CO-SPROUT: A PILOT DOUBLE-BLINDED RANDOMISED CONTROL TRIAL of BROCCOLI SPROUT for PREGNANT WOMEN with COVID-19: STUDY PROTOCOL

Background: COVID-19 is caused by SARS-CoV-2 and has is responsible for over 619 million infections and over 6.5 million deaths globally since identification in 2019. Infection during pregnancy is associated with increased adversity including increased risks of admission to intensive care, increased ventilatory support, preeclampsia, preterm birth and maternal death. Vaccination remains the best protection against severe disease. The majority of trials for novel or repurposed COVID-19 therapies including mRNA vaccinations have excluded pregnant or lactating women despite being an at-risk population. Broccoli sprout extract contains a naturally occurring phytonutrient sulforaphane which upregulates the Nrf2 transcription factor resulting in expression of antioxidant proteins, anti-inflammatory effects and has demonstrated anti-viral effects in-vitro . Severe COVID-19 results in excessive cytokine production resulting in a proinflammatory state with significant oxidative stress and multi-organ dysfunction with evidence of placental abnormalities in almost half of infected mothers. Method(s): CO-Sprout is a pilot, double blinded, placebo controlled randomised trial that is recruiting pregnant women ( n = 60) between 20 and 36 weeks completed gestation with COVID-19 diagnosed within 5 days. Participants are randomised to either broccoli sprout capsules (containing 21 mg sulforaphane) or identical placebo (microcrystalline cellulose) twice daily for 14 days. The primary outcome will be duration (days) of COVID-19 related symptoms and other exploratory outcomes including unplanned hospital admissions, birth outcomes, inflammatory markers, microbiome and placental changes. Patients are recruited through maternity departments at Monash Health and Jessie McPherson Private Hospital. Result(s): Trial in progress. Conclusion(s): Trial results to be published after trial completion.

Rational design of anti-inflammatory lipid nanoparticles for mRNA delivery.

Lipid nanoparticles (LNPs) play a crucial role in delivering messenger RNA (mRNA) therapeutics for clinical applications, including COVID-19 mRNA vaccines. While mRNA can be chemically modified to become immune-silent and increase protein expression, LNPs can still trigger innate immune responses and cause inflammation-related adverse effects. Inflammation can in turn suppress mRNA translation and reduce the therapeutic effect. Dexamethasone (Dex) is a widely used anti-inflammatory corticosteroid medication that is structurally similar to cholesterol, a key component of LNPs. Here, we developed LNP formulations with anti-inflammatory properties by partially substituting cholesterol with Dex as a means to reduce inflammation. We demonstrated that Dex-incorporated LNPs effectively abrogated the induction of tumor necrosis factor alpha (TNF-ɑ) in vitro and significantly reduced its expression in vivo. Reduction of inflammation using this strategy improved in vivo mRNA expression in mice by 1.5-fold. Thus, we envision that our Dex-incorporated LNPs could potentially be used to broadly to reduce the inflammatory responses of LNPs and enhance protein expression of a range of mRNA therapeutics.

Testing the In Vitro and In Vivo Efficiency of mRNA-Lipid Nanoparticles Formulated by Microfluidic Mixing.

Lipid nanoparticles (LNPs) have attracted widespread attention recently with the successful development of the COVID-19 mRNA vaccines by Moderna and Pfizer/BioNTech. These vaccines have demonstrated the efficacy of mRNA-LNP therapeutics and opened the door for future clinical applications. In mRNA-LNP systems, the LNPs serve as delivery platforms that protect the mRNA cargo from degradation by nucleases and mediate their intracellular delivery. The LNPs are typically composed of four components: an ionizable lipid, a phospholipid, cholesterol, and a lipid-anchored polyethylene glycol (PEG) conjugate (lipid-PEG). Here, LNPs encapsulating mRNA encoding firefly luciferase are formulated by microfluidic mixing of the organic phase containing LNP lipid components and the aqueous phase containing mRNA. These mRNA-LNPs are then tested in vitro to evaluate their transfection efficiency in HepG2 cells using a bioluminescent plate-based assay. Additionally, mRNA-LNPs are evaluated in vivo in C57BL/6 mice following an intravenous injection via the lateral tail vein. Whole-body bioluminescence imaging is performed by using an in vivo imaging system. Representative results are shown for the mRNA-LNP characteristics, their transfection efficiency in HepG2 cells, and the total luminescent flux in C57BL/6 mice.

