News from the United Nations Commission on International Trade Law (UNCITRAL): the work of the 55th Commission session

The United Nations Commission on International Trade Law (UNCITRAL) is the core legal body of the United Nations system in the field of international trade law. It has been carrying out its mandate to further the progressive harmonization and unification of international trade law since 1966. This article provides an overview of the 55th session of UNCITRAL and the activities of its working groups and Secretariat from mid-2021 to mid-2022. The annual UNCITRAL session (27 June to 15 July 2022, New York) was held fully in person for the first time since the start of the COVID-19 pandemic. Delegates and observers were also able to listen to the Commission session remotely via the UN webcast system but were not able to intervene using that format. Though the Commission session operated under normal conditions, the activities of the UNCITRAL working groups and the Secretariat during the year were still affected by the pandemic, with the meeting time with interpretation in all six UN languages reduced for hybrid meetings that were held both in-person and via Zoom.

Get ready for a new mindset on women in customs leadership

Around the world, progressive customs administrations recognise the importance of strengthening their gender balance. In the past decade, the deliberate efforts of contemporary leaders have resulted in positive organisational changes focused on equitable opportunities to prepare women and men for customs leadership. We know that customs administrations are capable of large-scale and rapid transformation – the COVID-19 pandemic has clearly demonstrated just how adaptive and responsive they can be. We contend that customs administrations are well-placed to drive timely, organisation-wide change that will make gender diversity a reality. This paper highlights the need for diversity in administrations and introduces the Container Control Programme – Women's Professional Development Programme (CCP – WPDP) that is designed to significantly advance diversity in agencies to strengthen their organisational effectiveness. © 2022, International Network of Customs Universities. All rights reserved.

Rehabilitation of Person in a Barrel Syndrome Due to Sequela of Prolonged Intubation After COVID-19: A Case Report

Case Diagnosis: A 46-year-old male with severe COVID-19 pneumonia. Case Description or Program Description: The patient underwent bilateral orthotopic lung transplant (BOLT) after being on extracorporeal membrane oxygenation (ECMO) and mechanical ventilation for 202 days. He had multiple complications due to prolonged prone positioning, intubation, immobility and steroid use which include tongue fissure, critical illness neuromyopathy, bilateral brachial plexopathy, bilateral upper extremity contractures, avascular necrosis (AVN) of bilateral humeral heads and bilateral femoral heads, left sciatic mononeuropathy and a stage IV sacral wound. The patient had severe weakness throughout all limbs, but was cognitively intact. He was admitted to IPR 3.5 weeks after his BOLT. The patient was independent for ADLs and mobility prior to his illness and was dependent for activities of daily living (ADLs) and mobility at time of admission to inpatient rehabilitation (IPR). Setting(s): Inpatient rehabilitation hospital Assessment/Results: Following 12 weeks of IPR he ambulated independently and was discharged to the community with family assist in an outpatient Day Rehabilitation program for continued functional recovery. Unfortunately, he still required maximum assistance for ADLs due to loss of function of his arms. Discussion (relevance): This is a unique case of a patient with severe COVID-19 pneumonia who was intubated and on ECMO for a very long amount of time with survival ultimately leading to numerable sequela involving all extremities but notable injuries presenting as a person in a barrel type syndrome. Conclusion(s): Person in a barrel syndrome is a rare syndrome described by severe bilateral upper extremity weakness with strength preserved in the bilateral lower extremities as well as head, neck, and face. This patient developed this syndrome as a sequela to prolonged prone positioning and immobility related to severe COVID-19 disease. Consultation of PM&R services while in the ICU to aid in identification of patients at risk and help to optimize patient positioning without compromising life-saving procedures.

