Detection of Semantic Duplicates in Temporal Domains Using Directed Acyclic Graphs

We demonstrate the feasibility of a generalized technique for semantic deduplication in temporal data domains using graph-based representations of data records. Structured data records with multiple timestamp attributes per record may be represented as a directed graph where the nodes represent the events and the edges represent event sequences. Edge weights are based on elapsed time between connecting nodes. In comparing two records, we may merge these directed graphs and determine a representative directed acyclic graph (DAG) inclusive of a subset of nodes and edges that maintain the transitive weights of the original graphs. This DAG may then be evaluated by weighting elapsed time equivalences between records at each node and measuring the fraction of nodes represented in the DAG versus the union of nodes between the records being compared. With this information, we establish a duplication score and use a specified threshold requirement to assert duplication. This method is referred to as Temporal Deduplication using Directed Acyclic Graphs (TD:DAG). TD:DAG significantly outperformed established ASNM and ASNM+LCS methods for datasets rep-resenting two disparate domains, COVID-19 government policy data and PlayStation Network (PSN) trophy data. TD:DAG produced highly effective and comparable F1 scores of 0.960 and 0.972 for the two datasets, respectively, versus 0.864/0.938 for ASNM+LCS and 0.817/0.708 for ASNM. © 2023 IEEE.

EWRI Friends Visit London Water & Steam Museum and Union Chain Bridge-IHCEL

We strongly recommend EWRI members visit the London Water & Steam Museum. This presentation includes many slides of this outstanding museum near the Kew tube station. London Museum of Water & Steam features artefacts and interactive exhibits on water. On October 26, 2018, David Gilbert and Jerry Rogers toured the London Museum of Water & Steam, located at Green Dragon Lane, Brentford, London, TW8 0EN near Kew station. Kew Bridge Pumping Station was originally opened in 1838 by the Grand Junction Waterworks Company. In 1999, the United Kingdom government's Department for Culture, Media, and Sport described Kew Bridge Pumping Station as "the most important historic site of the water supply industry in Britain." The heart of the museum showcases a majestic collection of steam pumping engines, including engines from Corynwall, as well as rotative engines. There are many excellent London water supply and treatment exhibits also. Due to COVID-19, the planned International Historic Civil Engineering Landmark plaque ceremony of July 26, 2020, for the 200-year-old Union Chain Suspension Bridge at Berwick-upon-Tweed was cancelled. Note the book: Samuel Brown and Union Chain Bridge: Gordon Miller, Friends of the Union Bridge, 306 pp, 135 photographs, 15.5 GBP. A tour of the Paxton Estate (Paxton Trust), a historic house at Paxton, Berwickshire, was planned to be a part of the plaque ceremony. There is discussion of having a modified plaque ceremony in the spring of 2023 (specific date to be determined) possibly before the May 2023 EWRI Congress in Henderson, Nevada. © World Environmental and Water Resources Congress 2023.All rights reserved

Development of an Online Learning Module on Gastroenterology Issues in Global Health

Introduction: Global health (GH) education is expanding and 23.1% of US medical students acquire international health experience prior to postgraduate training. Digestive diseases carry a high global burden. However, few GH programs and professional societies consider the inclusion of gastroenterology into their standard curriculum. In addition, travel restrictions during the COVID-19 pandemic have brought traditional GH rotations to a halt and spurred new educational approaches. Our goal is to develop a comprehensive online learning module on gastroenterology issues in GH for medical students undertaking GH electives. Method(s): A team of faculty and residents was convened between the Center for Community and Global Health and the Division of Gastroenterology. GH curricula across institutions and core competencies across 2 professional societies were examined via literature review. A survey was conducted among 2nd (MS2) and 3rd year medical students (MS3) interested in GH to assess attitudes toward GI-related issues in GH curriculum. An online learning module was developed consisting of 10, video-based lessons each addressing specific GH competencies (Figure 1). Result(s): In total, 41% (28/69) of MS2 and MS3 interested in GH responded to the survey, with a similar distribution of MS2 (13/28) and MS3 (15/28). Nearly all (92.8%) reported that learning GI conditions in a GH curriculum is moderately or very important (Table 1). A majority (78.5%) also reported feeling at least somewhat anxious or more about managing GI conditions during GH electives. Few medical students reported feeling moderately or extremely prepared to identify risk factors for GI conditions in different settings (21.5%) and to define approaches to therapy in resource-limited settings (14.3%). Interestingly, a majority (71.4%) reported feeling not at all prepared or slightly prepared to deliver cost-effective care to challenging populations. Conclusion(s): Our survey responses demonstrated an unmet need for GI-related training and cost-conscious care in the GH curriculum. Developing an online learning module on GI conditions to supplement GH curriculum may be useful and feasible. A randomized controlled trial is underway to examine the effect of this online learning module on medical student knowledge and preparedness to address GI conditions in GH electives.

