Forecasting of COVID-19 Pandemic Using ARIMA and Fb-Prophet Models: UK Case Study

This study aims to provide insights into predicting future cases of COVID-19 infection and rates of virus transmission in the UK by critically analyzing and visualizing historical COVID-19 data, so that healthcare providers can prepare ahead of time. In order to achieve this goal, the study invested in the existing studies and selected ARIMA and Fb-Prophet time series models as the methods to predict confirmed and death cases in the following year. In a comparison of both models using values of their evaluation metrics, root-mean-square error, mean absolute error and mean absolute percentage error show that ARIMA performs better than Fb-Prophet. The study also discusses the reasons for the dramatic spike in mortality and the large drop in deaths shown in the results, contributing to the literature on health analytics and COVID-19 by validating the results of related studies. Copyright © 2023 by SCITEPRESS - Science and Technology Publications, Lda. Under CC license (CC BY-NC-ND 4.0)

High Pandemic-Related Mortality Amongst People with Hiv in Saskatchewan, Canada

Background: Saskatchewan, a Canadian Prairie province, faces a complicated HIV epidemic characterized by high rates of transmission due to injection drug use (IDU) and disproportionate representation of younger persons, women, and persons of Indigenous ethnicity. HIV incidence in Saskatchewan in 2021 was 19.7 per 100,000, 4.5 times higher than the Canadian average. Concurrently, during the COVID-19 pandemic, the recreational use of synthetic opioids such as fentanyl increased, leading to high numbers of overdose events & deaths. We characterized the difference in cascade of care outcomes & mortality amongst people with HIV (PWH) living in southern Saskatchewan during the COVID-19 pandemic. Method(s): We conducted a retrospective cohort study for all PWH cared for in the Infectious Diseases Clinic (IDC) at Regina General Hospital between December 31/19 and June 10/22. Age, sex, ethnicity & primary mode of HIV acquisition were collected from the IDC database, along with cascade of care & mortality data. Deaths, including most likely cause of death were characterized via individualized case review. Result(s): On December 31/19, IDC cared for 518 PWH. This increased to 585 by June 10/22. Amongst the current cohort, 245 (42%) were female, 163 (28%) were <= 35 years old, 306 (52%) were Indigenous, and 318 (54%) had acquired HIV through IDU. Cascade of care indicators worsened during the COVID-19 pandemic. 58.1% of the cohort were retained in care & 76.1% virally suppressed (HIV RNA <= 200 copies/mL) in December 2019, decreasing to 51.3% retained (p=0.02) & 68.8% suppressed (p=0.06) by June 2022. There were 80 deaths during the study period, representing 15.4% of the cohort from the end of 2019. Most deaths (49, 61.3%) were due to suspected or confirmed drug overdose. 10 (12.5%) additional deaths occurred due to complications from IDU (i.e., sepsis). No deaths were directly attributable to COVID-19. Most who died acquired HIV from IDU (69/80, 86%). Conclusion(s): We describe intersecting epidemics of HIV and IDU disproportionately affecting high-risk populations, leading to significant morbidity & mortality during the COVID-19 pandemic. Contributing factors may have included disruption of safe opioid supply and disrupted access to harm reduction services due to COVID-19. Comprehensive population-level harm reduction and addictions management strategies are urgently needed to reduce morbidity & mortality from drug use amongst PWH in Saskatchewan.

