The COVID-19 Pandemic Experience for Patients with Central Nervous System (CNS) Tumors: Differences in Patient- Reported Outcomes (PROs) and Practice Recommendations

Background/Purpose: The COVID-19 pandemic and associated mitigation procedures have significantly altered daily life in ways that may disproportionately affect patients with CNS tumors. This study aimed to explore differences in symptom burden and interference, mood disturbance, and health-related quality of life in the CNS tumor patient population during the COVID-19 pandemic, compared to a normative sample of pre-pandemic data. Method(s): Data from the Neuro-Oncology Branch (NOB) Natural History Study, including demographic and clinical data, as well as PROs including PROMIS Anxiety and Depression Short-Forms, EQ- 5D-3L, MDASI-Brain Tumor/Spine Tumor, and NeuroQOL-Cognition Function, were collected and compared across groups ('NOB normative sample' and 'COVID year' patients) using one-sample proportion tests. Result(s): 178 COVID year CNS tumor patients (55% male, 82% Caucasian, median age 45 years) were compared with 678 NOB normative sample patients with similar demographic and clinical characteristics. Symptom burden remained comparably high during the COVID year compared to the NOB normative sample with the most common moderate-severe symptoms being fatigue (31% vs. 35%), difficulty remembering (28% vs. 24%), drowsiness (22% vs. 25%), disturbed sleep (20% vs. 22%), and distress (20% for both). However, a significantly greater proportion of COVID year assessments endorsed moderate-severe depression on the PROMIS compared to the NOB normative sample (17% vs. 12%, p = 0.023, Cohen's h = 0.22) and moderate-severe depression/anxiety on the EQ-5D-3L was also more prevalent (53% vs. 43%, p = 0.009, Cohen's h = 0.28). There were no other significant differences in PROs between groups. Conclusions and Implications: These findings demonstrated that while objective symptom burden for CNS tumor patients was unchanged, there was an increase in depression reported during the COVID-19 pandemic. Future work should investigate potential pandemic-era interventions for screening, targeting, and improving both mood disturbance and other disease-specific symptoms to improve symptom burden and quality of life.

Analysing preservice teachers' enactment of the UDL framework to support diverse students in a remote teaching context

Internationally, the investigation of inclusive education in foreign language teaching and foreign language teacher education is a relatively new phenomenon. Part of this imperative has been the pressing need to research how teachers perceive inclusion and learn to support a diverse range of students. Responding to this challenge, this paper reports on the results of a case study that investigated the perceptions and attitudes toward inclusion of a group of Chilean preservice teachers of English (n = 6) enacting the Universal Design for Learning (UDL) in ELT. The study drew on qualitative data generate through interviews, focus group discussion and an artefact analysis, and was conducted within a remote teaching context due to COVID pandemic during 2020 and 2021. The outcomes suggested that preservice teachers conceptualised inclusion as ‘not-segregation', expressing positive attitudes toward diversity and a commitment to principles of inclusion in their teaching. The enactment of UDL allowed participants to diversify the representation of contents and making language more comprehensible. However, participants also experienced frustration and anxiety as they felt their practices were sometimes ineffective. The findings also made visible the complex challenges and struggles preservice teachers confront as they attempt to teach inclusively, particularly in remote learning environments. © 2023 Elsevier Ltd

The Outreach Virtual Fracture Clinic - a Pilot Report of the Initial Nine Months.

The virtual fracture clinic (VFC) enables the safe, cost-effective delivery of high-quality patient-centred fracture care, whilst reducing hospital footfall. Within our institution, an Outreach VFC was launched, accepting a pre-defined range of trauma referrals from the outreach centre's emergency department (ED). The initial nine months' worth of cases referred to the Outreach VFC were assessed. The injury pattern, time to review, treatment plan and discharge destination of each referred patient were examined. A total of 822 patients were referred to the Outreach VFC during its initial nine months in operation. Owing to COVID-19-related alterations in the patient pathway, 58.1% of patients were referred on to fracture clinic/ED, with 34.4% of patients being referred for physiotherapy input. 44.9% of patients were reviewed at the Outreach VFC within 72 hours of ED presentation, with 88.6% of patients reviewed within 7 days. The Outreach VFC pilot initiative saved the Dublin Midlands Hospitals Group approximately €83,022 over nine months. The Outreach VFC model represents a novel approach to trauma care delivery with advantages for patient and hospital alike. Rural communities serve to benefit from its future implementation and the remote management of orthopaedic trauma. The Outreach VFC model provides a means of delivering safe and timely orthopaedic care whilst maintaining high levels of patient satisfaction.

