Investigation of the Radiographer's adherence and compliance with radiation protection and infection control practices during COVID-19 mobile radiography.

Radiological staff, especially radiographers, work as front liners against the COVID-19 outbreak. This study aims to assess compliance with radiation protection and infection control practices during COVID-19 mobile radiography procedures. This cross-sectional study included 234 radiographers (females, 56%, n = 131; males, 44%, n = 103) who were asked to complete an online questionnaire consisting of demographic data, radiation protection and infection control practices during COVID-19 portable cases, and knowledge and awareness. After informed consent was completed, SPSS statistical software was used for the data analysis. The most common age group of participants ranged from 18 to 25 years old (30.3%, n = 71). Bachelor's degree holders were 74.4% (n = 174). Most radiographers (39.7%, n = 93) had a working experience of 1-5 years, followed by 27.8% (n = 65) with more than 16 years of experience. Most respondents (62.4%, n = 146) handled approximately 1-5 cases daily, the majority of them (56%, n = 131) stated affirmatively they had obtained special training to handle COVID-19, and when inquired if they had received any special allowances for handling COVID-19 suspected/confirmed cases most of them stated negative (73.9%, n = 173). Most participants stated that they always wear a TLD during portable cases (67.1%, n = 157) and a lead apron (51.7%, n = 121). Around 73% (n = 171) knew the latest information on COVID-19 and attended the COVID-19 awareness course. A significant association was found between the work experience of the radiographers and their responses to following the best practices (p = 0.018, α = 0.05). Radiographers who had COVID-19 training (µ = 48.78) tend to adhere more to best practices than those who have not (p = 0.04, α = 0.05). Further, respondents who handled more than 16/more COVID-19 suspected/confirmed cases followed the best practices more (µ = 50.38) than those who handled less (p = 0.04, α = 0.05). This study revealed detailed information on radiation protection and infection control practices during COVID-19 mobile radiography. It has been observed that the participants/radiographers have good knowledge and awareness of radiation protection and infection-control practices. The present results may be used to plan future requirements regarding resources and training to ensure patient safety.

Development of Wasted Non-woven Fabric Mask (NFM) Disposal Machine

Since the outbreak of the Covid-19 pandemic, masks have been widely used as a personal protective equipment (PPE) to prevent respiratory infection. A major type of masks used is non-woven fabric mask (NFM), which is currently classified as domestic waste and mostly disposed to general rubbish bins then eventually sent to the already saturating landfills. Moreover, the contaminated NFM is not disinfected properly during the disposal, which increases the risks of viral transmission and pollutes the environment. To alleviate the existing pressure to the environment, the amount of used NFM being disposed to landfills should be reduced. This paper studied the feasibility of recycling the used NFM and developed a prototype of disposal machine as the primary recycling process. By inserting the used NFM into the disposal machine, the masks can be shredded, disinfected and packed for further recycling processes. © 2022 IEEE.

A Community-Designed Qr Code-Based Animation Helps Patients Prepare for Endoscopies

Aim: Conventionally, patients are gathered to watch an introductory video at the clinic before endoscopic investigations take place. This may arouse practical issues under the COVID pandemic. Our centre, in collaboration with students from a local secondary school, has designed a set of animations which patients can easily access to with a QR code using their own mobile devices, so as to avoid patient gathering and increase their flexibility to read the information. This study aims to evaluate patients' perception of the QR code-based introductory animations of esophagogastroduodenoscopy (OGD) and colonoscopy (CLN). Method(s): A QR code linking to the animation was attached to the appointment sheet. Patients were asked to watch the animation with their own mobile devices before the endoscopy. A questionnaire with 5 questions was distributed after completion of their procedures. Result(s): A total of 144 patients undergoing OGD and CLN were recruited in May-June, 2022 at Tin Shui Wai Hospital. The response rate was 91.7%. Positive feedback was received. 12 patients (8.3%) did not gain access to the animation. A majority of patients agreed or totally agreed that the animation offered them more flexibility to understand the procedures before their OGD (75.4%) and CLN (79.1%). The QR code-based animation was deemed easy-to-use (80.3%), appealing (78.0%) and educational (81.0%). Conclusion(s): With increasing accessibility to mobile devices, patient education in preparation for medical procedures is no longer confined to the hospital setting. QR code-based animation is shown to be an effective and welcoming tool to prepare patients for endoscopies.

