Repurposing Drugs for Viruses and Cancer: A Novel Drug Repositioning Strategy for COVID-19

The high infection capacity and rapid mutations in coronavirus disease 2019 (COVID-19) has been no stranger to many. The etiological agent that contributed to this global health crisis is by no means the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). COVID-19 is characterized by an episode of immune fluctuations, followed by hyperactivation of inflammatory responses, known as the cytokine storm. The rapid progression of the COVID-19 pandemic calls for new and promising antiviral therapeutics. Repositioning anticancer drugs against the virus is very much explored due to the common similar pathways or targeting structures, opening new windows for many possibilities. As such, the repurposing of zidovudine for Friend leukemia virus and ouabain for Ebola virus are among the successful examples. Other potential FDA-approved anticancer drugs to be repositioned for COVID-19 include imatinib, saracatinib, and homoharringtonine, which have been studied for other coronaviruses in the past. Furthermore, current anticancer drugs like carmofur, carfilzomib, zotatifin, plitidepsin, and toremifene have gained interesting outcomes with respect to SARS-CoV-2. It is well recognized that to achieve viral replication, viruses antagonise or hijack host proteins and signaling pathways to gain productive infection, with SARS-CoV-2 indeed being no exception. This review aims to discuss the drug repositioning approaches concerning previously established anticancer drugs on viruses, especially on SARS-CoV-2. We accentuate this idea with specific examples of how potential anticancer inhibitors can effectively be used against SARS-CoV-2 as well as the limitations and future perspectives of drug repositioning. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.

Multisystem Inflammatory Syndrome in Children

Multisystem inflammatory syndrome in children (MIS-C) is an uncommon but emerging syndrome related to SARS-CoV-2 infection. While the presentation of MIS-C is generally delayed after exposure to the virus that causes coronavirus 2019, both MIS-C and Kawasaki disease (KD) share similar clinical features. Multisystem inflammatory syndrome in children poses a diagnostic and therapeutic challenge given the lack of definitive diagnostic tests and a paucity of evidence regarding treatment modalities. We review the clinical presentation, diagnostic evaluations, and management of MIS-C and compare its clinical features to those of KD.

The impact of COVID-19 on hospitalization outcomes of patients with acute myocardial infarction in the USA.

Background/study objective: The effect of the COVID-19 pandemic affected health care delivery, as it led to variable outcomes in different disease states including cardiovascular diseases. In this study, we evaluated the impact of coexisting COVID-19 on Acute Myocardial Infarction (AMI). Design/setting: We analyzed discharge records of AMI patients from the National Inpatient Sample (NIS) in the year 2020. Main outcome measures: Using propensity score matching, we assessed the impact of COVID-19 infection on the in-hospital outcomes of patients presenting with AMI. Results: There were 1154 patients with concomitant COVID-19 infection and AMI who were matched with 109,990 patients with AMI and without COVID-19. We found that patients with COVID-19 who had AMI were less likely to have dyslipidemia (64.6 % vs. 70.4 %, p < 0.001), peripheral vascular disease (2.4 % vs. 3.8 % p = 0.0017), smoking history (23.5 % vs. 28.2 % p < 0.0001) and hypertension (37.1 % vs. 40.1 % p = 0.004).COVID-19 was associated with higher hospital mortality rates (Adjusted odds ratio aOR: 2.72, CI: 2.23-3.30, p < 0.001), cardiac arrest (aOR: 1.65, 95 % CI: 1.26-2.15, p < 0.001), cardiogenic shock (aOR:1.36,95 % CI: 1.10-1.68, p = 0.004) and respiratory failure (aOR:1.81, 95 % CI: 1.55-2.11 p < 0.001) compared to AMI patients without COVID-19. There was also a significant association between coexisting COVID-19 and longer duration of hospital stay (Adjusted mean differences:1.40, 95 % CI: 1.31-1.59 p < 0.0001) in AMI patients. Conclusion: COVID-19 infection is associated with worse in-hospital mortality and cardiorespiratory complications in patients with AMI.

