Use of Non-Invasive Respiratory Support Strategies in pediatric patients with SARS-CoV-2. A Scoping Review

Introduction: The use of non-invasive respiratory support strategies (NIRS) has been shown to reduce the consumption of resources associated with the requirement of intensive care unit and hospital stay in pediatric patients with acute respiratory failure, however, it is considered important to identify their frequency of use in pediatric patients with SARSCoV-2 and its relationship with the hospital stay. Objective: To identify the frequency of use of noninvasive respiratory support strategies (NIRS) in pediatric patients with SARS-CoV-2. Material and methods: Scoping review of the frequency of use of NIRS in pediatric SARS-CoV-2 between January 2020 and September 2021. The search was executed in the Cochrane Library, PubMed, Scopus databases, and the bibliographic search engines Science Direct and Oxford. Results: It was found that conventional, follow-up, or high-flow oxygen therapy and noninvasive mechanical ventilation are used more frequently in hospital settings. Conclusion: The NIRS of greater implementation in the pediatric patient with SARS-CoV-2 was conventional oxygen therapy and as a finding of interest its association with higher hospital stays was evidenced. © 2023 Academia Nacional de Medicina. All rights reserved.

Adapting through a Pandemic: Creating a Hands-On Mechatronics Laboratory with Team-Based Collaboration for Remote Learning

This paper introduces a hands-on laboratory curriculum for an undergraduate mechatronics course that delivers a team-based collaborative student experience for remote learning. COVID-19 pandemic created unexpected challenges for educators, where in-person teachings had to quickly transition to remote learning. This significantly impacted learning outcomes for hands-on laboratory courses by students not having access to laboratory equipment and the difficulty to follow the education practice “learn by doing” in the confines of their home. A remote laboratory curriculum is introduced with a series of hands-on mechatronic labs. Three individual student labs introduce how to operate a microcontroller, process infrared sensor signals, and program digital communication displays. Then two team-based collaborative labs explore how students can transmit/receive signals to control a servo using an ESP32 microcontroller with wireless communication over a bi-directional shared server. Then a course project on remote teleoperation is introduced for student-to-student collaboration at home. The learning experience gave students insight into a growing technological area, where teleoperation is in such fields as in-home healthcare, space and ocean exploration, and human-machine collaboration. Student survey results provided positive feedback on their ability to meet project requirements with the challenges of being at home instead of having an in-person learning environment. © American Society for Engineering Education, 2022.

SARS-CoV-2 Cycle threshold (Ct) values predict future COVID-19 cases

Background. The threat of surging COVID-19 cases prompted many hospitals in the United States to preemptively suspend elective procedures throughout the pandemic. Utilizing samples from a large hospital in Los Angeles, we sought to determine if temporal trends in SARS-CoV-2 Cycle threshold (Ct) values (proxy for viral RNA loads) were predictive for the number of future COVID-19 cases. Methods. Nasopharyngeal specimens on symptomatic patients and asymptomatic admissions were tested using the Xpert Xpress SARS-CoV-2 and SARS-CoV-2/ Flu/RSV assays (Cepheid). Ct values for all SARS-CoV-2 detections between October 2020 to March 2021 were compiled for analysis. Results. A total of 2,114 SARS-CoV-2-positive samples were included. The number of tests performed per week increased dramatically in December peaking the first week of January before returning to pre-surge numbers by Mid-February. Ct values fell during this same period with values in December and January (25.6±7.8 and 27±7.9, respectively) significantly lower than those of the other months (30±9.3 to 37.7±6.3). Average weekly Ct values for all patients were significantly, negatively correlated with the number of tests run the following week (R= -0.71, P< 0.001) and two weeks later (R= -0.75, P< 0.0001). Ct values for patients who were asymptomatic at the time of testing most strongly correlated with total number of tests performed one month later (R= -0.86, P< 0.0001). Average weekly Ct values and number of test run As cases (light grey) increased during December and January, there was a significant decrease in Ct values (dark grey) during that same time period. Average Ct values are a leading indicator of cases Average weekly Ct values for all patients (light grey) were significantly, negatively correlated with the number of tests run the following week (R= -0.71, P<0.001) and two weeks later (R= -0.75, P<0.0001). Ct values for patients who were asymptomatic at the time of testing (dark grey) most strongly correlated with total number of tests performed one month later (R= -0.86, P<0.0001). Conclusion. Lower Ct values, representing higher levels of viral RNA, have been associated with risk of intubation and infectivity. During the winter surge, we observed significantly lower Ct values suggesting that the increased transmission and morbidity of COVID-19 was temporarily associated with higher viral loads. Interestingly, Ct values for asymptomatic patients were most strongly associated with number of cases observed 1 months in the future, suggesting that asymptomatic viral load may be a leading indicator for forthcoming outbreaks. Given this association, Ct values may be a useful tool for predicting regional outbreaks of COVID-19 and more judicious cessation of elective procedures.