‘We all sort of struggled through it together': students' lived experiences of university life during the pandemic

The COVID-19 pandemic led to significant changes to the student experience. Thus, there is a need to centre students' lived experiences in pedagogical research which explores the effects of the pandemic on student life. The current study aimed to explore how the COVID-19 pandemic impacted undergraduate students, with a focus on students' educational experiences, social interactions, and mental wellbeing. Open-ended questionnaires were disseminated to undergraduate students across the UK (N = 53). A student-centred reflexive thematic analysis identified four dominant themes that each relate to students' lived experiences of Higher Education during COVID-19. These were: variations in motivation during the pandemic, the importance of personal connection, a disconnect between university and the student, and students' development through adversity. These themes broadly demonstrate the variability in student experiences during the pandemic and, crucially, highlight the need for future education provision to centre personal connections, including between students and their institutions. Lack of interaction with staff and peers, as well as barriers to support, led to feelings of detachment from university. Implications for policy and practice are discussed. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Uncovering the Importance of Peer-to-Peer Communication during the COVID-19 Pandemic: Rotating Chromatography Experiments to Overcome Limited Student Capacity

Even though scientific communication and collaboration play critical roles in academic success, they often come in second to teaching laboratory fundamentals. COVID-19 associated capacity constraints forced our program to reexamine the traditional laboratory instruction paradigm by limiting physical attendance, as well as laboratory duration. Instead, we opted to turn these restrictions into opportunities to study peer-to-peer communication as a means to enhance in-person experimentation. Here, a two-week high performance liquid and gas chromatography (HPLC and GC) module uses centralized student communication between peer groups to not only maintain but increase quality laboratory experiences. Students rotate between two chromatography experiments to ensure each person gains exposure to foundational separations techniques. The module's first week focuses on method development, while the second week highlights method validation. Since HPLC and GC can accommodate similar experimental objectives, students receive comparable method development and validation experiences no matter which specific instrument they are assigned to that week. By integrating communication into the experimental process and adding peer accountability to the laboratory's design, the authors observed an increase in laboratory report words and figures when compared to the prior years' reports. Student questionnaires also indicated structured rotation and group communication increased student interest and investment in obtaining and reporting quality data. © 2023 Authors. All rights reserved.

Risk of hospitalisation or death in households with a case of COVID-19 in England: an analysis using the HOSTED data set.

OBJECTIVE: To determine whether household contacts of confirmed cases of COVID-19 have an increased risk of hospitalisation or death. METHODS: We used the HOSTED data set of index cases of COVID-19 in England between June and November 2020, linked to Secondary Uses Service data on hospital episodes and Office for National Statistics' mortality data. Multivariable logistic regression models of the odds of household contacts being hospitalised or dying within six weeks of an index case, adjusted for case type, age, sex and calendar month were calculated. Excess risk was determined by comparing the first six weeks after the index case with 6-12 weeks after the index case in a survival analysis framework. RESULTS: Index cases were more likely to be hospitalised or die than either secondary cases or non-cases, having adjusted for age and sex. There was an increased risk of hospitalisation for non-cases (adjusted hazard ratio (aHR) 1.10; 95% confidence interval (CI) 1.04, 1.16) and of death (aHR 1.57; 95% CI 1.14, 2.16) in the first six weeks after an index case, compared to 6-12 weeks after. CONCLUSION: Risks of hospitalisation and mortality are predictably higher in cases compared to non-cases. The short-term increase in risks for non-case contacts following diagnosis of the index case may suggest incomplete case ascertainment among contacts, although this was relatively small.

Construction of a new chromosome-scale, long-read reference genome assembly for the Syrian hamster, Mesocricetus auratus.

