ABSTRACT
As a small group of academicians in a private medical university in Malaysia, we observed, in 2020, how the COVID-19 pandemic, changed our lives and the lives of our students. We would like to share our experiences in this commentary. It describes the contingency plans taken by the School of Medicine at International Medical University (IMU) to ensure that the delivery of the medical curriculum and its assessments has the best possible outcome in these tumultuous times, with plans to improve the delivery of teaching and learning, with an emphasis on technology-enhanced learning (TEL). We hope that this commentary is beneficial to those reading and that the contingency plans developed by IMU will help other institutions in the country and in this region navigate safely through the COVID-19 storm. © Malaysian Association of Education in Medicine and Health Sciences and Penerbit Universiti Sains Malaysia. 2023.
ABSTRACT
Hong Kong and South Korea have often been the regions best responded to the COVID-19 pandemic, especially through non-pharmaceutical measures, during the pandemic. However, both economies have encountered challenges in implementing the massive vaccination rollout. In this study, we examined how various factors behind their social settings from history, culture, economy, and politics have complexly intertwined with COVID-19 vaccination in similar and different ways in the two East Asia's developed economies. © TheEditor(s) (ifapplicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2021, 2022.
ABSTRACT
Objectives: Cardiac rehabilitation (CR) exercise classes in Singapore were either cancelled or suspended due to the ongoing COVID-19 pandemic. In response, a hybrid CR programme utilising telehealth was created to reduce reliance on in-person sessions. Our study aimed to assess early patients' impressions of this novel CR delivery method. Methods: Each hybrid CR programme comprises: (a) one CR orientation session via the Zoom video conferencing platform where patients interact with CR nurses and physiotherapists, (b) two 6-minute walk test fitness assessments (at baseline and upon completion), (c) five in-person supervised exercise classes and (d) two teleconsultation sessions (scheduled after exercise sessions 2 and 4) where CR physiotherapists review symptoms and discuss exercise prescriptions with patients over the phone. Upon programme completion, patients filled 2 anonymous online questionnaires - one assessing the videoconferencing component and another assessing the teleconsultation component and overall programme. Results: Seven patients underwent the hybrid CR programme. The majority were male (n=6, 86%), aged between 51 to 65 years (n=4, 57%) and had previously used a wide range of mobile applications (n=6, 86%). 100% of patients either agreed or strongly agreed that both videoconferencing and teleconsultation were: (a) easy to use, (b) as valuable as in-person sessions, (c) saved time and (d) had lower infection risk compared to in-person sessions (Figure). The overall ratings for videoconferencing, teleconsultation and the hybrid programme were 9.3, 9.6 and 9.6 (out of 10) respectively. All patients would definitely recommend the programme to others. Conclusion: Responses by participants of a novel hybrid CR programme utilising telehealth are highly encouraging. From a patient perspective, incorporation of telehealth to enable remote CR is feasible, acceptable and should be considered as an alternative CR delivery method.
ABSTRACT
Rationale: SARS-CoV-2, the virus that causes COVID-19, exhibits an ACE2-dependent airway epithelial tropism, and exploits host cell proteins to replicate and evade detection. The impact of asthma on COVID-19 susceptibility and severity is unclear. We sought to discover how genes encoding SARS-CoV-2-associated host proteins are expressed in primary human bronchial epithelial cells (HBECs), and how these genes are regulated by cytokines important in asthma. Methods: We compiled a list of 342 SARS-CoV-2-associated genes. We cultured primary HBECs at air-liquid interface in the absence of cytokine, or with interleukin (IL)-13, IL-17, interferon (IFN)-α, or IFN-γ. We used bulk RNA-seq and single cell RNA-sequencing to identify changes in gene expression. We correlated cytokine-regulated changes in SARS-CoV-2-associated transcripts on cytokine exposure in vitro with gene expression changes in transcriptomic profiling datasets derived from individuals with mild-to-moderate asthma and chronic obstructive pulmonary disease (COPD). Results: Transcripts encoding 332 of 342 (97%) SARS-CoV-2-associated proteins were detected in HBECs (≥1 RPM in 50% samples);85 (26%) were regulated by at least one cytokine (>1.5-fold change, FDR < 0.05). 21 and 19 of the 41 IL-13 responsive, SARS-CoV-2-associated genes identified in HBECs correlated with type 2 inflammatory gene signature scores in transcriptomic profiling datasets derived from individuals with mild-to-moderate asthma and COPD (p < 0.05);few IL-17 or interferon-responsive genes were correlated with their respective signatures in either dataset. Single cell RNA-sequencing revealed that 143 of the 332 (43%) SARS-CoV-2-associated transcripts detected in HBECs were differentially expressed between cell types (FDR < 0.05). 11 SARS-CoV-2-associated genes were modulated by IL-13 in a cell type-specific manner (>1.25-fold change, FDR < 0.05). Conclusions: Many genes encoding proteins associated with SARS-CoV-2 infection are expressed in HBECs, with substantial differences among cell subsets. IL-13 induces extensive changes in the expression of SARS-CoV-2-related genes that correlated with a measure of type-2 inflammation in vivo, providing a plausible basis for differences in outcome of COVID-19 in individuals with asthma.