Functional Improvements of Patients Admitted to an Inpatient Rehabilitation Facility after Bilateral Lung Transplant Due to Severe COVID-19 Pulmonary Disease

Objective: To describe the inpatient rehabilitation (IPR) course of patients who underwent bilateral lung transplant due to severe COVID-19 pulmonary disease. Design(s): Retrospective chart review Setting: Free-standing, academic, urban inpatient rehabilitation hospital Participants: Seventeen patients aged 28-67 years old (mean 53.9 +/- 10.7) who developed COVID-19 respiratory failure and underwent bilateral lung transplant. Intervention(s): Patients participated in a comprehensive IPR program including physical, occupational, and speech therapy tailored to the unique functional needs of each individual. Main Outcome Measure(s): Primary outcome measures of functional improvements, include mobility and self-care GG scores, as defined as quality measures by the Centers for Medicare and Medicaid Services. Other functional measures included 6 minute walk test, Berg balance scale, and Mann Assessment of Swallowing Ability (MASA). Wilcoxon Signed Rank Sum Test was used to evaluate statistical significance between admission and discharge scores. Result(s): Fourteen patients completed inpatient rehabilitation. Self-care (GG0130) mean score improved from 20.9 to 36.1. Mobility (GG0170) mean score improved from 30.7 to 70.7. Mean 6-minute walk distance improved from 174.1 to 455.1 feet. Mean Berg balance scores improved from 18.6/56 to 36.3/56. MASA scores improved from 171.3 to 182.3. All scores changes were statistically significant with p value < 0.01. 76% of patients discharged home. Conclusion(s): This retrospective review demonstrates that this new and unique patient population can successfully participate in a comprehensive inpatient rehabilitation program and achieve functional improvements despite medical complications. Advances in medical technology have increased the number of people with severe respiratory failure who are eligible for lung transplant and inpatient rehabilitation facilities have adapted to the changing COVID-19 medical landscape. It is important for rehabilitation providers to recognize opportunities to treat new patient populations and to be able to adjust treatment protocols accordingly.

Sex and gender differences in the neurological and neuropsychiatric symptoms of long COVID: a narrative review

COVID-19 was deemed a global pandemic in March 2020 and, since then, millions of people have been affected worldwide. Now, nearly two years later, the long-term sequelae of the virus are becoming increasingly appar-ent. This novel form of the disease, commonly referred to as “long COVID”, appears to be more common in females than in males. In this narrative review, we consulted published studies on long COVID reporting sex-disaggregated findings and discuss the possible mechanisms underlying potential sex differences. We found that females are more likely to experience milder acute COVID-19 disease, lower mortality, and a higher number of persistent physical, cognitive, neu-rological, and neuropsychiatric symptoms compared to males. Stronger innate and adaptive immune responses in females may be one of the mechanisms underlying this sex difference. The arrival of COVID-19 presents a unique occa-sion to study sex differences in the prevalence, symptomatol-ogy, risk factors, and disease progression shortly after disease emergence. We argue that advantage must be taken of this opportunity to provide researchers with the proper tools to address sex differences in COVID-19 and effectively tailor assessments and treatments toward individual needs. © 2022, Il Pensiero Scientifico Editore s.r.l.. All rights reserved.

Methodological Considerations for Survey-Based Research During Emergencies and Public Health Crises: Improving the Quality of Evidence and Communication

The novel coronavirus (COVID-19) outbreak has resulted in a massive amount of global research on the social and human dimensions of the disease. Between academic researchers, governments, and polling firms, thousands of survey projects have been launched globally, tracking aspects like public opinion, social impacts, and drivers of disease transmission and mitigation. This deluge of research has created numerous potential risks and problems, including methodological concerns, duplication of efforts, and inappropriate selection and application of social science research techniques. Such concerns are more acute when projects are launched under the auspices of quick response, time-pressured conditions–and are magnified when such research is often intended for rapid public and policy-maker consumption, given the massive public importance of the topic. Copyright © 2022 Kennedy, Jensen and Jensen.

Danish national film archives available for reminiscence activities

BACKGROUND: Among important elements' in person-centred care is knowledge about a person's life, and how this ties into his/her daily activities and care. Finding historical film footage about a particular local setting, or a relevant topic, is time-consuming and difficult for the care staff. The Danish Film Institute - a government institution under the Ministry of Culture - set out to develop a platform that made part of their historical archive available for staff, to support the national agenda of creating a dementia-friendly society. METHOD: Based on knowledge from reminiscence theory, suitable archive footage was selected and grouped into four packages, consisting of several short film clips and supportive documents. The platform was tested on eight nursing home residents with a dementia diagnosed, in two groups of four. Each group performed one session per week for three weeks at the nursing home. Due to COVID-19 restrictions, only proxy data was collected in terms of interviews with a group leader and two on-site observers after every session, about their experiences with the material and their observed participant reactions. Data collection without the voices of the participants themselves was performed due to the need for obtaining at least proxy data on the effect of targeted film clip to stimulate frail elderlies with dementia - also in a pandemic lockdown situation. Informed consent from all participants was obtained. Data and ethics approval was done in accordance with Danish law. RESULTS: Although the archive content was not targeted people with declining cognitive function, the staff assessed the effect of this pedagogical dissemination of well-designed film clip content, as very positive in relation to the participants with dementia. The sessions managed to stimulate engaging discussion and storytelling about the participant's own life in what can be described as deep memory recollections. Some instances of transference of new knowledge about life history to daily care of the participants were reported. CONCLUSION: The study instances that tailored archived film content can be used in professional person-centred care to stimulate memories of people with dementia and quality moments in participant`s daily life. © 2021 the Alzheimer's Association.

