Genomic epidemiology of SARS-CoV-2 in Sudan: A retrospective analysis 2020-2022 (preprint)

SARS-CoV-2 was first detected in Sudan on 13th March 2020. Here, we describe the genomic epidemiology of SARS-CoV-2 in Sudan between May 2020 and April 2022 to understand the introduction and transmission of SARS-CoV-2 variants in the country. A total of 667 SARS-CoV-2 positive samples were successfully sequenced using the nCoV-19 Artic protocol on the Oxford Nanopore Technology ([≥]70% genome completeness). The genomes were compared with a select contemporaneous global dataset to determine genetic relatedness and estimate import/export events. The genomes were classified into 37 Pango lineages within the ancestral strain (107 isolates across 13 Pango lineages), Eta variant of interest (VOI) (78 isolates in 1 lineage), Alpha variant of concern (VOC) (10 isolates in 2 lineages), Beta VOC (26 isolates in 1 lineage), Delta VOC (171 isolates across 8 lineages) and Omicron VOC (242 isolates across 12 lineages). We estimated a total of 144 introductions of the observed variants from different countries across the globe. Multiple introductions of the Eta VOI, Beta VOC and Omicron VOC were observed in Sudan mainly from Europe and Africa. These findings suggest a need for continuous genomic surveillance of SARS-CoV-2 to monitor their introduction and spread consequently inform public health measures to combat SARS-CoV-2 transmission.

Governing systemic and cascading disaster risk in Indonesia: where do we stand and future outlook

PurposeThis paper aims to identify key factors for a contextualised Systemic Risk Governance (SRG) framework and subsequently explore how systemic risks can be managed and how local institutional mechanisms can be tweaked to deal with the complex Indonesian risk landscape.Design/methodology/approachUsing a case study from Palu triple-disasters in Central Sulawesi, Indonesia, the authors demonstrate how inland earthquakes in 2018 created cascading secondary hazards, namely tsunamis, liquefactions and landslides, caused unprecedented disasters for the communities and the nation. A qualitative analysis was conducted using the data collected through a long-term observation since 2002.FindingsThe authors argue that Indonesia has yet to incorporate an SRG approach in its responses to the Palu triple-disasters. Political will is required to adopt more appropriate risk governance modes that promote the systemic risk paradigm. Change needs to occur incrementally through hybrid governance arrangements ranging from formal/informal methods to self- and horizontal and vertical modes of governance deemed more realistic and feasible. The authors recommend that this be done by focusing on productive transition and local transformation.Originality/valueThere is growing awareness and recognition of the importance of systemic and cascading risks in disaster risk studies. However, there are still gaps between research, policy and practice. The current progress of disaster risk governance is not sufficient to achieve the Sendai Framework for Disaster Risk Reduction (2015–2030) unless there is an effective governing system in place at the local level that allow actors and institutions to simultaneously manage the interplays of multi-hazards, multi-temporal, multi-dimensions of vulnerabilities and residual risks. This paper contributes to these knowledge gaps.

Guillain-Barré syndrome following COVID-19 vaccination: An updated systematic review of cases.