A Threshold GARCH Model for Chilean Economic Uncertainty

In this paper, an autoregressive moving average (ARMA) model with threshold generalized autoregressive conditional heteroscedasticity (TGARCH) innovations is considered to model Chilean economic uncertainty time series. Uncertainty is measured through the Business Confidence Index (BCI) and Consumer Perception Index (CPI). The BCI time series provide useful information about industry;commerce;the finance, mining, construction, and agricultural sectors;and the global economic situation and the general business situation. As a counterpart, the CPI time series measure the perception of consumers regarding the state of the Chilean economy, evaluating their economic situation and expectations. The ARMA-TGARCH model is compared with the classical seasonal ARIMA and threshold AR ones. The results show that the ARMA-TGARCH model explains the regime changes in economic uncertainty better than the others, given that negative shocks are associated with statistically significant and quantitatively larger levels of volatility produced by the COVID-19 pandemic. In addition, a diagnostic analysis and prediction performance illustrates the suitability of the proposed model. Using a cross-validation analysis for the forecasting performance, a proposed heteroscedastic model may effectively help improve the forecasting accuracy for observations related to pessimism periods like the social uprising and the COVID-19 crisis which produced volatility in the Chilean uncertainty indexes. © 2022 by the authors.

Factors That Promoted The Non-Inclusion Of Basic Education Students In Presence In A Post-Pandemic Context : Case: Factors identified in the Technical Secondary School no.51 of the municipality of Tepic, Nayarit

This research was focused on secondary school students due its importance on their growing processes from childhood to teens, on this stage the experiences lived build their character and personality. Therefore, it is needed to take care their issues and emotional needs generated by a pandemic context. Students results show several behaviors coming from anxiety and stress situations according to the results, the attitudes observed are socializing fear, anxiety and concern about spaces completely disinfected, isolation and lack of interest in attending face-to-face classes. © 2022 IEEE.

SARS-CoV-2 Anti-Spike IgG Antibodies in Neonates After Maternal Vaccination Against COVID-19 During Pregnancy and Outcomes

Background. Worldwide, attempts to understand the neonatal response and the benefits of immunity conferred by the mother to continue preventing COVID-19 infection in vulnerable groups. Therefore, research on the efficacy of vaccination against SARS-CoV-2 in pregnancy remains as an important tool to prevention of complications. Methods. Cross-sectional study in which blood samples from 379 neonates taken from the umbilical cord. The inclusion criteria were: newborns of mothers with a history of vaccination against SARS-CoV-2 during pregnancy. Infants whose mothers had COVID-19 infection at birth, or receiving any immunosuppressive treatment during pregnancy were excluded. Results. 379 neonates were studied for their antispike IgG levels. The majority were full-term female neonates were of adequate weight for their gestational age and without complications during their birth, 28 neonates required NICU care for their. Antispike IgG levels were obtained in 94.9% . Mothers received first dose at first trimester in 28.4%, second trimester in 51.9% and in the third trimester 19.6). A total of 318 mothers (87.8%) completed the two-dose schedule receiving the same vaccine, six (1.6%) received another anti-COVID vaccine, and the remaining 39 (10.7%) received only one dose of vaccine. 64.9% were vaccinated with the BNT162b2 vaccine, were higher leves when received two vaccine doses compared to only one. Vaccines that stimulated highest levels were mRNA-1273 and BNT162b2, lowest levels were found in the CoronaVac and Ad5-nCoV vaccines. Finally, it should be noted that only four neonates presented levels below 0.8 BAU/ mL (non-positive). Conclusion. This study provides evidence on timing of maternal anti-COVID vaccination, antibody production, and transplacentary transfer ensuring maternal and neonatal protection through vaccination is key to encourage women to be vaccinated against COVID-19 during pregnancy. Follow-up studies in infants are needed to understand the persistence of placental-transferred antispike IgG and the role of breast milk antibodies in maximizing the protection of infants at this stage of risk of severe SARS-Cov-2 disease. These findings have implications for determining new public health and vaccination strategies for pregnant women.