Perceptions of the European Space Sector: Youth Engagement With Space Education Events

Space education not only plays a key role in helping young people understand the natural world and their impact on the planet but is also vital in ensuring that future generations can make meaningful contributions to the space sector at all levels. Positive perceptions of the space sector can lead young people to take roles where they can contribute to new knowledge, develop new technologies, and tackle societal challenges. As the relationship between science and society is tested by global events-such as climate change and the COVID-19 pandemic-scientific trust and accountability have become topics of frequent and public debate. The way in which young people engage with space education and perceive their potential involvement with the space sector is of greater importance now than ever before. This paper describes a two-year European space education project that was carried out before and during the COVID-19 global pandemic. An evaluation of the project activities showed that young people are generally enthusiastic about space, but their perceptions of the European space sector-and their connections to it-are less positive. Recommendations are made on the challenges facing the space sector and how it needs to adapt to better support the development of a more inclusive space education community.

Household food security in the United States in 2020

This report provides statistics on food security in U.S. households throughout 2020 based on the Current Population Survey Food Security Supplement data collected in December 2020. An estimated 89.5 percent of U.S. households were food secure throughout the entire year in 2020, with access at all times to enough food for an active, healthy life for all household members. The remaining households (10.5 percent, unchanged from 10.5 percent in 2019) were food insecure at least some time during the year, including 3.9 percent with very low food security (not significantly different from 4.1 percent in 2019). Very low food security is the more severe range of food insecurity where one or more household members experienced reduced food intake and disrupted eating patterns at times during the year because of limited money and other resources for obtaining food. Although the prevalence of food insecurity and very low food security for all households remained unchanged from 2019, some subgroups experienced increases in food insecurity and very low food security. For example, among children, food insecurity and very low food security increased significantly from 2019. Children and adults were food insecure in 7.6 percent of U.S. households with children in 2020 (up from 6.5 percent in 2019);very low food security among children was 0.8 percent (up from 0.6 percent in 2019). In 2020, the typical food-secure household spent 18 percent more on food than the typical food-insecure household of the same size and household composition. About 55 percent of food-insecure households participated in one or more of the three largest Federal nutrition assistance programs: Supplemental Nutrition Assistance Program (SNAP, formerly food stamps);Special Supplemental Nutrition Program for Women, Infants, and Children (WIC);and the National School Lunch Program during the month prior to the 2020 survey. Because of the coronavirus (COVID-19) pandemic, USDA granted States significant program flexibilities and contingencies to serve nutrition assistance program participants. The prevalence of food insecurity in the 30-day period from mid-November to mid-December 2020 was 5.7 percent for the Nation. Food insecurity was substantially higher for households with a householder or reference person (an adult household member in whose name the housing unit is owned or rented) who was unable to work because of the pandemic (16.4 percent food insecure in the 30-day period from mid-November to mid-December 2020) and households with a reference person who was not employed and was prevented from looking for work because of the pandemic (20.4 percent food insecure in the same 30-day period).