Key Clinical Message: Guillain-Barré syndrome (GBS) is a rare but possible complication that may occur after COVID-19 vaccination. In this systematic review, we found that GBS presented in patients with an average age of 58. The average time for symptoms to appear was 14.4 days. Health care providers should be aware of this potential complication. Abstract: Most instances of Guillain-Barré syndrome (GBS) are caused by immunological stimulation and are discovered after vaccinations for tetanus toxoid, oral polio, and swine influenza. In this systematic study, we investigated at GBS cases that were reported after receiving the COVID-19 vaccination. Based on PRISMA guidelines, we searched five databases (PubMed, Google Scholar, Ovid, Web of Science, and Scopus databases) for studies on COVID-19 vaccination and GBS on August 7, 2021. To conduct our analysis, we divided the GBS variants into two groups, acute inflammatory demyelinating polyneuropathy and non-acute inflammatory demyelinating polyneuropathy (AIDP and non-AIDP), and compared the two groups with mEGOS and other clinical presentation In this systematic review, 29 cases were included in 14 studies. Ten cases belonged to the AIDP variant, 17 were non-AIDP (one case had the MFS variant, one AMAN variant, and 15 cases had the BFP variant), and the two remaining cases were not mentioned. Following COVID-19 vaccination, GBS cases were, on average, 58 years of age. The average time it took for GBS symptoms to appear was 14.4 days. About 56 percent of the cases (56%) were classified as Brighton Level 1 or 2, which defines the highest level of diagnostic certainty for patients with GBS. This systematic review reports 29 cases of GBS following COVID-19 vaccination, particularly those following the AstraZeneca/Oxford vaccine. Further research is needed to assess all COVID-19 vaccines' side effects, including GBS.

The high mutation rate at the D614G hotspot-furin cleavage site region increases the priming efficiency of the Spike protein by furin protease: analysis of Indonesian SARS-CoV-2 G614 variants obtained during the early COVID-19 pandemic.

D614G mutation plays a significant role in the transmissibility of SARS-CoV-2. Identification of other mutations related to D614G mutation within the Spike protein is pivotal as they might contribute to the pathogenicity of SARS-CoV-2. This study aims to analyze the mutation rate of furin cleavage site (FCS) region of Indonesian origin SARS-CoV-2 and to predict the effect of mutation against Spike priming efficiency by furin. A total of 375 sequences of Indonesian isolates obtained during the early pandemic were used for mutation analysis. Mutation analysis includes mutation pattern, variability, frequency of mutation, amino acid conservation, and mutation rate. The effect of mutation against Spike priming efficiency by furin protease from eight sequences with mutation in the FCS region was analyzed by protein-protein docking. We showed that mutations related to the G614 variant were increasing through time, in contrast to the D614 variant. The FCS region at the position 675-692 contained the most variable (66.67%) as well as the highest mutation frequency (85.92%) and has been observed to be the hotspot mutations linked to the D614G mutation. The D614G hotspot-FCS region (residue 600-700) had the highest amino acid change per site (20.8%) as well as the highest mutation rate as 1.34 × 10-2 substitution per site per year (95% CI 1.79 × 10-3-2.74 × 10-2), compared with other Spike protein regions. Mutations in the FCS region were the most common mutation found after the D614G mutation. These mutations were predicted to increase the Spike priming efficiency by furin. Thus, this study elucidates the importance of D614G mutation to other mutations located in the FCS region and their significance to Spike priming efficiency by furin. Supplementary Information: The online version contains supplementary material available at 10.1007/s13337-023-00827-w.

Informal settlements, Covid-19 and sex workers in Kenya.

This paper highlights the challenges faced by female sex workers living and working in the urban informal settlements in Nairobi, Kenya, during the Covid-19 outbreak and the aftermath of the pandemic. Using data collected through phone interviews during the immediate crisis, we document the experiences of urban poor sex workers, illustrating the acute problems they faced, including precarious housing with the reality of eviction and demolition. The paper highlights the ramifications of the Covid-19 crisis for the sex industry and predominantly women working within this informal, illegal economy. Through our empirical data we illustrate how the nature of selling sex has changed for sex workers in this context, increasing risks of violence including police abuses. We argue that examining the Covid-19 crisis through the lens of one the most marginalised populations graphically highlights how the pandemic has and will continue to deepen pre-existing structural urban inequalities and worsen public health outcomes among the urban poor. Sex worker communities are often located at the intersections of structural inequalities of gender, class, race and nation and the socio-spatial fragmentations of how they live make them some of the most vulnerable in society. We close with comments in relation to sexual citizenship, exclusionary state practices and the feminisation of urban poverty.

COVID-19 Immune Response In Adults Post Measles-Rubella Vaccination.