Kidney Function After SARS-CoV-2 Infection in Patients With and Without AKI During Hospital Admission in Western Mexico

Background: Kidney damage in COVID-19 patients has been of special concern. Kidney function after COVID-19 has not been comprehensively studied, and there is scarce information comparing kidney function among patients with or without AKI during hospital admission. Method(s): Retrospective cohort study in a secondary level center in Guadalajara, Mexico. Patients who were admitted due to COVID-19 from April-December 2020 and who survived at discharge and who had at least one follow-up visit in the outpatient clinic 6 months after initial symptoms were included. Information was obtained from outpatient electronic medical files. Result(s): From a total of 1085 patients, 733 survived at discharge. 113 had AKI during admission and only 33 (29.2%) had any kind of outpatient follow-up. Their mean age was 60.6 years, 63.6% were men, 48.4% had DM and 66.6% had HTN. Mean baseline SCr was 0.82 mg/dL with a mean eGFR of 90.82 ml/min. On follow-up mean stable SCr increased to 1.49 mg/dL, with a mean eGFR of 65.71 ml/min, a mean decrease of 25.11 ml/min. 15 patients (45.45%) developed CKD and 1 patient (3.03%) started RRT. Mean follow-up time was 451 days. 34 patients with no AKI during admission had a follow-up visit;mean age was 58.1 years, 58.8% were men, 47.1% had DM and 70.6% had HTN. Mean baseline SCr was 0.78 mg/dL and mean eGFR was 92.33 ml/min. On follow-up mean stable SCr increased to 0.86 mg/dL, with a mean eGFR of 86.64 ml/min, a mean decrease of 5.69 ml/min. 1 patient (2.94%) developed CKD and none required to start RRT. Mean follow-up time was 468 days. Conclusion(s): AKI during COVID-19 was associated to a significant decrease in eGFR on follow-up. Those with COVID19 without AKI during admission also had a small decrease in eGFR on follow-u. Timely and more intense follow-up strategies after COVID19 and AKI are needed.

SAFETY AND EFFICACY OF THYMIC PEPTIDES IN THE TREATMENT OF HOSPITALIZED COVID-19 PATIENTS IN HONDURAS.

Coronavirus disease 2019 (Covid-19) active cases continue to demand the development of safe and effective treatments. This is the first clinical trial to evaluate the safety and efficacy of oral thymic peptides. ; We conducted a nonrandomized phase 2 trial with a historic control group to evaluate the safety and efficacy of a daily 250-mg oral dose of thymic peptides in the treatment of hospitalized Covid-19 patients. Comparisons based on standard care from registry data were performed after propensity score matching. The primary outcomes were survival, time to recovery, and number of participants with treatment-related adverse events or side effects by day 20. ; A total of 44 patients were analyzed in this study: 22 in the thymic peptide group and 22 in the standard care group. There were no deaths in the intervention group compared to 24% mortality in standard care by day 20 (log-rank P=0.02). Kaplan-Meier analysis showed a significantly shorter time to recovery by day 20 in the thymic peptide group than in the standard care group (median, 6 days vs. 12 days; hazard ratio for recovery, 2.75 [95% confidence interval, 1.34 to 5.62]; log-rank P=0.002). No side effects or adverse events were reported. ; In patients hospitalized with Covid-19, the use of thymic peptides resulted in no side effects, adverse events, or deaths by day 20. Compared with the registry data, a significantly shorter time to recovery and mortality reduction were measured.