TemporalDedup: Domain-Independent Deduplication of Redundant and Errant Temporal Data

Deduplication is a key component of the data preparation process, a bottleneck in the machine learning (ML) and data mining pipeline that is very time-consuming and often relies on domain expertise and manual involvement. Further, temporal data is increasingly prevalent and is not well suited to traditional similarity and distance-based deduplication techniques. We establish a fully automated, domain-independent deduplication model for temporal data domains, known as TemporalDedup, that infers the key attribute(s), applies a base set of deduplication techniques focused on value matches for key, non-key, and elapsed time, and further detects duplicates through inference of temporal ordering requirements using Longest Common Subsequence (LCS) for records of a shared type. Using LCS, we split each record's temporal sequence into constrained and unconstrained sequences. We flag suspicious (errant) records that are non-adherent to the inferred constrained order and we flag a record as a duplicate if its unconstrained order, of sufficient length, matches that of another record. TemporalDedup was compared against a similarity-based Adaptive Sorted Neighborhood Method (ASNM) in evaluating duplicates for two disparate datasets: (1) 22,794 records from Sony's PlayStation Network (PSN) trophy data, where duplication may be indicative of cheating, and (2) emergency declarations and government responses related to COVID-19 for all U.S. states and territories. TemporalDedup (F1-scores of 0.971 and 0.954) exhibited combined sensitivities above 0.9 for all duplicate classes whereas ASNM (0.705 and 0.732) exhibited combined sensitivities below 0.2 for all time and order duplicate classes. © 2023 World Scientific Publishing Company.

Acceptability and usability of a soft, flexible, wearable device for cough detection in children with cystic fibrosis

Background: Cough is a common symptom in cystic fibrosis (CF), and an increase in cough is an important sign of worsening lung disease and pulmonary exacerbation, the most common cause of hospitalization in people with CF. Objective monitoring of cough could be an important outcome measure for clinical trials, especially in children too young to perform pulmonary function tests. There are no accurate, objective methods of quantifying the frequency, severity, and duration of cough. Devices that have been tested to measure cough are neither highly reliable nor user friendly. We developed a mechano-acoustic sensor (MAS): a 4.8- cm- x 2.8-cm- (1 inch) long, thin, lightweight, stretchable, wireless device that adheres easily and securely to the skin surface and is worn at the base of the neck. The devicewas validated in adults being monitored for COVID- 19. This study evaluated usability and acceptability to children and their parents. Method(s): In Cohort 1, a small, flexible, fully wireless accelerometer-based MASwas applied to the suprasternal notch of children with CF using gentle adhesives. Participants were asked to perform activities that included forced coughs while sitting, lying down, and performing activities such as jumping or jogging and other pharyngolaryngeal activities such as swallowing, speaking, and throat clearing. The sessions were an average of about 30 minutes long. In Cohort 2, participants were asked to test the device for a longer period of wearable time (4-6 hours) in various settings, including outpatient clinics, inpatient rooms, and outside clinic and athome environments. Upon completion, all participants from both cohorts were asked to fill out the Acceptability and Usability Questionnaire, which consisted of six questions ranked on a 4-point Likert scale. Result(s): Cohort 1 included 21 children aged 3 to 18 (mean age 9.25 +/- 4.85), and Cohort 2 included 12 children aged 7 to 18 (mean age 12.15 +/- 4.42). On 31 (94%) questionnaires returned, 35.5% of participants strongly agreed and 61.3% agreed with the statement "I [or my child] like(s) wearing the cough sensor." Similarly, most participants found the cough sensor easy to use (74.2% strongly agreed, 25.8% agreed) and comfortable to wear (64.5% strongly agreed, 29.0% agreed), although they found the adhesive sticker difficult to take off and the device too obvious or large. Conclusion(s): Although qualitative and quantitative acceptability and usability data were overall positive, we have redesigned the cough sensor for comfort and are continuing enrollment. The new sensor, 3.5 x 1.6 x 0.8 cm, is smaller and sits lower on the neck so participants can better conceal it underneath clothing (Figure 1). We are providing universal adhesive remover wipes to all participants. Future work includes long-term monitoring (1-2 weeks) of pulmonary exacerbations using the new devices and further assessing usability and acceptability from participants.(Figure Presented) Figure 1. New cough sensor design with a longer neck and a smaller body, allowing it to be better concealed underneath a shirtCopyright © 2022, European Cystic Fibrosis Society. All rights reserved