Objective: This study aimed to see how measles, mumps, and rubella vaccination affected the increase in SARS-CoV-2 immunoglobulin levels in individuals who had received the second dose of the SARS-CoV-2 vaccine. Material and Method: This research is a quasi-experimental type with a pre-post test design. The population studied were adults who had received the second dose of the SARS-CoV-2 vaccine, consisting of 30 people. Results: The results of this study were that most (60%) research subjects experienced an increase in IgM and some subjects (46.6%) experienced an increase in anti-SARS-CoV-2 IgG levels. The administration of the MR vaccination had no effect on increasing anti-SARS-CoV-2 IgG and IgM levels. This happened because the increase in IgM and IgG levels in the pre and post-tests in most research subjects was relatively low. Conclusion: The administration of the MR vaccine to adults who had received a second dose of the SARS-CoV-2 vaccine elicited a response with low levels of IgG and IgM SARS-CoV-2.

Objetivo: Este estudio tuvo como objetivo ver cómo la vacunación contra el sarampión, las paperas y la rubéola afectó el aumento de los niveles de inmunoglobulina contra el SARS-CoV-2 en personas que habían recibido la segunda dosis de la vacuna contra el SARS-CoV-2. Material y Método: Esta investigación es de tipo cuasi-experimental con un diseño pre-post test. La población estudiada fueron adultos que habían recibido la segunda dosis de la vacuna contra el SARS-CoV-2, conformada por 30 personas. Resultados: Los resultados de este estudio fueron que la mayoría de los sujetos de investigación (60%) experimentaron un aumento de IgM y algunos sujetos (46,6%) experimentaron un aumento en los niveles de IgG anti-SARS-CoV-2. Según los resultados de la prueba T pareada, el valor de p fue superior a 0,05, lo que indica que no hubo cambios significativos en los niveles de IgG e IgM antes y después de la vacunación con MR. Esto sucedió porque el aumento en los niveles de IgM e IgG en las pruebas previas y posteriores en la mayoría de los sujetos de investigación fue relativamente bajo. Conclusión: La administración de la vacuna MR a adultos que habían recibido una segunda dosis de la vacuna SARS-CoV-2 provocó una respuesta con niveles bajos de IgG e IgM SARS-CoV-2.

Mix Method Study Of Acceleration Of Vaccination Acceptance In Community In Polewali And Campalagian Districts

Objectives: This study examined the effectivity of subsystem components in community which could accept the acceleration of Covid-19 vaccine in Polman Region, therefore it becomes information for decision makers to create better health service management which is equal for everyone. Methods: this study applied mix method exploratory design which was conducted in two respective phases: qualitative and quantitative study. Qualitative study was conducted through focus group discussion on 3 target groups (primary, secondary and tertiary) to identify themes, ideas, perspectives, and believes, which became part of quantitative study to be explored. In quantitative study, 133 respondents were recruited from two boarding schools in the target area. Indepth interview and Focus group Discussion were used to collect data in the qualitative method. Quantitative study used descriptive statistics to describe information with frequency distribution. Results: The main results prove that there were relations between the variables found in the two methods which were significant and there was no internal conflict between the qualitative and quantitative findings. The result of the analysis found that the vaccine acceleration model which can be carried out namely involving local organizations and social groups in the COVID-19 information education system as well as taking preventive measures such as vaccination, and it will also be very effective if there were social relationships between individuals who were able to disseminate information about the importance of maintaining health protocols and also to conduct vaccinations in every level of society that could increase trust and follow-up for those who were still doubt about COVID-19 or about government's recommendation for vaccination. Conclusions: We conclude that each dimension of the social ecology and Health Belief Model was found to be consistent in both qualitative and quantitative research findings. [ FROM AUTHOR] Copyright of Journal of Pharmaceutical Negative Results is the property of ResearchTrentz and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Mathematical Modeling of Covid-19 Transmission in Jakarta with Optimal Control Strategy