Household food security in the United States in 2019

This report presents findings from data collected in December 2019 for the year that preceded the Coronavirus Disease (COVID-19) pandemic. An estimated 89.5 percent of U.S. households were food secure throughout the entire year in 2019, with access at all times to enough food for an active, healthy life for all household members. The remaining households (10.5 percent, down from 11.1 percent in 2018) were food insecure at least some time during the year, including 4.1 percent with very low food security (not significantly different from 4.3 percent in 2018). Very low food security is the more severe range of food insecurity where one or more household members experienced reduced food intake and disrupted eating patterns at times during the year because of limited money and other resources for obtaining food. Among children, changes from 2018 in food insecurity and very low food security were not statistically significant. Children and adults were food insecure in 6.5 percent of U.S. households with children in 2019;very low food security among children was 0.6 percent. In 2019, the typical food-secure household spent 24 percent more on food than the typical food-insecure household of the same size and household composition. About 58 percent of food-insecure households participated in one or more of the three largest Federal nutrition assistance programs: Supplemental Nutrition Assistance Program (SNAP, formerly food stamps);Special Supplemental Nutrition Program for Women, Infants, and Children (WIC);and the National School Lunch Program during the month prior to the 2019 survey.

Fighting Alcohol Craving Using Virtual Reality: the Role of Social Interaction

Craving is a cause of relapse in patients suffering from a substance use disorder. Cue-exposure therapy builds on eliciting feelings of craving in patients in safe and controlled environments to condition them to control these feelings. Different efficient and resource-friendly methods of eliciting craving exist, (such as written material, still pictures, etc.). However, these methods create knowledge and skill transfer gaps between therapy sessions and real life scenarios. Virtual reality allows more true-to-life experiences, and research demonstrates its capabilities in eliciting craving in patients. Studies have identified different environments that elicits craving, suggesting bars to be one of the most effective ones. Research also suggests the presence of others to be an effective method of eliciting craving in users. However, the effect of social interaction has not yet been explored. Therefore, this paper presents a virtual bar with the purpose to investigate whether social interaction affects alcohol craving in users. The VR intervention is designed with close cooperation with a psychiatrist experienced in working with individuals suffering from alcohol use disorder. In this paper, we present the designed and developed VR intervention and discuss how an experiment can be conducted after the COVID-19 shutdowns.

A Place for Space: The Shift to Online Space Education During a Global Pandemic

The COVID-19 global pandemic has transformed the relationship between science and society. The ensuing public health crisis has placed aspects of this relationship in harsh relief;perceptions of scientific credibility, risk, uncertainty, and democracy are all publicly debated in ways unforeseen before the pandemic. This unprecedented situation presents opportunities to reassess how certain disciplines contribute to the public understanding of science. Space education has long provided a lens through which people can consider the intersection of the natural world with society. Space science is critical to understanding how human activity and pollution affect global warming, which in turn, inextricably links it to perceptions of the natural world, environmental change, science communication, and public engagement. The pandemic has caused a dramatic shift in how space education projects connect with public audiences, with participation pivoting to online engagement. This transition, coupled with the renewed societal examination of trust in science, means that it is an ideal time for the field of space education to reflect on its development. Whether it evolves into its own distinct field, or remains an area that straddles disciplinary boundaries, such as science education, communication, and public engagement, are crucial considerations when scientific trust, accountability, and responsibility are in question. This paper describes the current state of space education, recent advances in the field, and relevant COVID-19 challenges. The experience of an international space education project in adapting to online engagement is recounted, and provides a perspective on potential future directions for the field. © Copyright © 2021 Roche, Bell, Hurley, D’Arcy, Owens, Jensen, Jensen, Gonzalez and Russo.