Efficacy of home respiratory culture kits in people with cystic fibrosis

Background: Respiratory cultures are an important part of clinical care for people with cystic fibrosis (CF). Telemedicine visits during the COVID-19 pandemic have not allowed for routine collection. To address this, the University of Michigan Adult Cystic Fibrosis Program mailed home culture kits to patients. We hypothesized that results from home sputum samples would be consistent with prior cultures obtained in sputum collected in clinic but that self-collected throat swabs would provide false-negative results. We also sought to determine percentage return rate. Method(s): Adults with CF were sent culture kits containing a specimen cup and a throat swab. Patients had the choice to submit either sample for processing. Medical personnel provided written instructions with the culture kits and, on occasion, instructed patients on proper collection techniques via phone. Samples were then refrigerated for up to 24 hours before a delivery service returned the specimen to a University of Michigan laboratory for analysis. Data collected from December 2020 to December 2021 (N = 77) included percentage return rate, result, source, and presence of microorganisms. Pairwise culture data of samples collected in clinic versus home-collected samples within 1 yearwere included in the analysis. Descriptive statistics and Cohen kappa correlation coefficients were computed for all culture data and subgroups (Table 1A-E). Result(s): Of 77 culture kits returned, 46 had corresponding clinic samples collected using the same method, and the remaining 21 were collected using different methods (throat swab vs sputum sample). Overall, approximately 200 kits were mailed to patients, with a return rate of 38.5%. A similar percentage of positive culture results was obtained with same method of collection: sputum and throat samples (Table 1C, D, E), although the discordance rate between cultures collected in clinic and at home ranged from approximately 10% to 30%. Correlation between clinic and home culture data was generally good throughout, except for clinic Table 1 ( 115): Analysis of respiratory culture results for (A) all cultures, (B) different collection, and (C, D, E) same collection method. *p < 0.05. Cohen kappa correlation coefficient between groups: poor agreement <0.20;fair agreement = 0.21-0.40;moderate agreement = 0.41-0.60;good agreement = 0.61-0.80;very good agreement = 0.81-1.00. PsA = Pseudomonas aeruginosa;Staph = Staphylococcus aureus.(Table Presented)versus home throat swabs, probably because of a lowevent rate in the small sample size. Conclusion(s): The data suggest that, overall, clinic and home culture kits provide similar positive results, although discordance in specific culture results was common. This may be due to natural fluctuations from culture to culture in people with CF. A limitation of this study is that the cultures being compared in our study were not completed on the same day. Nevertheless, our data also indicate that collection technique may influence results for certain microorganisms. How these differences might influence antibiotic selection and treatment outcomes in the era of telemedicine requires more investigation. The return rate was found to be relatively low, demonstrating the need for interventions to improve patient outreach and compliance.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

Stress During the Early Months of COVID in the U.S.: The Role of Fear and Health Status Across the Age Spectrum

The stress that the COVID pandemic has caused is immeasurable and is likely to impact people for many years to come. Service providers such as social workers are experiencing these impacts both personally and professionally. As new research emerges, a greater understanding of the emotional toll related to COVID can help to inform social work practice. To add to this gap in the literature, an online survey explored the factors that contribute to higher stress reactions among individuals in the general population (n = 412) and across the age spectrum. Bivariate analyses indicated a significant increase in stress from pre-to during-COVID for the entire sample and across the three age groups. Multivariate analysis revealed more conversations about COVID, more alcohol use, knowing someone who had tested positive, increased fear, greater avoidance of reading/watching information about COVID, decreased health status, and increased income contributed to stress during-COVID. Increased fear and decreased health status were significant when stress was examined separately among the three age groups. The results indicated the importance of understanding and responding to fear during public health crises and illustrate how interventions may shift for clinical social workers as they seek to address multi-layered concerns. Social workers can help manage the impact of the pandemic by providing clients with therapeutic services, psychoeducation, and case management. © 2022 Authors.

A collaborative project aimed at improving the acute rehabilitation unit environment in order to increase patient's social interaction and better support their sense of well-being

Introduction: Research shows patients having in-patient rehabilitation spend most of their day inactive with few opportunities for social interaction. Evidence suggests the physical environment impacts on well-being during rehabilitation. On the acute stroke unit, at St Georges Hospital, social spaces available for patients were repurposed for clinical use during the COVID pandemic. This project aimed to collaborate with patients, families and staff to enhance the ward environment. Method(s): CREATE, a co-designed, collaborative project model aiming to increase patient activity on stroke units, was adopted. Questionnaires were distributed to patients, families and staff on their views of the current use of the ward spaces with suggestions for change. Charitable funds were contacted to gain advice around provision of resources and funding. Result(s): Results indicated a lack of communal spaces for socialising and a need for more organised activities. Two strands of focus were agreed: 1. Revitalisation of communal spaces;2. Establishing a permanent activities coordinator. The project is now in the implementation phase. Conclusion(s): This quality improvement project sought to understand the views of patients, families and staff on how the physical ward environment was utilised and the interplay with their rehabilitation experience. Findings suggested the need to reclaim and revitalise social spaces on the ward and to establish a permanent activities coordinator role. The creation of a less institutional and more welcoming environment will better support patients' sense of well-being during rehabilitation. Success will lead to an increase in participation in social interaction for patients outside of therapy time.