Covid19 has infected many individuals around the world, this virus is spreading rapidly. In the context of controlling and handling the spread of COVID-19, appropriate strategies and policies are needed, mathematics will play a very important role in this problem, especially to provide information about this with an understanding of the dynamics of the transmission of this covid virus. To suppress the spread of the Covid-19 virus which is currently hitting, several countries have implemented large-scale social restrictions. To identify the best approach to reduce of this Covid-19 disease spreading at minimal cost, we developed a mathematical model of the covid 19 virus by implementing large-scale social restrictions and applying optimal control theory. We provide two types of control: the first is in the form of an education campaign about covid-19 and an awareness program, and the second is in the form of a quarantine program. Compared with no optimal control, giving optimal control can provide a more significant reduction in the number of populations S, Sr, O, P, I and increase the number of individual populations that recover more significantly.

COVID-19 vaccine acceptance and associated factors among people living with HIV in the Middle East and North Africa region

AJOL : Background: Identifying coronavirus disease 2019 (COVID-19) vaccine acceptance and associated factors among people living with HIV (PLHIV) in the Middle East and North Africa region is important to meet the need for broad-scale vaccination against COVID-19. Objectives: To investigate the COVID-19 vaccine acceptance rate and factors among PLHIV in the Middle East and North Africa region. Method: An online cross-sectional survey was conducted among PLHIV currently living in Egypt, Tunisia and Saudi Arabia between March 2021 and August 2021. Results: Of the 540 respondents, 19.3% reported already being vaccinated against COVID-19 (n = 104), 32.0% responded 'definitely yes' (n = 173), and 13.3% responded 'probably yes' (n = 72) for intention to receive a COVID-19 vaccine, with an overall COVID-19 vaccine acceptance rate of 64.6% among PLHIV in the region. The most significant predictors of COVID-19 vaccine acceptance included feeling less worried about COVID-19 transmission post- vaccination (221.0% higher odds), and believing the disease is vaccine-preventable (160.0% higher odds). Reported barriers to COVID-19 vaccine acceptance include concerns about vaccine effectiveness and belief that HIV medications protect against COVID-19 transmission, living in a rural area and reporting less-frequent engagement with HIV care. Nine out of 10 participants reported that the chances of them getting COVID-19 vaccine would increase if given adequate information and if their doctor recommended it. Conclusion: Findings of the study can help researchers, health officials, and other health system actors understand the predictors and barriers to COVID-19 vaccine acceptance reported by PLHIV. This understanding could inform the future planning of interventions tailored to PLHIV

Reflections on medical student evaluations of a public health clerkship

Introduction The COVID-19 pandemic demonstrated the need for skilled medical practitioners in public health, and outbreak investigations. The College of Medicine and Health Sciences at the United Arab Emirates University (UAEU) introduced a clerkship in public health constituting theoretical and practical sessions to 5th year medical students in 2015. The aim of this study is to explore the satisfaction of the students with the public health clerkship which is crucial for the assessment and reformation of the taught curriculum. Methods A cross-sectional, post-evaluation analysis was conducted from the period 2015–2022. The evaluation questionnaire was conducted via an online university system. The survey contained 5 themes: pre-course instructions, structure of the clerkship, academic staff, activities, and learning outcomes. Ethics approval was secured from the Social-IRB of the UAEU. We used SPSS version 26 to analyze the data using independent t-test and ANOVA. Results One hundred and seventy four students (27.4% response rate) participated in the study. Overall, the students had an average satisfaction score of 2.86 out of 4. The majority of the students reported having a good understanding of public health (93.7%), improving their oral presentation skills (91.2%), and developing new skills (87.2%). Furthermore, more than 9 in 10 students (96.1%) reported that the program expanded their knowledge, skills, and confidence. The mass (90.2%) of students agreed that the clerkship content was covered in sufficient depth, majority of the students agreed that they had received enough information about the clerkship before it started (74.6%), majority of the students agreed that the faculty were interested in their personal development (86.1%) The students who completed the clerkship prior to the COVID-19 pandemic had a statistically significant (P = 0.02) higher average rating (72.8%) than students who completed the clerkship during the pandemic (71.1%). Discussion Medical students at the UAEU were satisfied with the activities and delivery of the public health clerkship and found it rewarding. Conducting needs assessment and proposal writing provided them with the knowledge, skills, and confidence to conduct research in their career. These findings may be useful in helping and support other institutes to plan and develop a clerkship in the public health.