The Pandemic and Advertising: Be (AD)Normal

The coronavirus (COVID-19) has severely impacted numerous industries through country lockdowns and border closures, affecting daily routines and leading to an era of ‘remote everything'. These are challenging times for brands as consumer behaviour, purchasing patterns, and media habits are quickly changing. However, not everything will adhere to the new norm. While brands can benefit from this situation and finding opportunities to engage with consumers, the heart of the matter is, should brands advertise? Do consumers wish to hear from brands? If yes, what do consumers need during the pandemic? Accordingly, this chapter aims to discuss key trends in media consumption during the COVID-19 pandemic and its implications on brand strategy and advertising. Moreover, given the growth in digital traffic during this time, quarantainment came to dominate all types of screen and redefined the uses and gratifications afforded by media. In this context, brands needed to practise empathy, embrace purpose-led communications, accelerate digital capabilities and amplify brand community to improve brand resonance. In particular they needed to adapt to four types of pandemic-induced consumer type, which can be identified as worrywart, unflappable, hard-headed and unbothered. The pandemic has proven that the value of media is growing, and brands should stay in the conversation for contribution, not just conversion. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2021.

A COMPARISON OF PULSE METHYLPREDNISOLONE TO LOW-DOSE METHYLPREDNISOLONE IN CRITICALLY-ILL PATIENTS WITH SARS-COV-2 PNEUMONIA: RETROSPECTIVE, OBSERVATIONAL STUDY

Intro The RECOVERY trial showed evidence that dexamethasone given at moderate doses for a short period of time reduced mortality in comparison to standard of care in hospitalised COVID-19 patients. However, there is no evidence to demonstrate whether higher doses of steroid may improve or worsen the outcomes. This study compares the effectiveness of low-dose- methylprednisolone to pulse-methylprednisolone among the critically-ill COVID- 19 patients. Methods This is a retrospective observational study among critically-ill COVID- 19 patients whom were admitted to intensive care unit Hospital Pulau Pinang from August 2020 until February 2021. We collected the data of patients that received either methylprednisolone dose more than 2mg/kg/day or methylprednisolone dose equal or less than 2mg/kg/day. Both groups received standard of care. The primary outcome is all-cause mortality within 30 days from symptoms onset. The secondary outcomes are duration of mechanical ventilation, length of ICU stays and rate of complications such as acute kidney injury, sepsis, bleeding tendency and diabetic ketoacidosis. Findings A total of 100 patients were included in the analysis, whom 64% were male, mean age of 56.6 (SD 13.4) and 53% have at least one comorbidity. The survival analysis revealed that 30 days survival rate were 91.2% in the low-dose- methylprednisolone group and 81.8% in the pulse-methylprednisolone group (p = 0.226) and showed no significant differences after adjustment for covariates such as the doses of methylprednisolone, gender, requirement of mechanical ventilation and absence or presence of comorbidity. However, age more than 60 years old does increase the risk of mortality (p value 0.018). Comparing the low- dose-methylprednisolone to pulse-methylprednisolone, the duration of mechanical ventilation were 15.7 days vs 13.8 days (p 0.572), length of ICU stay were 14.9 days vs 15 days (p 0.875) and rate of complications were not significantly differences. Conclusion The use of pulse-methylprednisolone in critically-ill COVID-19 patients does not improve the survival rate.

Game-Based e-Tourism-e-Health Using SQL

AR games such as Pokemon Go, Jurassic world Alive and other games encourage us to venture out in the real open world to also see the beauty of it. However, tourism has come almost to a virtual stop during the first year of the COVID-19 pandemic and recovery is slow. We present a tile-based experience-sharing PixoMap, which incorporates some aspects of smart tourism. For user requirements gathering, we first compare factors that make popular games such as Pokemon Go, Minecraft, and the Sims popular. Findings indicate that people enjoy collecting objects, such as monsters or cards, freedom and creativity, escape and sometimes nostalgia. Our PixoMap game allows players to virtually browse an area in the map, and choose a tile. Each tile contains memories (Memors)/experiences/stories. Users can read others' experiences and share their own experiences, play a minigame to earn in-game currency, to change his/her 2D avatar or change the tile's color or optionally, to own the tile. Alpha user feedback confirms and refines our design. Heuristic evaluation and user experience feedback at the end of the study, are positive and encouraging.

Corrigendum to 'Single domain antibodies derived from ancient animals as broadly neutralizing agents for SARS-CoV-2 and other coronaviruses': Biomedical Engineering Advances 4 (2022) 100054.

