Evaluation of the Impact of Modality for Equity Program

In this poster, we investigate the impact of online versus in-person summer equity programs. We designed and implemented a summer bridge program from 2020 through 2022 and collected pre- and post-survey data from students to measure the program's impact on students' self-concept, science motivation, growth mindset, help-seeking and concealment attitude, science identity, and sense of belonging. Our research questions are: RQ1: How do students' indicators change from pre-survey to post-survey in the online summer program (2020 and 2021) versus the in-person program (2022) RQ2: What indicators are most impacted (positively or negatively) in an online version of the program These questions will help inform us about how to support students who have started their undergraduate programs during the COVID-19 remote instruction period and whether or not the additional cost of an in-person summer program is justifiable by its impact on students. © 2022 Owner/Author.

Change in Incidence of Multisystem Inflammatory Syndrome in Children Across the COVID-19 Pandemic in Chicago - March 2020 - March 2022

Background. Peak counts of multisystem inflammatory syndrome in children (MIS-C) have followed each COVID-19 peak by 2-5 weeks. Fewer cases of MIS-C occurred after the Delta-predominant period compared to early waves of the pandemic. The Chicago Department of Public Health analyzed the ratio of MIS-C to pediatric COVID-19 hospitalization by period of variant predominance from March 2020 - mid-March 2022 to evaluate differences by variant. Methods. MIS-C in Chicago residents was reported using the standard CDC MIS-C case report form. Four periods of COVID-19 infection were identified with dates defined by variant predominance (>=50%);date ranges for corresponding MIS-C periods were defined as starting 21 days after the COVID-19 period (Table 1). MIS-C cases were compared to hospitalizations as a measure of COVID-19 disease activity in children (rather than case counts which are more subject biases inherent in disease testing) among confirmed and probable COVID-19 cases in children <=21 years reported to CDPH. Ratios of MIS-C cases per 100 corresponding pediatric hospitalizations for each variant period were calculated. Proportions of MIS-C hospitalizations with intensive care unit (ICU) admission, mechanical ventilation (MV), and receipt of vasopressors (VP) were calculated as markers of disease severity in MIS-C for each wave. Results. 90 cases of MIS-C and 1,597 pediatric COVID-19 hospitalizations were reported (Table 2). The overall ratio was 5.6 MIS-C cases/100 pediatric COVID-19 hospitalizations. The first period with predominance of the original lineage had a ratio of 10.2;subsequent periods with variant predominance all had lower ratios. The Delta period had the second highest ratio which was 68% of the first period. Across waves, 74% of MIS-C patients were admitted to ICU (range, 67-82%);11% underwent MV (range, 0-14%);and 52% received VP (range, 45-71%). Conclusion. The ratio of MIS-C to pediatric COVID-19 hospitalizations varied by period of SARS-CoV-2 variant predominance. The ratio was highest in the early pandemic. There was no consistent change in MIS-C severity. Further study is needed to determine if the change in ratio is due to increased immunologic exposure (vaccination or previous infection) or if it is variant dependent.

Allosteric Inhibition of the SARS-CoV-2 Main Protease: Insights from Mass Spectrometry Based Assays

The SARS-CoV-2 main protease (Mpm) cleaves along the two viral polypeptides to release non-structural proteins required for viral replication. MPro is an attractive target for antiviral therapies to combat the coronavirus-2019 disease. Here, we used native mass spectrometry to characterize the functional unit of Mpro. Analysis of the monomer/dimer equilibria reveals a dissociation constant of Kd = 0.14± 0.03 pM, indicating MPro has a strong preference to dimerize in solution. We characterized substrate turnover rates by following temporal changes in the enzyme-substrate com- plexes, and screened small molecules, that bind distant from the active site, for their ability to modulate activity. These compounds, including one proposed to disrupt the dimer, slow the rate of substrate processing by ~35 %. This informa- tion, together with analysis of the x-ray crystal structures, provides a starting point for the development of more potent molecules that allosterically regulate MPro activity. . © 2020 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Dose-Dependent Respiratory Viral Inhibition by a Safe Inhaled Alkaline Treatment