Socio-ecological value chain resilience and cleaning workers

Examining the ways that industries survived the COVID-19 pandemic can teach us a great deal about the resilience of value chains, the ways value chain dynamics shape worker resilience, and the measures states can adopt to support both. In this paper we critically examine the thriving body of theory known broadly as supply chain resilience and explore a branch that embraces socio-ecological perspectives. We first develop a theoretical model that takes what we perceive to be the most fruitful elements of these literatures for industrial relations scholarship and bring it together with approaches tangential to industrial relations concerned with value chain actor and worker agency and resilience. We then apply this model in an analysis of the Australian commercial cleaning sector during the pandemic. Finally, we assess federal and state measures to assist and "buffer" employment and the economy in Australia, including JobKeeper and JobSeeker. We find that these government measures, combined with earlier restructuring of the labour market and restrictive immigration policies, provided the institutional scaffolding for the failure of the cleaning industry during the pandemic, exactly when cleaning became an essential service for the resilience of the whole of society.

The development of Virtual simulation technology learning materials in General X-Ray Positioning Lower Extremity for Education of Radiological Technology student

Introduction Positioning the patient and radiography techniques employing General X-ray are the fundamentals that a Radiological Technology student must understand. Because of the Covid-19 outbreak, online training has become the primary instructional technique. Students may lose interest in studying as a result of the lack of communication. The purpose of this study was to develop Virtual Reality learning resources that might be utilized as teaching aids. Methods Lower Extremity Positioning was researched and developed utilizing General X-ray documentation and VDO360 degree. Permitting three experts to experiment with virtual reality learning materials and conducting three evaluations, including the Technology Acceptance Model, content and media appropriateness, and Content Validity Index, and using the data to design virtual reality learning materials displayed on the Oculus Rift S. The sample group was subsequently provided with the evaluated learning materials. Radiology technical third-year students(n=31) from the Faculty of Medicine at Prince Songkhla University were selected at random to submit the examination and satisfaction evaluation form. Results According to the findings of the research, the three evaluations' results were acknowledged by the three experts and were adequate in terms of content and media appropriateness (x= 4.29, SD = 0.53). The sides of the Technology Acceptance Model 3 were approved. The exam was consistent with the Content Validity Index score (S-CVI = 0.934) (x= 4.31, SD = 0.66) and the exam was consistent with the Content Validity Index score (x= 4.31, SD = 0.66) At the 0.05 significant level, the student post-test score (x= 17.00, SD = 1.50) seemed to be higher than the pretest score (x=11.00, SD = 3.00), and the student's satisfaction feedback with the learning material was at the highest level (x=4.73, S.D. = 0.13). Conclusion Student feedback indicates that VDO 360 degree General X-Ray Positioning Lower Extremity Virtual Simulation is an efficient instructional tool for radiography. Due of its practical use, virtual reality simulation is seen as a significant instructional tool by students. To realize the advantages of virtual reality, it must be methodically integrated into the curriculum.

Humoral Response After a Third Dose of Sars-CoV-2 mRNA Vaccine in Transplant Recipients

