computation and communication that uses self-assembling DNA message molecules. Due to their design, these message molecules can compute mathematical operations while self-assembling. They can be used in DNA-based nanonetworks to detect DNA sequences and compute information for releasing either medication or other molecules. This paradigm avoids many limitations that electromagnetic nanonetworks currently face. This paper presents a variety of novel advantages and use cases for DNA-based molecular communication. For many of those, no feasible solution exists today. DNA-based molecular communication can even detect and consider multiple different DNA sequences for decision-making. Furthermore, it allows for adjustable error correction, immediate treatments, bio-compatibility, and the use of already available materials.

Accommodating guests during pandemic times: a case-study of the Airbnb Host Community in Aarhus, Denmark

Purpose: This paper explores how Airbnb hosts' experiences with and responses to the coronavirus disease 2019 (COVID-19) health crisis may differ according to their motivations to host and to the type and spatial layout of their Airbnb accommodation. Based on these insights, the paper reflects on the lessons that are learned for the future of short-term rentals. Design/methodology/approach: This is a qualitative multi-method small-scale case study, which relies on in-depth interviews and a focus group discussion carried out with a group of hosts affiliated to the Airbnb Host Community in Aarhus, Denmark. Informed by an interpretivist approach, the study aims to make sense of people's subjective experiences with hosting on the Airbnb platform, and how they have continued and adapted their hospitality practices during the pandemic. Findings: Participants' adaptive practices vary according to their motivations to host and the type of accommodation that they rent out. Although all hosts in this study now implement more intensive cleaning practices, hosts who stay with their guests onsite tend to take stricter preventative measures to avoid contamination and transmission of the virus in their social interactions with guests. On the contrary, hosts who rent out their entire properties and have minimal contact with their guests found themselves less affected by the pandemic's impacts and have had a continued demand for their properties. Social implications: The COVID-19 pandemic has unevenly affected Airbnb hosts. Hosts who share their homes with guests require different adaptations to their daily behaviour and cleaning practices at home than hosts who do not stay with their guests and rent out entire properties. However, unlike professional hosts who largely or solely rely on Airbnb for their income, occasional home-sharing hosts tend to be more flexible in coping with cancelled or fewer bookings. Originality/value: This study provides novel insights into the uneven impact of the COVID-19 pandemic on participants in the platform economies of tourism. It contributes to existing literature on the impacts of the pandemic on Airbnb's operations by showing how hosts' adaptive practices are informed by their subjective living conditions and the type of accommodation they can offer their guests. © 2022, Simon Lind Fischer and Maartje Roelofsen.

Effectiveness of the BNT162b2 mRNA COVID-19 vaccine in patients with multiple myeloma three and six months after vaccination

Background: Vaccination is considered essential for individual protection during the SARS-CoV-2-pandemic. The efficacy of the current vaccines in MM-patients is unknown. Aim: To determine seroconversion rates and antibody levels in MM about 3 and 6 months after the second dose of the vaccine BNT162b2. Methods: Patients with symptomatic MM without prior COVID19 were eligible. We measured levels of SARS-CoV-2-spike-and-nucleocapsid-antibodies (AB) by electro-chemiluminescence-immunoassay and extracted clinical data from hospital records. Results: 101±14 (mean±SD) days after the second vacccination sero-conversion (anti-spike-[S]-AB ≥0.8 U/l) was detectable in 54/59 (91.5%) MM-patients and 21/21 controls, with lower concentrations in MM-patients (median 166 U/l versus 929 U/l, p<0.001). The percentage of individuals with anti-S <250 U/l was 9% (1/11) for vaccination during "watch-and-wait", 39% (12/31) during maintenance and 82% (14/17) during (re-)induction. No patient developed COVID19. Details regarding the vaccination-response according to different clinical factors are shown in the table. The anti-S-concentration fell significantly (mean-45%, range-100%-+42%, p<0.001) at follow-up (mean 88±11 days after the first measurement;performed in MM-patients only). Conclusions: Most MM-patients responded to the BNT162b2 vaccine, but often with lower concentrations of anti-S three months after the second vaccination, which additionally declined over time. Besides age and markers of immunosupression, treatment-modalities seem to affect the vaccination-response more than disease-related factors. Daratumumab did not influence the anti-S-concentration in our cohort. In order to determine the anti-S threshold for a third vaccination, regular assessment of the vaccination response in all MM patients, regardless of treatment, seems advisable.