BACKGROUND: The Syrian hamster (Mesocricetus auratus) has been suggested as a useful mammalian model for a variety of diseases and infections, including infection with respiratory viruses such as SARS-CoV-2. The MesAur1.0 genome assembly was generated in 2013 using whole-genome shotgun sequencing with short-read sequence data. Current more advanced sequencing technologies and assembly methods now permit the generation of near-complete genome assemblies with higher quality and greater continuity. FINDINGS: Here, we report an improved assembly of the M. auratus genome (BCM_Maur_2.0) using Oxford Nanopore Technologies long-read sequencing to produce a chromosome-scale assembly. The total length of the new assembly is 2.46 Gb, similar to the 2.50-Gb length of a previous assembly of this genome, MesAur1.0. BCM_Maur_2.0 exhibits significantly improved continuity, with a scaffold N50 that is 6.7 times greater than MesAur1.0. Furthermore, 21,616 protein-coding genes and 10,459 noncoding genes are annotated in BCM_Maur_2.0 compared to 20,495 protein-coding genes and 4,168 noncoding genes in MesAur1.0. This new assembly also improves the unresolved regions as measured by nucleotide ambiguities, where ∼17.11% of bases in MesAur1.0 were unresolved compared to BCM_Maur_2.0, in which the number of unresolved bases is reduced to 3.00%. CONCLUSIONS: Access to a more complete reference genome with improved accuracy and continuity will facilitate more detailed, comprehensive, and meaningful research results for a wide variety of future studies using Syrian hamsters as models.

Corporate occupiers’ attitude to flex space in the post-Covid environment

Purpose: This paper investigates how large UK corporate occupiers perceive the potential role of flexible office space in their office portfolios in a post-pandemic context. Design/methodology/approach: The research methodology is qualitative and applied. For a longitudinal survey, convenience sampling was used to obtain co-operation from 11 corporate real estate managers with responsibility for managing large corporate real estate portfolios spread across a range of business sectors and countries. Semi-structured interviews were selected as the core research method to seek and to optimise the balance between discovery and generalisability. Findings: Although the pandemic has led corporate occupiers to fundamentally re-appraise where and when different work tasks are performed, it is not yet clear whether this has major implications for the flex space sector. The flex space model, with its blending of various occupiers and activities, is perceived to be poorly aligned with an increasing emphasis on the office as a core corporate hub facilitating connection, collaboration, enculturation, learning and creativity. Since most flex space is concentrated in central locations, it is also not well positioned to benefit from any decentralisation of office functions. However, as the flex space sector evolves in response to structural shifts in employment and working practices and business change, its various products are likely to be a continuing requirement from corporate occupiers for short-term solutions to demand shocks, the need for rapid market entry, accommodation for short-term projects and access to desk space in multiple locations. Practical implications: Understanding occupiers' drivers in their decision-making on selecting the method of occupation will assist investors in how they might adjust what they offer in the marketplace. Originality/value: Whilst there has been a substantive number of surveys of corporate occupiers' perceptions and intentions regarding their office portfolio, this paper focusses on a specifically on the flex space sector. Whilst previous research has mainly been extensive, this research study is intensive. © 2022, Emerald Publishing Limited.

Acute to Chronic Pain Signatures Program (a2CPS): Implementation of Remote Training for a Multisite Observation Study During COVID-19

Chronic pain produces the largest non-fatal burden of disease, yet our understanding of factors that contribute to the transition from acute chronic pain are poorly understood. The Acute to Chronic Pain Signatures Program (A2CPS) is a longitudinal, multi-site observational study to identify biomarkers (individual or biosignature combinations) that predict susceptibility or resilience to the development of chronic pain after surgery (knee replacement or thoracotomy). Due to the COVID-19 pandemic, however, travel between sites was restricted just as the study was preparing to begin enrollment. Here, we present multiple training protocol adaptations that were successfully implemented to facilitate remote research-related training. The A2CPS consortium includes 2 Multisite Clinical Centers (MCCs, 10 recruitment sites), a Clinical Coordinating Center (CCC), a Data Integration and Resource Center (DIRC), 3 Omics Data Generation Centers, and representation from the NIH Pain Consortium, Common Fund, and National Institute of Drug Abuse. The A2CPS is collecting candidate and exploratory biomarkers including pain, fatigue, function, sleep, psychosocial factors, quantitative sensory testing (QST), genomics, proteomics, metabolomics, lipidomics, and brain imaging. The CCC adapted the A2CPS training and evaluation techniques for certifying the MCCs to ensure competency with recruitment, assessments (surveys, QST, function), and data entry across clinical sites using a combination of virtual training sessions, standardized quantitative measurements, video demonstrations, and reliability assessments. Staff at data collection sites have been successfully certified in all psychophysical assessments (QST, function). This included use of stop watches and metronomes to ensure standard application rates, completion of application-rate and inter-rater-reliability worksheets at each clinical site, designation of site-specific master examiners, training rubrics and video demonstration to verify competency was harmonized across sites. Adaptation of training protocols to a remote format enabled initiation of subject enrollment while maintaining documented standards with high data completion rates for surveys and assessments. The A2CPS Consortium is supported by the National Institutes of Health Common Fund, which is managed by the OD/Office of Strategic Coordination (OSC). Consortium components include: Clinical Coordinating Center (UO1NS077179), Data Integration and Resource Center (UO1NS077352), Omics Data Generation Centers (U54DA049116, U54DA049115, U54DA09113), and Multisite Clinical Centers: MCC 1 (UM1NS112874) and MCC 2 (UM1NS118922). Postdoctoral support for GB provided by the National Institutes of Neurological Disease and Stroke (NINDS) of the NIH under Award Number U24NS112873-03S2.