On to Quantifying the Effect of Droplet Size Distribution on the Airborne Transmission of the Virus

This research will study a novel aspect of the physics of COVID-19 transmission associated with actively altering droplet size distribution. Viruses can be transmitted through droplets and aerosols released during speaking, sneezing, and coughing phenomena. We previously found that these distributions can be altered using food ingredients. The study will be carried out to study the hypothesis of relaxed guidance in social distancing and mask usage is possible with the proposed approach using CFD models of human sneezes. The adult human is positioned inside a ventilated room condition and the droplet/aerosols are to be released to explore the impacts of the various distributions that relate to how the food ingredients vary the function, hence, the size of the droplets will be the function of the use of food ingredients. Results study the concentration of droplet particles at various distances away from the mouth, also called exposure maps and indicate that Corn Starch and Xanthum usage increase the exposure intensity level, while Xanthum reducing the exposure area implies that social distancing can be reduced with its use. In contrast, the use of Lozenge and Zingiber reduces the exposure level, related to the increase in the viscosity and reduction of the mass flow rate of saliva. Copyright © 2022 by ASME.

Keys for transforming the curriculum of the Chilean education system after the pandemic

The curriculum in Chile has been under pressure in recent decades and, considering the implications of the pandemic, the pressure has spread and deepened. This situation has had repercussions for the curricular management of schools, where problems detected require a systemic analysis of their elements. In this article, through a review of national and international evidence, we reflect on curriculum management during the pandemic, focusing on primary school education. Tensions and challenges are addressed using the indicative performance standards currently in force in Chile as a reference. The analysis reflects the accumulation of administrative functions and responsibilities carried out by the management staff. Likewise, the analysis highlights an overloaded curriculum, lack of clarity in the use of non-instructional time, and problems in the understanding and treatment of evaluations and their link with learning objectives. We present three proposals to move forward: 1) educational policies aimed at greater curricular decentralization, based on a limited set of learning objectives at the national level and flexibility to incorporate objectives at the regional level;2) professional development coherent with curricular design and implementation in regional teams;and 3) specific spaces for school principals to analyze pedagogical practices that allow for relevant curricular implementation.

Planning for a trip: Selecting the mode of air transport

The chapter presents the results of selecting the mode air travel by considering other modes of transportation to highlight public's preferences of mode transport. The approach was a cross-sectional study by employing a questionnaire to a sample size of N=500;the data were collected from January to June 2019. The main conclusion of the analysis was that the preferred mode of transport was by bus (59.6%) followed by air travel (23.6%). Some of the cons and pros of air travel are the following: 1) air travel is considered too expensive (90%);it is believed that 70% of Mexicans do not participate in air travel;2) it may be perceived as unreliable due to the unexpected such as extreme weather, earthquakes (e.g., the 19 September earthquake in 2017) and volcanic activity ("Popocatepetl" volcano eruptions);3) it is perceived as the fastest and most comfortable compared to bus and car transportation;4) the benefits of the air transport industry in Mexico pre-COVID-19 pandemic were that it contributed to 3.05% of the country's GDP. © 2022, IGI Global.

Surfacing Inequities and Their Broader Implications in the CS Education Research Community

Problem. Diversity, equity, and inclusion (DEI) need to be embedded throughout the computer science education (CSEd) research community in order to achieve empirically-based strategies in CSEd that is responsive to the needs of all of its constituents. However, there are no comprehensive studies that investigate what the barriers and challenges to DEI are among CSEd researchers. Research Question. When considering DEI among the CSEd research community, what barriers and challenges do different CSEd researchers face when conducting research? Method. We conducted a systematic literature review, developed a survey from the literature, and analyzed the quantitative and qualitative data from participants (n=72). Findings. Beyond finding that over half of the participants reported the COVID-19 pandemic as a barrier to engaging in research, participants reported that working more than an average 40-hour work week each year was a challenge. The lack of computing education being recognized as a subdiscipline within CS departments also was a barrier. Participants also reported that a lack of 1) awareness and adoption of practices from other education research fields and 2) general educational research theory were significant challenges for the CSEd research field. With respect to DEI, participants noted that lack of diversity among CSEd research partners/collaborators, among CSEd researchers in the community and among CSEd research community leadership are challenges for the community. Implications. Employing cultural competence is integral to CSEd research as we, as a community, inherently navigate differences in identities among researchers, and between researchers, practitioners, and participants in the currently unrepresentative and inequitable state of our field. As we grow our attitude, awareness, knowledge, and skill in cultural competence, we produce better-equipped allies, and greater resilience and belonging among community members from historically marginalized groups. We urge the community and relevant stakeholders to understand how to remove the barriers and challenges identified in our study. © 2022 ACM.

