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This research follows a previously published paper presented by Pourtoulidou and Frey which describes the conversion of a classroom-based to blended training for new employees entering aerospace companies [1]. This paper presents the lessons learned that derived from the analysis of the results after evaluating the blended training according to the participants', subject matter experts', and trainer's perspectives. Prior to the training, Pourtoulidou and Frey analyzed the demands of aerospace companies and the labor market in order to develop this introductory training [1]. The classroom-based training was developed, implemented and evaluated in 2018/2019. Utilizing this evaluation, the blended training consisted of an online phase, which lasted six months and provided access to lecture videos, literature material, quizzes, forums and virtual meetings over the Moodle platform. In the middle of the online phase, a face-to-face session took place in October 2021 in which the participants worked with practical applications and associated with subject matter experts operating directly in industrial projects. The lessons learned focus on the training development for employees' blended courses and on the specific limitations resulting from developing a joint training for entry-level aerospace engineers. The flexibility and further benefits of the training's online phase were well received from the participants, while the opportunity to meet, work and exchange experiences in person during the training was highly appreciated. The impact of COVID-19 on participants' experience and feedback was also visible and commented on. © 2022 SEFI 2022 - 50th Annual Conference of the European Society for Engineering Education, Proceedings. All rights reserved.
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INTRODUCTION: During the COVID-19 pandemic, many hospitals employed neoadjuvant chemotherapy (NAC) to delay oncologic resections to mitigate resource strain. But the role of neoadjuvant chemotherapy in ampullary carcinoma is unclear. This study aimed to compare outcomes of NAC and adjuvant chemotherapy (AC) for surgically treated patients with ampullary carcinoma. METHOD(S): The National Cancer Database was queried for patients with stage I to III ampullary carcinoma diagnosed between 2004 and 2017 and treated with both chemotherapy and surgery. Factors associated with receiving NAC were identified. Patients in the NAC group were propensity matched in a 1:5 ratio with patients in the AC group by using the nearest neighbor method. Odds of negative resection margin and overall survival for the matched groups were compared using Fisher's Exact test and Cox hazards regressions, respectively. RESULT(S): Of 3,930 patients included in the study, 137 (3.5%) received NAC. Patients were more likely to receive NAC if they had stage I disease (odds ratio [OR] 3.12, 1.87 to 5.22 vs stage III), were treated in the Midwest (OR 2.25, 1.10 to 4.58 vs the West) or were age 65 or older (OR 1.98, 1.13 to 3.46). There were no differences between the matched NAC and AC groups for any stage in rate of negative surgical margins or overall survival (Table) CONCLUSION(S): We found that NAC is rarely used in the treatment of ampullary carcinoma. However, it is associated with outcomes similar to AC for this disease. Delay of surgical resection through utilization of NAC may be reasonable for this population when necessary.
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INTRODUCTION: Time from diagnosis to treatment initiation for many cancers is lengthening. During the COVID pandemic, many institutions were forced to postpone cancer treatment to reallocate resources, despite the unclear impact of treatment delays. This study sought to investigate the association between time to treatment initiation (TTI) and overall survival in patients with hepatopancreatobiliary (HPB) cancers. METHODS: The National Cancer Database (NCDB) was queried for patients diagnosed with de novo cancers of the pancreas, liver, and intrahepatic and extrahepatic bile ducts between 2004 and 2017. Kaplan-Meier survival analysis and Cox regression were used to investigate the association between TTI and overall survival for each cancer type, stratified by stage. Multivariable linear regression identified factors associated with longer TTI. RESULTS: Of 318,931 patients with HPB cancer, median TTI across all cancers was 31 days, ranging from 26 days for pancreas cancer to 48 days for liver cancer. Longer TTI was associated with increased mortality in patients with stages I, II, and III extrahepatic bile duct (EHBD) cancer (Figure 1), and stage I pancreatic adenocarcinoma. Compared to TTI of 3 to 30 days, the risk-adjusted hazard ratios for stage I EHBD cancer for TTI 31 to 60, 61 to 90, and ≥90 days were 1.17 [95% CI 1.07-1.29], 1.39 [1.21-1.59], and 1.63 [1.40-1.90], respectively. For the same time frames, hazard ratios in stage I pancreatic cancer were 1.08 [1.03-1.13], 1.19 [1.11-1.28], and 0.99 [0.90-1.09], respectively. Factors most strongly associated with increased TTI for all cancers included treatment with radiation only (β = +14.1 days, p< 0.001), early stage disease (+13.8 days for stage I vs. stage IV, p< 0.001), Black race (+4.4 days, p< 0.001), Hispanic ethnicity (+4.2 days, p< 0.001), and treatment in the West (+3.9 days vs. Northeast, p< 0.001). CONCLUSIONS: Delayed initiation of definitive therapy leads to increased mortality in stage I-III EHBD and stage I pancreatic cancer. Some patients, including Blacks and Hispanics, are more likely to experience delayed care. Treatment initiation for these cancers should be expedited, and pandemic-related postponements should be avoided if possible.
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Introduction: Patients not suspected to be infected with SARS-CoV2 but suffering from COVID-19 or patients hospitalized during the incubation period of COVID-19 pose a risk for transmitting SARS-CoV2 to fellow patients. Objectives: We aimed to describe the incidence of patients hospitalized in our tertiary care center with community- and healthcareassociated COVID-19, calculate the number of patients who exposed other patients to SARS-CoV2 and the secondary attack rate of exposed patients, and investigate risk factors for SARS-CoV2 transmission. Methods: In this retrospective study, all patients admitted to the University Hospital Zurich, Switzerland, with a positive SARS-CoV2 PCR were included. Community- or healthcare-associated COVID-19 were defined according to the European Centre for Disease Prevention and Control (ECDC) criteria. Patients receiving standard care during their period of contagiousness were defined as potential index patients. Exposed patients were patients sharing a room with a potential index patient 1) on the general ward for any time, 2) on the intermediate or intensive care unit (IMC/ICU) for ≥ 6 h, or 3) on the IMC/ICU for any time with an index undergoing aerosol-generating procedures. Results: Of 1131patients with a positive SARS-CoV2 PCR or labeled to be a patient with COVID-19 between October 2020 and April 2021, 90.6% (n = 1025) had community-associated illness, 3.5% (n = 40) had probable and 3.8% (n = 43) had definite healthcare-associated COVID- 19, and 2.0% (n = 23) had indeterminate illness. Of all patients, 19.0% (n = 215) were potential index patients, and 56.3% (n = 121) of these exposed at least one other patient. Of 292 exposed patients, 47 were later diagnosed with COVID-19. The mean secondary attack rate per index patient was 14.4%. Transmission of SARS-CoV2 was higher if contact time was longer (adjusted Odds Ratio (aOR): 1.03, 95%CI: 1.02- 1.04) and if CT-value of index was lower (aOR: 0.92, 95%CI: 0.87-0.97). Conclusion: The secondary attack rate after exposure to SARS-CoV2 of patients in the hospital setting is comparable to rates reported from the household setting. The risk of an incident SARS-CoV2 infection increases with longer duration of exposure and higher viral load of index patient.