A review on Natural Language Processing Models for COVID-19 research

This survey paper reviews Natural Language Processing Models and their use in COVID-19 research in two main areas. Firstly, a range of transformer-based biomedical pretrained language models are evaluated using the BLURB benchmark. Secondly, models used in sentiment analysis surrounding COVID-19 vaccination are evaluated. We filtered literature curated from various repositories such as PubMed and Scopus and reviewed 27 papers. When evaluated using the BLURB benchmark, the novel T-BPLM BioLinkBERT gives groundbreaking results by incorporating document link knowledge and hyperlinking into its pretraining. Sentiment analysis of COVID-19 vaccination through various Twitter API tools has shown the public's sentiment towards vaccination to be mostly positive. Finally, we outline some limitations and potential solutions to drive the research community to improve the models used for NLP tasks. © 2022 The Author(s)

On How I Got Through COVID-19 Lockdown: An Autoethnographic Approach to Resilience in Disability

I explore how I—a person born with a physical disability living alone in a foreign country—was able to cope with COVID-19 lockdown. I used the autoethnographic method (Chang, 2016) to scrutinize sources of my resilience. Through evocative autoethnography, I reviewed risks/coping strategies recalling the lessons drawn from my childhood in the care of two supportive women. Then, performing analytical autoethnography, I self-assessed my lived experiences through a social science lens. A theoretical validation of my personal story helped me to acknowledge how resilience in my life had been built and was mobilized in the face of the pandemic.

CAN VIRTUAL EXERCISE PROMOTE PHYSICAL RESILIENCE DURING THE COVID-19 PANDEMIC AMONG ACTIVE OLDER ADULTS?

Background: Gerofit is a facility-based exercise and health promotion program for older Veterans that transitioned to virtual delivery in March 2020. Little is known about how virtual exercise would promote resilience in the physical function of individuals previously participating in-person. Methods: Preliminary data from 1 of 14 sites was gathered 72 Veterans returning to facility-based exercise after COVID mandated shutdowns. 39 individuals chose not to participate virtually, and 33 actively participated virtually for over 1 year. Re-entry data were then compared to the patients' most recent test. Assessment means were compared within groups. Results: Change scores from T1 to T2 were: -1.19 versus +2.4 repetitions for 30-second arm curls;+1.57 repetitions for 30-second chair stands;and -113.87 versus -77.3 yards for six-minute walk distance for non-virtual versus virtual groups. Implications: Participation in virtual exercise interventions may promote resilience and resistance to functional decline in previously active individuals during enforced isolation.

EMBRACING OUR DIVERSITY: ENHANCING THE GEROFIT PROGRAM FOR PATIENT EXPERIENCE

The Veterans Health Administration has long been at the forefront of telehealth development and advances. Gerofit to Home (GTH) is a novel, telehealth-based adjunct to a widely successful Gerofit facility-based program for Veterans ages 65 and older with multi-morbidities and functional limitations. Of note, participants are allowed to remain in the program as long as they wish, all of which enhances social engagement and camaraderie. Now disseminated to nearly 30 VA medical centers across the country, all of our sites transitioned within 6 weeks of the COVID-19 pandemic to group-based virtual classes, aptly called GTH. Because of the rapid and continuously evolving changes in telehealth, we had near daily Veteran feedback on what was working and what was not working. We cast a wide net and used multiple methods to obtain Veteran feedback. These were quite successful and allowed us to make ongoing improvements to our classes. The first presentation describes results from a telephone survey deployed to all patients who transitioned from facility-based Gerofit to GTH. The second presentation describes the development of a Gerofit Veterans Advisory Panel and the perspectives they provided in terms of scheduling, patient-requested content, feasibility and access. The third presentation explores patient satisfaction and retention in GTH participants, with an emphasis on rural vs non-rural settings. The fourth paper details an innovative approach to integrating student learners in to the Gerofit program, and explores the impact of these inter-generational interactions.

EXPLORING MULTIDIMENSIONAL RESILIENCE IN OLDER VETERANS WITH PTSD DURING THE PANDEMIC

The COVID-19 pandemic and restrictions for physical and social distancing has affected all older adults, but one segment that has unique needs and experiences is older veterans with PTSD. This presentation will explore how PTSD symptomology, and psychosocial functioning in this population have changed compared to pre-pandemic findings. The impact of the pandemic on daily life activities and functional impairment will also be explored. Participants recruited to a wellness clinical trial for older veterans with PTSD at two different timepoints (pre-pandemic, n=54;post-pandemic, n=28) completed PTSD and mental health assessments, and a physical performance battery testing strength, mobility, balance, and aerobic endurance. PTSD symptoms, specifically avoidance and hypervigilance were markedly lower in the post-pandemic sample. Higher levels of physical impairment were observed in the post-pandemic sample, suggesting a need for targeted outreach and health promotion programs among older adults with PTSD symptoms during the pandemic.

