Cloth face mask fit and function for children part two: Material Selection

The second component of this three-paper series studying cloth face masks for children ages 4 to 6 years old concentrates on optimizing aerosol capture and air permeability through fabric selection. Material choices were evaluated in two modes: Flat Filter (FF) and Head Form (HF). FF isolates material factors while HF simulates the performance of the constructed masks on a 3D printed child head form. In FF mode, higher filtration efficiency correlated to lower air permeability in both reusable commercial and experimental face masks regardless of fiber contents, fabric structures, and number of layers. Our prototype face mask developed in design exploration successfully captured 37 +/- 12% of 0.3 mu m, 87 +/- 3% of 0.5 mu m, and 87 +/- 2% of 1.0 mu m particles while maintaining good air permeability, moisture capture, and aerosolized salt capture in HF mode. Sealing masks to minimize outward leakage reduced particle capture up to 64%. Particle leakage data captured at the eye level of the head form illuminated the synergy between mask design, material choice, and fit.

Real-World Effectiveness of Sotrovimab for the Early Treatment of COVID-19 During SARS-CoV-2 Delta and Omicron Waves in the USA.

INTRODUCTION: Sotrovimab, a recombinant human monoclonal antibody (mAb) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had US Food and Drug Administration Emergency Use Authorization for the treatment of high-risk outpatients with mild-to-moderate coronavirus disease 2019 (COVID-19) from 26 May 2021 to 5 April 2022. Real-world clinical effectiveness of sotrovimab in reducing the risk of 30-day all-cause hospitalization and/or mortality was evaluated for the period when the prevalence of circulating SARS-CoV-2 variants changed between Delta and Omicron in the USA. METHODS: A retrospective analysis was conducted of de-identified patients diagnosed with COVID-19 between 1 September 2021 to 30 April 2022 in the FAIR Health National Private Insurance Claims database. Patients meeting high-risk criteria were divided into two cohorts: sotrovimab and not treated with a mAb ("no mAb"). All-cause hospitalizations and facility-reported mortality ≤ 30 days of diagnosis ("30-day hospitalization or mortality") were identified. Multivariable and propensity score-matched Poisson and logistic regressions were conducted to estimate the adjusted relative risk (RR) and odds of 30-day hospitalization or mortality in each cohort. RESULTS: Compared with the no mAb cohort (n = 1,514,868), the sotrovimab cohort (n = 15,633) was older and had a higher proportion of patients with high-risk conditions. In the no mAb cohort, 84,307 (5.57%) patients were hospitalized and 8167 (0.54%) deaths were identified, while in the sotrovimab cohort, 418 (2.67%) patients were hospitalized and 13 (0.08%) deaths were identified. After adjusting for potential confounders, the sotrovimab cohort had a 55% lower risk of 30-day hospitalization or mortality (RR 0.45, 95% CI 0.41-0.49) and an 85% lower risk of 30-day mortality (RR 0.15, 95% CI 0.08-0.29). Monthly, from September 2021 to April 2022, the RR reduction for 30-day hospitalization or mortality in the sotrovimab cohort was maintained, ranging from 46% to 71% compared with the no mAb cohort; the RR estimate in April 2022 was uncertain, with wide confidence intervals due to the small sample size. CONCLUSION: Sotrovimab was associated with reduced risk of 30-day all-cause hospitalization and mortality versus no mAb treatment. Clinical effectiveness persisted during Delta and early Omicron variant waves and among all high-risk subgroups assessed.

A Study of the Student Experience in Video Conferences and Virtual Worlds as a Basis for Designing the Online Learning Experience

The design of online learning environments has a fundamental and immediate impact on how students experience learning in these environments and particularly on the students' satisfaction and learning engagement. The COVID-19 pandemic has resulted in students participating in online learning on a large scale and forcing educational institutions to adopt various communication and virtual teaching environments: this has provided an opportunity to study and compare different online learning environments. To understand the design performance of the currently available virtual learning environments, they should be considered and evaluated from the students' point of view. Identifying their pros and cons gives designers a better idea of how to enhance the design of virtual learning environments and provide a positive educational experience for students. The two most broadly used types of virtual learning environments are video conferencing and virtual worlds. These two mediums provide different affordances for students to experience and interact with the learning materials as well as to interact with the instructor and other students. This paper reports on a study comparing the use of Zoom as an example of video conferencing and Gather.Town as an example of a virtual world in online learning during the COVID-19 pandemic. The study is based on students' responses to an online survey asking them to compare the two environments based on their experience in their courses. The participants were CS undergraduate students exposed to both environments and experiences with both platforms. A qualitative analysis of the data collected showed that students realized certain values from the affordances offered by the virtual world environment that facilitated collaborative learning with peers and instructors and made the learning experience more effective and engaging. © 2022 IEEE.

