The Pandemic, Telemedicine, and Andrology: What Have We Learned?

INTRODUCTION AND OBJECTIVE: Telemedicine has gained wide acceptance during the COVID-19 pandemic. Worldwide lockdowns made this interface an indispensable one for patient care. Recent evidence suggests that urology patients were receptive to telemedicine;however, no systematic review has been done to date on andrology patients in particular and their perception of telemedicine. METHOD(S): Three electronic databases: PubMed, Scopus, and Web of Science, were searched from their inception until June 2022 for relevant articles. Two independent teams reviewed s and extracted data from the selected manuscripts. A meta-analysis was completed in line with PRISMA 2020 and AMSTAR Guidelines. For our study, we limited telemedicine to communication through videoconferencing or telephone encounters between patients and medical professionals. Positive response to telemedicine was defined as patients "wishing for telemedicine consultation", "preferring telemedicine over in person", "accepting the current telemedicine arrangement", "having needs addressed with teleconsultation", or "willingness to do a teleconsultation". RESULT(S): Of the 1128 retrieved s, 56 underwent fulltext review and 12 were included in the final analysis, comprising a total cohort of >4021 cases. All 8 studies that assessed perception of andrology patients to telemedicine showed that most patients had "positive perception". Telemedicine was shown to save an average cost of $149-252/patient. Pooled analyses of positive response to telemedicine were 68.7% (95% CI = 49.4-83.1%, p=0.057) and of patients who recommended telemedicine were 65.1% (95% CI = 18.4-93.9%, p=0.577). 84.6% pooled proportion for recommending video compared to 38.9 % pooled proportion for recommending telephone practice, p=0.035. In the telephone-only encounters, 27.1% of patients preferred in-person visits as security and privacy of any mode of telecommunication were of concern. CONCLUSION(S): Most patients have a positive perception of telemedicine, particularly with videoconferencing and less so with telephone visits. Telemedicine will plausibly continue to be integral in andrology practice.

Opening the World During Lockdown: Multilingual and Multicultural Experiences for Learners in Wales Through Mentoring

The onset of the pandemic in March 2020 reset everyday experiences for children and young people across the UK. Despite best efforts, variable provision across schools and the wider ripple effects of the pandemic led to learning loss, with learners from socio-economically challenging backgrounds most acutely impacted. Concerned about the impact that the pandemic would have on an already precarious situation for language learning in Wales, MFL Mentoring launched the Post-16 Languages Recovery Project, to provide inclusive spaces for learners to engage in language and cultural learning opportunities. In this chapter, we will consider the global challenges facing education, illuminating key issues arising from the pandemic focusing in particular on the loss of learning. Secondly, we will consider the specific context for education in Wales and the impact of the pandemic on preparations for the Curriculum for Wales. We will analyse pre-pandemic trends in language learning in Wales in order to understand why languages are particularly vulnerable to the impacts of COVID-19, above all amongst the most deprived learners. Finally, we will evaluate the success of the Post-16 Languages Recovery Project through analysing primary data collated from learners throughout the first lockdown period, April-July 2020, and from teachers July-August 2021. © The Editor(s) (if applicable) and The Author(s), under exclusive licence to Springer Nature Switzerland AG 2022

Elevation of Donor Derived Cell Free Dna Levels Due to Hiv Infection in Heart Transplant Patient

55 year old African American Male with history Human ImmunoDeficiency Virus (HIV) and end stage heart failure thought to be secondary to HIV underwent successful Heart Transplantation. At the time of transplantation the HIV viral load was <20 copies/ml and he was on Biktarvy (3 drug regimen) Patient had uneventful post transplant course with no evidence of treated rejection. His viral load was closely monitored and was <20 copies/ml. However about a year after his heart transplantation his antiviral regimen was changed to Cabotegravir/Rilpivirie once monthly intramuscular injections. The change was done mainly for ease of administration. However his viral load started increasing on this regimen. This was thought to be due to silicone gluteal implants of the patient and inadequate absorption of the medication. The levels peaked at 70,000 copies/ml. Patient's donor derived cell free DNA (dd-cfDNA)was routinely monitored, and his levels were always less than 0.20%. However the dd-cf DNA level increased and was high at 0.4% (more than 3 times the baseline). There was no reason for this elevation as his graft function was preserved with no clinical evidence of rejection. Repeat dd-cf DNA done after few months, showed normalization of the values. At this time his viral load was around 40-50 copies/ml.. DD-cf DNA is a marker of injury to the transplanted heart. It is usually elevated with rejection and higher the grade of rejection, higher the cell free DNA values. However other etiologies like coronary artery vasculopathy, elevated donor specific antibody, hepatitis c infection are some of the other causes of elevated levels. It is well known that CMV infection increases the ALLOMAP values. However CMV infection is not known to cause elevation in the cell free DNA value. Recently association with COVID infection was evaluated and has not shown to cause cell free DNA elevation. There is no report on dd-cf DNA values with HIV Infection. Ours is the first case of such association. There was no suspiciousness of rejection otherwise, hence biopsy was not pursued. The dd-cf DNA levels decreased with the decrease of the HIV viral load. HIV viral infection is known to cause cardiomyopathy. Ours is the first case of elevated dd-cf DNA values in a patient with elevated viral load. It is possible that HIV viral infection caused elevation in the dd-cf DNA value in our patient. [ABSTRACT FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Increasing access to COVID-19 testing in underserved Black American neighborhoods