A telemedical interface for at-home cognitive testing

BACKGROUND: The COVID-19 pandemic has limited in-lab cognitive testing. While at-home alternatives exist (testing over the phone), differences in test design and delivery complicate direct comparison of most in-lab and at-home tests. Here we describe the design, infrastructure, and implementation of the California Cognitive Assessment Battery (CCAB), a cognitive test battery and administration system. Using automated remote administration over cellular networks, identical computerized cognitive tests can be administered at-home or in the lab.

Diabetes Analysis with a Dataset Using Machine Learning

Diabetes is a disease that actually impacts the capacity of the body to obtain blood glucose, which is usually referred to as blood sugar. At the end of 2019, a new public health problem (COVID-19) emerged. This disease has greatly harmed people with diabetes. Therefore, we intend to make use of data mining algorithms to prevent death and improve the quality of life through the prediction of diabetes. In this paper, four different algorithms have been used to analyze Diabetes from DAT260x Lab01: Logistic, Decision Tree Classifier, Xgboost and SVC. The models are evaluated for which algorithm is much effective. The paper then provides a quick overview of both the set of data and the fieldwork carried out on the subject. In the adjoining step, the dataset and its features are discussed. In addition, the paper explains the four algorithms and virtual environments that have been used to clarify the variables, which have the largest impact on raw data. The findings are obtained by evaluating the confusion matrix applied to the whole selected algorithm. The paper outlines the full observations and conclusions taken based on the results. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

THE EFFECTIVE MANAGEMENT OF IDIOPATHIC INTRACRANIAL HYPERTENSION DELIVERED BY INPERSON AND VIRTUAL GROUP CONSULTATIONS

Background In response to the rising incidence of IIH and service pressures, we set out to develop a group consultation (GC) service for IIH. Method Iterative, co-designing(with patients) a bespoke GC, i. e. clinical reviews in a group setting. Outcomes measured: patient satisfaction, self-perceived health literacy, successful implementation of GC. Results Eight in-person GCs delivered: once-monthly(Oct-Dec 2019), then twice-monthly(Jan-Feb 2020). Feedback from 49/ 53: 100% felt more satisfied and heard;100% felt more involved in decision making;98% had a better understanding of their condition;96% felt more able to cope with their condition and keep themselves healthy;94% rated this as a positive experience;90% reported improved access and more time with their clinician compared to existing 1:1 appointments. Since Sept 2020 (in response to COVID-19 pandemic) we have delivered once-weekly virtual GC (18 to date). Feedback median scores: patient satisfaction 9.5/10;being listened to by clinician 10/10;involved by clinician in treatment decisions 10/10;clinician explanation of treatment 10/10;opportunity to discuss condition or treatment 10/10). Conclusions GC is safe and effective for IIH and preferred in our cohort. This allowed ongoing high-quality, person-centred care despite the COVID19 pandemic. We will also share the potential for GC for other neurological conditions.

Supporting the Contact Tracing Process with WiFi Location Data: Opportunities and Challenges

Contact tracers assist in containing the spread of highly infectious diseases such as COVID-19 by engaging community members who receive a positive test result in order to identify close contacts. Many contact tracers rely on community member's recall for those identifications, and face limitations such as unreliable memory. To investigate how technology can alleviate this challenge, we developed a visualization tool using de-identified location data sensed from campus WiFi and provided it to contact tracers during mock contact tracing calls. While the visualization allowed contact tracers to find and address inconsistencies due to gaps in community member's memory, it also introduced inconsistencies such as false-positive and false-negative reports due to imperfect data, and information sharing hesitancy. We suggest design implications for technologies that can better highlight and inform contact tracers of potential areas of inconsistencies, and further present discussion on using imperfect data in decision making. © 2022 ACM.