'You can't walk through water without getting wet' UK nurses' distress and psychological health needs during the Covid-19 pandemic: A longitudinal interview study.

BACKGROUND: Pre-COVID-19 research highlighted the nursing profession worldwide as being at high risk from symptoms of burnout, post-traumatic stress disorder (PTSD) and suicide. The World Health Organization declared a pandemic on 11th March 2020 due to the sustained risk of further global spread of COVID-19. The high healthcare burden associated with COVID-19 has increased nurses' trauma and workload, thereby exacerbating pressure on an already strained workforce and causing additional psychological distress for staff. OBJECTIVES: The Impact of COVID-19 on Nurses (ICON) interview study examined the impacts of the pandemic on frontline nursing staff's psychosocial and emotional wellbeing. DESIGN: Longitudinal qualitative interview study. SETTINGS: Nurses who had completed time 1 and 2 of the ICON survey were sampled to include a range of UK work settings including acute, primary and community care and care homes. Interviewees were purposively sampled for maximum variation to cover a broad range of personal and professional factors, and experiences during the COVID-19 pandemic, including redeployment. METHODS: Nurses participated in qualitative in-depth narrative interviews after the first wave of COVID-19 in July 2020 (n = 27) and again at the beginning of the second wave in December 2020 (n = 25) via video and audio platform software. Rigorous qualitative narrative analysis was undertaken both cross-sectionally (within wave) and longitudinally (cross wave) to explore issues of consistency and change. RESULTS: The terms moral distress, compassion fatigue, burnout and PTSD describe the emotional states reported by the majority of interviewees leading many to consider leaving the profession. Causes of this identified included care delivery challenges; insufficient staff and training; PPE challenges and frustrations. Four themes were identified: (1) 'Deathscapes' and impoverished care (2) Systemic challenges and self-preservation (3) Emotional exhaustion and (4) (Un)helpful support. CONCLUSIONS: Nurses have been deeply affected by what they have experienced and report being forever altered with the impacts of COVID-19 persisting and deeply felt. There is an urgent need to tackle stigma to create a psychologically safe working environment and for a national COVID-19 nursing workforce recovery strategy to help restore nurse's well-being and demonstrate a valuing of the nursing workforce and therefore support retention.

Vaginal Cuff Closure during Laparoscopic Hysterectomy Comparing the EndoStitch and RD-180 Suturing Devices

Introduction: To facilitate vaginal cuff closure, several endomechanical suturing devices can be used. This retrospective study was undertaken to compare two different devices to determine if there was an advantage to either device. Methods: Laparoscopic hysterectomies performed where vaginal cuff closure times could be measured on recorded video were reviewed. Demographic information was obtained on these cases and the two suturing devices were compared. Results: Cuff closure times with the EndoStitch® (Covidien, Norwalk, CT) and the RD-180® (LSI Solutions, Rochester, NY) devices were evaluated for overall cuff closure time, per stitch time, and assessed for confounding factors. The EndoStitch had an overall faster cuff closure time than the RD-180 (17.2 minutes vs. 20.1 minutes, p = 0.046). However, the per-stitch closure times were similar (5.66 minutes/stitch, 5.56 minutes/stitch, p = 0.78). No conversions to laparotomy and no cuff dehiscences were experienced. Per-stitch closure time was not affected by the level of resident, but was lengthened by increased patient body mass index. However, closure times were longer with both devices than when using barbed suture and conventional suturing techniques. Conclusions: Both the EndoStitch and RD-180 suturing devices provide a reasonable cuff closure time with a low risk of cuff dehiscence. The learning curve for both instruments is relatively flat. (J GYNECOL SURG 37:227) © Copyright 2021, Mary Ann Liebert, Inc., publishers 2021.