A qualitative analysis of COVID-19 vaccination intent, decision-making, and recommendations to increase uptake among residents and staff in six homeless shelters in Seattle, WA, USA

COVID-19 vaccines mitigate severe disease, yet uptake remains low among people experiencing homelessness (PEH) despite the risk of transmission in congregate settings like homeless shelters. This study evaluated retrospective COVID-19 vaccination intent and decision-making between March 2020-October 2021 to identify modifiable factors to improve vaccine acceptance among PEH. We conducted 31 semi-structured interviews and eight focus group discussions across six homeless shelters in Seattle-King County, Washington. Residents and staff aged >= 18 years were recruited through purposive sampling for interviews and convenience sampling for focus groups. Thematic analysis was conducted. Participants reported that too much contradictory and changing information about COVID-19 vaccines led to confusion. Information deemed trustworthy contributed to individual's knowledge and in some cases changed their vaccination intent. While many intended to get vaccinated without external motivators, others were motivated by incentives and requirements. Despite intention to vaccinate, participants reported barriers to COVID-19 vaccine access including availability of vaccine doses, timely eligibility for vaccination, and availability of appointments. Participants presented recommendations to improve COVID-19 information content and dissemination, access, and use of incentives in shelter settings. Future research should test recommended vaccination strategies rooted in the voices and experiences of PEH to determine feasibility and effectiveness in shelter settings.

Exploring the Measurement of Hospice Resilience

Resilience is an emergency management concept that encompasses disaster preparedness, continuity of essential services, and recovery and transformation. Attention to healthcare resilience is growing;research on healthcare resilience has increased since events such as the 2014 Ebola epidemic and the COVID-19 pandemic. However, no studies have been conducted on resilience of hospices, despite a unique patient population and the important role hospices could play in public health emergencies. Quantifying hospice resiliency can aid in planning and response, as well as improving the ability of organizations to transform functionally in response to environmental changes;that is, their transformative capacity. This review examines four measures of resilience that have been applied to the healthcare sector. There are no measures of healthcare resilience that are validated and reliable with respect to the operational profiles of hospices. Further research is necessary to assess and develop valid and reliable measures of hospice resiliency. © The Author(s) 2023.

Identifying Variability in U.S. COVID-19 Response Through Temporal Partial Ordering Detection

We gain insight to the COVID-19 pandemic response by the various U.S. states through analysis of open source emergency declaration, mitigation, and response policy data. We propose ASNM + POD, a Partial Ordering Detection extension to the Adaptive Sorted Neighborhood Method to identify redundancies and implied temporal ordering requirements to understand how various U.S. states respond to COVID-19. We further strengthen the well-established ASNM entity matching method and address key limitations of its Longest Common Subsequence extension (ASNM + LCS) through detection of all temporal order requirements. Partial order requirements are determined probabilistically through empirical review of all records' time-ordered event sequences. We demonstrate effectiveness against a COVID-19 U.S. state policy dataset comprised of daily time-series data pulled from February and October 2022, where attributes are partially and variably populated. ASNM + POD yielded an F1 of 0.995 and an MCC of 0.985, significantly outperforming both ASNM and ASNM + LCS with F1/MCC improvements of 22%/50% and 15%/37%, respectively. Finally, we highlight the limited consensus on policies enacted, the variability in timelines of policy activations/deactivations, and activity at and after the two-year mark. © 2022 IEEE.