Preliminary Design and Implementation Discussion of Low Latency Live Video Web Streaming Engine

The threat of COVID-19 maximizes the demands for live video streaming. How to provide a video streaming service with low latency becomes one urgent and necessary research issue. This paper would survey and discuss the critical factors to impact transmission latency from the perspective of software implementation of a web streaming engine. Based on the initial experiment, the proposed live video web streaming engine can achieve under 3-second latency. © 2022 IEEE.

Addressing Cancer Readmission Prediction Model Drift: A Case Study

The cancer readmission prediction model classifies patients as high-risk or low-risk for readmittance. Consequently, intervention strategies focus on high-risk patients. Nevertheless, the performance of machine learning models generally degrades over time due to changes in the environment that violates models' assumptions, which include statistical data changes and process changes. This research introduces a framework that improves the sensitivity of the cancer readmission prediction model by identifying new features of cancer readmission, such as Diabetes and Anti-Nausea, which potentially cause the model's sensitivity to drift. The proposed model considers these 20 new factors with the 35 original factors that use the most recent dataset to predict cancer readmissions. Recursive feature elimination was used to identify key features. Some of the most popular classification algorithms, which include logistic regression and adaptive boosting, were used to retrain and classify cancer readmissions. The best algorithm was validated on a new dataset that was collected over 11 months, which covered three different waves of Covid-19. The results suggested K-Nearest Neighbors (KNN) algorithm performs the best among all eight studied algorithms. The KNN model incorporated new dominant features that did not exist in the original Random Forest (RF) model. The KNN model has an improvement of 8.05% in sensitivity compared to the RF model. The presence of Covid-19 does not have a significant impact on the performance of the KNN model. The suggested framework identifies potential admitted patients for intervention actions, helps reduce cancer readmission rates, costs, and improves the quality of care for cancer patients. © 2022 IISE Annual Conference and Expo 2022. All rights reserved.

COVID-19 vaccine humoral response and treatment effect in patients with hematologic malignancy

Background: Patients with hematologic malignancies have a lower vaccine response and higher rates for SARS CoV-2 morbidity and mortality. We present preliminary data focusing on humoral vaccine responses and correlates with disease subtype and treatment exposure. Methods: We analyzed data from 332 patients with a hematologic malignancy from May 1, 2021 - Jan 31, 2022 who received SARSCoV-2 vaccination and performed a prospective cohort serologic study with the Elecsys®Anti-SARSCoV-2-S test. Patients received homologous or heterologous vaccine combination of BNT162b2, mRNA1273, ChAdOx1 nCoV-19, and/or Ad26.COV2.S. Blood samples were obtained before any vaccination, 2-6 weeks after the second vaccine (2V), before third vaccine (3V), and 2-6 weeks after 3V. Results: The median age was 67 years (range 18-91years) with 41.9% female. At 2V, 11.5% and at 3V, 23.8% received heterologous vaccines. Treatment status at first vaccine dose significantly affected peak 2V antibody response (p < 0.05). Seropositive rate and median antibody titer after 2V for previously untreated patients were higher compared to patients on active therapy or had previously been treated. Treatment naïve (n = 60;seropositivity 85.1%;median titer 1306 U/mL;[Q1-Q3:11.4-> 2499]);first-line (1L) active therapy (n = 127;65.4%;41.25 U/mL;[ < 0.8-592.5]);second-line and beyond (2L+) active therapy (n = 56;60.7%;2.6U/mL;[ < 0.8-154]);previous treatment with 1L (n = 66;64.8%;118 U/mL;[ < 0.8-> 2499]);previous treatment with 2L+ (n = 23;59.1%;4U/mL;[ < 0.8-229.5]). Of 61 patients that were seronegative at 2V, 17 (27.9%) seroconverted after 3V. Anti-CD20 monoclonal antibody (mAb) containing therapy as the most recent treatment from 2V had the greatest impact on humoral response. Exposure to anti-CD20 mAb based regimens or as monotherapy revealed low antibody responses (n = 84;seropositivity 22.6%;median titer < 0.8 U/mL;Q1-Q3 [ < 0.8-< 0.8]). On analysis of indolent B-cell Non-Hodgkin Lymphomas whereby antiCD-20 mAb are often incorporated, treatment proximity to 2V impacted responses: < 3 months (n = 33;22%;< 0.8 U/ mL;[ < 0.8-< 0.8]) vs. 12-24 months (n = 4;60%;228 U/mL;[ < 0.8-232]). In contrast, tyrosine kinase inhibitor (n = 38;100%;858 U/mL;[221-> 2499]), proteosome inhibitor monotherapy (n = 4;100%;median titer 1520 U/mL;[462-> 2499]) were among the subgroups with the highest numerical responses, however, the addition of corticosteroids impacted vaccine response as seen in proteosome inhibitor with corticosteroids (n = 7;85.7%;6.6 U/mL;[1.8-115.2]). Conclusions: The humoral response from our single institution cohort identifies diminished responses depending on treatment status and the type of treatment including the proximity of treatment exposure to receipt of vaccination. Furthermore, vaccine boosters can induce antibody responses in patients who were previously seronegative.