The College of Radiographers Research Strategy for the next five years.

This article outlines the updated College of Radiographers (CoR) Research Strategy. This new research strategy will shape the approach to research from the radiography profession over the next five years. This will apply to all the profession and is aspirational and future thinking. The updated research strategy is the fifth research strategy presented by the CoR. Over the last five years, there have been considerable developments within healthcare and healthcare research. As this article is being written we are still in the middle of a global pandemic (Covid-19) which has influenced all our lives. However, despite the challenges of the last year, we are in a stronger position as a profession with more radiographers working towards and gaining masters and doctoral level qualifications. There are more radiographers working in clinical academic roles and there has been further development of radiographers coordinating and delivering research as well as becoming research leaders. This updated research strategy supports the radiography profession in delivering research-based practice over the next five years offering a framework within which radiographers can develop.

A Case of Acute Interstitial Pneumonia during the COVID-19 Pandemic

IntroductionAcute respiratory distress syndrome (ARDS) typically has a precipitating cause. The most common histological finding in ARDS is diffuse alveolar damage (DAD). DAD is described as injury to the endothelium and alveolar cell lining. Acute interstitial pneumonia (AIP) is defined by the sudden development of bilateral pulmonary infiltrates without a precipitating cause with histological DAD. Case PresentationWe present the case of a 60-year old male with a past medical history of hypertension and hyperlipidemia who initially presented with dyspnea and a two week history of polyarthralgias. He was a current one pack per day smoker and worked an office job in the HVAC industry. His Chest CT showed impressive multi-lobe ground glass opacities. He was treated with oxygen, dual antibiotics and empiric steroids. Extensive infectious workup including PCR respiratory virus panel, fungal testing, urine antigens for Legionella and Streptococcus Pneumonia, and multiple COVID-19 tests were all negative. Autoimmune and vasculitis testing only had a positive ANA 1:160 titer with a nucleolar pattern. Left lung transbronchial biopsies with infectious bronchoalveloar lavage were non-diagnostic. A larger surgical pathology specimen was obtained through video assisted thorascopic surgery (VATS) with biopsies taken from three lobes. His pathology was consistent with organizing diffuse alveolar damage with hyaline membranes suggestive of the acute phase of DAD with no evidence of granulomas or vasculitis. In the idiopathic form, this is consistent with AIP. His severe hypoxic and hypercapneic respiratory failure was treated with permissive hypercapnea and high PEEP strategy (7.24pH/89 pCO2). Extracorporeal membrane oxygenation (ECMO) was considered but he was not a candidate. He developed a spontaneous left lung pneumothorax due to barotrauma. He was treated with high dose intravenous pulse dosed steroids with minimal improvement. His case was discussed with the transplant team, and he was not a candidate due to prolonged mechanical ventilation and inability to give consent. His code status was changed to comfort care and he passed away. DiscussionPatients diagnosed with AIP are treated with supportive care including mechanical ventilation and intravenous pulse dose corticosteroids. There have been cases of patients receiving single lung transplants for AIP and surviving. Extracorporeal membrane oxygenation (ECMO) can be considered as bridge to recovery or lung transplant in AIP. Although the patient we described was not a candidate for either. Despite being amidst the COVID-19 pandemic, other rare causes of fulminant respiratory failure still exist, such as AIP.

Variation in predicted COVID-19 risk among lemurs and lorises.