Purpose: Prior studies demonstrated an increased immune response post-3rd COVID-19 vaccine dose when given 1-month post-2nd dose in solid organ transplant recipients (SOT). This study assessed whether a 3rd mRNA vaccine dose administered 6 months post-2nd dose enhanced humoral immune response in SOT. Method(s): A prospective cohort study was conducted of SOT, without prior COVID-19, who received 3 mRNA vaccine doses (BNT162b2 (Pfizer) or mRNA- 1273 (Moderna)). Primary outcome was a positive serologic response characterized by an anti-receptor-binding domain (RBD) antibody (Ab) level of >100 U/mL 4 weeks post-3rd dose (measured with the Roche Elecsys anti-SARS-CoV-2 immunoassay). Result(s): 175 SOT were enrolled: 48 (27%) heart, 72 (41%) lung, 51 (29%) kidney, 4 (2%) other SOT (Figure 1). A positive anti-RBD Ab level measured 4-weeks post-3rd vaccine dose was present in 105/175 (60%). In a multivariable model, age >60 years (adjusted odds ratio [aOR] 0.41;95% CI 0.19 to 0.87), heart (aOR 0.28;95% CI 0.10 to 0.76) or lung (aOR 0.20;95% CI 0.07 to 0.55) transplant, and mycophenolate use (aOR 0.24;95% CI 0.11 to 0.54) were independent risk factors for not developing a positive Ab post-3rd dose. Patients transplanted >10 years ago were more likely to have a positive Ab (aOR 4.95;95% CI 1.04 to 23.42). Those with a low positive Ab (>0.8 to <100 U/mL) post-2nd vaccine dose were more likely to have a positive Ab post-3rd dose than those with an undetectable Ab (<0.8 U/mL). But 26/105 (25%) participants with an undetectable Ab post-2nd dose developed an Ab of >100 U/ mL;9/26 (35%) developed an Ab >1000 U/mL (Figure 2). 4 (2%) SOT developed rejection within 30-days post-3rd dose. Conclusion(s): Despite the extended time interval of 6 months between the 2nd and 3rd doses, the proportion of non-responders (40%) in this study was similar to other studies when the 3rd dose was given 1-month post-2nd dose. These data suggest that a substantial proportion of SOT remain at risk for COVID-19 after 3 mRNA vaccine doses. Additional interventions need to be further studied, including monoclonal Ab as pre-exposure prophylaxis and 4th vaccine doses. (Figure Presented).

THE NATIONAL CENSUS OF UK ENDOSCOPY SERVICES 2021

Introduction The Joint Advisory Group (JAG) on Gastrointestinal (GI) Endoscopy biennial census provides an insight into the provision of UK endoscopy services. We report on the 2021 census which was conducted to understand the impact of COVID-19 and ongoing pressures on endoscopy services. Methods The census was disseminated to all JAG-registered services in April 2021 using an online survey platform. Prior to analysis, any missing data from services was sought as part of a second step verification process. Data were analysed across the domains of endoscopic activity, waiting time targets, workforce, COVID-19, safety, GI bleeding, anaesthetic support, equipment and decontamination. Outcome variables from each section of the census were analysed against independent variables derived from service-specific core demographic data (JAG accreditation status, sector and region) using a variety of statistical methods. Results Overall, 321 services completed the census, with information pertaining to 393 individual units (response rate 79.2%). In 2020, just over 1.5 million endoscopic procedures were performed across all services. In the first 3 months of 2021, 66% of services met urgent cancer waits, 38.7% met routine waits and 33.9% met surveillance waits (Figure 1). Workforce redeployment was the predominant reason cited for not meeting targets. There were significant regional differences in the proportion of patients waiting 6 or more weeks (p = 0.001). During the pandemic, 64.8% of NHS services had staff redeployed and there was a mean sickness rate of 8.5% with no clear variation across sectors or regionally. Endoscopic activity was outsourced to the private sector in 21.6% of services. Services were, on average, at 79.3% activity compared to 2 years ago. JAG accredited services are more likely to meet urgent cancer waits, with a lower proportion of patients waiting 6 weeks or more (p = 0.03). Clinical endoscopists, who make up 11% of the endoscopist workforce, have a significantly greater number of annual planned sessions per individual than consultant colleagues, who make up 75% of the workforce. Over 10% of services stated that equipment shortage interferes with service delivery. Conclusions Services are adapting to continued pressure and there are signs of a focussed response to demand during a time of ongoing uncertainty. These findings will inform ongoing guidance from JAG and relevant stakeholders.