Family businesses navigating the COVID-19 pandemic through a gender perspective: the role of external and internal factors in stimulating dynamic capability development

PurposeThe paper aims to decipher, through intertwined external and internal perspectives, how female and male owners of family businesses (FB) that have been affected by the pandemic develop new capabilities to respond to the market's crisis-related needs. Specifically, this study seeks to decipher the role of external support, mediated by the owner's psychological capital (i.e. internal perspective) and moderated by gender, on the development of capabilities related to the market's changing needs, drawing on the dynamic capabilities conceptualization.Design/methodology/approachA sample of responses from 261 Canadian FB owners was generated during the pandemic, and online questionnaires were distributed.FindingsRegression analyses and Hayes' PROCESS tool revealed that while external support directly invigorates capability development, external support is also mediated by psychological capital and moderated by gender, so that female owners were found less likely to use external support for capability development than men. These findings are explained by women's traditional responsibility in FB of protecting the family from external circumstances. Nevertheless, both women and men orchestrated external support, due to the higher psychological capital of FB, to develop capabilities that respond to pandemic-related market needs.Originality/valueThis study explores and demonstrates the unique navigation of FB owners during crises, and the role of the owner's gender in pursuing capability development. The study's value is in interconnecting external and internal perspectives while probing FB during crises. Implications for the ecosystem's conduct toward FB are discussed.

A multi-country phase 2 study to evaluate the suitcase lab for rapid detection of SARS-CoV-2 in seven Sub-Saharan African countries: Lessons from the field

Background : The COVID-19 pandemic led to severe health systems collapse, as well as logistics and supply delivery shortages across sectors. Delivery of PCR related healthcare supplies continue to be hindered. There is the need for a rapid and accessible SARS-CoV-2 molecular detection method in low resource settings. Objectives : To validate a novel isothermal amplification method for rapid detection of SARS-CoV-2 across seven sub-Sharan African countries. Study design : In this multi-country phase 2 diagnostic study, 3,231 clinical samples in seven African sites were tested with two reverse transcription Recombinase-Aided Amplification (RT-RAA) assays (based on SARS-CoV-2 Nucleocapsid (N) gene and RNA-dependent RNA polymerase (RdRP) gene). The test was performed in a mobile suitcase laboratory within 15 minutes. All results were compared to a real-time RT-PCR assay. Extraction kits based on silica gel or magnetic beads were applied. Results : Four sites demonstrated good to excellent agreement, while three sites showed fair to moderate results. The RdRP gene assay exhibited an overall PPV of 0.92 and a NPV of 0.88. The N gene assay exhibited an overall PPV of 0.93 and a NPV 0.88. The sensitivity of both RT-RAA assays varied depending on the sample Ct values. When comparing sensitivity between sites, values differed considerably. For high viral load samples, the RT-RAA assay sensitivity ranges were between 60.5 and 100% (RdRP assay) and 25 and 98.6 (N assay). Conclusion : Overall, the RdRP based RT-RAA test showed the best assay accuracy. This study highlights the challenges of implementing rapid molecular assays in field conditions. Factors that are important for successful deployment across countries include the implementation of standardized operation procedures, in-person continuous training for staff, and enhanced quality control measures.