[This corrects the article DOI: 10.1016/j.bea.2022.100054.].

CUMULATIVE INCIDENCE OF COVID-19 AND VACCINE PROFILES AMONG ASEAN PERITONEAL DIALYSIS POPULATIONS: A PRELIMINARY RESULT OF THE "InCoV-PD" STUDY GROUP

Introduction: Although there are several reports of COVID-19 in patients on peritoneal dialysis (PD), all of them were retrospective and mono-national-state designs, and none reported vaccination profiles. Method(s): The incidence of COVID-19 infection among PD patients and vaccination profiles of COVID-19 from 1 January 2020 to 30 September 2021 were retrieved from the survey of PD leaders in the ASEAN countries. Countries were excluded if their infection rates (IR) in PD populations were smaller than the lower limit value of 95% confidence interval (CI) of the overall pooled prevalence of 1.25 reported in kidney failure patients with COVID-19 infection globally, considering the possibility of under-reporting and if the number of PD population is less than 50 cases. Thus, Burma (45 cases, unknown IR), Cambodia (1 case, IR 0%), Indonesia (2,692 cases, unknown IR), Laos PDR (3 cases, IR 33%), and Vietnam (PD 1,500 cases, IR <1%) were excluded. Result(s): Figure 1 demonstrates the incidence of COVID-19 infection in PD populations in selected ASEAN members. The cumulative incidence of COVID-19 has gradually increased in all reported countries. The cumulative incidence rate of Singapore reached a plateau in the second quarter of 2020 but has since seen a surge in the third quarter of 2021 with an average incidence of 0.5-1.5 cases per 100 population. Overall IR ranged from 0.1% in Singapore to 23.8% in the Philippines with an average ASEAN IR of 2.6%. The majority of ASEAN had less than half of their populations fully vaccinated, ranging from only 13% in Vietnam to 46% in Brunei. Despite Laos being a low-income country, it was the first ASEAN to vaccinate its population. Singapore had the highest vaccination rates, with 83% and 81% of its population partially and completely vaccinated, respectively. Brunei, albeit being a high-income country, is the last country to roll out vaccination with a tardy vaccination rate, possibly due to the under-preparedness of the government and a false sense of security as Brunei had 15 months of zero cases before the latest wave. The incidence of ASEAN PD patients with COVID-19 infection surged during the second and third quartiles of 2021 despite the vaccine roll-out (Table 1). [Formula presented] Abbreviations: Ad26, Ad26.COV2.S;BBIBP, BBIBP-CorV;BNT, BNT162b2;Covishield, ChAdOx1 nCoV-19 (Covishield);Gam, Gam-COVID-Vac;mRNA, mRNA-1273;Vaxzeria, ChAdOx1 nCoV-19 (Vaxzeria) Remarks: Yellow, Conventional inactivated vaccines (BBIBP-CorV [Sinopharm], CoronaVac [Sinovac]);Green, RNA vaccines (BNT162b2 [Pfizer-BioNTech], mRNA-1273 [Moderna]);Pink, Viral vector vaccines (Gam-COVID-Vac [Sputnik], ChAdOx1 nCoV-19 [Covishield], ChAdOx1 nCoV-19 [Vaxzeria] and Ad26.COV2.S [Johnson & Johnson]) [Formula presented] Figure 1. Cumulative incidence of COVID-19 infected PD patients in selected ASEAN Conclusion(s): Overall IR of the ASEAN PD population varied widely among countries. However, the rollout rate of vaccination lagged behind that of western countries. This should increase efforts to educate their population on the benefits of timely vaccination. There remain a lot of uncertainties regarding COVID-19, and hence there is an urgent need for large prospective studies with international collaboration, to address these questions. No conflict of interestCopyright © 2023