Addressing Challenges of Community and Academics for CS Pre-Majors: CS Redshirt Program

Mirroring the trend of the growth of Computer Science (CS) programs nation and worldwide, the CS program in the College of Engineering at Tennessee Technological University has experienced similar growth in the number of students enrolling in its B.S., M.S., and Ph.D. programs. This growth of enrollment in CS has been accompanied by a growth in another student population at the university that is often overlooked: Interdisciplinary Studies - Interest in Computer Science (ICSC) majors. This population represents students who have qualified for admission at Tennessee Tech, but have not qualified for entry into the CS program. Indeed, just as the freshman class of CS has grown 44%, the ICSC program has grown 63%. To address the problem of retention and migration into CS from ICSC, we have developed the pre-CS Redshirt program, which is aimed at providing increased advising, peer mentoring, tutoring, and connections to faculty. Launched in Fall 2020, the challenges facing these students have been compounded by COVID-19. In order to study initial effectiveness, we measured Fall-Spring retention, comparative GPAs for students in the CS and ICSC programs, and conducted a survey of students to measure students' sense of belongingness with the measured population including students of all levels currently enrolled in the CS program as well as the pre-CS Redshirt students.

A HYBRID REXCEPTION NETWORK FOR COVID-19 CLASSIFICATION FROM CHEST X-RAY IMAGES

Nowadays, with the rapid spread of Coronavirus disease (COVID-19) across the globe, the necessity to develop an intelligent system for early diagnosis and detection the COVID-19 infectious disease increases. In recent researches, Chest X-ray (CXR) of individual lungs became a common method to identify COVID-19 virus. Manual interpretation of the CXR images can be a lengthy process and subjective to human errors. In this paper, a hybrid Deep Learning model called ReXception is implemented, trained, and evaluated using two types of datasets;Mutliclass and Binary. The network is evaluated based on its overall accuracy, loss, precision, and recall, in addition to the running time and network size. The results show positive indications of the network's performance, especially when compared to other state-of-the-art networks.

Venetoclax with Azacitidine or Low Dose Cytarabine As an Alternative to Intensive Chemotherapy in Fit Adults during the COVID19 Pandemic: Real World Data from the UK National Health Service

