Assessing the Zoom learning experience of the elderly under the effects of COVID in Hong Kong: application of the IPO model

PurposeThis study aims to investigate the perceptions of elderly learners in experiencing Zoom learning under the effects of COVID in the case of Hong Kong. Design/methodology/approachAn online survey and focus group interviews have been conducted with quantitative and qualitative approaches, respectively. The survey design was based on the input-process-output (IPO) model conceptual framework and used to assess students' perceptions regarding their Zoom learning experiences at the Elder Academy of Hong Kong Metropolitan University. Thereafter, selected students were invited to participate in focus group interviews to offer more in-depth comments for analysis purposes. Statistical Product and Service Solutions software and SmartPLS were used for data analysis of the survey, and content analysis was used to summarize opinions from the focus group interviews;thus, a comprehensive picture of elderly learners' learning experiences on Zoom is presented. FindingsAn overall positive perception was the result of elderly learners' Zoom learning journeys, particularly in the "input" and "process" stages of the IPO model. Yet, their perception of the "learning outcomes achieved" level in the "output" stage was lower among the rest, thus strongly affected by the factors of "interactions" and "teaching" experienced by elderly learners on Zoom. Although the perception of the youngest age group was more positive, none have agreed that Zoom learning was more favourable when compared with the traditional face-to-face mode. Originality/valueGiven Zoom as the short-term replacement option under the COVID pandemic, this study will provide recommendations for educators/institutions to improve their design of the whole learning process for elderly learners on the Zoom platform.

Interpreters' Resilience and Self-care During Pandemic Restrictions in Australia and New Zealand

The onset of the COVID-19 pandemic in 2020 brought about abrupt and lasting changes to the way community interpreting is organized and delivered in Australia and New Zealand. This paper reports on a qualitative study conducted among community interpreters in these two countries, especially those based in Auckland and Melbourne, as both cities went through several periods of strict lockdowns. The study attempts to understand the experiences of the interpreters working remotely or in-person between early 2020 and late 2021, focusing on how they coped with such significant challenges. The findings of the study point to practitioners' conscious efforts in their self-care behavior and resilience-building strategies, both of which were key to maintaining professional and personal wellbeing. It is argued that self-care practices should be embedded in pre-service training and professional development, and appropriate working conditions should be monitored on an ongoing basis. © 2022 International Association of Translation and Intercultural Studies. All rights reserved.

Mothers' Knowledge, Attitudes, and Perception Regarding Extended-Release Buprenorphine

Introduction: In the past two decades, the prevalence of opioid use disorder (OUD) among pregnant and postpartum individuals has quadrupled in the United States. Recent studies have suggested that extended-release buprenorphine (XR-BUP) may be an attractive option for pregnant and postpartum individuals with OUD. However, little is known about this population's awareness and understanding of this medication for opioid use disorder (MOUD). The purpose of this study was to explore pregnant and postpartum individuals' knowledge, attitudes, and perception regarding XR-BUP injection. Method(s): An anonymous paper-based survey was distributed to individuals with OUD attending a multi-disciplinary prenatal and postpartum specialty care clinic where XR-BUP is available. Participants' non-identifiable demographic and treatment characteristics, including duration and satisfaction of current MOUD, were collected. Participants' knowledge, attitudes, and perceptions about XR-BUP were assessed using a 5-point Likert scale. Descriptive statistics were used to summarize the data. Result(s): From February 2021-August 2021, a total of 79 respondents completed the survey, representing a response rate of 81% (79/98). The majority were 26-35 years old (87%), identified as Caucasian (84%), and had a high school degree or more (76%). Most (58%) were pregnant (10% first trimester, 31% second trimester, and 17% third trimester), and 42% were within one year of postpartum. More than nine out of ten respondents were currently taking MOUD: sublingual buprenorphine/naloxone (49%), methadone (28%), sublingual buprenorphine (6%), XR-BUP (9%), naltrexone injection (2%), or none (6.3%). Nearly half (53.2%) took their current OUD medication for six months or more, and practically two-thirds (64%) were either satisfied or very satisfied with the current MOUD. Almost half (49%) had never heard of XR-BUP, followed by 36% who heard about it from a health care provider and 24% from friends or family. Most (85%) did not personally know anyone taking XR-BUP. However, 46% were interested in starting an injectable medication for OUD to avoid trouble remembering to take daily medication, 44% were comfortable coming to the clinic for a monthly injection during the Covid-19 pandemic, and 29% were interested in XR-BUP to avoid daily withdrawal symptoms. One in eight respondents reported that pain from an injection site would discourage them from taking XR-BUP. Conclusion(s): In a population of pregnant and postpartum individuals, nearly half were unaware of a monthly XR-BUP option for MOUD, bu a sizeable proportion was interested in considering this medication. While XR-BUP is not currently recommended for pregnant individuals, future studies are needed to explore this option for postpartum individuals.