Introduction: SARS-CoV-2 respiratory infection is pandemic and continues to cause significant mortality and morbidity worldwide. Respiratory viral infections in general are a leading cause of hospital admissions and mortality throughout the world as well. Most respiratory viral infections require an acidic intracellular and endosomal environment in order to enter host cells, replicate, and cause illness. We study the beneficial effects of airway alkalinization by an inhaled drug, Optate, that we currently have demonstrated is safe to inhale by healthy subjects and those with stable airways disease. We have recently shown that treatment with 4.5 mg/ml Optate safely inhibits SARS-CoV-2 infection in primary human airway epithelial cells (HAECs). We hypothesized that this inhibition would be dose dependent and that Optate would also inhibit other viral infections in a dosedependent manner. Methods: HAECs were infected with respiratory syncytial virus with green fluorescent protein (RSV-GFP) or SARS-CoV-2 virus. A dose-response curve of Optate was performed in each infection model and compared to a control group. Viral infection was quantified using fluorescence microscopy, plaque assays, and viral protein quantification. Optate pH was measured at each dose and a corresponding dose/pH curve was calculated to compare pH to dose-response. Results: SARS-CoV-2 infection was significantly inhibited by doses of Optate > 2.25 mg/ml, corresponding with an Optate pH > 9.2 (n = 4, p < 0.001). RSV infection was significantly inhibited by doses of Optate > 2 mg/ml, corresponding with an Optate pH > 9 (n = 3, p < 0.001). No significant difference was noted between control and Optate treated HAECs at lower concentrations of Optate. Conclusions: Optate inhibits SARS-CoV-2 and RSV viral infections in a dose-dependent manner that correlates with Optate pH. These findings suggest that Optate may be an inhaled therapeutic for patients with respiratory viral infections. (Table Presented).

Class Exercises Involving Ethical Issues Reinforce the Importance and Reach of Biomedical Engineering (and the Impact of the Coronavirus on Teaching Strategy and Measures of Assessment)

This paper builds on the ethical aspects of an introductory engineering course - BR200 - an Introduction to Biomedical and Rehabilitation Engineering. Various details of this course have been presented at ASEE Conferences in 2011, 2019 and here in 20211,2,3 and elsewhere.4 The course structure was described in 2011;one ethical innovation (story-writing) in 2019;and here in 2021 the didactic changes needed to adapt to a partial or full online presence as the result of the COVID pandemic. This present paper focuses on the impact of the COVID-19 on the teaching strategy used to introduce and discuss medical engineering ethical issues within the class as it abruptly transitioned from face-to-face instruction to completely remote in Spring 2020 (S20), and as it reappeared as a hybrid course in Fall 2020 (F20) and Spring 2021 (S21). The focus of this present paper is not on the instructional changes required by COVID (and discussed in our companion paper), but rather on how those in turn changed the approach to the handling of ethical questions and to the assessments of students' responses to those scenarios. One hypothesis is whether the content or style of the pre-post scenario answers and of the reflections changed between an answer handwritten under time-pressure and one electronically captured with little time constraint. Did the answers or reflections measurably change if more time were to be allowed for consideration? Another hypothesis was that the ethical dilemmas presented increased students' integration and appreciation of the biomedical engineering field regardless of comment modality. Biomedical engineering ethics can certainly be taught face-to-face, in a hybrid setting or completely online - but how well? Did ethics instruction suffer depending on modality? Our conclusion seemed clear - It didn't matter especially if each method employed a blended learning management system like Moodle or other similar platforms. An instructor receives qualitative feedback in the classroom (i.e., a sense of how students are responding). Data from off-line grading of responses can be assessed and quantified. In sum, the major consideration brought about by a switch among in-person, online and hybrid instruction was how to handle the interactive, immersive ethical vignettes that the students were required to respond to, sometimes as an in-class exercise and sometimes as a post-lecture submission. That is a major focus of this paper. Ethical vignette assignments used in BR200 were authentic assignments,5,6 a term used to describe assignments that often focused on messy, complex real-world situations and their accompanying constraints. The concepts of authentic assessment and authentic teaching are also explored in this paper, especially as they relate to ethical scenarios and the student's grasp of ethical principles. Our results indicate that applying authentic assignments, assessments and teaching strategies to the teaching of ethical principles and practices might prove to be a beneficial adjunct to packaged ethical case studies. © American Society for Engineering Education, 2021

Teaching an Immersive Experiential Introductory Biomedical Engineering Course in the Land of Covid (AKA: An Old Dog Has to Learn New Tricks)