Background Based on early evidence of a high rate of coronavirus mortality in patients with acute myeloid leukaemia (AML) undergoing intensive chemotherapy (IC), the national health service (NHS) in the United Kingdom temporarily made venetoclax available as an alternative therapy, with the aim of reducing both mortality and healthcare resource use. From late April 2020, venetoclax was available to patients aged >16y with NPM1 mutation without FLT3 internal tandem duplication (ITD), patients aged >50y with NPM1, IDH1 or IDH2 mutations (regardless of FLT3 status) and patients aged >60y without favourable-risk cytogenetics. Venetoclax could be given with either azacitidine or low-dose cytarabine (LDAC), with the latter recommended mainly for patients with NPM1 mutation. We report a health-system-wide real world data collection for toxicity and patient outcomes across 65 NHS Hospitals. Methods Each patient was registered on a central NHS database. Clinicians certified that their patient met the above criteria, had not received previous AML treatment, and was fit for induction chemotherapy. Anonymised data were retrospectively collected by treating physicians. Venetoclax dose, duration and toxicity information was requested for the first 4 cycles of therapy. Response definitions were as per European Leukaemia Network (ELN) guidelines. A total of 870 patients have been registered on the scheme, with outcomes reported here for those with follow-up information at a data cut on 1st August 2021. Results There were 301 patients, median age 72y (range 34 - 90) with 62% male. The majority (81%) had an ECOG performance status of 0-1. AML was secondary to a previous haematological disorder in 33%, therapy-related in 10% and de novo in the remaining 57%. MRC cytogenetic risk was intermediate in 70% and adverse in 27%. NPM1 mutations were detected in 28% and FLT3-ITD in 12%. Next-generation sequencing results were available in 86% of patients, which detected mutations in IDH1 or IDH2 in 28%, ASXL1 in 20%, RUNX1 in 17% and TP53 in 12%. The ELN risk was favourable for 23%, intermediate for 30% and adverse for 44%. A majority received venetoclax in combination with azacitidine (85%), with the remaining 15% receiving LDAC. The LDAC cohort was enriched for de novo AML (76% vs 54%) and NPM1-mutated disease (56% vs 23%). Most patients (81%) followed the recommended initial schedule of venetoclax 100mg daily for 28 days in combination with posaconazole or voriconazole. Patients spent a median 14 days in hospital in cycle 1, then a median of 0 days for cycles 2-4. In cycles 1, 2, 3 and 4, the median number of days for recovery of neutrophils to >0.5x10 9/L was 33, 25, 24 and 14 respectively, and the median number of days to recovery of platelets to >50x10 9/L was 22, 3, 0 (no drop below 50) and 0. The composite complete remission (CR) / CR with incomplete haematological recovery (CRi) rate was 70%. MRD data is being collected. The best response was morphological leukaemia free state (MLFS) in 2%, partial remission in 7% and refractory disease in 11%. CR/CRi was higher in de novo (78%) compared to secondary AML (57%, p=0.02);NPM1 mutated (78% vs 67%, p=0.02) and IDH1/IDH2 mutated disease (85% vs 62%, p=0.02). ELN favourable risk patients had the highest CR/CRi rate (85%, intermediate 71%, adverse 60%, p=0.01). Median follow-up was 8.2 months (95%CI 7.8 - 9.0) with median overall survival (OS) 12.8 months (95%CI 10.9 - not reached). Mortality at day 30 was 5.7% and day 60 was 8.4%. 12-month overall survival was 51%, increasing to 71% in those who achieved CR/CRi. Survival was poorer in secondary (HR 1.9, p <0.01) and therapy-related AML (HR 2.1, p=0.02), better in NPM1 mutated (HR 0.6, p=0.02) and IDH mutated (HR 0.5, p=0.02) disease and poorer with TP53 mutation (HR 2.0, p=0.01). Overall survival did not differ for patients treated with LDAC compared to azacitidine (HR 1.1, p=0.7). Conclusion This large real-world study demonstrates CR/CRi and survival rates comparable to those reported in prospective clinical trials. Importantly, during t e COVID-19 pandemic, the adoption of venetoclax regimens permitted the great majority of treatment to be delivered as an outpatient with significant resource saving at a time of critically constrained inpatient resources. The data support prospective comparisons of venetoclax-based regimens to IC in fit adults with AML particularly in older patients with de novo AML, NPM1-mutated and IDH-mutated disease. [Formula presented] Disclosures: Belsham: Celgene: Other: meeting attendance;Abbvie: Other: meeting attendance. Khan: Abbvie: Honoraria;Astellas: Honoraria;Takeda: Honoraria;Jazz: Honoraria;Gilead: Honoraria;Novartis: Honoraria. Khwaja: Pfizer: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Novartis: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Jazz Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Astellas: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Abbvie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Latif: Kite: Consultancy, Honoraria, Speakers Bureau;Jazz: Consultancy, Honoraria;Daiichi Sankyo: Consultancy, Honoraria;Novartis: Consultancy, Honoraria;Amgen: Consultancy, Honoraria;Abbvie: Consultancy, Honoraria;Astellas: Consultancy, Honoraria, Speakers Bureau;Takeda UK: Speakers Bureau. Loke: Pfizer: Honoraria;Amgen: Honoraria;Janssen: Honoraria;Novartis: Other: Travel;Daichi Sankyo: Other: Travel. Murthy: Abbvie: Other: support to attend educational conferences. Smith: ARIAD: Honoraria;Pfizer: Speakers Bureau;Daiichi Sankyo: Speakers Bureau. Whitmill: Daiichi-sankyo: Other: travel fees;EHA in stockholm: Other: conference support. Craddock: Novartis Pharmaceuticals: Other: Advisory Board;Celgene/BMS: Membership on an entity's Board of Directors or advisory committees, Research Funding. Dillon: Shattuck Labs: Membership on an entity's Board of Directors or advisory committees;Jazz: Other: Education events;Pfizer: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: educational events;Novartis: Membership on an entity's Board of Directors or advisory committees, Other: Session chair (paid to institution), Speakers Bureau;Menarini: Membership on an entity's Board of Directors or advisory committees;Astellas: Consultancy, Other: Educational Events, Speakers Bureau;Amgen: Other: Research support (paid to institution);Abbvie: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Research Support, Educational Events.