Authentic research experience through mock grant application roleplay

Many universities resort to online teaching due to the COVID-19 pandemic. It is a challenging endeavour, especially in Biology courses that require lab access. Mock grant application roleplay is one alternative to lab-based activities. Although using mock grant applications as an assessment tool is not new, there have been few studies on students' opinions. To the best of our knowledge, this is the first time that it has been used in place of lab-based exercises and in conjunction with virtual lab modules. Students are engaged in three aspects: (i) targeted literature review, (ii) research proposal writing and (iii) 5-min project pitching. The design of this module is flexible, and other lab-based courses can adopt it. This module encourages undergraduate students to explore the lab techniques and concisely present their research proposals. Compared to the previous semester before COVID-19, the number of students that achieved the "Distinction” grade or higher increased by 6.3%, whilst the failures decreased by 3.2%. A similar trend was observed in 2021, the second year this activity was carried out. A survey amongst students who took this unit reported that student satisfaction with this unit has improved by 11.1%. This improvement could be attributed to this mock grant activity because the format and difficulty level of the student assessments had remained constant. Furthermore, qualitative analysis conducted via focus group interviews indicated that students agreed that the mock grant proposal assessment was useful in preparing them for future careers and was relevant to the course learning outcomes. Several participants pointed to the assessment's potential usefulness for careers in research. In conclusion, this roleplay module can fulfil the learning objectives of this course whilst providing an authentic research experience without lab-based activities. Copyright © 2023 Tan and Lim.

Effective recycling of disposable medical face masks for sustainable green concrete via a new fiber hybridization technique.

Global public response to the COVID-19 (SARS-CoV-2) pandemic is highly focused on human health. However, conservationists have cautioned of unprecedented threats to the natural environment from a new type of non-biodegradable microplastic waste resulting from extensive use of disposable medical face masks (DMFMs). Thus, this waste must be recycled in an eco-friendly manner on an urgent basis. In this research, we developed a new environmentally friendly recycling technique using waste DMFMs in sustainable green concrete. More explicitly, a new fiber hybridization approach has been introduced in which two types of fibers namely DMFM fiber and basalt fiber (BF) were incorporated into fiber reinforced recycled aggregate concrete (FRAC). The volume fractions of DMFM fiber were 0%, 0.1%, and 0.2% and the volume fractions of BF were 0%, 0.25%, and 0.5%. In addition, two mineral admixtures (fly ash and ground granulated blast furnace slag) were also used. Test results indicated increase of approximately 12% in compressive strength, 26% in split tensile strength, and 60% in flexural strength of FRAC containing hybrid fibers and mineral admixtures. The density and ultra-sonic pulse velocity (UPV) of DMFM fiber- and BF-modified FRAC ranged from 2406-2433 kg/m3 and 4502-4541 m/s, respectively, which meets structural concrete requirements. The water absorption rate gradually increased with an increase in the volume fractions of fibers but remained within the allowable water absorption limit for construction materials. Lastly, the microstructure investigation indicated excellent concrete quality, improved interfacial transition zones (ITZs), and good compatibility of host concrete matrix with both DMFM fiber and BF that correlates well with the experimental results reported in this study.

Outcome of emergency transvenous cardiac pacing placement by echocardiography guidance in non-cardiac centre

Background: Temporary transvenous cardiac pacing (TTVCP) is crucial and lifesaving procedure for hemodynamically unstable bradyarrhythmia. TTVCP placement under fluoroscopy guidance is considered the "gold-standard". However, its use is limited by equipment availability. During the COVID-19 pandemic, access to operation-theatre with fluoroscopy service is severely restricted due to delay in confirming patient COVID-19 status (COVID19 PCR 6 h, GeneXpert 2 h). With this limitation, physicians rely on echocardiography guided placement of TTVCP for unstable emergent cases. The aim of the study is to describe and determine outcome of temporary transvenous cardiac pacing placement by echocardiography guidance. Methodology: A retrospective analysis was carried out on all patients who underwent TTVCP in Hospital Sungai Buloh and Hospital Selayang from March 2020 until March 2022. All TTVCP were inserted by cardiology fellow. A bipolar electrode catheter was inserted in the jugular vein with vascular ultrasound guidance and placed in the right ventricular apex by means of echocardiography or fluoroscopy. Physicians chose the method of TTVCP taking into account their own experience and patient's clinical condition. All echocardiography guided TTVCP placement underwent formal readjustment under fluoroscopy once patient COVID-19 status was confirmed. Baseline characteristics and outcome were compared between two groups (echocardiography-guided and fluoroscopy-guided). Result(s): Total of 18 patients underwent TTVCP: 9 echo-guided and 9 fluoro-guided TTVCP placement. Patients with echo-guided placement were significantly more hypotensive and higher ionotropic support compared to fluoro-guided at baseline. The indication-to-pacing time (elapse of time from the cardiologist decision for TTVCP implantation to the time of transvenous pacing activation) was significantly shorter in the echo-guided group compared to fluoro-guided group [70 +/- 15 vs 210 +/- 120 min, p < 0.00001]. There was a slightly higher pacing threshold in the echo-guided group compared to fluoro-guided group [0.8 +/- 0.3 vs 0.5 +/- 0.2 p = 0.18]. There were no significant difference in complications such as TTVCP death, infection, sepsis, hematoma and ventricular arrhythmia. Conclusion(s): Temporary transvenous cardiac pacing implantation under echocardiography guidance is a feasible and safe alternative in hemodynamically unstable bradyarrhythmia particularly during COVID-19 pandemic. Copyright © 2022