Clarkson University's BR200 is a highly interactive and well-subscribed (~50 students per term) face-to-face entry-level biomedical engineering class. Its title is Introduction to Biomedical and Rehabilitation Engineering. This long paper deals with the successes and pitfalls of taking this course abruptly online mid-course in the spring 2020 semester and as a hybrid but mainly remote fall 2020 course, both as the result of the COVID-19 pandemic. This class had been taught for over 25 semesters by the same instructor with the help of a few guest lectures. The 2020 Coronavirus pandemic profoundly altered the way any business or social interaction could be carried out. Universities were no exception. One day in mid-March 2020 undergraduate students were suddenly told to pack up and leave campus. All instruction was then to be remote. We describe and analyze 1) the incremental changes made in the approach to teaching this face-to-face class that were implemented from spring 2011 until fall 2019 based on feedback and assessment;2) the changes made to the in-person spring 2020 class at its start because of a fall 2019 two-day institutional Quality Matters2 (QM) class taken by the instructor;3) the rapid, fairly painless and sometimes clueless transition mid-spring 2020 to online instruction aided by the QM rubrics that were already in place for the class;and 4) the painful but necessary transition to a “proper” method of hybrid teaching (split in-class and online) that was greatly aided by the University's offering of a 4-week volunteer (i.e., no pay) intensive summer program for faculty entitled “RISE: Reframing Instruction for Success Everywhere.”3 Using abundant student assessment and reflective data, this paper takes a deep dive into lessons learned, work required, comparisons of didactic approaches, and how students' assessments changed. The first author relates how he, as an old dog and set in using his unlearned teaching methods, had to learn new tricks in order to survive as an effective instructor during a pandemic. The Quality Matters and the RISE courses prepared the instructor for better online course management, especially for the hybrid fall 2020 term. But the hours required for course management increased >10-fold for the fall term over the course as it was previously offered. BR200 used a highly effective interactive synchronous exercise to get naive students fired up about the biomedical engineering field. Translating this synchronous immersive exercise for remote learning was a challenge. The students really missed or found it hard to carry out interactive class assignments either with the professor or with each other. The majority of students surveyed in the COVID era said that they preferred face-to-face classes but tolerated remote learning because they needed to. Yet when given the chance to be face-to-face in a hybrid class, only 1 or 2 students did so. The 8am class time played a role, but COVID-avoidance might have been a bigger cause. Student vaccination only became available mid-April 2021. Module-based untimed open-source quizzes, although difficult, were preferred by the students over hand-written open notebook midterms and finals. Many commented that their stress was significantly reduced even if they struggled with the quizzes. The open-access online flipped finals yielded more complete answers than did an open-notebook in-class final. Flipped testing required the students to outline what they had learned from each module and provide a synopsis in the form of a summary essay for review. In addition to finding out what they knew, the instructor could determine what they didn't know or had misconceptions with. © American Society for Engineering Education, 2021

Peripheral Vascular System Thrombosis and COVID-19: A Chilling Revelation

Introduction: As the COVID-19 pandemic reaches, its zenith a worrying trend has been noticed of late, that is arterial and venous thrombosis in patients presenting with COVID-19. Arterial and venous thrombosis was found in patients with asymptomatic state to severe affliction and most of them had a delayed presentation. Materials and Methods: An observational study was carried out by the Department of Vascular Surgery, Madurai Medical College. There were around 15200 total admissions between March 15, 2020, to September 30, 2020, in corona specialty hospital and trauma care center affiliated to Madurai medical college, out of which: (1) Acute deep venous thrombosis (DVT) was seen in 349 patients. (2) Acute limb ischemia (ALI) was found in 75 patients, out of which 70 patients had lower limb involvement and 5 patients had upper limb involvement. (a) Class 3-50 patients. (b) Class 2b-15 patients, (c) Class 1-10 patients. (3) Acute mesenteric ischemia was seen in 8 patients. Conclusion: COVID-19 is associated with an increased incidence of arterial and venous thrombosis of peripheral vascular system wherein arterial thrombosis, presenting, as ALI is profound and has a multi fold increased incidence than in non-COVID-19 patients and venous thrombosis is much higher than the non COVID-19 state.

Cystic fibrosis airway cells are less susceptible to sars-cov-2 infection and have altered ph regulatory protein expression