BLENDED LEARNING MODALITIES: EXAMINING THE STUDENTS’ COGNITIVE PERFORMANCE USING THE DIGITAL AND PRINTED MODULES

Pandemic has not only brought significant changes in the world’s economy. The educational sector has also made abrupt adjustments just to cater to the needs of learners. Among the solution that wasrealized in the Philippines was the implementation of the blended learning modality. Public schools prepared digital and printed copy of modules which will serve as the self-learning kit of the students when the face-to-face teaching was not possible due to the COVID 19 pandemic. Aligned to this context, the present study aimed to gauge the cognitive performance of the students and to know the extent of the usage of digital and printed modules. Utilizing a quantitative approach, the data revealed that the Senior High school students showed similar extent of using the digital and printed module during the implementation of the blended learning modalities. Both were extensively utilized by the respondents. This explains that student’s agreement on the usage of digital copy of the module may be because of their ability on the digital technologies, the availability of gadgets and the internet connectivity knowing for a fact that the research locale is a highly urbanized city. Therefore, the study recommends t hat teachers may consi der the preference of st udent s whether to use di gi tal, pri nted modul e or whatever modal i t i es that are appropri ate to the l earni ng scheme of the st udents.

SIMPLE RNA EXTRACTION METHOD FOR REVERSE TRANSCRIPTION LOOP-MEDIATED AMPLIFICATION DETECTION OF SARS-COV-2

Reverse transcription loop-mediated isothermal amplification (RT-LAMP) is a robust and cost-effective assay for rapid diagnosis of SARS-CoV-2 compared to reverse transcription quantitative (RT-q) PCR. The study evaluated the performance of RT-LAMP technique that incorporated a simple Chelex 100 resin-based RNA extraction step for SARS-CoV-2 detection targeting virus E (encoding envelope protein) and RdRP (encoding RNA-dependent RNA polymerase). Using primer sets for E and RdRP, the developed RT-LAMP assay had a limit of detection (LOD) of 1 copy/µl transcribed RNA. For nasopharyngeal and oropharyngeal swab samples (n = 58), in comparison to the gold standard RT-qPCR (amplifying E and RdRP) sensitivity, specificity, positive predictive value, and negative predictive value of SARS-CoV-2 RT-LAMP assay targeting E gene was 88% (95% confidence interval (CI): 75-96%), 87% (95% CI: 59-98%), 99% (95% CI: 97-100%), and 28% (95% CI: 14-48%), respectively and for RdRP gene was 67% (95% CI: 51-98%), 87% (95% CI: 59-98%), 100% (95% CI: 96-100%), and 12% (95% CI: 8-18%), respectively. The whole process of RT-LAMP assay was completed within ~60 minutes. This developed RT-LAMP method for on-site COVID-19 detection should be useful in resource limited settings. © 2022, SEAMEO TROPMED Network. All rights reserved.