Using the technology acceptance model to examine acceptance of telemedicine by cancer patients in an ambulatory care setting

Background: Telemedicine has demonstrated benefits for cancer patients including the potential to improve care coordination and patient outcomes. Since June 2020, teleconsultations have been implemented in the National Cancer Centre Singapore. Objective(s): This study aims to assess cancer patients acceptance of telemedicine as a complement to traditional in-person care and identify factors affecting their acceptance. Method(s): An online self-administered questionnaire was designed using a modified technology acceptance model (TAM) previously validated to predict acceptance of telemedicine by patients and factors affecting acceptance. Descriptive statistics were used to summarise data on demographic factors and TAM construct scores. Univariate and multivariate logistic regression were used to determine how demographics factors and TAM constructs influenced acceptance. Result(s): Respondents (n = 278;mean age 59 years) were mostly female (67.6%), Chinese (86.3%) and received parenteral chemotherapy (72.6%). Technology access and confidence were generally moderate to high, while past telemedicine use was low (18%). Overall, more than half (59.7%) expressed acceptance. The odds of acceptance were significantly higher if respondents agreed that their healthcare access would improve by using telemedicine (OR 4.17, 95% CI 1.71-10.16) or they would have the necessary resources for using telemedicine (OR 4.54, 95% CI 2.30-8.97). Conclusion(s): Acceptance of telemedicine was high amongst respondents. Facilitating conditions such as having necessary resources and perceived improved access were identified as main predictors of high acceptance. Telemedicine services should work to improve these aspects, leverage on advantages and address disadvantages brought up by patients. Copyright © The Author(s) 2022.

Motivating and Mobilizing: Leveraging Psychiatric Providers and Settings to Maximize Vaccinations among Individuals with Serious Mental Illness

Background: Individuals with serious mental illness(SMI) are at increased risk of hospitalization and mortality from respiratory infections, including COVID19, influenza, and pneumonia(1,2). Nonetheless, they are less likely to utilize vaccinations partly due to low health literacy, attitudinal hesitancy, and practical barriers(2,3). A multipronged approach is needed to address these barriers. Psychiatric clinics where patients are seen frequently and longitudinally provide an ideal venue for this approach with psychiatric providers being best positioned to promote healthy behavior of vaccination given their expertise in motivational interviewing and nudging(3). Mobile Vaccine Clinics(MVCs) in psychiatric settings can remove practical barriers to accessing vaccines. Method(s): Using a three-pronged approach, we first mobilized psychiatric providers at a community mental health center through in-service education to identify and address barriers to COVID19 vaccination in a cohort of 193 clozapine-treated patients from February to June 2021. Secondly, a vaccination monitoring tool was created in electronic medical records (EMR) to track vaccination intention, hesitancy, and uptake at each outpatient visit. We replicated the intervention in a neighboring psychiatric clinic not only to encourage COVID19 vaccines, but also influenza and pneumococcal vaccines. Finally, in collaboration with a pharmacy, we set up MVCs in psychiatric settings, offering COVID19 and influenza vaccines. Result(s): By June 30, 2021, the COVID19 vaccination rate in our pilot cohort was 84.5%, higher than the Massachusetts rate estimated to be between 62.5% and 77% at the time. While attitudinal hesitancy seemed to decrease over visits, practical barriers (scheduling, transportation, remembering appointments) commonly remained. Setting up MVCs subsequently increased the COVID19 vaccination rate to 93%, with many patients receiving the influenza vaccine simultaneously. In a short questionnaire about the MVC experience, nearly all participants reported it was easy accessing vaccines, with most preferring MVCs for future vaccinations. Discussion(s): When psychiatric providers were empowered to lead vaccine discussions with patients using a standardized vaccine monitoring tool in EMR, their patients had high COVID19 vaccination rates. Embedding MVCs in psychiatric settings was preferred and cost-effective (pharmacy was reimbursed by insurance), and removed practical barriers, particularly for those who may have cognitive limitations associated with SMI. Conclusion/Implications: This multi-pronged approach of integrating preventive care and mental health care in psychiatric settings was highly effective in maximizing vaccine uptake in people with SMI. Leveraging psychiatric providers and settings can help protect people with SMI against vaccine-preventable respiratory diseases, reduce health disparities, and benefit public health. References: 1. Olfson M, Gerhard T, Huang C, et al. Premature mortality among adults with schizophrenia in the United States. JAMA psychiatry. 2015;72(12):1172-81. 2. Siva N. Severe mental illness: reassessing COVID-19 vaccine priorities. The Lancet. 2021;397(10275):657. 3. Lim C, Van Alphen M, Freudenreich O. Becoming vaccine ambassadors: A new role for psychiatrists. Curr Psychiatry. 2021;20(8):10-1. Copyright © 2022