Gilteritinib for Relapsed Acute Myeloid Leukaemia with FLT3 Mutation during the COVID-19 Pandemic: Real World Experience from the UK National Health Service

Background Early data suggest that patients undergoing salvage chemotherapy for relapsed or refractory (R/R) acute myeloid leukaemia (AML) have poor outcomes if infected with SARS-CoV-2, and nosocomial transmission has been a major problem worldwide. Gilteritinib is effective in R/R FLT3 mutated AML, is significantly less immunosuppressive and does not require hospital admission, however at the start of the pandemic this was not yet approved for routine use in all countries. In the United Kingdom, the National Health Service (NHS) made gilteritinib available as an emergency measure from late April 2020 to patients aged >16y with R/R FLT3 mutated AML, with the aim of reducing both mortality and healthcare resource use. We report a health-system-wide real world data collection for toxicity and patient outcomes across 27 NHS Hospitals. Methods Each patient was registered on a central NHS database, with clinicians certifying that their patient met the above criteria. Anonymised data were retrospectively collected by treating physicians. Gilteritinib dose, duration and toxicity information was requested for the first 4 cycles of therapy. Response definitions were as per European Leukaemia Network (ELN) guidelines. A total of 81 patients have been registered on the scheme, with outcomes reported here for those with follow-up information at a data cut on 1st August 2021. Results Fifty patients were included with a median age of 59y (range 19 - 77) and 50% male. The majority (83%) had an ECOG performance status of 0-1. AML was secondary to a previous haematological disorder in 12%, therapy-related in 4% and de novo in the remaining 84%. The disease was refractory to the last therapy in 38%. Most patients had previously received 1 (65%) or 2 (33%) lines of therapy, including intensive chemotherapy in a majority (86%). A FLT3 inhibitor had previously been administered to 45% and 35% were post allogeneic transplant. The FLT3 mutation was an internal tandem duplication (ITD) in 80% and tyrosine kinase domain (TKD) mutation in 22%. NPM1 mutations were detected in 34%. Next-generation sequencing results were available for 94% of patients, with mutations in IDH1 or IDH2 in 12.5%, ASXL1 in 2%, RUNX1 in 21% and no TP53 mutations. Patients spent a median 3.5 days in hospital in cycle 1, 0 days in cycles 2 and 3 and 1 day in cycle 4. In cycles 1, 2, 3 and 4, the median number of days of grade 4 neutropenia was 18, 7, 7.5, and 6.5 respectively, and the grade 4 thrombocytopenia was 2, 7, 0.5 and 0.5. The composite complete remission (CR) / CR with incomplete haematological recovery (CRi) rate was 27%. MRD data is being collected. The best response was morphological leukaemia free state (MLFS) in 4%, partial remission (PR) in 25% and refractory disease in 38%. The rate of combined CR/CRi did not differ in those with previous exposure to FLT3 inhibitors (23% vs 32%, p=0.6) or with past allogeneic transplant (29% vs 27%, p=0.3). There were no CR/CRi in patients with adverse cytogenetic risk. Median follow-up was 10.5 months (95%CI 7.3 - 12.3) with median overall survival (OS) 6.7 months (95%CI 4.5 - not reached). Mortality at day 30 was 0% and day 60 was 14%. 12-month overall survival was 38%. Patients who achieved a CR/CRi had a 12-month OS of 83%, and for PR this was 35%. Survival did not differ in those with previous FLT3 inhibitor exposure (HR 1.0, p>0.9) or allogeneic transplant (HR 0.63, p=0.3). Seven patients (14%) so far have been bridged with gilteritinib to allogeneic transplant. Conclusion Our data demonstrate that gilteritinib is well tolerated and clinically active in adults with relapsed FLT3 mutated AML. Importantly, during the COVID-19 pandemic, its availability has permitted the great majority of treatment to be delivered as an outpatient with significant resource saving at a time of critically constrained inpatient resources. Patients who achieve CR/CRi have good short-term outcomes and are able to proceed to a potentially curative allogeneic stem cell transplant. [Formula presented] Disclosures: Belsham: Celgene: Other: meeting attendance;Abbvie: Other: meeting attendance. Byrne: Incyte: Honoraria. Khan: Abbvie: Honoraria;Astellas: Honoraria;Takeda: Honoraria;Jazz: Honoraria;Gilead: Honoraria;Novartis: Honoraria. Khwaja: Pfizer: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Novartis: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Jazz Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Astellas: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Abbvie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Latif: Kite: Consultancy, Honoraria, Speakers Bureau;Jazz: Consultancy, Honoraria;Daiichi Sankyo: Consultancy, Honoraria;Novartis: Consultancy, Honoraria;Amgen: Consultancy, Honoraria;Abbvie: Consultancy, Honoraria;Astellas: Consultancy, Honoraria, Speakers Bureau;Takeda UK: Speakers Bureau. Loke: Amgen: Honoraria;Daichi Sankyo: Other: Travel Support;Janssen: Honoraria;Novartis: Other: Travel Support;Pfizer: Honoraria. Munisamy: Jazz Pharmaceuticals: Speakers Bureau;Roche: Speakers Bureau. Murthy: Abbvie: Other: support to attend educational conferences. Smith: Daiichi Sankyo: Speakers Bureau;Pfizer: Speakers Bureau;ARIAD: Honoraria. Craddock: Novartis Pharmaceuticals: Other: Advisory Board;Celgene/BMS: Membership on an entity's Board of Directors or advisory committees, Research Funding. Dillon: Amgen: Other: Research support (paid to institution);Astellas: Consultancy, Other: Educational Events, Speakers Bureau;Menarini: Membership on an entity's Board of Directors or advisory committees;Novartis: Membership on an entity's Board of Directors or advisory committees, Other: Session chair (paid to institution), Speakers Bureau;Pfizer: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: educational events;Jazz: Other: Education events;Shattuck Labs: Membership on an entity's Board of Directors or advisory committees;Abbvie: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Research Support, Educational Events.