CD64 GENE-MODIFIED PRIMARY NK CELLS LOADED with ANTI-HIV bNAbs TRIGGER HIGH ADCC

Background: As part of a combined HIV CURE immuno-therapy strategy, we transduced primary human NK cells with the high affinity CD64 Fc receptor and pre-loaded them with HIV-specific bNAbs. We named these chimeric NK cells "NuKES" (NK Enhancement Strategy) for their augmented capacity to mediate ADCC and their potential clinical application as an autologous primary NK cell immuno-therapy against HIV. Methods: We transduced primary NK cells from control donors with a lentivirus expressing human CD64 in the presence or absence of irradiated K562 feeder cells expressing co-stimulatory molecules (CD40, 4-1BB) and/or cytokine pre-stimulation (IL-2, IL-21, IL-15). CD64 expressing NK cells were CFSE labeled and expanded ex vivo or FACS sorted at various times post transduction to high purity. CD64 expressing NK cells were then pre-loaded with HIV-specific bNAbs and tested in a functional ADCC CD107a degranulation assay against HIV-1 infected autologous CD4+ primary T cells. Results: After pre-stimulation with cytokines and/or irradiated K562 Feeder Cells, we could routinely achieve (n=5) greater than 40% CD64 expression in primary human NK cells (Day 14 post-transduction shown in Figure 1A). NK cells maintained strong proliferation potential with greater than 6 cells divisions beyond 10 days post transduction as determined by CFSE dilution (Day 10 post-transduction shown in Figure 1B). Phenotypically, CD64 transduced NK cells were similar to control NK cells and possessed strong expression of CD56, CD16, CD69 with intermediate levels of the NK maturation marker CD57. CD64 transduced NK cells could be successfully pre-loaded with HIV-specific bNAbs and possessed an enhanced capacity (GMFI of 2,014 versus 276) to retain 10-1074 for several hours as compared to control NK cells (Figure 1C). Functionally, CD64 transduced NK cells showed a significant two-fold increase in ADCC-triggered degranulation capacity against autologous HIV-1 infected CD4+ primary T cells compared to control NK cells after pre-loading with HIV-specific bNAbs (27.6% versus 13.2% CD107a). Conclusion: Primary human NK cells can be successfully transduced with CD64 and expanded ex vivo to high purity. Preparation of bNAbs specific NuKES represent a viable autologous NK immuno-therapy approach against HIV-1 with potential adaptation for added disease targets (i.e., COVID, Cancer) moving forward.

TranScent in Stillness: Exploring the Feasibility of Using Incense Art with Virtual Reality for Meditation

The need of supporting meditation through digital technology has been increased especially after COVID-19. By combining the olfactory experience provided by the ambient incense connected with virtual reality technology, we propose to bring the aesthetic and affective aspects of smell to the users for meditation in the digital era. TranScent aims to provide users a hybrid composition of sensory experiences that transcends the spatial and temporal characteristics in their surroundings. It lets the users meditate with the incense burnt in the real world while immersing in the audiovisual virtual environment. Rather than emphasizing on the mobility in fast pace, it focuses on giving users the stillness atmosphere for meditation practice through olfactory art with virtual reality. © 2021 Copyright held by the owner/author(s). Publication rights licensed to ACM.

A human pluripotent stem cell-based model of SARS-CoV-2 infection reveals an ACE2-independent inflammatory activation of vascular endothelial cells through TLR4.

To date, the direct causative mechanism of SARS-CoV-2-induced endotheliitis remains unclear. Here, we report that human ECs barely express surface ACE2, and ECs express less intracellular ACE2 than non-ECs of the lungs. We ectopically expressed ACE2 in hESC-ECs to model SARS-CoV-2 infection. ACE2-deficient ECs are resistant to the infection but are more activated than ACE2-expressing ones. The virus directly induces endothelial activation by increasing monocyte adhesion, NO production, and enhanced phosphorylation of p38 mitogen-associated protein kinase (MAPK), NF-κB, and eNOS in ACE2-expressing and -deficient ECs. ACE2-deficient ECs respond to SARS-CoV-2 through TLR4 as treatment with its antagonist inhibits p38 MAPK/NF-κB/ interleukin-1ß (IL-1ß) activation after viral exposure. Genome-wide, single-cell RNA-seq analyses further confirm activation of the TLR4/MAPK14/RELA/IL-1ß axis in circulating ECs of mild and severe COVID-19 patients. Circulating ECs could serve as biomarkers for indicating patients with endotheliitis. Together, our findings support a direct role for SARS-CoV-2 in mediating endothelial inflammation in an ACE2-dependent or -independent manner.