COVID-19 AND COLORECTAL ONCOLOGICAL SURGERY. EXPERIENCE IN A HIGH COMPLEXITY UNIVERSITY HOSPITAL

Purpose/Background: Perioperative COVID-19 infection is associated with an increase in morbidity and mortality, in addition to the consequences on surgical pathologies due to delays in diagnosis and treatment. Hypothesis/Aim: The aim of this study it is to describe and evaluate the effects of the pandemic on patients undergoing colorectal cancer surgery in the UC-Christus Healthcare Network. Methods/Interventions: A retrospective observational cross-sectional cohort study was made. It was based on the review of the admissions and surgical protocols of patients operated due to colon and rectal cancer diagnosis between 03/18/2019 - 03/17/2021 in the UC-Christus Healthcare Network. Patients with incomplete records and follow-ups, recurrences, or endoscopic treatments were excluded. The results of patients who were operated before the sanitary restrictions were compared with those who were operated afterwards (03/18/2020). The variables of sex, age, date of surgery, procedure, approach, tumor location, TNM, biopsy, pathological stage, presence of neoadjuvant and/or adjuvant, cause of mortality, emergency admission, and ostomy requirement were recorded in a database. The descriptive and analytic statistics of the results were analyzed using the Microsoft SPSS-Statistics21 program. Proportions were compared with the Chi2 test and Fisher's exact test in variables whose frequency was less than 5. Results/Outcome(s): One hundred seven records were included in the first period (79 colon and 28 rectal tumors) and 134 in the second (100 colon and 34 rectal tumors), with no significant differences between the number of patients nor the distribution by sex in both periods. In the colon tumors group, there were no significant differences between the groups of patients with early-stage (17), locally advanced (118), and metastatic (44) tumors between both periods. Nineteen patients (10.6%) underwent emergency surgery, 36 patients (20.1%) required an ostomy to be performed without significant differences in both periods. At the rectum tumor group, there were no significant differences concerning sex, nor pathological stage, where 17 (26.9%) were in the initial stages, 29 (46%) locally advanced, and 17 (26.9%) were metastatic. The laparoscopic approach was preferred in all tumor groups, requiring conversion in 6 (4.65%) colon tumor and 1 (2.17%) rectal tumor cases. No mortalities were recorded 30, 60, nor 90 days after Limitations: Among the limitations of our study is a selection bias, since it was carried out only in one institution, so the results obtained here are not necessarily extrapolated to the general population. Conclusions/Discussion: In patients operated in the oncology program of the Healthcare Network, there were no significant differences regarding the number of operated patients, their pathological stage, mortality, or approach in the compared periods.

Atypical clinical presentation of inflammatory marker negative septic arthritis, osteomyelitis, and bacteremia following a single dose of tocilizumab in the treatment of COVID-19: A case report