Emerging Hybrid Online Learning in Post-pandemic Situation: Idealism and Reality

The Covid-19 pandemic has significantly changed the way of learning models, one of which is the implementation of hybrid online learning (HOL). Although some instructors have applied this model to their learning activities, the process and results are still not optimal due to various constraints. Therefore, this paper explores HOL implementation regarding its idealism and reality in post-pandemic situations where face-to-face (F2F) learning is allowed in limited circumstances. For this reason, a descriptive-analytical systematic review of the relevant papers discusses the implementation of learning with the HOL model and is relied upon in this study to draw the reality of its implementation and offer solutions to potential problems. The investigation shows that many instructors have tried to apply this learning model because it is considered very suitable in post-pandemic situations to facilitate students who can attend face-to-face (F2F) in classrooms and for those who choose to be in a different room but still need to keep interacting synchronously with the other participants in the classroom. However, this learning model is considered not optimal in the real situation, both regarding the learning process and achievement of expected learning outcomes, due to several technical and non-technical obstacles. © 2022 IEEE.

Response to COVID-19 vaccination post CAR T therapy in patients with non-Hodgkin lymphoma and multiple myeloma

COVID-19 adversely affects individuals with cancer. Several studies have found that seroconversion rates among patients with hematologic malignancies are suboptimal when compared to patients without cancer. Patients with non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) are immunocompromised due to impaired humoral and cellular immunity in addition to prescribed immunosuppressive therapy. Chimeric antigen receptor T-cell (CAR T) therapy is now widely used for NHL and MM, but little is known about seroconversion rates after COVID-19 vaccination among these populations. We evaluated SARS-CoV-2 spike-binding IgG antibody levels following COVID-19 vaccination among NHL and MM CAR T therapy recipients. Out of 104 CAR T infusions, 19 patients developed known COVID-19 infection post-CAR T. We tested 17 patients that received CAR T for antibody spike titers post COVID-19 vaccination, only 29 % (n=5) were able to mount a clinically relevant antibody response (>250 IU/mL). Clinical Practice Points : Approximately one-third of patients with NHL and multiple myeloma following COVID-19 vaccination and CAR T therapy were able to mount an immune response using the strictest criteria for vaccination immunogenicity in our relatively small sample. Even though patients that receive CAR T have impaired humoral response, COVID-19 vaccination may still benefit this population and perhaps boosters should follow immune reconstitution.

Supply Chain Resilience and Operational Performance: The Role of Digital Technologies in Jordanian Manufacturing Firms

This study aims to analyze the relationship between supply chain resilience (SCR) practices and operational performance and the moderating role of digital technologies in Jordanian manufacturing firms. A descriptive-analytical approach was adopted using a questionnaire based on the study model and previous related literature. Four hundred supply chain (SC)-related managers within seventy-one firms were reached to collect the needed data;three hundred and seventy-two complete questionnaires were analyzed. The results revealed that the level of SCR practices and operational performance was high;SCR (with its sub-dimensions: SC agility (SCA), SC flexibility (SCF), and SC collaboration (SCC)) had a significant positive relationship with operational performance;and the appropriate use of digital technologies had a significant moderating impact on the aggregate level of the SCR–operational performance relationship. Finally, research limitations, practical implications, and future research conclude this study.

The role of partners, parents and friends in shaping young women's reproductive choices in Peri-urban Nairobi: a qualitative study.