Antibody therapy reverses biological signatures of COVID-19 progression.

Understanding who is at risk of progression to severe coronavirus disease 2019 (COVID-19) is key to clinical decision making and effective treatment. We study correlates of disease severity in the COMET-ICE clinical trial that randomized 1:1 to placebo or to sotrovimab, a monoclonal antibody for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (ClinicalTrials.gov04545060). Laboratory parameters identify study participants at greater risk of severe disease, including a high neutrophil-to-lymphocyte ratio (NLR), a negative SARS-CoV-2 serologic test, and whole-blood transcriptome profiles. Sotrovimab treatment is associated with normalization of NLR and the transcriptomic profile and with a decrease of viral RNA in nasopharyngeal samples. Transcriptomics provides the most sensitive detection of participants who would go on to be hospitalized or die. To facilitate timely measurement, we identify a 10-gene signature with similar predictive accuracy. We identify markers of risk for disease progression and demonstrate that normalization of these parameters occurs with antibody treatment of established infection.

Cloth face mask fit and function for children part one: design exploration

Commercially available children's cloth masks range widely in material type and fabric structures, methods of construction, layering, and shape, and there is a lack of sizing systems, anthropometric data or guidelines specifically targeting the fit assessment and design of cloth face masks for children 4-6 years old. To better identify and understand the cloth face mask fit and functional needs of children ages 4-6 years old, the researchers embarked on interdisciplinary in-depth study to investigate commercial market offerings of children's face masks, identify consumer perspectives, and explore mask design improvements through design research. By triangulating results from survey feedback, commercial market content analysis, and wear trial observations, the researchers were able to identify important design criteria that can be used in the improvement of children's cloth face mask design: size, comfort, dexterity, movement, and thermal comfort. These criteria were used to iteratively develop new mask prototypes involving a 3D printed head form, traditional sewing and hand patternmaking skills, and the creation of multiple mask versions to explore the design criteria listed above. The designs were interpreted through Bye's (2010) Problem-Based Design Research (PBDR) framework, which identifies common design research practices in the field on a spectrum and situates PBDR as a process centered on a problem as impetus for design through which artifacts are developed.

Will You Be Vaccinated? A Methodology for Annotating and Analyzing Twitter Data to Measure the Stance Towards COVID-19 Vaccination

People turn to social media to express their opinion towards different topics and issues. This makes social media a valuable resource for mining public opinion. Stance detection is an approach to analyzing social media users’ content to determine public opinion. In this paper, we present a replicable methodology for coding tweets for stance detection towards the COVID-19 vaccination. The methodology includes a codebook for coding the stance towards COVID-19 vaccination and 2 approaches to sampling Twitter data for manual coding: keywords and hashtags. The codebook provides a template for other researchers to code social media data for stance towards vaccination. Our analysis of the results from 2 sampling approaches shows that sampling with hashtags leads to high inter-coder agreement. We analyze the stance and compare it with the results from sentiment analysis on the same dataset to highlight the distinction of our methodology for stance analysis when compared to sentiment analysis towards vaccination. The major contributions of this paper are: a replicable methodology for annotating stance towards COVID-19 vaccination with a codebook and dataset, and a comparison of sampling Twitter data with keywords and hashtags on the inter-coder agreement along with the resulting distribution of stance. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

The virtual neurologic exam: Instructional videos and guidance for the COVID-19 Era

Objective: To outline features of the neurologic examination that can be performed virtually through telemedicine platforms (the virtual neurological examination [VNE]), and provide guidance for rapidly pivoting in-person clinical assessments to virtual visits during the COVID- 19 pandemic and beyond. Background: The arrival of the COVID-19 pandemic necessitated a swift transition from inperson to virtual care for most physicians. For neurologists, the ability to perform a detailed neurological examination is critical, and poses a barrier to virtual care adoption. Many aspects of the examination are not amenable to virtual platforms and require adapting standard techniques. Design/Methods: We sought to develop a complete screening "virtual" neurological exam" (VNE) that can be performed reliably in most circumstances, and also virtually and tailored depending on the nature of the referral. Videos were created to help with rapid adoption and demonstrate the techniques. Results: Collaborating with general neurologists and various subspecialists (neuromuscular, cognitive neurology, movement disorders and neuro-ophthalmology), a complete VNE was developed, and is described in detail - complete with accompanying videos that demonstrate the most common maneuvers. We also provide guidance on the VNE for specific neurologic complaints, including cognitive impairment, neuromuscular disorders and movement disorders. Conclusions: Given the importance of the physical exam to the practice of neurology, proficiency in performing a virtual neurological exam is an indispensable skill in the context of the COVID-19 pandemic and beyond. We have developed a practical approach to the VNE along with short instructional videos that can be easily implemented in clinical practice.