Evolution of viruses and the emergence of SARS-CoV-2 variants

Life implies adaptation. This is one of the fundamental principles that has permitted most living species to survive through ages in an ever-changing environment. Spontaneously occurring events have shaped also virus populations and their fitness. Thanks to their plasticity, viruses have thrived in extremely dissimilar conditions. Unsurprisingly, SARS-CoV-2, the etiological agent of COVID-19, is no exception. Thanks to an unprecedented rate of molecular tracing and sequence scrutiny, the virus was followed in all its changes and shown to evolve in such a way as to possibly determine subsequent waves of infection after the first global and massive outbreak. This review illustrates the major modifications occurred to the virus since its discovery. We describe the potential advantages that these changes conveyed as regards SARS-CoV-2 transmissibility, resistance to host innate and adaptive barriers and molecular diagnosis.

Curating pandemic contingencies: Remote collaboration and display reconfiguration in practice

Amid the restrictions on travelling and gathering imposed during the COVID-19 pandemic, exhibitions with international collaborations in Hong Kong experimented with curating across borders and time. This article examines recent curatorial practices in Hong Kong's art institutions, particularly relating to site-specific installations and performances that had to cope with the artist's physical absence and institutional restrictions. Two site- specific art -commissions - Shirley Tse's Negotiated Differences (2020), installed at the M+ Pavilion, and Eisa Jocson's Zoo (2020), performed at Tai Kwun Contemporary serve as cases in point illustrating how curatorial practices enabled remote collaboration and display reconfiguration to address authorial absence and institutional interventions during the installation and exhibition phases due to the pandemic. The former case study decentralized the authorial control of artistic criticality from the artist to a collective curation and installation process, while the latter evolved in accordance with protean institutional and social contexts by actively changing the display during the exhibition. Despite the pandemic-imposed separation and restrictions, these two case studies shed light on how curators collaborated with artists and participants across distance and time, actively and flexibly forging responsive and relevant connections between site-specific artworks and the immediate present. Their curatorial practices as artistic mediation - complicated the conceptual framework of artworks and exhibitions through co-curation and co-production with artists, thus lending a collaborative dimension to the model of exhibition-making and the role of the curator as the 'curator-as-artist'.

Impaired aminotransferase levels in long COVID-19 are associated with pro-inflammatory interleukin 8 (il-8) and vital neutrophil extracellular traps (netosis)