During and After COVID-19: The Roles and Perceived Benefits of Virtual Initiatives in Building Resilient Global Health Partnerships

Background: Global Health Partnerships (GHPs) represent collaborative efforts towards training, research, and capacity building. Virtual GHP initiatives (VGHPIs) evolved to ensure GHP continuity during the COVID-19 pandemic, however, the current VGHPI landscape is unknown. This study aimed to increase understanding of the existing GHPs' perspectives on VGHPIs to inform future approaches for re-organization and reprioritization of GH activities. Methods: From 15 October to 30 November 2020, authors conducted an online, international survey using snowball sampling to assess pandemic-related changes in activities and document perceived acceptability and barriers to VGHPIs. Analysis stratified responses by country income classification and GHP type. The authors described categorical and continuous data using descriptive statistics. Chisquare tests were used to analyze categorical variables, with alpha set at 0.05. Results: A total of 128 respondents described 219 GHPs, with 82/128 (64%) responding to >1 GHP. Most GHPs (152/219, 69%) were transnational, of >5 years duration (157/219, 72%) and with bidirectional site visits (127/219, 60%);with HIC partners sending significantly more learners to LMIC partner sites (P = 0.0098). Within GHPs, respondents reported the pandemic was a significant disruptor to communication (122/219, 56%), funding (71/219, 32%), activities (195/219, 89%), and access to professional support (73/219, 33%). While 84/219 (38%) of GHPs described VGHPIs prior to the pandemic, respondents indicated that VGHPIs would be important to the majority (206/219, 94%) of GHPs moving forward. Available resources for VGHPIs were significantly different between LMIC and HIC respondents, as were their preference for VGHPIs, technological capacity, and acceptability of VGHPIs (P < 0.0001). There was no significant difference between groups regarding VGHPIs' perceived barriers. Conclusion: The pandemic disrupted many essential GHP elements, compounding on differences in the resources and preferences for VGHPIs between LMIC and HIC. VGHPIs have the potential to bridge existing gaps and maximize gains, bi-directionality, and equity of GHPs during and after COVID-19.

A National Survey Evaluating the Impact of the COVID-19 Pandemic on Medical Students Pursuing Careers in Neurosurgery

INTRODUCTION: The COVID-19 pandemic has significantly disrupted medical students (MSs)' educational experience, and this has unclear implications for those pursuing careers in neurosurgery. METHODS: A cross-sectional, online survey was distributed to MSs and foreign medical graduates (FMGs) residing in the United States who are considering or pursuing careers in neurosurgery. Descriptive statistics comparing MS years were performed. RESULTS: A total of 379 respondents from 67 medical schools completed the survey. Across all participants, 92% (n = 347) have stopped in-person didactic education, and 43% (n = 161) have experienced basic science and 44% (n = 167) clinical research delays. Sixty percent (n = 227) cite a negative impact on academic productivity. Among first year medical students (MS1s), 18% (n = 17) are less likely to pursue a career in neurosurgery. Over half of MS2s and MS3s are likely to delay taking the United States Medical Licensing Examination (USMLE) Steps I and II. Among MS3s, 77% (n = 91) report indefinite postponement of sub-internships, and 43% (n = 53) are unsatisfied with communication from external programs. Many MS4s (50%, n = 17) are graduating early to participate in COVID-19-related patient care. The top student-requested support activities included access to studentfocused educational webinars and studentfocused sessions at upcoming neurosurgical conferences. CONCLUSION: Medical students pursuing careers in neurosurgery have unique academic, career, and personal challenges secondary to the pandemic. These challenges may become opportunities for new initiatives guided by organized neurosurgery and residency programs.

Informal care in Australia during the COVID-19 pandemic

Australia has been less impacted by COVID-19 than most other countries, partly due to strong preventive responses by government. While these measures have resulted in lower rates of infection, family and friend carers have been disproportionately affected by public health orders. The heightened risk of transmission to vulnerable populations, combined with the impact of economic uncertainty, unclear government communication, significant restrictions on movement and personal contact, and the reduction in formal support services, have highlighted pre-existing, systemic shortcomings in support for carers. The COVID-19 pandemic left many carers more stressed, isolated and worse off financially.