Hemoadsorption therapy in severe covid-19 patients requiring venovenous ecmo: A retrospective study

Introduction: Patients with severe COVID-19 may develop sepsis-like syndrome that can progress to multiple organ failure and ultimately death. Underlying mechanism have been explored and suggest a profound dysregulation of the immune system associated with hyperinflammation, hemodynamic instability and respiratory failure. Approaches modulating the dysregulated immune response, such as CytoSorb hemoadsorption, have been used. However, data of ECMO-dependent patients in comparison to a control cohort remain scarce. Patients and methods: Included were 26 critically ill COVID-19 patients requiring high-flow veno-venous extracorporeal membrane oxygenation (VV ECMO) therapy due to severe ARDS, of whom 16 were additionally treated with an extracorporeal hemoadsorption device, and compared to a control group of 10 patients. Assessed were levels of inflammatory markers, vasopressor requirements, as well as clinically relevant outcome variables. Results: Treatment with the applied multimodal therapy approach resulted in a stabilization in hemodynamics, a control of the hyperinflammatory response as evidenced by a significant reduction in inflammatory mediators, as well as a marked improvement in lung function. No device related adverse events were observed while treatment appeared safe and feasible. Conclusions: Treatment of critically ill COVID-19 patients with respiratory failure requiring VV ECMO support and hemoadsorption therapy led to a rapid and sustained hemodynamic stabilization, a control of inflammatory response and an improvement in oxygenation. Given these signals pointing towards a patient-oriented benefit of extracorporeal hemoadsorption therapy in those patients, future controlled, randomized studies should focus on the investigation of the appropriate timing and dosing of this promising treatment modality.

Review of DNACPR orders within the coordinate my care (CMC) system during the first wave of the COVID-19 pandemic

CMC is an NHS service to support urgent and advanced care planning for frail and palliative patients and patients with complex and life-limiting conditions. CMC's consent model ensures that no decisions about a patient's treatment - including 'Do Not Attempt Cardio-Pulmonary Resuscitation' (DNACPR) decisions - are made without the patient and, where appropriate, a loved one. We assess if there was a change in the way patients were consented and had DNACPR orders recorded during the first wave of Covid-19 by reviewing 107,614 published CMC care plans. Overall, 68% of care plans were created with the direct consent of the patient, 6% with the consent of and Lasting Power of Attorney (LPA) and 26% in the patient's best interest providing clear justifications for the decision. Although we observed an increase in patients added to CMC in the first wave of Covid-19, the consent pattern remained consistent with pre-Covid data. CPR decisions were added to 27,161 CMC care plans between March and September 2020, 15,898 (59%) of which were recorded with DNACPR decisions. Of these, 52% were recorded as having the mental capacity to discuss the decision (consistent with pre- Covid data) and 37% as not having the capacity to discuss. 29% were recorded for resuscitation, which is more than the same decision in pre- Covid-19 data (18%). During first wave of Covid-19, 90% of care plans show a clear yes/no CPR decision, compared to 88% Pre-Covid-19. Of the CMC care plans which included DNACPR during the first wave of pandemic and where no mental capacity was indicated, all provide supporting information on discussions with family/LPA. We conclude that, with the right systems in place, conversations about advance care planning took place and were recorded on CMC. Embedding personalised advanced care planning into the standard health care practice enables bespoke patient-centred care, even during the pandemic.

[Successful treatment of a geriatric COVID-19 patient with severe chest trauma : An interdisciplinary case report]. / Erfolgreiche Behandlung des schweren Thoraxtraumas einer geriatrischen COVID-19-Patientin : Ein Fallbericht von interdisziplinärer Bedeutung.

The coronavirus disease 2019 (COVID-19) has spread rapidly worldwide and leads to high morbidity and mortality. Clinical experience regarding the surgical management in COVID-19 patients is limited. We report the interdisciplinary approach in a COVID-19 patient with severe thoracic trauma and pulmonary symptoms, who was admitted to the emergency unit after blunt chest trauma with dislocated serial rib fractures and concomitant hemothorax.

Using a design thinking approach for an asynchronous learning platform during COVID-19

The COVID-19 pandemic abruptly shut down schools in an urban based school district in the Spring of 2020. As the closures persisted over months, an immediate educational need arose for online curricula that could help alleviate the learning gaps caused by the shutdown. The purpose of this study was to create a process and model for the development of a fully asynchronous online learning environment for prekindergarten through 2nd grade students that could help other districts implement similar projects. Since the turnaround time for development and implementation was a matter of weeks the project team used an iterative process to solve a “wicked problem” and identified solutions to create an improved user experience. A modified design thinking model approach was developed through the process of developing this six-week, theme based virtual curriculum that included interactivities in early literacy, writing, reading comprehension, science and math. This adjusted model includes 6 stages: Discover, interpretation, ideation, experimentation, implementation, and evolution. This research focuses on the processes involved during each of the stages and the resulting use by the intended audience. The curriculum was used by over 5,800 prekindergarten through second grade students during the 6-week period of the summer of 2020. The online platform continues to be used by students presently. © 2021, The International Academic Forum (IAFOR). All rights reserved.