A Qualitative Analysis of COVID-19 Vaccination Intent and Recommendations to Increase Uptake Among Residents and Staff in Six Seattle Homeless Shelters

Background. COVID-19 vaccines are important to mitigate severe disease in congregate settings, yet uptake remains lower among people experiencing homelessness (PEH) than in the general population. This study aimed to explain changes in COVID-19 vaccination intent over time and identify modifiable factors to improve vaccine acceptance among PEH. Methods. We utilized the Health Belief Model and 3Cs Model of Vaccine Hesitancy to develop a conceptual framework to explore factors that may influence COVID-19 vaccination intent among PEH. Between July 27 - October 15, 2021, we conducted semi-structured interviews (SSIs) and focus group discussions (FGDs) across six homeless shelters in Seattle-King County, Washington. Residents and staff aged 18 years and older were recruited through purposive sampling for SSIs and convenience sampling for FGDs. We captured retrospective information about perceptions of and intent to receive COVID-19 vaccines between March 2020 - August 2021. Thematic analysis was conducted using Dedoose. Results. We conducted 31 SSIs (25 residents and six staff) and eight FGDs with 43 residents. Participants reported that too much contradictory and changing information about COVID-19 vaccines led to confusion. Information deemed trustworthy (i.e., objective, honest, professional, and recommended by others) contributed to individual's knowledge and in some cases changed their vaccination intent. Despite intention to vaccinate, participants reported barriers to COVID-19 vaccine access including availability, eligibility, appointments, and timeliness. While many intended to get vaccinated on their own, others were motivated by incentives and requirements. Participants presented recommendations to improve COVID-19 information content and dissemination, access, and incentives in shelter settings (Table 1). Table 1. Recommendations for Interventions to Increase COVID-19 Vaccine Uptake in Shelter Settings Conclusion. COVID-19 vaccination strategies that are rooted in the voices and experiences of PEH are presented and can inform improved vaccine implementation among key stakeholders. Future research should test recommended strategies to determine feasibility and effectiveness in shelter settings.

Environmental and Nasal Pathogen Surveillance in Seattle Area Homeless Shelters

Background. The need for community surveillance of respiratory viruses in high-risk settings such as homeless shelters has been underscored by the COVID-19 pandemic. Here, we show that sampling high-touch surfaces is a low-cost, minimally intensive means of community respiratory virus surveillance. Methods. Environmental samples were collected weekly from adult and family homeless shelters in King County, WA from November 2019 - April 2020. At times when residents were present, a 10cm2 area of selected high-touch surfaces were swabbed and bioaerosol samples were collected in high-traffic areas. Surfaces included entrance and restroom doorknobs, counters, and surfaces unique to each shelter. Study staff collected mid-turbinate swabs from shelter resident participants aged > 3 months with symptoms of acute respiratory illness (ARI). All samples were tested by RT-PCR for 27 viruses. From January 1, 2020 onward, samples were also tested for SARS-CoV-2. Results. A total of 788 environmental swabs, 1509 nasal swabs, and 98 bioaerosol samples from 6 adult and 3 family shelters were tested. Adenovirus (109 positive swabs, 13.8% of tested swabs), rhinovirus (107, 13.6%) and human bocavirus (62, 7.9%) were the most frequently detected viruses in surface swabs. Rhinovirus (160, 10.6%), human coronaviruses (79, 5.24%) and influenza B (43, 2.85%) were the most detected in nasal swabs. All viruses detected in nasal swabs were found in surface swabs. Of 9 surfaces, exterior bathroom doorknobs were the physical location with the highest number of pathogens detected. SARS-CoV-2 was first detected in surface swabs on 3/20/20, and in nasal swabs on 3/10/20. Bioaerosol samples detected virus in a low percentage of samples relative to surface and nasal swabs. Table 1 Count and period prevalence of environmental viral detection by shelter type, November 18, 2019 - April 10, 2020. (Figure Presented) Conclusion. Respiratory viruses detected through environmental sampling in homeless shelters were similar to the viruses detected from ARI episodes in study participants. Environmental surface sampling presents a plausible, minimally invasive method of surveillance for both endemic and emerging respiratory pathogens, as evidenced by the detection of SARS-CoV-2 during the early stages of the pandemic. Further research could focus on sampling public locations for broader community surveillance and culturing viruses found on these surfaces.