Background: Tocilizumab is an immunomodulating agent that inhibits the inflammatory cascade via interleukin-6 (IL-6) signaling. A recent meta-Analysis written by the World Health Organization, and other large, randomized trials, have found that the medication results in reduced all-cause mortality in the treatment of severe coronavirus disease 2019 (COVID-19) illness, likely by targeting aberrant inflammatory pathways. With the medication now recommended by infectious diseases societies in the treatment of COVID-19, many providers will begin using this medication in critically ill patients, and for some it will be their first exposure to the medication and its side effects. Although atypical secondary infections have been observed following multiple administrations of tocilizumab, our case is significant as it displays an atypical presentation of invasive bacterial illness and sepsis following a single dose. Case Description: Our case consists of a 52-year-old man with severe COVID-19 pneumonitis who was given tocilizumab due to worsening respiratory status and elevating inflammatory markers, who later developed severe, invasive bacterial disease with minimal objective findings suggesting severe illness. Six days following tocilizumab administration, the patient was diagnosed with Staphylococcus aureus (S. aureus) bacteremia, septic arthritis, and osteomyelitis, at which time inflammatory markers were within normal limits, he was no longer febrile or tachycardic, and his only objective findings suggesting illness were a tender shoulder with an isolated, neutrophilic predominant leukocytosis. This complication resulted in a washout of a septic joint, a 6-week course of intravenous antibiotics, and a 59-day hospitalization. The patient was discharged without new chronic medical issues, including a lack of new end-organ dysfunction or chronic pain of the joint affected by septic arthritis. Conclusions: This case demonstrates an atypical presentation of gram-positive systemic infection, displaying the complications which may develop with the use of immunomodulators. Because of the potential for severe infection with atypical, insidious presentation, a high index of suspicion should be maintained in all patients receiving these agents. © Journal of Emergency and Critical Care Medicine.

Impact of the COVID-19 pandemic on manufacturing operations and supply chain resilience: effects and response strategies

Purpose Manufacturing organisations are striving towards adapting and responding to the unprecedented challenges posed by the coronavirus disease 2019 (COVID-19) pandemic, along with the operations research streams endeavouring to support their recovery. With a view to bridging our knowledge gap on the impact of the COVID-19 pandemic on the manufacturing operations, this paper investigates the key challenges and strategies formulated by manufacturing organisations operating in the Northern region of Cyprus. Design/methodology/approach The research was conducted through 10 in-depth interviews that analyzed the effects of the pandemic, the associated causes and the response strategies implemented. Findings The effects of the pandemic on the manufacturing organisations investigated are identified, along with the associated causes, and the response strategies deployed. Learnings and countermeasures implemented to date are established in light of the insights captured from the practitioners. Originality/value Contributions are made to the body of knowledge on manufacturing management and manufacturing supply chain resilience through fostering our understanding of the impacts that the pandemic had on manufacturing organisations, and practical contributions are presented through evidencing and transferring of the operations management knowledge and solutions devised in various sectors to date.

Building a 100% Online Rocket Propulsion Course During a Pandemic

The worldwide COVID pandemic of 2020 forced universities to quickly shift their instructional strategies from the classroom toward online delivery modes to respond to the disruptive social distancing guidelines that evolved. The objective of this paper is to describe the process and the results of rebuilding an undergraduate/graduate rocket propulsion class for a new 100% online deployment due to the COVID pandemic. The case study is Rocket Propulsion I at the University of Alabama in Huntsville for the fall of 2020. A team of instructional designers led a Quality Education Practices Online training program with the instructor to restructure the entire course to meet baseline online distance learning standards. During this rebuild, the instructor also incorporated and developed all new lecture materials, quizzes, and homework based on the adoption of a new course textbook. The comprehensive approach included refining course/module objectives, establishing detailed grading rubrics, developing new procedures for unsupervised online exams, learning live video communication software/equipment, designing a new online course in Canvas, and delivering it to 100 students—all without leaving his home. When compared with the previous five years of assessment data, the overall results in student project grades, course grades, and student evaluations of instructor effectiveness indicated a steady performance level through this significant change in material and life circumstances. The final student course scores increased in this offering when compared with the previous years. Student survey data also suggested a significant increase in the students’ assessment of instructor effectiveness. While there are many possible explanations, the collaborative relationships among the participants while the training, organizing, and delivering the course material specifically for online learning is a significant factor behind these positive outcomes for this case. © 2021, American Institute of Aeronautics and Astronautics Inc.. All rights reserved.