The novel coronavirus SARS-CoV-2, which in humans leads to the disease COVID-19, has caused global disruption and more than 2 million fatalities since it first emerged in late 2019. As we write, infection rates are at their highest point globally and are rising extremely rapidly in some areas due to more infectious variants. The primary target of SARS-CoV-2 is the cellular receptor angiotensin-converting enzyme-2 (ACE2). Recent sequence analyses of the ACE2 gene predict that many nonhuman primates are also likely to be highly susceptible to infection. However, the anticipated risk is not equal across the Order. Furthermore, some taxonomic groups show high ACE2 amino acid conservation, while others exhibit high variability at this locus. As an example of the latter, analyses of strepsirrhine primate ACE2 sequences to date indicate large variation among lemurs and lorises compared to other primate clades despite low sampling effort. Here, we report ACE2 gene and protein sequences for 71 individual strepsirrhines, spanning 51 species and 19 genera. Our study reinforces previous results while finding additional variability in other strepsirrhine species, and suggests several clades of lemurs have high potential susceptibility to SARS-CoV-2 infection. Troublingly, some species, including the rare and endangered aye-aye (Daubentonia madagascariensis), as well as those in the genera Avahi and Propithecus, may be at high risk. Given that lemurs are endemic to Madagascar and among the primates at highest risk of extinction globally, further understanding of the potential threat of COVID-19 to their health should be a conservation priority. All feasible actions should be taken to limit their exposure to SARS-CoV-2.

The utility of paired upper and lower COVID-19 sampling in patients with artificial airways

Background: The Centers for Disease Control and Prevention (CDC) recommends upper respiratory tract (URT) polymerase chain reaction (PCR) testing as the initial diagnostic test for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Lower respiratory tract (LRT) testing for patients requiring mechanical ventilation is also recommended. The goal of this study was to evaluate concordance between paired URT and LRT specimens in children undergoing pre-admission/procedure screening or diagnostic testing. We hypothesized that < 10% of paired tests would have discordant results. Methods: Single center cross-sectional study including children with artificial airways who had paired URT and LRT SARS-CoV-2 PCR testing between 4/1/2020 and 6/8/2020. URT specimens included nasopharyngeal (NP) swabs and aspirates. LRT specimens included tracheal aspirates and bronchoalveolar lavages. URT and LRT specimens were classified as paired if the two specimens were collected within 24 hours. Artificial airways included tracheostomies and endotracheal tubes. Tests were classified as diagnostic versus screening based on the indication selected in the order. Results: 102 paired specimens were obtained during the study period. Fifty-nine were performed for screening and 43 were performed for diagnosis of suspected SARS-CoV-2. Overall, 94 specimens (92%) were concordant, including 89 negative from both sources and 5 positive from both sources. Eight specimens (8%) were discordant, all of which were positive from the URT and negative from the LRT (Figure 1). Among patients undergoing screening, 3 of 4 positive tests were discordant and among symptomatic patients, 5 of 9 positive tests were discordant. There were no instances of a positive LRT specimen with a negative URT specimen. Conclusion: Overall, most paired samples from the URT and LRT yielded concordant results with no pairs positive from the LRT and negative from the URT. These data support the CDC recommendation that URT specimens are the preferred initial SARS-CoV-2 test, while LRT specimens should be collected only from mechanically ventilated with suspected SARS-CoV-2. (Figure Presented).

HOSTED-England's Household Transmission Evaluation Dataset: preliminary findings from a novel passive surveillance system of COVID-19.

BACKGROUND: Household transmission of SARS-CoV-2 is an important component of the community spread of the pandemic. Little is known about the factors associated with household transmission, at the level of the case, contact or household, or how these have varied over the course of the pandemic. METHODS: The Household Transmission Evaluation Dataset (HOSTED) is a passive surveillance system linking laboratory-confirmed COVID-19 cases to individuals living in the same household in England. We explored the risk of household transmission according to: age of case and contact, sex, region, deprivation, month and household composition between April and September 2020, building a multivariate model. RESULTS: In the period studied, on average, 5.5% of household contacts in England were diagnosed as cases. Household transmission was most common between adult cases and contacts of a similar age. There was some evidence of lower transmission rates to under-16s [adjusted odds ratios (aOR) 0.70, 95% confidence interval (CI) 0.66-0.74). There were clear regional differences, with higher rates of household transmission in the north of England and the Midlands. Less deprived areas had a lower risk of household transmission. After controlling for region, there was no effect of deprivation, but houses of multiple occupancy had lower rates of household transmission [aOR 0.74 (0.66-0.83)]. CONCLUSIONS: Children are less likely to acquire SARS-CoV-2 via household transmission, and consequently there was no difference in the risk of transmission in households with children. Households in which cases could isolate effectively, such as houses of multiple occupancy, had lower rates of household transmission. Policies to support the effective isolation of cases from their household contacts could lower the level of household transmission.