Bioprospecting for Antiviral Peptides

Mosquito-borne alphaviruses (e.g. chikungunya virus and Venezuelan equine encephalitis virus-VEEV) are of great concern due to their potential to cause severe acute human disease. The absence of available vaccines or therapeutic agents for almost all arboviruses makes development of effective treatment options a significant national security and public health issue. Here, we focus on the study of VEEV as a model arbovirus. Cationic antimicrobial peptides (CAMPs) of innate immunity represent a promising resource for the development of new antiviral therapeutics. However, there is need for a system specifically designed for purpose of discovering AMPs with antiviral activity. We aim to develop a bioprospecting-inspired process for the identification of antiviral peptides against VEEV, using an integrated workflow that combines novel antiviral peptide harvesting microparticles, advanced mass spectrometry, and data analysis tools in order to establish peptide sequences and identify those with potential antiviral properties. We will focus on alligators and snakes CAMPs, since both have been suggested as potential arbovirus reservoir species.

Relapsing COVID-19 Pneumonia in Patients Receiving Rituximab Therapy

Background. Rituximab is a monoclonal antibody against the CD20 antigen on B-lymphocytes leading to B-cell death and depletion. Patients who receive rituximab and are infected with the novel severe acute respiratory syndrome coronavirus-2 (SARSCoV2) causing coronavirus disease (COVID-19) may have increased difficultly clearing the virus and be at risk for persistent disease. While the limited literature available is mixed regarding the severity of COVID-19 in patients receiving rituximab, there is minimal literature regarding persistent and relapsing COVID-19 in this patient population. This is a case series of patients with persistent COVID-19 who previously received rituximab. Methods. This is a retrospective review of 5 patients admitted between 1/1/2021 and 5/1/2021 to our institution with confirmed COVID-19 and receipt of rituximab for any indication within the previous 12 months. Information regarding hospital readmissions, time course of positive infection, medical management, disease severity, and discharge disposition were collected. Results. Five patients, median age of 46, currently or recently on rituximab therapy were admitted a median of 2 times due to persistent, severe COVID-19 (Table 1). Patients received their initial COVID-19 diagnosis a median of 34 days (8-102 days) since their last rituximab administration and had documented SARS-CoV-2 infection a median of 66 days (19-195 days;Figure 1). All 5 patients received remdesivir and corticosteroids over the course of their COVID-19 disease and 2 patients received convalescent plasma therapy 1 and 5 days prior to a positive SARS-CoV-2 antibody IgG. Figure 1. Patient SARS-CoV-2 Infection Course Table 1. Patient Clinical and Therapeutic Data Conclusion. Rituximab therapy may be associated with persistent or relapsing COVID-19 disease. Controlled investigations are necessary to evaluate the exact impact anti-CD20 agents have on the course of COVID-19 and whether convalescent plasma or other therapies can prevent relapsing disease.

"I'm at breaking point"; Exploring pharmacists' resilience, coping and burnout during the COVID-19 pandemic.

BACKGROUND: There is a lack of evidence on how the multimodal dynamic process of resilience has impacted personal adaptation of frontline healthcare professionals, working under extreme pressure during the COVID-19 global pandemic. OBJECTIVES: To explore resilience, burnout and wellbeing for UK pharmacists in patient-facing roles, including individual and organisational factors that align to the ABC-X theoretical model of the dynamic process of resilience. METHODS: A non-experimental pragmatist research design was adopted, with a cross-sectional online survey distributed via social media and professional networks between June and July 2020. Quantitative data aligned to a positivist research paradigm was collected using validated scores, to statistically analyse wellbeing, burnout and resilience. Qualitative textual data, consistent with an interpretivist research paradigm, were analysed following an inductive thematic approach. RESULTS: A total of 199 surveys from pharmacists working within community, hospital and GP sectors were analysed. Wellbeing scores were strongly correlated to resilience scores. Wellbeing and resilience scores were both inversely correlated with burnout scores. Two-thirds of participants were classified as high-risk within the burnout scales.Key stressors were highlighted by participants, who described how individual resources and perceptions shaped their experience, which overall contributed to their burnout. Organisations that supported pharmacists embraced change and quickly adopted new ways of working, such as teleconsultations, flexible and remote working, redesign of workflow, alongside clear guidance. However, there was also reported frustration at lack of, slow or conflicting guidance from employers. CONCLUSIONS: This study adds to the growing evidence base for how individuals are affected by adverse events in a dynamic environment, alongside the role that employers can play in supporting individual and organisational resilience. It provides an opportunity to learn from pharmacists' responses to the COVID-19 pandemic, and a call to action for healthcare organisations to rebuild and invest resources into sustained support for staff wellbeing.