Human Parainfluenza Epidemiology in Homeless Shelters - King County, Washington

Background. Human parainfluenza viruses (HPIV) cause respiratory illness in individuals of all ages. However, HPIV epidemiology data in people experiencing homelessness (PEH) are limited. Methods. We analyzed cross-sectional data from a clinical trial and SARS-CoV-2 surveillance study in 23 homeless shelters in King County, Washington from October 2019-May 2021. Questionnaires and nasal swab specimens were obtained from eligible participants at enrollment. Between October 2019-March 31, 2020, participants included those aged > 3 months with acute respiratory illness. Monthly shelter surveillance was also conducted where participants were recruited regardless of symptoms. With the community spread of SARS-CoV-2, the study design transitioned from a clinical trial to a SARS-CoV-2 surveillance study which expanded enrollment eligibility to include participants with or without symptoms from April 1, 2020, onward. Participants were not followed longitudinally but were permitted to enroll multiple times during the study period. Specimens were tested for HPIV 1-4 and other respiratory viruses using RT-PCR. Results. Among 14,464 specimens, 32 were HPIV-positive from 29 participants (median age 9 years, range 0.3-64 years;45% female;28% Black;10% with chronic conditions) of which 59% were children. Family shelters had the highest percentage of HPIV infections (Table). HPIV was detected every month before the community spread of SARS-CoV-2. All HPIV-positive samples in May 2021 came from a single family shelter (Figure). Only 67% of HPIV-positive participants had symptoms with runny nose, cough and sore throat the most commonly reported. HPIV codetection with other respiratory viruses occurred in 19% of HPIV-positive specimens;Rhinovirus co-detection (16%) was the most common. Human Parainfluenza Encounters by Shelter Type Before and After April 1, 2020 Human Parainfluenza Positive Samples by Shelter Type Among Unique Participants Conclusion. HPIV affected PEH of all ages with most cases in shelters with children. Coinciding with community-wide SARS-CoV-2 mitigation efforts, the number of HPIV infections were reduced. However, a cluster of HPIV infections still occurred within one family shelter. Shelter-specific public health measures including nonpharmaceutical interventions used during the COVID-19 pandemic may reduce HPIV infections among residents.

Persistent Subclinical Photoreceptor Loss in a Patient with Acute Posterior Multifocal Placoid Pigment Epitheliopathy After Reactivation of Symptoms post COVID Vaccine