Inflammatory parameters distinguish severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) pediatric presentations, coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children (MIS-C)

Purpose: Pediatric SARS-CoV-2 infections result in at least three distinct disease manifestations. Most children infected acutely remain asymptomatic or develop only mild symptoms of COVID-19;however, small proportion of acutely infected children, develop progressive respiratory illness, multi-organ involvement, and an associated hyperinflammatory syndrome. These COVID-19 presentations are contrasted by MIS-C, a post-infectious hyperinflammatory condition characterized by fever, shock, and multi-organ dysfunction. We sought to characterize the hyperinflammatory syndromes of SARS-CoV-2 infections, in order to identify biomarkers that may distinguish the hyperinflammation seen in these conditions from that of HLH. Methods:We enrolled children admitted to the Children's Hospital of Philadelphia who had positive SARS-CoV-2 RT-PCR tests or met clinical criteria for MIS-C.We measured plasma levels of 10 cytokines on a MesoScale Discovery platform and correlated these values with available clinical parameters of inflammation. Results: Fifty patients were classified into asymptomatic/mild COVID- 19 (amC19;N = 18), severe COVID-19 (sevC19;N = 11), or MISC (MIS-C;N = 21). Five cytokines (IL-1beta, IL-2, IL-4, IL-12p70 and IL-13) were excluded from further analyses, as their levels were not abnormal. Of the remaining (IL-6, IL-8, IL-10, TNF-alpha and IFNgamma) thatwere often elevated, we found statistically significant elevations in IL-10 in both sevC19 andMIS-C, when compared to amC19 patients. Some patients in each cohort had markedly elevated IFNgamma, but the cohort means were not statistically different. While the maximal C-reactive protein levels were elevated in both sevC19 and MIS-C, these were not statistically different,while maximal ferritin levels differentiated sevC19 from amC19 andMIS-C. Conclusion: While the pathogenesis of pediatric COVID-19 andMIS-C are not fully elucidated, differences between observed biomarkers suggest that the immune pathogenesis of the hyperinflammation in these syndromes is likely to be mechanistically different, although overlap may exist with HLH in some patients.

A systematic review of droplet and aerosol generation in dentistry.

OBJECTIVES: This review aimed to identify which dental procedures generate droplets and aerosols with subsequent contamination, and for these, characterise their pattern, spread and settle. DATA RESOURCES: Medline(OVID), Embase(OVID), Cochrane Central Register of Controlled Trials, Scopus, Web of Science and LILACS databases were searched for eligible studies from each database's inception to May 2020 (search updated 11/08/20). Studies investigating clinical dental activities that generate aerosol using duplicate independent screening. Data extraction by one reviewer and verified by another. Risk of bias assessed through contamination measurement tool sensitivity assessment. STUDY SELECTION: A total eighty-three studies met the inclusion criteria and covered: ultrasonic scaling (USS, n = 44), highspeed air-rotor (HSAR, n = 31); oral surgery (n = 11), slow-speed handpiece (n = 4); air-water (triple) syringe (n = 4), air-polishing (n = 4), prophylaxis (n = 2) and hand-scaling (n = 2). Although no studies investigated respiratory viruses, those on bacteria, blood-splatter and aerosol showed activities using powered devices produced greatest contamination. Contamination was found for all activities, and at the furthest points studied. The operator's torso, operator's arm and patient's body were especially affected. Heterogeneity precluded inter-study comparisons but intra-study comparisons allowed construction of a proposed hierarchy of procedure contamination risk: higher (USS, HSAR, air-water syringe, air polishing, extractions using motorised handpieces); moderate (slow-speed handpieces, prophylaxis, extractions) and lower (air-water syringe [water only] and hand scaling). CONCLUSION: Gaps in evidence, low sensitivity of measures and variable quality limit conclusions around contamination for procedures. A hierarchy of contamination from procedures is proposed for challenge/verification by future research which should consider standardised methodologies to facilitate research synthesis. CLINICAL SIGNIFICANCE: This manuscript addresses uncertainty around aerosol generating procedures (AGPs) in dentistry. Findings indicate a continuum of procedure-related aerosol generation rather than the common binary AGP or non-AGP perspective. The findings inform discussion around AGPs and direct future research to support knowledge and decision making around COVID-19 and dental procedures.