Performing feminist research: creative tactics for communicating COVID-19, gender, and higher education research

Presenting research findings outside of the form of a traditional research report requires different modes of making and communicating. This paper offers an account of how The #FEAS Report, a satirical news video, was made to communicate the findings from interviews and a survey as part of the mixed-methods study, Sexism, Higher Education, and COVID-19: The Australian Perspective to a wider public. Three creative tactics for research communication were used: DIY aesthetics, humour, and situated bodies. These communication tactics enabled the researchers to think differently about what research findings mean, and how to articulate them in ways that are intelligible. The paper shows how these tactics worked to bring findings to audiences beyond the academy and ask audiences within the academy to think differently about research reporting and knowledge communication. The paper considers how performing research in this way generates different conversations that compliment those started by more common ways of presenting research findings, and most importantly, how crucial it is for feminist researchers to make space for the creative within contemporary higher education.

Predictors of outcomes in patients hospitalised with COVID-19 pneumonitis

Introduction/Aim: Medium and long-term impacts of COVID-19 pneumonitis are being increasingly recognised. Our study aimed to evaluate outcomes of hospitalised COVID-19 patients with moderate-to-severe respiratory compromise. Method(s): Patients admitted to a tertiary centre with COVID-19 pneumonitis (March 2020-October 2022) were followed in the Post-COVID Respiratory Clinic at 6-24 weeks. Baseline demographics, admission details, pulmonary function tests (PFTs), and clinic data were collected. Univariable and multivariable logistic regression were performed to investigate for predictors of persisting respiratory symptoms (dyspnoea, cough, chest pain) and functional limitation (self-reported). Result(s): 125 patients (64.8%male, 63.2+/-16.7years, 42.5% former/current smokers, BMI 31.0+/-8.0kg/m2, 49.6% fully vaccinated) with median follow-up time of 85 [interquartile range (IQR) 64-131] days were included. Pre-existing conditions included lung disease (29.6%), immunocompromise (15.2%), diabetes (24.8%) and hypertension (43.6%). 35.2% required ICU care (14.4% mechanical ventilated, 4% ECMO), 44.8% received high flow nasal prong oxygen and/or continuous positive airway pressure (CPAP). At initial clinic follow up, 65.4% had persisting X-ray changes. Mean predicted FEV1, FVC, DLCO were 86.8+/-20.7%, 85.3+/-20.3%, 82.2+/-19.8% respectively. Symptoms included dyspnoea (63.2%), fatigue (24.2%), cognitive dysfunction (12.9%) and musculoskeletal complaints (10.5%). Univariate predictors of continued respiratory and/or functional disability included age [odds ratio (OR) 1.03, 95%confidence interval (CI) 1.01-1.06, p = 0.01), prior lung disease (OR2.98, 95%CI 1.05-8.48, p = 0.04), hypertension OR2.61, 95%CI 1.09-6.22, p = 0.03) and length of hospital stay (LOHS) (OR1.03, 95%CI 1.00-1.07, p = 0.04). On multivariable analysis, only LOHS was independently predictive of continued respiratory and functional limitations (OR1.03, 95%CI 1.00-1.07, p = 0.02). Conclusion(s): Patients recovering from COVID-19 pneumonitis have a large burden of disability at follow-up. Older age, hypertension, lung disease and LOHS are risk factors for delayed recovery.

Did the COVID-19 Pandemic Affect Fertility Desires in Australia? Understanding Why People Changed Their Attitudes towards Having a First or Additional Child

An understanding of whether and how childbearing desires have been affected by the COVID-19 pandemic is key for explaining subsequent fertility patterns and fertility behavior in general, but empirical information is still lacking. Using a quasi-experimental cohort design and unique panel survey data collected before and after the outbreak of COVID-19, this study examines whether childbearing desires were affected by COVID-19 in Australia and investigates which pandemic-related factors affected childbearing desires the most. Results show that parents who already had one child were the most likely to experience a decline in childbearing desires because of the pandemic, while childbearing desires were most stable among those who were childless. Economic and employment-related factors did not appear to be of great relevance in predicting changes in childbearing plans. However, changes in the quality of couple relationships and of social support from family and friends were found to be of strong importance. © 2023 The Authors. Population and Development Review published by Wiley Periodicals LLC on behalf of Population Council.

Real world prospective evaluation of clinical outcomes in patients with non-metastatic castrate resistant prostate cancer treated with darolutamide