Purpose : Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is a generally self-limited disease with a good prognosis and resolution of symptoms between 4 weeks and 6 months. Retinal imaging is used to establish the diagnosis;however, the resolution of routine diagnostic imaging to assess changes at the photoreceptor level is limited. Here we explored outer cellular retinal structure of APMPPE lesions in a patient 4 years after initial presentation and 8 months after recurrent scotoma symptoms in the same region as her initial APMPPE scotomas a few days after her first COVID-19 vaccine. Methods : The subject underwent a complete eye exam and high resolution imaging. Outer retinal structure was assessed using spectral domain optical coherence tomography (SD-OCT), and the photoreceptor mosaic was imaged using both confocal and split detection adaptive optics scanning light ophthalmoscopy (AOSLO). Results : SD-OCT identified a subtly irregular ellipsoid zone (EZ) band in the area of a previous APMPPE lesion, improved from initial presentation and initial visit after reactivation. Confocal AOSLO (Figure A) revealed an abrupt transition from dense regularly spaced cones to a disrupted photoreceptor mosaic. However, confocal AOSLO signal can be difficult to interpret in the presence of debris or non-waveguiding cones. Split detection AOSLO (Figure B) highlights cone inner segments providing a clearer view of cone distribution even in the absence of waveguiding and revealed reduced photoreceptor density in disrupted areas (Figure A and B '∗'). Conclusions : COVID-19 vaccination may induce reactivation of APMPPE symptoms. Despite improved EZ band structure by SD-OCT in the areas of previous APMPPE lesions, AOSLO revealed several focal areas of persistent subclinical photoreceptor loss. Split detection AOSLO allows for more precise assessment of photoreceptor structure and highlights the variability in inner segment changes throughout retina lesions. This demonstrates the potential utility of split-detector AOSLO for assessment of photoreceptor structure alterations in retinal uveitic diseases such as APMPPE. (Figure Presented).

Standardized Risk Mitigation Measurement in Extended Reality Environments Utilizing the IEEE Experience API (xAPI) Standard

Recent reports indicate increased organizational appetite and spend in the energy industry in both the areas of operational risk management training and enablement and in extended reality hardware and software, as part of larger automation and digital transformation initiatives. Furthermore, recent advances in immersive technology, along with more dispersed, asynchronous working conditions due to COVID, have resulted in scalable, immersive simulations that more and more closely resemble real world environments. While recent standards have defined JSON syntax appropriate for tracking and measuring human behavior data in generic learning environments (IEEE P9274.1) and in a manner that more closely approximates human behavior in the workplace, as typically tracked in operational risk management systems, no risk-based ontology has yet been defined that more closely crosswalks and correlates data from simulated environment systems to those in operational environments. Thus, the true efficacy of extended reality-based risk mitigation training cannot be fully measured. In this effort, a risk-based ontology and matrix was constructed in accordance with the xAPI standard syntax and allowable extensions and was utilized to transform a subset of historical data from simulated operational risk-based scenarios from the energy industry. Transformed data from this initial subset closely approximated operational risk reporting data and provided insights into human behavior data in simulated environments that can be easily compared and correlated to existing operational excellence and risk mitigation KPIs. Implications for mapping of additional advanced data from simulated environments in larger, more complex datasets, such as eye tracking and biometrics, were also considered and explored. © 2022 IEEE.

Chronic Pain Patients During COVID-19: Machine Learning Reveals Attributes Leading to Pandemic Susceptibility and Resilience