Background: The new coronavirus-19 (COVID-19) disease has been associated with a persistent symptomatic state after the acute phase, called Long COVID-19. This study aimed to find liver effects and their association with pro-inflammatory cytokines and percentage (%) of neutrophil extracellular traps (NETosis) in this stage Methods: Prospective, observational study including symptomatic subjects four months after COVID-19 diagnosis. Clinical, demographic, anthropometry data, and blood samples were collected at enrollment time. Non-contrast computed tomography of chest and abdomen was performed, and fatty liver was defined as liver attenuation <40 Hounsfield units. Alanine aminotransferase [ALT], aspartate aminotransferase [AST], glycemic and insulin blood levels were obtained. Interleukine (IL)-1β, IL-6, IL-8, IL-12, and Tumor necrosis factor (TNF-a) levels were measured in blood samples using flow cytometry. % of vital NETosis was measured in freshly isolated neutrophils using SYTOX and LIVE/DEAD dye correlated, ex vivo, with circulating cytokine levels. Continuous variables were analyzed by U de Mann-Whitney and nominal variables by Fisheŕs test. A logistic regression model analyzed the clinical association between liver attenuation. We evaluated the correlation between ALT, AST, cytokines, and NETosis using a linear model Results: 60 subjects were enrolled. The age average was 46.4 years old (standard deviation[SD]±13.1), and 32/60 (53.3%) were male. 25/60 (41.6%) reported severe COVID-19 during the acute phase. The prevalence of fatty liver was 17/60 (28.3%). 6 out of these 17 subjects had fatty liver before their COVID-19 diagnosis. Fatty liver was associated with high body mass index (p=0.02), waist circumference (p=0,01), insulin resistant (p=0,003), severe COVID-19 during acute phase (p=0,04), higher ALT (p<0.01), AST (p<0.01), IL-6 (p=0.02) and IL-12 (p=0.03). 12/60 (20%) patients had ALT elevation, although most of them, 8/12 (66.6%), did not have fatty liver. Both ALT and AST were correlated to IL-8 levels (R2=0.158, p<0.01), and IL-8 levels were significant correlated with % vital NETosis (R2=0.068, p=0.04) Conclusion: Fatty liver is prevalent and associated with severe COVID-19 during the acute phase and associated with high ALT, AST, IL-6, and IL-12 levels during the long COVID-19 phase. However, the ALT, AST and IL-8 elevations in the long COVID-19 might not be necessarily related to fatty liver. Therefore, the association between IL-8 and vital NETosis could be a possible pathway.

Virtual vision outreach program: Give kids sight day (GKSD) 2020

Purpose : Give Kids Sight Day is an annual free outreach program in Philadelphia region, targeting low-income and underinsured communities. In 2020, a novel virtual screening program was conducted to face the challenges presented by the COVID19 pandemic. Continual innovation in vision screening methods is necessary to help reduce rates of blindness and visual impairment in children and adolescents. We performed a retrospective chart review to describe the outcomes of this new program. Methods : Families to be screened were sent a packet with an eye chart and a 5-foot string, as well as instructions. On GKSD, screeners called the families and instructed the adults through screening the children over the phone. Results were collected and children who failed screening were sent to Wills Eye Hospital for an in-person appointment for rescreening and evaluation. After the Wills Eye Hospital Institutional Review Board approved this study, registration forms and clinical charts of all patients who attended GKSD 2020 were reviewed retrospectively. Demographic characteristics and ophthalmic findings were analyzed. Visual acuity on virtual screening was compared with in-person vision testing using Pearson correlation coefficient. Further subgroup analysis is being conducted at the time of abstract submission. Results : Four hundred and seventy five children registered for virtual vision screening. Consequently, 151 children (43% female;27% speaking languages other than English) with median age 11 years (age range 5-17 years) who failed screening received in-person evaluation. Out of these, 19% children underwent an eye exam for the first time. Refractive errors correctable with glasses were seen in 88%;30 children with other diagnoses were referred to pediatric ophthalmology for further evaluation and management. There was a moderate correlation between screening and in-person visual acuity without refractive correction (R= 0.66 OD, 0.58 OS);and a strong correlation between screening and inperson visual acuity with refractive correction (R= 0.76 OD, 0.91 OS). Conclusions : The GKSD virtual visual acuity testing demonstrated good correlation with in-person visual acuity testing, supporting the virtual screening approach as a useful tool for future applications in vision outreach programs.

High median nerve lesion secondary to severe giant cell arteritis (GCA)