Introduction: In the airways of people with Cystic Fibrosis, reduction in HCO3- secondary to loss of CFTR protein function contributes to low extracellular pH and impaired mucus clearance making them more susceptible to infection.1 It may also contribute to the higher intracellular pH seen in CF primary human airway epithelial cells (HAECs). Respiratory viruses are a leading cause of pulmonary exacerbations in people with CF. While it was expected that SARS-CoV-2 would lead to severe infection in this population, only 500 confirmed cases have been identified with most being categorized as mild. We have recently shown that increasing intracellular pH with a novel inhaled alkaline treatment, Optate, inhibits the replication of SARS-CoV-2 in normal HAECs. We hypothesize that the baseline increased intracellular pH in the airways of people with CF is protective against SARS-CoV-2 infection. We further hypothesized that pH regulatory proteins may contribute to this increased intracellular pH in CF beyond decreased secretion of bicarbonate. Methods: CF and non-CF primary HAECs were infected with SARS-CoV-2 at a multiplicity of infection of 1. SARS-CoV-2 viral titers in cell media were subsequently quantified by plaque assay. Cytopathic effects (CPE) were evaluated by visual microscopy. Results were compared between CF and non-CF HAECs. Levels of pH regulatory proteins NHERF1, LDHd, LDHb, LDHa, glutaminase, S-nitrosoglutathione reductase (GSNOR), DUOX1, CCNO, carbonic anhydrase 2 (CA2), carbonic anhydrase 12 (CA12), and ATP12a S-were measured in cell lysates from the same CF and non-CF HAECs by JESS automated western blot (ProteinSimple, San Jose, CA, USA). Finally, pH was compared between the CF and non-CF HAECs using a pH-sensitive fluorescent dye, pHrodo Red (Thermo Fisher Scientific, Waltham MA, USA) imaged during fluorescent microscopy. Results: Intracellular pH of CF HAECs was significantly higher than non-CF HAECs (n = 6, p < 0.001). CF HAECs had significantly less SARS-CoV-2 viral titers than non-CF HAECs (n = 6, p = 0.0192). No difference in CPE was observed between groups. CA2 and CA12 protein levels were significantly increased in CF HAECs compared to non-CF HAECs (n = 6, p = 0.0094 and 0.0113, respectively). Conclusions: CF HAECs are less susceptible to SARS-CoV-2 viral infection that non-CF HAECs. This may be due to the increased intracellular pH in CF HAECs compared to non-CF HAECs. Since carbonic anhydrases produce bicarbonate ions, CA2 and CA12 upregulation may contribute to increased intracellular pH in CF along with decreased bicarbonate extrusion due to CFTR function loss.

Clinical Characteristics and Outcomes in Patients with COVID-19 and Cancer: a Systematic Review and Meta-analysis.

Much of routine cancer care has been disrupted due to the perceived susceptibility to SARS-CoV-2 infection in cancer patients. Here, we systematically review the current evidence base pertaining to the prevalence, presentation and outcome of COVID-19 in cancer patients, in order to inform policy and practice going forwards. A keyword-structured systematic search was conducted on Pubmed, Cochrane, Embase and MedRxiv databases for studies reporting primary data on COVID-19 in cancer patients. Studies were critically appraised using the NIH National Heart, Lung and Blood Institute's quality assessment tool set. The pooled prevalence of cancer as a co-morbidity in patients with COVID-19 and pooled in-hospital mortality risk of COVID-19 in cancer patients were derived by random-effects meta-analyses. In total, 110 studies from 10 countries were included. The pooled prevalence of cancer as a co-morbidity in hospitalised patients with COVID-19 was 2.6% (95% confidence interval 1.8%, 3.5%, I2: 92.0%). Specifically, 1.7% (95% confidence interval 1.3%, 2.3%, I2: 57.6.%) in China and 5.6% (95% confidence interval 4.5%, 6.7%, I2: 82.3%) in Western countries. Patients most commonly presented with non-specific symptoms of fever, dyspnoea and chest tightness in addition to decreased arterial oxygen saturation, ground glass opacities on computer tomography and non-specific changes in inflammatory markers. The pooled in-hospital mortality risk among patients with COVID-19 and cancer was 14.1% (95% confidence interval 9.1%, 19.8%, I2: 52.3%). We identified impeding questions that need to be answered to provide the foundation for an iterative review of the developing evidence base, and inform policy and practice going forwards. Analyses of the available data corroborate an unfavourable outcome of hospitalised patients with COVID-19 and cancer. Our findings encourage future studies to report detailed social, demographic and clinical characteristics of cancer patients, including performance status, primary cancer type and stage, as well as a history of anti-cancer therapeutic interventions.

Neurologic Manifestations of Severe Respiratory Viral Contagions. LID - e0107

Endemic and pandemic viral respiratory infections have recently emerged as a critical topic of investigation given the recent severe acute respiratory syndrome coronavirus-2 outbreak. Data from such outbreaks indicate that severe systemic comorbidities including acute neurologic illness are associated with illness and lead to significant outcome differences. Herein, we will discuss the neurologic manifestations of severe viral respiratory infections including coronavirus, influenza, respiratory syncytial virus, metapneumovirus, and enterovirus.Data Sources:: PubMed and EMBASE were searched by two independent investigators up to March 2020. Study Selection:: Data selection included preclinical and clinical studies detailing neurologic manifestations of viral respiratory infections. Data Extraction and Synthesis:: Two independent investigators reviewed and extracted the data. Conclusions:: Neurologic manifestations including seizures, status epilepticus, encephalitis, critical illness neuromyopathy, acute disseminated encephalomyelitis, acute necrotizing encephalitis, Guillan-Barré syndrome, transverse myelitis, and acute flaccid myelitis have all been associated with severe viral respiratory infections. Having an understanding of the direct neurotropism of such viruses is imperative to understanding pathogenesis, clinical presentation, and potential treatment paradigms aimed at improving morbidity and mortality. FAU - Robinson, Christopher P.