The Effect of Emotional Responses on Reuse Intention by Impulse Buying Types: Focused on Live Shopping in China

This study aims to present the problems and solutions of live shopping to suggest the direction of live commerce broadcasting in the future by examining the influence of the types of impulse buying on consumers’ emotional responses and the reuse intention according to changes into non-contact economy due to the COVID-19 pandemic. To achieve the purpose of this study, the theoretical foundation of related factors was established based on literature research and previous studies. Accordingly, research models and research hypotheses were presented. To verify the hypothesis, a survey was conducted through an online survey method targeting 300 consumers who have experience using live shopping in China. The statistical analysis was conducted by frequency analysis, exploratory factor analysis, correlation analysis and multiple regression analysis using SPSS26.0 program. The results of the empirical analysis and implications of this study are as follows. First, pure impulse buying, planned impulse buying, stimulus impulse buying and reminder impulse buying had a significant positive (+) effect on jealousy and vanity of emotional response. Therefore, the seller of the product is expected to increase sales by stimulating customers ’ impulse buying. In addition, the purchaser may meet emotional responses such as jealousy or vanity, but this may lead to economic losses or unnecessary product purchases. Second, jealousy and vanity of emotional response had a significant positive (+) effect on reuse intention. Therefore, the purchaser should try to find ways to reduce emotional responses such as jealousy and vanity. Third, pure impulse buying, planned impulse buying, stimulus impulse buying and reminder impulse buying had a significant positive (+) effect on reuse intention. Therefore, impulse buying can lead to product purchase even if there is no stimulus of emotional reaction such as jealousy or vanity, so product buyers should exclude the factors that can cause impulse buying as much as possible. This study also aims to present the research results and implications based on some limitations in the process of the study. First, if the study is conducted for all age groups, it is expected that the results of more objective research will be derived. Second, if comparative research is conducted on live shopping users in various countries, it is judged that strategies will be derived to help identify the tendency of live shopping users by country and to establish marketing strategies for product sellers. © 2022, Success Culture Press. All rights reserved.

Home based peritoneal dialysis training during COVID-19 era: A single centre experience

Introduction: COVID-19 disease has been declared as a pandemic since February 2020. Resulting from this, home peritoneal dialysis training programme was implemented. However, infectious complications was one of our major concerns. Material(s) and Method(s): This is a single centre, observational, retrospective study. We recruited patients who were newly enrolled into the peritoneal dialysis programme from January 2020 until March 2021 and follow up them for 6 months duration. Patients' demographic data, baseline characteristic, clinical outcome were collected through electronic health record (eHIS) and data were analysed using SPSS version 23. Result(s): A total of 133 patients were enrolled into the peritoneal dialysis programme. The median age of the patients was 55(42-65) years old. Most of the patients were on CAPD, 87(65.4%), and 76(57.1%) of them were on self-care peritoneal dialysis (PD). During this observational period, 29(21.8%) patients underwent hospital based training, while a total of 104(78.2%) patients underwent home based training. The PD peritonitis rate for hospital based training was 1 episode per 55.8 patient months while home based training group was 1 episode per 25.4 patient month. The survival free to 1st PD peritonitis for home based training was 83.7% over 6 months. The exit site infection rate was 1 episode per 73.1 patient month. Conclusion(s): Home based PD training should be encouraged especially during Covid-19 pandemic period, but standardised training protocol should be implemented to improve the clinical outcome of our patients.