Introduction: The novel coronavirus has disrupted chronic pain patients’ care, on-going clinical studies, interrupted daily routines and pain management plans, as well as halted social/extracurricular activities. These disturbances may contribute to increased pain intensity, worsening disability, and deteriorating mood in a population with mental and physical health comorbidities. COVID-19 presented a unique opportunity to observe patients’ pain experience, including quality-of-life (QoL) and daily activities, as well as identify and characterize individuals who are potentially susceptible to changes during a substantial stressor. Methods: As part of on-going multi-site Boston Scientific studies prospectively observing up to 1700 chronic leg and back pain patients’ responses to spinal cord stimulation (SCS), we used smartphones to collect daily self-reported pain intensity, mood, sleep, medications, and activities. We also obtained in-clinic questionnaires and objective measures from smartwatches, sleep sensors, weekly voice recordings, and SCS usage. To evaluate changes during COVID-19, we defined two 6-week periods: “COVID” (03/6/2020—04/17/2020), “Pre-COVID” (12/20/2019- 01/30/2020). Since patients may be differentially impacted, we performed multivariate analyses integrating changes in self-reported variables between periods, which were normalized and K-means clustered to identify sub-cohorts. We also administered questions to assess patients’ emotional state during the pandemic, analyzed with natural language processing (NLP). Results: In our results (Figures 1-4), we found no differences in self-reports between pre-COVID and COVID for the entire cohort (n=70/159). However, clustering identified 3 sub-cohorts: individuals whose pain worsened (pain-susceptible), whose activities decreased (ADLsusceptible), and whose mood, sleep, medication, and activities remained the same or improved (QoL-resilient) during COVID. Partial correlations between changes in self-reports also showed differences as a function of period and sub-cohort. Sensor data indicated that NLP-identified fear related speech content during COVID was lower for the QoL-resilient group, who also had greater watch step counts during pre-COVID, supporting the idea that they had the best overall wellbeing or initial behaviors of the 3 groups. There were no differences in clinical assessments or SCS usage between sub-cohorts or periods. Conclusion: Our results indicate the existence of 3 patient sub-cohorts that diverge in their behaviors during COVID-19. We find each sub-cohort has a characteristic signature that allows us to predict the response an individual patient had to the pandemic. These findings demonstrate the importance of multi-dimensional digital monitoring with important implications for telemedicine, clinical trials and neuromodulation system management. Disclosure: Richard Rauck, MD: Boston Scientific: Contracted Research: Self, Medtronic: Contracted Research: Self, Mainstay: Contracted Research: Self, Saluda: Contracted Research: Self, Stimwave: Contracted Research: Self, SPR Therapeutics: Contracted Research: Self, Nevro: Contracted Research: Self, Neuros: Contracted Research: Self, Sara Berger, PhD: IBM: Employee:, Guillermo Cecchi, PhD: IBM: Employee:, Carla Agurto, PhD: IBM: Employee:, Elif Eyigoz, PhD: IBM: Employee:, Kristen Lechleiter, MS: Boston Scientific: Employee:, Dat Huynh, PhD: Boston Scientific: Employee:, Brad Hershey, BS: Boston Scientific: Employee:, Eric Loudermilk, MD: None, Julio Paez, MD: None, Louis Bojrab, MD: None, John Noles, MD: None, Todd Turley, MD: None, Mohab Ibrahim, MD: None, Amol Patwardhan, MD: None, James Scowcroft, MD: Nevro: Contracted Research:, Boston Scientific: Contracted Research:, Saluda: Contracted Research:, Rene Przkora, MD: Boston Scientific, Abbott, Nevro, Medtronic: Contracted Research:, Nathan Miller, MD: None, Gassan Chaiban, MD: Boston Scientific: Consulting Fee:, Matt McDonald, MS: Boston Scientific: Salary/Employee: Self, Jeffrey Rogers, PhD: IBM: Employee: [Formul presented] [Formula presented] [Formula presented]

Prevalence and Impact of Post-Acute Sequelae of COVID-19 among People Experiencing Homelessness in King County, WA between September 2020 - May 2021

Background. Homeless shelters are high risk settings for SARS-CoV-2 transmission. People experiencing homelessness (PEH) have high rates of chronic illness, and have been disproportionately affected by COVID-19. The burden of post-acute sequelae of COVID-19 (PASC) in PEH has not been well-studied and PEH may be uniquely affected due to barriers to medical care and the potential exacerbation of existing threats to health, housing, employment, and self-care. Methods. The Seattle Flu Study conducted community-based surveillance for SARS-CoV-2 in nine homeless shelters from September 1, 2020 and May 31, 2021. Individuals with and without respiratory symptoms were tested for SARS-CoV-2 infection using a PCR assay. We completed follow-up surveys with shelter residents age ≥18 years at days 5, 10, 30 and 60+ after positive or inconclusive diagnosis with SARS-CoV-2 infection. Individuals were asked about residual symptoms, impact on activities of daily living, access to medical care, and health-related quality of life. Results. Of 51 eligible participants, 22 (43%) completed a follow-up survey, with six at day 5 or 10 survey, 11 at day 30, and 18 at day 60+. The median time from enrollment to last follow-up survey was 77 (range 49-138) days. Five (23%) participants reported at least one symptom at day 0, five (83%) at day 5 or 10, eight (73%) at day 30 and seven (39%) at day 60+ (Figure 1). Eight (36%) reported at least one symptom on a day 30 or 60+ follow up survey that interfered or prevented their daily activities. Nine (41%) received medical care at the quarantine facility. Of those with symptoms persisting beyond day 10, four (30%) received medical care outside of a medical provider at the quarantine facility. Prevalence of self-reported symptoms at Day 0 (enrollment), Day 5 or 10, Day 30, and Day 60+ in shelter residents who tested positive or inconclusive for SARS-CoV-2. Conclusion. PEH reported a high prevalence of persistent COVID-19 symptoms 30+ days after their SARS-CoV-2 detection. Few participants accessed medical care for their persistent illness. The impact of COVID-19 extends beyond acute illness and PASC may exacerbate existing challenges PEH face in health and wellbeing.