Clinical features and prognostic factors of intensive and non-intensive 1014 COVID-19 patients: an experience cohort from Alahsa, Saudi Arabia.

BACKGROUND: COVID-19 is a worldwide pandemic and has placed significant demand for acute and critical care services on hospitals in many countries. OBJECTIVES: To determine the predictors of severe COVID-19 disease requiring admission to an ICU by comparing patients who were ICU admitted to non-ICU groups. METHODS: A cohort study was conducted for the laboratory-confirmed COVID-19 patients who were admitted to six Saudi Ministry of Health's hospitals in Alahsa, between March 1, 2020, and July 30, 2020, by reviewing patient's medical records retrospectively. RESULTS: This cohort included 1014 patients with an overall mean age of 47.2 ± 19.3 years and 582 (57%) were males. A total of 205 (20%) of the hospitalized patients were admitted to the ICU. Hypertension, diabetes and obesity were the most common comorbidities in all study patients (27.2, 19.9, and 9%, respectively). The most prevalent symptoms were cough (47.7%), shortness of breath (35.7%) and fever (34.3%). Compared with non-ICU group, ICU patients had older age (p ≤ 0.0005) and comprised a higher proportion of the current smokers and had higher respiratory rates (p ≤ 0.0005), and more percentage of body temperatures in the range of 37.3-38.0 °C (p ≥ 0.0005); and had more comorbidities including diabetes (p ≤ 0.0005), hypertension (p ≥ 0.0005), obesity (p = 0.048), and sickle cell disease (p = 0.039). There were significant differences between the non-ICU and ICU groups for fever, shortness of breath, cough, fatigue, vomiting, dizziness; elevated white blood cells, neutrophils, alanine aminotransferase and alkaline aminotransferase, lactate dehydrogenase, and ferritin, and decreased hemoglobin; and proportion of abnormal bilateral chest CT images (p < 0.05). Significant differences were also found for multiple treatments (p < 0.05). ICU patients group had a much higher mortality rate than those with non-ICU admission (p ≤ 0.0005). CONCLUSION: Identifying key clinical characteristics of COVID-19 that predict ICU admission and high mortality can be useful for frontline healthcare providers in making the right clinical decision under time-sensitive and resource-constricted environment.

Clinical, Imaging, and Lab Correlates of Severe COVID-19 Leukoencephalopathy.

BACKGROUND AND PURPOSE: Patients infected with the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) can develop a spectrum of neurological disorders, including a leukoencephalopathy of variable severity. Our aim was to characterize imaging, lab, and clinical correlates of severe coronavirus disease 2019 (COVID-19) leukoencephalopathy, which may provide insight into the SARS-CoV-2 pathophysiology. MATERIALS AND METHODS: Twenty-seven consecutive patients positive for SARS-CoV-2 who had brain MR imaging following intensive care unit admission were included. Seven (7/27, 26%) developed an unusual pattern of "leukoencephalopathy with reduced diffusivity" on diffusion-weighted MR imaging. The remaining patients did not exhibit this pattern. Clinical and laboratory indices, as well as neuroimaging findings, were compared between groups. RESULTS: The reduced-diffusivity group had a significantly higher body mass index (36 versus 28 kg/m2, P < .01). Patients with reduced diffusivity trended toward more frequent acute renal failure (7/7, 100% versus 9/20, 45%; P = .06) and lower estimated glomerular filtration rate values (49 versus 85 mL/min; P = .06) at the time of MRI. Patients with reduced diffusivity also showed lesser mean values of the lowest hemoglobin levels (8.1 versus 10.2 g/dL, P < .05) and higher serum sodium levels (147 versus 139 mmol/L, P = .04) within 24 hours before MR imaging. The reduced-diffusivity group showed a striking and highly reproducible distribution of confluent, predominantly symmetric, supratentorial, and middle cerebellar peduncular white matter lesions (P < .001). CONCLUSIONS: Our findings highlight notable correlations between severe COVID-19 leukoencephalopathy with reduced diffusivity and obesity, acute renal failure, mild hypernatremia, anemia, and an unusual brain MR imaging white matter lesion distribution pattern. Together, these observations may shed light on possible SARS-CoV-2 pathophysiologic mechanisms associated with leukoencephalopathy, including borderzone ischemic changes, electrolyte transport disturbances, and silent hypoxia in the setting of the known cytokine storm syndrome that accompanies severe COVID-19.