Rivaroxaban for Improvement in Thromboembolism Outcomes in Patients with Multiple Myeloma on Lenalidomide-Based Therapy: The Rithmm Feasibility Pilot Trial

Introduction:The association between thrombosis (TE) and cancer has been well established. The risk for thrombosis in Multiple Myeloma (MM) is further compounded by therapy-related factors, which increase the risk for both arterial and venous TE. Lenalidomide + dexamethasone (Ld) is the most widely used backbone therapy for MM and may increase the risk of TE. The current standard TE prophylaxis for patients on Ld is low dose aspirin (ASA) for low risk patients or low molecular weight heparin for high risk patients. Direct oral anticoagulants have been used empirically and have been evaluated in small prospective cohort studies with promising results. Methods: RithMM is an ongoing open label Canadian multicenter pilot feasibility RCT to assess the efficacy and safety of daily oral rivaroxaban 10 mg (Riva) versus ASA 81 mg in patients with MM on Ld-based therapy. Our primary objective is to assess the feasibility of accrual of patients with MM starting on Ld-based therapy. Patients not on therapeutic anticoagulation or antiplatelet agents for another indication (e.g. atrial fibrillation) are eligible for RithMM. Primary clinical endpoints are major cardiovascular (CV) events or major bleeding as per the ISTH criteria. The study will be considered feasible if 86 patients in 4 Canadian sites (London, Ottawa, Halifax, Niagara) can be enrolled in 12 months after each site activation. Sites are expected to accrue an average of 1.8 patients per month. Patients are randomly assigned to receive ASA (control) or Riva (intervention) using a simple randomization sequence run by the Redcap system, utilizing an automated assignment procedure. Patients enter the study at the time of anticoagulant initiation and are followed for 6 months, or until they withdraw from the study;die or develop a primary clinical outcome;whichever comes first. Herein we present the interim analysis of RithMM after study completion in 2 of 4 sites. Feasibility assessment: 17 patients were randomized to ASA and 17 to Riva (1 patient did not take the study drug). Feasibility assessment was severely impacted by the temporary but prolonged research activity closures secondary to the COVID-19 pandemic that limited direct patient accrual and led to significant delays in REB approval of the participating sites. The first patient was enrolled in January 2019 in London. Ottawa opened in October 2019, Halifax in December 2020 and Niagara in May 2021. A total of 34 patients have been enrolled: 22 London, 11 Ottawa and 2 Halifax. London was the only site actively accruing for 12 consecutive months. Ottawa opened for 3 months, held accrual for 9 months, then reopened for 7 months. Halifax was open for only 1 month. Niagara opened in May 2021, the time of study data lock for this . In addition, 7 potentially eligible patients were not screened given that they were enrolled in a MM treatment trial that did not permit enrolment in another trial. The accrual rate was excellent for London (105%) and Ottawa (52% in 10 months). The drop-out rate was 6% (2 patients) and drug compliance 100%. Clinical Outcomes: Baseline characteristics are depicted in the table. One patient in the ASA arm developed a proximal deep vein thrombosis 2 months after starting treatment, and another developed a clinically relevant nonmajor bleeding 6 weeks after starting ASA. Discussion: This is the interim analysis of the RithMM pilot trial that aims to evaluate the feasibility of accrual of MM patients on Ld -base therapy to assess the efficacy and safety of Riva versus ASA in preventing TE complications. The study was initiated during the COVID-19 pandemic turmoil, which severely impacted in the proper activation of 3 of the 4 participating sites. Despite this significant limitation, 2 sites were able to maintain the accrual of patients. Only 1 site remained opened according to the pre-specified consecutive 12- month study period. Despite this barrier, we could still attain an excellent accrual rate of 39.5% in 2 sites (London and Ottawa). The incidence of TE or bleeding was low, with o difference between ASA and Riva. However, the study was not powered to assess these outcomes. Lastly, Ld is the most widely used backbone therapy in MM, both in upfront and relapsed settings. Our group does not anticipate any barriers to achieving successful completion of accrual provided the hospital's activities remain safe and research activities open. [Formula presented] Disclosures: Louzada: Celgene: Honoraria;Janssen: Honoraria;Pfizer: Honoraria;Amgen: Honoraria. McCurdy: Sanofi: Honoraria;GSK: Consultancy, Honoraria;Takeda: Consultancy, Honoraria;Janssen: Consultancy, Honoraria;Amgen: Consultancy, Honoraria;Celgene: Consultancy, Honoraria. Phua: Pfizer: Honoraria;Amgen: Honoraria;AstraZeneca: Honoraria;Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees;NovoNordisk: Honoraria, Membership on an entity's Board of Directors or advisory committees;Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees. Le Gal: Aspen: Honoraria;Bayer: Honoraria;Pfizer: Honoraria;LEO Pharma: Honoraria;BMS: Honoraria;Sanofi: Honoraria. Lam: Bristol-Meyers Squibb: Honoraria, Membership on an entity's Board of Directors or advisory committees;Amgen: Honoraria, Membership on an entity's Board of Directors or advisory committees;AstraZeneca: Honoraria, Membership on an entity's Board of Directors or advisory committees;Pfizer: Honoraria, Membership on an entity's Board of Directors or advisory committees;Servier: Honoraria, Membership on an entity's Board of Directors or advisory committees;Millennium: Honoraria, Membership on an entity's Board of Directors or advisory committees;Sanofi: Honoraria, Membership on an entity's Board of Directors or advisory committees;Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees;AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees;Beigene: Honoraria, Membership on an entity's Board of Directors or advisory committees;Hoffmann-La Roche: Honoraria, Membership on an entity's Board of Directors or advisory committees;Johnson & Johnson: Honoraria, Membership on an entity's Board of Directors or advisory committees;Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees;Gilead: Honoraria, Membership on an entity's Board of Directors or advisory committees;SeaGen: Honoraria, Membership on an entity's Board of Directors or advisory committees. OffLabel Disclosure: Rivaroxaban 10 mg oral daily for thrombosis prophylaxis in myeloma patients on lenalidomide-based therapy. Health Canada approved the off label use for study purposes