Background: The RECORD Study is a real world data, prospective evaluation of clinical outcomes in patients with nmCRPC treated with Darolutamide. This study will increase the understanding of treatment response and management and in particular informregarding use of next generation imaging in this setting. Method(s): Patient data from 9 UK centres was collected based on the recommendation of NICE for Darolutamide as an option for the treatment of non-metastatic castrate resistant prostate cancer (nmCRPC) from November 2020. Data cut-off was 15 September 2022. The study is ongoing. Result(s): 87 patients were analysed with a median age of 78 (range 61-92). Median pre-treatment PSA and PSA doubling time (PSAdT) were 13 (range 1.99-110.6) mg/L and 5.05 (range 0.6 -10) months. 42 patients (49.4%) had pre-treatment PSAdT of <6 months and 43 (50.6%) patients had PSAdT of >=6 months (2 patients had no pre-treatment PSAdT data). 6 patients (6.90%) had next generation imaging prior to initiation of Darolutamide. Median duration of treatment on Darolutamide was 17 months for patients with pre-treatment PSAdT <6 months but median duration had not been reached for patients with pre-treatment PSAdT >=6 months after 24 months of treatment, a significant difference p=0.018 (HR=0.385, 95% CI 0.17-0.88). 30 patients have come off treatment so far (34.5%);21 (70%) for disease progression, 5 (16%) for a medical cause unrelated to the drug (e.g. COVID infection, reduced performance status secondary to pre-existing Parkinson's), 3 (10%) for unacceptable toxicity (rash, Grade3 fatigue, muscle aches, memory issues), and 1 patient died (unrelated). Conclusion(s): In the RECORD study, predominantly the diagnosis of nmCRPC is based on conventional imaging. The majority of patients respond and tolerate Darolutamide well, comparable with the ARAMIS trial. There is a significant difference between time on Darolutamide for those with pre-treatment PSAdT of<6 months compared with>=6 months. Further long-term toxicity, MFS and OS data will continue to be collected prospectively within the study.

Remote Supergroup for Chemistry Undergraduates: An Inclusive Scientific Community for Primarily Undergraduate Institutions

The Remote Supergroup for Chemistry Undergraduates (RSCU) is a community of students and faculty from primarily undergraduate institutions that aims to (1) engage students in discussions of chemical research, (2) inform students of further educational and career pathways, (3) increase awareness and discourse of equity issues in science, and (4) foster scientific community across institutions. RSCU engaged participants in impactful virtual activities during the summer of 2020 when the COVID-19 pandemic precluded in-person undergraduate research experiences, and the program continued in 2021 as in-person research resumed. Results from self-reported surveys show that RSCU successfully achieved its aims both years, and both students and faculty research mentors benefited from participation. The diverse activities and scientific network cultivated by RSCU complement undergraduate research experiences and could be adapted to other disciplines. © 2022 American Chemical Society and Division of Chemical Education, Inc.

Intra Operative Ultrasound (IOUS) versus Guidewire (GW) Wide Local Excision (WLE) of breast cancer - One-year study in a district general hospital

Introduction: Guidewire Wide Local Excision (GWWLE) of screen detected breast cancer is still the standard of treatment in UK. This study was to evaluate the non-inferiority/equivalence of Intra Operative Ultrasound IOUS over GW WLE with added benefits. Methods: One hundred and eighty-nine patients who underwent WLE during December 2018 to December 2019 were included in the study. They were grouped into either IOUS or GW WLE depending on Surgeon's expertise. Patient and tumour characteristics were analysed using Chi-squared test and Mann-Whitney test. Re-excision rates were assessed with rate difference and resection volume with Calculated Resection Ratio (CRR). Non-inferiority margins were set at 0.05 for rate difference and 0.5 for CRR difference, after considering current evidence. Results: A total of 134 patients had GW WLE and 55 patients had IOUS WLE. Re-excision was needed in 12, 3 patients respectively. Median CRR is 1.94 (IQR: 1.047 – 2.795) in the GW group and 1.75 (IQR: 1.020 – 2.926) in the IOUS group. IOUS was found to be non-inferior to GW in re-excision rates, and CRR, with a one sided 97.5% CI (0.035 for re excision and 0.388 for CRR) and non-inferiority margins of 0.05 and 0.5 respectively. Conclusions: This study demonstrates that IOUS WLE is non-inferior in both metric, and also has the benefit of reducing additional procedures with financial implications. This is especially helpful given the backlog of patients due to COVID-19 pandemic.

Higher mortality in extracorporealmembrane- oxygenation patients with COVID-19 compared with H1N1-influenza

Introduction/Aim: The use of veno-venous Extracorporeal Membrane Oxygenation (V-V ECMO) in the management of refractory respiratory failure due to viral illnesses has increased with recent pandemics. The aim of this study is to describe the clinical characteristics and outcomes of hospitalized patients with COVID-19 requiring ECMO and compare this population to that observed during the H1N1-influenza pandemic at Royal Prince Alfred Hospital (RPAH). Methods: Between March to October 2021, medical records of inpatients diagnosed with COVID-19 at RPAH requiring v-v ECMO were analysed. The clinical characteristics and outcomes of these patients were compared to data from patients with H1N1 influenza requiring ECMO at RPAH between July 2009 and August 2017. The primary outcome was analysed using Cox Regression Model, categorical variables were analysed using Fisher's exact test and continuous variables were analysed using two-sample T-test. Results: ECMO was used for 18 patients with COVID-19 and 32 patients for H1N1 at RPAH. The COVID-19 group was older. Both groups were obese with low rates of comorbidities prior to admission. The in-hospital mortality rate was significantly higher for the COVID-19 group with an odds ratio of 6.31 (95%CI 1.3-30.0;p = 0.01). Days on ECMO were longer in the COVID-19 group, with similar rates of ECMO related complications. There was a trend to higher rates of secondary infection in the COVID group, with a significant increase in blood stream infections compared to the H1N1 group. Conclusion: Our single centre experience demonstrates the significant in-hospital morbidity and mortality of severe COVID-19 requiring ECMO above and beyond that experienced during the H1N1 pandemic. (Figure Presented).