BACKGROUND: Contraceptive use among young women in Nairobi remains low despite high general knowledge of family planning (FP) methods. This paper draws on social norms theory to explore the role of key influencers (partners, parents and friends) in women's FP use and how women anticipate normative reactions or sanctions. METHODS: A qualitative study with 16 women, 10 men and 14 key influencers across 7 peri-urban wards in Nairobi, Kenya. Interviews were conducted during the COVID-19 pandemic in 2020 by phone. A thematic analysis was conducted. RESULTS: Women identified parents, specifically mothers, aunts, partners, friends and healthcare workers as key influencers on FP. Their interactions with these key influencers varied based on trust, the information they needed about FP, and whether they perceived a key influencer to perpetuate or challenge existing social norms on FP. Mothers were perceived to understand the social risks of using FP and thus could advise on discreet FP use, and aunts were trusted and approachable sources to impartially describe the benefits and drawbacks of FP. Although women identified partners as key FP decision makers, they were cognisant of possible power imbalances affecting a final FP choice. CONCLUSIONS: FP interventions should consider the normative influence key actors have on women's FP choices. Opportunities to design and deliver network-level interventions which seek to engage with social norms surrounding FP in order to challenge misconceptions and misinformation among key influencers should be explored. Intervention design should consider dynamics of secrecy, trust and emotional closeness that mediate discussions of FP to address changing norms. Further training to change norms held by healthcare providers about why women, in particular unmarried young women, access FP should be provided to reduce barriers for FP access.

Women's decisions to use family planning (FP) are influenced by social norms, the unwritten rules of appropriate actions within social networks, and are shaped by advice and information received from key influencers­important individuals who shape what is acceptable within social networks. The aim of this study was to understand how key influencers uphold and transmit information and norms about FP, and explore who women consult as they make FP decisions and why they consult these key influencers.We interviewed 16 women, 10 partners and 14 key influencers in peri-urban Nairobi, Kenya.We found that key influencers for decisions about FP included mothers, aunts, partners, friends and healthcare providers. In making a decision about FP use, women consulted key influencers based on who they deemed trustworthy to keep their FP use secret and described less trust to speak with men about FP in their social networks. Mothers understood the social risks of using FP and so could advise on its discreet use, and aunts were approachable sources of impartial information about FP. Although women identified partners as key decision makers, they were aware that power imbalances might affect final FP choices.Our findings underscore the importance of FP interventions working with women's social networks and to address social norms influencing women's decisions in using FP. Interventions to change FP norms should consider dynamics of secrecy, trust and emotional closeness that affect FP discussions among women's networks.

Response to COVID-19 Vaccination Post-CAR T Therapy in Patients With Non-Hodgkin Lymphoma and Multiple Myeloma.

COVID-19 adversely affects individuals with cancer. Several studies have found that seroconversion rates among patients with hematologic malignancies are suboptimal when compared to patients without cancer. Patients with non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) are immunocompromised due to impaired humoral and cellular immunity in addition to prescribed immunosuppressive therapy. Chimeric antigen receptor T-cell (CAR T) therapy is now widely used for NHL and MM, but little is known about seroconversion rates after COVID-19 vaccination among these populations. We evaluated SARS-CoV-2 spike-binding IgG antibody levels following COVID-19 vaccination among NHL and MM CAR T therapy recipients. Out of 104 CAR T infusions, 19 patients developed known COVID-19 infection post-CAR T. We tested 17 patients that received CAR T for antibody spike titers post COVID-19 vaccination, only 29 % (n = 5) were able to mount a clinically relevant antibody response (>250 IU/mL).

Reflections on medical student evaluations of a public health clerkship.