Running Community Solidarity and Well-Being Motivated by Instagram Multimodal Communications Under the COVID-19 Pandemic

This paper investigates how the city runners of a local running group maintain a sense of belonging and commitment to the running group and running exercises under the new abnormal living situations by the COVID-19 pandemic. A netnographic approach to study the running group’s Instagram posts and the members’ responses shows how community-based solidarity and interventions provide both intrinsic and extrinsic motivations to shape the members’ self-regulated behaviours and running practices by interactive and multimodal communications. Their self-regulated physical exercises and collective and connective activities help to promote community health and well-being when the formal community-based running exercises are suspended. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Impact of the COVID-19 pandemic on interventional radiology services across the world.

AIM: To review data on the impact of the COVID-19 pandemic on interventional radiology (IR) services. MATERIALS AND METHODS: A systematic review of the available studies was performed according to the PRISMA guidelines. RESULTS: A total of 14 studies met the inclusion criteria. IR caseload reduced between 16.8-80%, with elective activity affected more than emergency work. Trainees also experienced a 11-51.9% reduction in case volumes and many were redeployed to critical care. IR departments re-organised operations and personnel, and many continued to offer 24/7 services and support critical care areas through redeployment of staff. The majority of studies report no significant issues with the availability of personal protective equipment and that local or national governing body or radiology society guidelines were followed. CONCLUSION: The COVID-19 pandemic reduced case volumes and training opportunities. IR departments showed flexibility in service delivery. The lessons learned offer novel insights into how services and training can be reorganised to ensure that IR continues to thrive.

Development of IoT-based smart recycling machine to collect the wasted non-woven fabric face mask (NFM)

The outbreak of COVID-19 pandemic has changed the human habit worldwide since 2019. Everyone wears face mask as an important personal protective equipment (PPE) to protect themselves away from the virus after leaving home for work, social activity or study. Epidemic-prevention might only be relaxed until the vaccine for coronavirus have developed successfully. Non-woven fabric face mask (NFM) have played the important role for public to defense from infection of coronavirus through air, NFM is commonly used because it costs with low price, light weight, disposable and easy-to-use. Polypropylene (PP) is one of the plastic materials and applied as a core mask filter and needed a lifespan of 450 years for partially degradable. Most of researchers are focusing on the new mask materials development and seldom to tackle the NFM recycling problem. This research paper aims to (1) investigate an existing disposal method of NFM;(2) conduct a feasibility study on recycling method;(3) design an IoT-based smart NFM recycling machine for collecting and sterilising the disposed NFM. Opportunities in recycling NFM will also be addressed. © 2020 IEEE.