Risk of missing colorectal cancer with a COVID-adapted diagnostic pathway using quantitative faecal immunochemical testing.

BACKGROUND: COVID-19 has brought an unprecedented challenge to healthcare services. The authors' COVID-adapted pathway for suspected bowel cancer combines two quantitative faecal immunochemical tests (qFITs) with a standard CT scan with oral preparation (CT mini-prep). The aim of this study was to estimate the degree of risk mitigation and residual risk of undiagnosed colorectal cancer. METHOD: Decision-tree models were developed using a combination of data from the COVID-adapted pathway (April-May 2020), a local audit of qFIT for symptomatic patients performed since 2018, relevant data (prevalence of colorectal cancer and sensitivity and specificity of diagnostic tools) obtained from literature and a local cancer data set, and expert opinion for any missing data. The considered diagnostic scenarios included: single qFIT; two qFITs; single qFIT and CT mini-prep; two qFITs and CT mini-prep (enriched pathway). These were compared to the standard diagnostic pathway (colonoscopy or CT virtual colonoscopy (CTVC)). RESULTS: The COVID-adapted pathway included 422 patients, whereas the audit of qFIT included more than 5000 patients. The risk of missing a colorectal cancer, if present, was estimated as high as 20.2 per cent with use of a single qFIT as a triage test. Using both a second qFIT and a CT mini-prep as add-on tests reduced the risk of missed cancer to 6.49 per cent. The trade-off was an increased rate of colonoscopy or CTVC, from 287 for a single qFIT to 418 for the double qFIT and CT mini-prep combination, per 1000 patients. CONCLUSION: Triage using qFIT alone could lead to a high rate of missed cancers. This may be reduced using CT mini-prep as an add-on test for triage to colonoscopy or CTVC.

Use of feature engineering to predict COVID-19 mortality

Rationale: Defining a reliable prognostication method in patients with COVID-19 has remained a challenge. Various combinations of inflammatory markers, including CRP, LDH, and D-dimer, have been predictive of increased severity in this group of patients. None of the markers mentioned, however, have had a significant association with increased mortality. Machine learning has been utilized for predictions related to COVID-19. Prior COVID-19 machine learning models used the original features as the input, but we hypothesize that the model can be improved via synthesis of new features by utilizing feature engineering. We aim to explore the predictive capacities of generated features and evaluate for improvements in COVID-19 mortality prediction. Methods: With the approval of the hospital Institutional Review Board, medical records of two hundred sixty-nine patients with a positive COVID-19 PCR study in two 350-bed medical centers were analyzed retrospectively from March 22nd through May 10th, 2020. One hundred sixty-six variables, including laboratory studies, vital signs, demographics, and comorbidities, were collected in total. Features with greater than 50 percent missing values were dropped. Missing data was imputed with SKlearn Multiple Imputation. Feature selection was performed using sequential feature selection via the machine learning extensions library (MLxtend), which led to a final feature space of seven. Feature engineering was performed using the seven features and four additional features generated. LightGBM was chosen as our classification model. The results were compared between the feature engineering and base datasets. Feature ranking was performed using SHapley Additive exPlanations (SHAP). Partial dependence plots were generated to determine feature value cutoffs that predict increased mortality. Results: LightGBM demonstrated good classification performance with an Area Under the Curve (AUC) of .9 in the base model. The feature engineering group had an increase in AUC to .94. The feature most predictive of COVID-19 mortality based upon the SHAP plot was the product of Maximum Blood Urea Nitrogen and Maximum Respiratory Rate (MaxBUN∗MaxRR). The partial dependence plot demonstrates that at a MaxBUN∗MaxRR value > 1000 there is a rise in SHAP values which denotes a rise in predicted mortality. Conclusion: The use of feature engineering improved predictive performance for mortality related to COVID-19. The strongest feature for the prediction of mortality was MaxBUN∗MaxRR. A sharp rise in predicted mortality was observed when the product of these values exceeded 1000. Feature engineering can be used to improve existing mortality prediction models.

Factors associated with intubation and prolonged intubation in hospitalized patients with COVID-19. (Special issue on COVID-19.)

Objective: To identify risk factors associated with intubation and time to extubation in hospitalized patients with coronavirus disease 2019 (COVID-19). Study Design: Retrospective observational study. Setting: Ten hospitals in the Chicago metropolitan area. Subjects and Methods: Patients with laboratory-confirmed COVID-19 admitted between March 1 and April 8, 2020, were included. We evaluated sociodemographic and clinical characteristics associated with intubation and prolonged intubation for acute respiratory failure secondary to COVID-19 infection.