Engineering Virtual Design Competition - A Solution for High School Summer Outreach During the Pandemic and Beyond (Evaluation)

Aspects of society and culture that encompass the response to COVID-19 have impacted all lives, including those of K-12 students and their families. The ongoing COVID-19 pandemic offers a complex context in which students can experience ambiguity with an engineering design challenge as an iterative process of divergent-convergent thinking while focusing on the big picture. Students can learn with an emphasis on systems thinking, making decisions in a collaborative team environment;and managing uncertainty in social processes [1]. The conversations around how schools could function during the pandemic offered a unique opportunity to engage students in problem solving about a situation that they are experiencing themselves. In the US Southwest, three state universities came together during the early stages of the 2020 pandemic lockdown to create a virtual design competition for high school students. The TriU Partnership, including engineering college deans, faculty, and college recruitment and outreach staff from Arizona State University, Northern Arizona University, and the University of Arizona, was formed as an outgrowth of a National Science Foundation, INCLUDES project [2]. One of the aims of this project was to increase engineering awareness and interest amongst a broad population of the state and thereby enhance entry into the state's four-year university engineering programs. The TriU Partnership served 96 high school students from 4 different states in a virtual educational event offered in June 2020. Twenty-five teams of students were asked to consider the challenges their high schools faced in achieving a safe reopening in a pandemic. Over six days, participants attended online seminars, consulted with experts and worked with engineering undergraduate mentors to come up with creative engineering solutions for protective equipment, hallway traffic patterns, bell schedules and social distancing in various high school settings. Final submissions included a detailed engineering notebook, a live online presentation, and interviews with a team of expert judges. The expert judge panel was composed of engineering faculty and industry partners. Teams also submitted prototypes and, in some cases, complete CAD drawings. In this paper, we tell the story of the TriU engineering partnership, share the logistics of the virtual design challenge, talk about lessons learned and share results. Data sources include student survey responses, daily exit tickets, and materials produced such as their final presentation, notebooks, and solutions. The TriU Partnership will continue each summer with each university taking the lead, in turn to offer the design challenge as part of their normal outreach efforts. © American Society for Engineering Education, 2021

Improving Spatial Visualization Skills of High School Students Through Sketch Training on a Touchscreen (Evaluation)

This paper evaluates an approach for training and improving high school students' Spatial Visualization skills. Using touchscreen devices from home, 45 high school juniors and seniors enrolled in an educational application consisting of nine lessons on drawing orthographic and isometric figures. As part of their remote instruction during the COVID 19 pandemic, engineering students downloaded the application onto their cell phone or tablet and completed a series of auto graded exercises that were assigned in their high school course. The application included gamification features such as stars for rewards and hints to encourage student persistence. The Purdue Spatial Visualization Test: Rotations (PSVT:R) was administered before the treatment and the mean score for the participant group was 74.0% Regardless of their pretest score, participants were required to complete all nine lessons in the application. After course completion, a post-test of the PSVT:R was administered and the mean score for the participant group improved by 6.3%. Results showed that students who were classified in the at risk low performing group and had a pre-test of 70% or lower improved on their post-test score by 15.6%. Sex differences were examined, with female students improving their post-test score on average by 10.7%. Of the nine female participants, five started in the low group and three out of those five ended up moving out of this at-risk group. Additionally, a 15 question evaluation survey was administered to gather student opinions about their user experience. © American Society for Engineering Education, 2021