Background. Black Americans have been disproportionately impacted by COVID-19, with systemic inequities contributing to increased incidence and mortality. In Chicago, access to COVID-19 testing was scarce in many predominantly Black neighborhoods early in the pandemic, exacerbating inequities. We aimed to assess uptake and yield of a COVID-19 testing campaign to increase access in high-risk, underserved Chicago communities. Methods. The Alive Church Network (ACN) is a community-driven coalition of Black pastors and public health researchers developed to address health inequities in Chicago. For this initiative, ACN implemented two strategies to improve access to COVID-19 testing in underserved neighborhoods: 1) church-based testing, with nurses and community health workers (CHWs) stationed in churches to perform PCR testing for community members and church staff (Dec 2020-Dec 2021) and 2) community site testing, with nurses and CHWs deployed to 8 local sites (e.g., Salvation Army) to conduct weekly PCR testing for employees and clients (May 2021-Mar 2022). We assessed characteristics of individuals undergoing testing;symptom and exposure history;and COVID-19 positivity. In addition, we compared positivity for ACN sites with Chicago citywide positivity over time. Results. A total of 3420 tests were performed for 1703 individuals. Of those tested, 931 (54.7%) were tested at churches and 772 (45.3%) were tested at community partner sites. Those presenting to churches were older (mean 44.8 vs. 39.1 years), more likely to be female (56.5% vs. 48.5%), and more likely to have a chronic medical condition (37.1% vs. 22.5%, Table). Prevalence of COVID-19 symptoms and exposure history were similar for those presenting to church and community sites (Table). Overall, ACN test positivity was similar to Chicago citywide positivity;however, ACN test positivity was much higher during the Omicron surge (24% vs. 11%, Figure). Characteristics of individuals tested for COVID-19 at church and community sites COVID-19 test positivity, ACN sites vs. Chicago citywide Conclusion. The ACN testing campaign increased access to COVID-19 testing in underserved neighborhoods in Chicago and had high yield during the Omicron surge. Church-based testing was successful for reaching older, medically vulnerable individuals. Ensuring widespread access to testing is essential for health equity and to reduce COVID-19 morbidity and mortality.

Pre-service Music Teachers' Understanding of Blended Learning: Implications for Teaching Post COVID-19

The significant increase in online teaching during the COVID-19 pandemic has created a heightened need for educators to implement teaching methods which do not rely solely on “face-to-face” learning within the same physical space. Blended Learning (BL) is one such approach, allowing for flexibility in the delivery of a class and constant access to unit materials. This paper reports on an investigation, by two Australian Pre-service Teacher (PST) educators, of their students' understanding of BL at the beginning and end of a BL music method unit. Data were collected for three consecutive years with three separate cohorts. Findings indicated that the majority of the participants began the unit with little to no understanding of BL. This improved considerably through direct BL experience, with some exceptions. The implications for the development of flexible and responsive PST education in the current and post pandemic education environment are considered. © 2021 Social Science Press. All rights reserved.

Characterisation of liver USS findings in pre-school children with cystic fibrosis

Objectives: European consensus guidelines recommend annual screening for cystic fibrosis-related liver disease (CFLD) with annual clinical, biochemical and ultrasound (USS) evaluation. Abdominal USS is initiated from age 5 in many centres across the UK;however, it has been our practice to initiate from age 2. In this study we aim to determine the incidence of liver abnormalities in young children as recent reduced access to radiological services due to the COVID-19 pandemic has prompted us to re-evaluate our practice. Methods: We retrospectively evaluated abdominal USS reports of consecutive children aged 2–5 years with confirmed diagnosis of CF attending the NI regional CF centre between 2012 and 2020, along with relevant demographic and clinical data and liver function tests. All data was retrieved from the Northern Ireland Electronic Care record (NIECR). Results: Seventy 2–5-year-olds underwent a total of 199 scans between 2012 and 2020. In 2-year-olds, 43% of scans detected an abnormality, increasing to 70% in 5-year-olds, RR 1.61, 95% CI 1.03, 2.65, p = 0.03. 107 (53.4%) scans had one or more abnormality reported. Increased echogenicity of liver and/or pancreas was the most common abnormality identified in 72 of 107 scans (67.2%);hepatomegaly in 46 (42.9%);coarse heterogeneous echotexture in 24 (22.4%);increased periportal echogenicity in 6 (5.6%) and other incidental findings in 10 (9.3%) of scans, including cholelithiasis, splenic cyst, renal scarring, renal stones, and micro gallbladder. Conclusion: Abnormalities are present in over half of abdominal ultrasound scans in 2–5-year-olds. Increased echogenicity, liver enlargement and coarsened echotexture are indicative of hepatic steatosis, which has unclear significance in this age group. Longitudinal studies are needed to determine the role of early USS in detection of liver disease, and whether any particular abnormalities may identify those at risk of development of severe CFLD.