He 'A'ali'i Kū Makani Mai Au: Developing a Cultural Framework for Advancing COVID-19 Related, Community-informed Health Policies

The Native Hawaiian and Pacific Islander community found itself on the front pages of national news when the COVID-19 pandemic struck the United States. By April 2020, the small, frequently overlooked community experienced the highest COVID-19 case rates in 5 states including Hawai'i. In response, Native Hawaiian and Pacific Islander networks across the US were mobilized to address the crisis. In Hawai'i, the Native Hawaiian Pacific Islander COVID-19 Response, Recovery, and Resilience Team was created. Framed by Indigenous Pacific based cultural values, protocols, and practices, the team consists of multiple committees that examine policy;testing, contract tracing, and isolation;communications;social supports and resources;and data and research. Inherent in this work are the shared core values of pono (righteousness, goodness), aloha (love, compassion), laulima (cooperation), and imua (moving forward with strength) as well as an 'ohana/aiga (family)-based, kuleana (responsibility)-centric approach that acknowledges, honors, and values 'ike kūpuna (ancestral knowledge). With the burden of not only COVID-19 disparities, but also chronic diseases and socioeconomic disparities that place Native Hawaiian and Pacific Islander communities at increased risk for adverse impacts from COVID-19, an effective response is critical. This article, authored by members of the Team's Policy Committee, discusses the development of a cultural framework that guides its advocacy efforts. The Policy Committee's work presents a cultural framework that grounds and guides their efforts for effectively promoting a strong voice in governmental and agency policies which would ultimately contribute to a healthy and thriving Native Hawaiian and Pacific Islander community. ©Copyright 2021 by University Health Partners of Hawai‘i (UHP Hawai‘i).