Impact of COVID-19 on delay in cancer diagnostic testing

Background: Early diagnosis is key to the best treatment options and possible outcomes for cancer patients. However, the COVID19 pandemic has put a heavy burden on the US healthcare system, causing hospitals and medical centers to stop or delay routine cancer screenings such as mammograms, pap tests, colonoscopies, CT scans and PSA assays. Subsequently, cancer diagnostic testing and cancer patient care have also been disrupted. Methods: To determine the extent of cancer diagnostic testing that was impacted during the COVID 19 pandemic in 2020, we analyzed the changes in cancer test volume at NeoGenomics Laboratories Inc. between 2019 and 2020, and especially between March and June 2020. Unique patient test counts were categorized by cancer types as determined by the diagnostic ICD 10 code C00-D49 (with a minimum of 100 tests in 2019). Results: Comparing test volumes in 2020 to 2019, an overall decrease in tests ordered in 2020 was seen for multiple cancers. These cancers include malignant neoplasms of breast (16%) and malignant neoplasm of bronchus and lung (19%), followed by malignant neoplasm of colon, polycythemia vera, and Hodgkin lymphoma. In addition, a decrease in benign cancers, and decreases in benign neoplasm of colon, rectum, anus and anal canal was observed. To determine if the US stay-at-home order implemented between March and early June 2020 had affected test volume, month-to-month comparison shows the greatest impact in test volume in malignant neoplasm of breast: a 28% decrease comparing April 2020 to April 2019, and a 32% decrease comparing May 2020 to May 2019. Similarly, a 24% and 33% decrease were seen in malignant neoplasm of bronchus and lung for the same months. Individual tests specific for breast and lung cancer also showed similar decreases: 49- 56% decrease for Breast Triple Stain (CK5 + p63 + CK 8/18), 11-41% decrease for ER test, and up to 39% decrease for HER2 diagnostic tests. Tests for ALK fusions for lung cancer showed decreases in test volume ranging from 15% to 30% during April, May and June 2020 as compared to 2019. Interestingly, we found that the total test volumes for each age group (increments of 10 up to age 80) decreased April and May 2020 as well, compared to April and May 2019. We did not see a difference in test volume decreases based on patient gender. Conclusions: There was a decrease in cancer tests ordered during the pandemic in 2020 for most cancer types, with a large decrease found in breast, lung and colon cancer. The sharp decrease in breast cancer tests is important to note as breast cancer has recently been identified as the most diagnosed form of cancer, surpassing lung cancer. This impact in cancer testing may translate to delayed diagnosis and treatment options. It remains to be seen whether this will lead to more aggressive cancer treatments, or to a greater patient mortality. It is imperative that we continue to monitor and screen patients for cancer as the pandemic continues or during any healthcare crisis in the future.

Impact of a Pandemic and Remote Learning on Team Development and Elements of Compassion in Prospective Medical Students Taking a Medical Humanities Course.

INTRODUCTION: We reported previously that when teams of students reflect on readings about communication, unconscious bias, and service-learning, their critical reflection, implicit bias mitigation, empathy, and compassionate behavior all increase. However, would these gains occur when intimate classroom settings, in-person team meetings, and direct interactions with people served were lost owing to the COVID-19 pandemic and remote learning? METHODS: Before an online Medical Humanities course began in August 2020 and following the course in December 2020, 61 prospective medical students (54.1% female) completed reliable surveys of their reflective capacity (RC) and cognitive empathy (compassion). Students also completed surveys about their implicit biases and team community service in December 2020. RESULTS: Both RC and empathy scores increased in students after they reflected on difficulties in communication, unconscious biases, and team service-learning experiences in the course. In written reflections, they reported how their compassionate behavior also grew owing to bias mitigation. Most students concurred that "unconscious bias might affect some of (their) clinical decisions or behaviors as a healthcare professional" and vowed to remain aware of these biases in clinical settings. CONCLUSIONS: Compared to previous years, the pandemic and remote learning had minimal effects on the benefits of our Medical Humanities course.

Edible insects unlikely to contribute to transmission of coronavirus SARS-CoV-2

In the context of food safety, edible insects are evaluated for biological hazards such as microbial pathogens according to regulations currently in place. When the European Food Safety Authority evaluated the hazards of edible insects as a potential source of pathogenic viruses for humans and livestock, the novel zoonotic coronavirus SARS-CoV-2 had not yet emerged but other pathogenic coronaviruses such as SARS (SARS-CoV) and MERS (MERS-CoV) were known. As a result of the COVID-19 pandemic, animal sources of protein for human consumption are being evaluated for the risks of being a transmission vector of coronaviruses, like SARS-CoV-2. Insects lack a receptor that can bind SARS-CoV-2, thus preventing the virus from replicating in insects, unlike some vertebrate livestock species and companion animals. Despite extensive monitoring, coronaviruses have never been recorded in insect microbiomes. Contamination of insects produced for food or feed may occur during the production process, resulting from rearing substrate or from insect farmers. However, the currently permitted rearing substrates do not include animal products and the farming process is highly automated, thus limiting interactions between farmers and insects. If contamination would still occur, the fact that the insects in production are not hosts to SARS-CoV-2 precludes virus replication and the further processing of the insects will destroy the contamination. We conclude that the hazard of edible insects being a transmission vector of SARS-CoV-2 is extremely low.