Healthy lifestyle behaviors are major predictors of mental wellbeing during COVID-19 pandemic confinement: A study on adult Arabs in higher educational institutions.

BACKGROUND: In the past infectious diseases affected the quality of lifestyle during home confinement. The study conducted examines the influence of home confinement during the COVID-19 pandemic outbreak on lifestyle, mental wellbeing, nutritional status, and sleeping pattern. METHOD: An online multicategorical questionnaire was distributed to collect demographic information combined with the following tools: Food Frequency Questionnaire (FFQ), International Physical Activity Questionnaire (IPAQ), WHO-5 wellbeing score, and Pittsburgh Sleep Quality Index (PSQI). A snowball non-discriminate sampling procedure was conducted to collect data from people attending or working at higher institutions from March 1, 2020 to April 24, 2020. A total of 1723 completed responses (917 males, 37.4 ±13.4 years old and 806 females 32.2 ± 11.5 years old) were collected. RESULTS: The female participants had significantly lower mental health scores than males (53.9% vs. 46.1%). The mental wellbeing scores were higher among participants with medium and high physical activity (PA) levels (p < 0.00). Additionally, the mental wellbeing scores were significantly improved by dietary quality and it's sleeping score (p < 0.001). However, PA was by far the major determinant of the mental health scores. CONCLUSION: Factors such as PA, diet, and sleeping patterns were associated with mental wellbeing during the COVID-19 confinement among Arab participants.

Healthy Lifestyle Behaviors Are Major Predictors of Mental Wellbeing During COVID-19 Pandemic Confinement: A Study on Adult Arabs in Higher Educational Institutions (preprint)

Background: In previous times, infectious diseases affected the quality of human life during home confinement. This study investigated the influence of home confinement during the COVID-19 pandemic outbreak on lifestyle, mental wellbeing, nutritional status, and sleeping pattern. Method: An online multicategory questionnaire was distributed to collect Demographical information and combined the following tools: Food Frequency Questionnaire (FFQ), International Physical Activity Questionnaire (IPAQ), WHO-5 wellbeing score, and Pittsburgh Sleep Quality Index (PSQI). A snowball none-discriminate sampling procedure was followed to collect data from people attending or working at higher institution had covering the period between Mar/00/2020 and Apr/24/2020. A total of 1723 completed responses (917 Males 37.4 ±13.4 yrs. old and (806 Females 32.2 ± 11.5 yrs. old) were collected.Results: Female participants had significantly lower mental health scores as compared to males (53.9% vs 46.1%). on Mental wellbeing score was better among participants with medium and high Physical Activity Levels (p < 0.00). Additionally, mental wellbeing score was significantly improved by dietary quality and sleeping score (p < 0.001). However, physical activity was by far the major determinants of mental health score. Conclusion: Factors such as PA, Diet, sleeping patterns were associated with mental wellbeing during COVID-19 confinement among Arab participants.

Healthy Lifestyle Behaviors Are Major Predictors of Mental Wellbeing During COVID-19 Pandemic Confinement: A Study on Adult Arabs in Higher Educational Institutions (preprint)

Background In previous times, infectious diseases affected the quality of human life during home confinement. This study investigated the influence of home confinement during the COVID-19 pandemic outbreak on lifestyle, mental wellbeing, nutritional status, and sleeping pattern.Method: An online multicategory questionnaire was distributed to collect Demographical information and combined the following tools: Food Frequency Questionnaire (FFQ), International Physical Activity Questionnaire (IPAQ), WHO-5 wellbeing score, and Pittsburgh Sleep Quality Index (PSQI). A snowball none-discriminate sampling procedure was followed to collect data from people attending or working at higher institution had covering the period between Mar/00/2020 and Apr/24/2020. A total of 1723 completed responses (917 Males 37.4 ± 13.4 yrs. old and (806 Females 32.2 ± 11.5 yrs. old) were collected.Results Female participants had significantly lower mental health scores as compared to males (53.9% vs 46.1%). on Mental wellbeing score was better among participants with medium and high Physical Activity Levels (p < 0.00). Additionally, mental wellbeing score was significantly improved by dietary quality and sleeping score (p < 0.001). However, physical activity was by far the major determinants of mental health score.Conclusion Factors such as PA, Diet, sleeping patterns were associated with mental wellbeing during COVID-19 confinement among Arab participants.