Should we replace telephone with video consultation to improve patient experience? - The Queen Elizabeth Hospital experience

Content: The COVID-19 pandemic has mandated rapid adoption of a new approach to outpatient appointments for our Haematology patients, the majority of whom are classed as vulnerable and have been required to isolate for prolonged periods following government guidelines. Within a short space of time remote consultation by telephone replaced the traditional face-to-face outpatient consultation for the majority of our patients. There has been appetite in other departments locally and regionally to consider implementation of video consultation as a replacement for telephone consultation and we were asked as a department to consider implementation to enhance patient experience. We were concerned that adoption of video consultation would create barriers for some, and questioned whether our patients would perceive a benefit of video, compared to telephone consultation. We identified and contacted by telephone 36 consecutive patients who had participated in a general haematology telephone consultation during the final two weeks of June 2020. We designed a survey to assess patient satisfaction of the telephone consultation;access to hardware necessary to participate in video consultation;relevant experience of using video calling / conferencing and their preference when offered further remote consultations. Of the 29 patients who consented to be surveyed, 28 were satisfied with the process and quality of their telephone consultation (97%). We found that 6 patients (21%) did not have access to necessary hardware to participate in video consultation and although the rest had the hardware to participate;only 15 patients (52%) had any prior experience of using video calling / conferencing and would feel confident to use similar software. We asked our patients about their level of preference for video consultation in the future. We found that only 5 patients (17%) would prefer to have a video consultation, with the level of preference falling further to only 2 patients (7%) should the software required to participate not be available to install remotely on a home device. Our results show that our patients have a high level of satisfaction using the telephone as a method of remote consultation. We demonstrate a low level of perceived preference for video consultation and highlight both the high level of unfamiliarity using video calling / conferencing software and inability for a significant proportion to access the necessary hardware to participate in video consultation at all. We conclude as a department, that changing to video consultation from telephone consultation as a standard means of remote consultation will not increase patient satisfaction and will focus our attention and resource allocation on other areas of practice to improve our patient's experiences.

Implementation of long-term non-participant reminders for flexible sigmoidoscopy screening.

The clinical effectiveness of screening is highly dependent on uptake. Previous randomised controlled trials suggest that non-participant reminders, which highlight the opportunity to re-book an appointment, can improve participation. The present analysis examines the impact of implementing these reminders within the English Flexible Sigmoidoscopy (FS) Screening Programme, which offers once-only FS screening to adults aged 55-59 years. We assessed the screening status of 26,339 individuals invited for once-only FS screening in England. A total of 10,952 (41.6%) had attended screening, and were subsequently ineligible. The remaining 15,387 had not attended screening, and were selected to receive a reminder, 1-2 years after their invitation. Descriptive statistics were used to assess the increase in uptake and the adenoma detection rate (ADR) of those who self-referred, six months after the delivery of the final reminder. Pearson's Chi-Square was used to compare the ADR between those who attended when invited and those who self-referred. Of the 15,387 adults eligible to receive a reminder, 13,626 (88.6%) were sent a reminder as intended (1,761 were not sent a reminder, due to endoscopy capacity). Of these, 8.0% (n = 1,086) booked and attended an appointment, which equated to a 4.1% increase in uptake from 41.6% at baseline, to 45.7% at follow-up. The ADR was significantly higher for those who self-referred, compared with those who attended when invited (13.3% and 9.5%, respectively; X 2 = 16.138, p = 0.000059). The implementation of non-participant reminders led to a moderate increase in uptake. Implementing non-participant reminders could help mitigate the negative effects of COVID-19 on uptake.

Humanizing practices in online learning communities during pandemics in the USA

Purpose: In this reflective essay, the authors, four educators of color, explore the relevance of humanizing practices of community in teaching and learning, school leadership and the potential challenges for equity work in education, during the COVID-19 pandemic. Design/methodology/approach: This reflective essay draws on lessons learned from the pedagogical practices of women of color, literature on teachers of color, as well as our experiences as educators of teachers and school leaders, as the authors think about new possibilities and challenges for anti-racist practice and living during the pandemic. Findings: This essay describes community-oriented practice of women of color educators to be important in orienting teaching and learning toward more humanizing practice. The reflections highlight both possibilities and challenges that can be helpful reimagining the practice in teacher and leadership education, as the authors prepare educators for an uncertain future. Originality/value: This essay offers valuable lessons from women of color educator practice that can offer humanizing approaches to teaching and learning as well as school leadership education. © 2020, Emerald Publishing Limited.