Background: Giant cell arteritis (GCA) is a systemic vasculitis affecting large to medium-sized vessels. Cranial nerve lesions are frequently documented secondary to GCA, however peripheral nerves are rarely involved. Objectives: We present an unusual case of a GCA-associated isolated high median nerve palsy. Methods: Case report. Results: A 76 year old white British female presented in Spain with three weeks of frontotemporal headaches, mandibular claudication, photopsia and constitutional symptoms, followed by acute-onset right hand paresis and dysaesthesia. Acute-phase reactants were elevated. COVID-19 PCR was negative. Shortly after admission she developed acute bilateral anterior ischaemic optic neuropathy and tongue necrosis with autoamputation. Temporal artery ultrasound and biopsy confirmed GCA. PET-CT showed no evidence of a diffuse large-vessel vasculitis. She was repatriated to the UK for ongoing inpatient care. Upper limb neurophysiology two months later demonstrated an isolated right high median nerve lesion, with reduced median motor responses and absent sensory responses with denervation in extensor carpi radialis. Imaging excluded a central lesion. The timing of her symptoms suggested the lesion was secondary to GCA. Treatment was with tocilizumab, methotrexate and tapering corticosteroids, alongside PEG feeding and careful multi-disciplinary rehabilitation. Conclusion: We suggest there are two important learning points from this complex case. Firstly, peripheral nerve lesions can occur in GCA, although they are rare. A literature search identified a modest number of case reports of brachial plexus or lower cervical nerve lesions1,2. Neurologic manifestations in GCA are attributed to vasculitis of the vasa nervorum, or extension of inflammation from arteries to contiguous nerves1,2. The restriction of clinical involvement to the median nerve alone would appear to favour the former mechanism. Functional recovery of neurological deficits is typically partial at best. Secondly, this case highlights the difficulty faced by clinicians in recognising GCA and the importance of urgent treatment with glucocorticoids. The patient developed GCA during the ongoing COVID-19 pandemic when Spain was the second-worst affected European country (5% seroprevalence;95% CI 4.7-5.4)3. The partial overlap in symptoms between GCA and COVID-19 (e.g. headache, pyrexia, malaise, elevated acute-phase reactants) can cause diagnostic confusion and treatment delay4. GCA should be considered in the differential diagnosis of older patients with suspected COVID-19, or the non-specifically unwell elderly patient.

The impact of hepatic steatosis on COVID-19 related outcomes

Background: Metabolic factors, such as diabetes, portend an increased risk of adverse outcomes in patients with COVID-19 We evaluated the association of radiographic hepatic steatosis with length of stay (LOS), need for intensive care unit (ICU), and mortality in patients admitted with COVID-19 Methods: We retrospectively identified a cohort of patients with COVID-19 admitted to two US medical centers from March 1, 2020 to June 22, 2020 All patients with abdominal imaging (computed tomography, magnetic resonance imaging, or ultrasound) within the last year were eligible Patient demographics, body mass index (BMI), comorbidities, baseline and admission laboratory values were collected Statistical comparisons were made using Mann- Whitney U-test for continuous measures and Chi-square and Fisher's exact test for categorical measures Multivariable linear and Adjusted covariates included age, sex, hemoglobin A1c, admission ALT, admission albumin, type of imaging, andpresence of chronic liver disease and heart disease Results: A total of 319 eligible patients (50% women and mean age of 63.7) were identified. 14% of patients had radiographic steatosis. There were no significant differences among age, race, BMI, or presence of diabetes or heart disease between those with steatosis and those without However, patients with steatosis had more chronic liver disease (40% vs 23%, p=0 02) and higher baseline ALT levels (28 IU/L vs 17 IU/L, p=0 002), but not more cirrhosis (12 8% vs 15 6%, p=0 63) The median LOS in those with steatosis was 6 1 days (4- 16), while 9 days (4-18) for those without steatosis (p=0 6) The need for ICU (24 4% vs 32 1%, p=0 3) and mortality rate (6.7% vs 16.5%, p=0.12) were not significantly different. On multivariable analysis, there was no difference in hospital LOS in those with steatosis compared to those without (b: -16 97, 95% CI: -35-1 05, P-value=0 06) Additionally, there was no difference in need for ICU care (OR: 0 19, 95% CI: 0 01-2 44, P-value=0 19) or mortality rates (OR: 1 4, 95% CI: 0 07-26 9, P-value=0 8) between the two groups on multivariable analysis Conclusion: Among patients with COVID-19 admitted to the hospital, those with radiographic hepatic steatosis do not have worse outcomes as measured by LOS, need for ICU, or in-hospital mortality Larger samples with more precise staging of liver disease may be required to identify subtle differences, if present.