Introduction: The COVID-19 pandemic demonstrated the need for skilled medical practitioners in public health, and outbreak investigations. The College of Medicine and Health Sciences at the United Arab Emirates University (UAEU) introduced a clerkship in public health constituting theoretical and practical sessions to 5th year medical students in 2015. The aim of this study is to explore the satisfaction of the students with the public health clerkship which is crucial for the assessment and reformation of the taught curriculum. Methods: A cross-sectional, post-evaluation analysis was conducted from the period 2015-2022. The evaluation questionnaire was conducted via an online university system. The survey contained 5 themes: pre-course instructions, structure of the clerkship, academic staff, activities, and learning outcomes. Ethics approval was secured from the Social-IRB of the UAEU. We used SPSS version 26 to analyze the data using independent t-test and ANOVA. Results: One hundred and seventy four students (27.4% response rate) participated in the study. Overall, the students had an average satisfaction score of 2.86 out of 4. The majority of the students reported having a good understanding of public health (93.7%), improving their oral presentation skills (91.2%), and developing new skills (87.2%). Furthermore, more than 9 in 10 students (96.1%) reported that the program expanded their knowledge, skills, and confidence. The mass (90.2%) of students agreed that the clerkship content was covered in sufficient depth, majority of the students agreed that they had received enough information about the clerkship before it started (74.6%), majority of the students agreed that the faculty were interested in their personal development (86.1%) The students who completed the clerkship prior to the COVID-19 pandemic had a statistically significant (P = 0.02) higher average rating (72.8%) than students who completed the clerkship during the pandemic (71.1%). Discussion: Medical students at the UAEU were satisfied with the activities and delivery of the public health clerkship and found it rewarding. Conducting needs assessment and proposal writing provided them with the knowledge, skills, and confidence to conduct research in their career. These findings may be useful in helping and support other institutes to plan and develop a clerkship in the public health.

The educational, social, and emotional impact of COVID19 on Rohingya youth: Implications for educators and policymakers.

The COVID-19 pandemic has greatly impacted the lives of many around the world, particularly refugee and immigrant communities. In the United States, millions of children and youth had to quickly shift from in-person to remote learning, encountering new challenges and uncertainties in their overall educational experiences. This study explored some of the impacts of the COVID-19 pandemic on the educational, socialization, and mental and emotional health and wellbeing of Rohingya refugee youth from Myanmar resettled in the United States. Through in-depth qualitative interviews with 15 Rohingya refugees ages 12-17, we found that Rohingya youth's experiences with COVID-19 pandemic presented both challenges and opportunities. The challenges included unavailability of personal space to conduct school work, difficulties adjusting to online school due to computer literacy levels, and familial responsibilities that often conflicted with their schooling, as well as feelings of boredom and sadness that consequently impacted their emotional and mental health state. Youth also noted opportunities such as spending more time with their parents who were unable to work due to the pandemic as well as feeling helpful in acting as caregivers to their siblings and in working alongside their parents. Implications for policymakers and educators are also discussed.

SARS-CoV-2 persistence and infectivity in COVID-19 corpses: a systematic review.

The persistence and infectivity of SARS-CoV-2 in different postmortem COVID-19 specimens remain unclear despite numerous published studies. This information is essential to improve corpses management related to clinical biosafety and viral transmission in medical staff and the public community. We aim to understand SARS-CoV-2 persistence and infectivity in COVID-19 corpses. We conducted a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocols. A systematic literature search was performed in PubMed, Science Direct Scopus, and Google Scholar databases using specific keywords. We critically reviewed the collected studies and selected the articles that met the criteria. We included 33 scientific papers that involved 491 COVID-19 corpses. The persistence rate and maximum postmortem interval (PMI) range of the SARS-CoV-2 findings were reported in the lungs (138/155, 89.0%; 4 months), followed by the vitreous humor (7/37, 18.9%; 3 months), nasopharynx/oropharynx (156/248, 62.9%; 41 days), abdominal organs (67/110, 60.9%; 17 days), skin (14/24, 58.3%; 17 days), brain (14/31, 45.2%; 17 days), bone marrow (2/2, 100%; 12 days), heart (31/69, 44.9%; 6 days), muscle tissues (9/83, 10.8%; 6 days), trachea (9/20, 45.0%; 5 days), and perioral tissues (21/24, 87.5%; 3.5 days). SARS-CoV-2 infectivity rates in viral culture studies were detected in the lungs (9/15, 60%), trachea (2/4, 50%), oropharynx (1/4, 25%), and perioral (1/4, 25%) at a maximum PMI range of 17 days. The SARS-CoV-2 persists in the human body months after death and should be infectious for weeks. This data should be helpful for postmortem COVID-19 management and viral transmission preventive strategy.