A multi-centre national study of COVID-19 infection in cancer patients

Background & aims: COVID19 disproportionately affects the immunosuppressed, but its epidemiology over time is incompletely characterised. We describe Australian experiences of COVID19 in a national observational study of patients with malignancy. Methods: An ongoing multisite prospective cohort study of adult COVID19 patients with active cancer was conducted. Clinical and laboratory data over 28 months (1/3/20-22/7/22) was collated from 15 hospitals. Results: There were 491 patients included. Patients were a median of 63(IQR:50-71) years with majority male (254,52%). Solid organ malignancy was most common (296,60%), followed by haematological malignancy (180,37%), then both (15,4%). Most common solid tumour was breast cancer (74/296,25%);most common haematological cancer was lymphoma (102/180,57%). Majority (275,56%) were undergoing cancer treatment at COVID19 diagnosis. From 2020-2022, patients presented less with lower respiratory tract infections (57%,36%,5%) with increasing outpatient management (26%,50%,67%). Improved mortality was seen (27%,19%,11%). Median inpatient length of stay was 8(4-11) days. Intensive care admission was low (21,4%). For patients who had repeated respiratory PCR testing, median time from first to last positive test was 17(7-25, n = 123) days. Cancer treatment modification occurred in 18(4%) and delay in 74(15%). Conclusion: Despite improvements in outcomes, COVID19 still results in morbidity with impacts on cancer treatment. This preliminary data shows that cancer patients remain a vulnerable group and should be prioritised for public health interventions.

Single domain antibodies derived from ancient animals as broadly neutralizing agents for SARS-CoV-2 and other coronaviruses.

With severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as an emergent human virus since December 2019, the world population is susceptible to coronavirus disease 2019 (COVID-19). SARS-CoV-2 has higher transmissibility than the previous coronaviruses, associated by the ribonucleic acid (RNA) virus nature with high mutation rate, caused SARS-CoV-2 variants to arise while circulating worldwide. Neutralizing antibodies are identified as immediate and direct-acting therapeutic against COVID-19. Single-domain antibodies (sdAbs), as small biomolecules with non-complex structure and intrinsic stability, can acquire antigen-binding capabilities comparable to conventional antibodies, which serve as an attractive neutralizing solution. SARS-CoV-2 spike protein attaches to human angiotensin-converting enzyme 2 (ACE2) receptor on lung epithelial cells to initiate viral infection, serves as potential therapeutic target. sdAbs have shown broad neutralization towards SARS-CoV-2 with various mutations, effectively stop and prevent infection while efficiently block mutational escape. In addition, sdAbs can be developed into multivalent antibodies or inhaled biotherapeutics against COVID-19.

Game-Based e-Tourism-e-Health Using SQL

AR games such as Pokemon Go, Jurassic World Alive and other games encourage us to venture out in the real open world to also see the beauty of it. However, tourism has come almost to a virtual stop during the first year of the COVID-19 pandemic and recovery is slow. We present a tile-based experience-sharing PixoMap, which incorporates some aspects of smart tourism. For user requirements gathering, we first compare factors that make popular games such as Pokemon Go, Minecraft, and the Sims popular. Findings indicate that people enjoy collecting objects, such as monsters or cards, freedom and creativity, escape and sometimes nostalgia. Our PixoMap game allows players to virtually browse an area in the map, and choose a tile. Each tile contains memories (Memors)/experiences/stories. Users can read others’ experiences and share their own experiences, play a minigame to earn in-game currency, to change his/her 2D avatar or change the tile’s color or optionally, to own the tile. Alpha user feedback confirms and refines our design. Heuristic evaluation and user experience feedback at the end of the study, are positive and encouraging. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.