ABSTRACT
Over the past decades, 360-degree virtual tours have been used to provide the public access to accurate representations of cultural heritage sites and museums. The COVID-19 pandemic has contributed to a rise in the popularity of virtual tours as a means of engaging with locations remotely and has raised an interesting question: How could we use such experiences to bring the public closer to locations that are otherwise unreachable in real life or not considered to be tourist destinations? In this study, we examine the effectiveness of promoting engagement with a city through the virtual presentation of unknown and possibly also inaccessible points of interest through a 360-degree panoramic virtual tour. The evaluation of the experience with 31 users through an online questionnaire confirms its potential to spark curiosity, promote engagement, foster reflection, and motivate users to explore the location and its attractions at their leisure, thus enabling them to experience it from their personal point of view. The outcomes highlight the need for further research to explore this potential and identify best practices for virtual experience design. © 2023 by the authors.
ABSTRACT
Social interaction has been recognized as positively affecting learning, with dialogue–as a common form of social interaction–comprising an integral part of collaborative learning. Interactive storytelling is defined as a branching narrative in which users can experience different story lines with alternative endings, depending on the choices they make at various decision points of the story plot. In this research, we aim to harness the power of dialogic practices by incorporating dialogic activities in the decision points of interactive digital storytelling experiences set in a history education context. Our objective is to explore interactive storytelling as a collaborative learning experience for remote learners, as well as its effect on promoting historical empathy. As a preliminary validation of this concept, we recorded the perspective of 14 educators, who supported the value of the specific conceptual design. Then, we recruited 15 adolescents who participated in our main study in 6 groups. They were called to experience collaboratively an interactive storytelling experience set in the Athens Ancient Agora (Market) wherein we used the story decision/branching points as incentives for dialogue. Our results suggest that this experience design can indeed support small groups of remote users, in-line with special circumstances like those of the COVID-19 pandemic, and confirm the efficacy of the approach to establish engagement and promote affect and reflection on historical content. Our contribution thus lies in proposing and validating the application of interactive digital storytelling as a dialogue-based collaborative learning experience for the education of history. Copyright © 2022 Petousi, Katifori, Servi, Roussou and Ioannidis.
ABSTRACT
[Formula presented] Introduction: Recent data suggest a suboptimal antibody response to COVID-19 vaccination in patients with hematological malignancies. Herein, we evaluated the development of neutralizing antibodies (NAbs) against SARS-CoV-2 in patients with plasma cell neoplasms (PCNs) after vaccination with either the mRNA BNT162b2 or viral vector AZD1222 vaccine, up to 50 days post their first vaccine dose. Methods: This is an ongoing large prospective study (NCT04743388) evaluating the kinetics of anti-SARS-CoV-2 antibodies after COVID-19 vaccination in healthy subjects and in patients with hematological malignancies or solid tumors. Here we present the data on patients with PCNs in comparison to controls of similar age and gender, who were vaccinated during the same time period (January to March 2021) in Athens (Greece). Major exclusion criteria for both patients and controls included the presence of: (i) autoimmune disorder under immunosuppressive therapy or other active malignant disease;(ii) HIV or active hepatitis B and C infection, (iii) end-stage renal disease and (iv) prior diagnosis of COVID-19. Serum was collected on day 1 (D1;before the first vaccine dose), on day 22 (D22;before the second dose of the BNT162b2 or 3 weeks post the first AZD1222 dose) and on day 50 (D50;4 weeks post second dose of the BNT162b2 or 7 weeks post the first AZD1222 dose). NAbs against SARS-CoV-2 were measured using an FDA approved-ELISA methodology (cPass™ SARS-CoV-2 NAbs Detection Kit, GenScript, Piscataway, NJ, USA). Results: We evaluated 382 patients with PCNs after vaccination with either the BNT162b2 or the AZD1222 vaccine. Patients with MM (n=213), WM (n=106), SMM (n=38) and MGUS (n=25) and 226 healthy controls were enrolled in the study. Of MM/SMM/MGUS patients, 215 (77.9%) were vaccinated with the BNT162b2 and 61 (22.1%) with the AZD1222 vaccine, while out of 106 WM patients 90 (84.9%) were vaccinated with the BNT162b2 and 16 (15.1%) with the AZD1222 vaccine. Vaccination with either two doses of the BNT162b2 or one dose of the AZD1222 vaccine led to lower production of NAbs against SARS-CoV-2 in patients compared with controls both on day 22 and on day 50 (P<0.001 for all comparisons). After the first dose of the vaccine, on D22, the patient group had lower NAb titers compared with controls: the median NAb inhibition titer was 27% (IQR: 15.3-42%) for MM/SMM/MGUS versus 20.5% (IQR: 10-37%) for WM patients versus 38.7% (IQR: 22-54.3%) for controls (P<0.001 for all comparisons). On D50 the median NAb inhibition titer was 62.8% (IQR: 26-88.9%) for MM/SMM/MGUS versus 36% (IQR: 18-78%) for WM patients versus 90% (IQR: 58-96.4%) for controls (P<0.001 for all comparisons). 57.3% MM/SMM/MGUS, 42% WM patients and 81% controls developed NAb titers ≥50% (p<0.001 for patients versus controls). Furthermore, MM patients showed an inferior NAb response compared with MGUS on day 22 (p=0.009) and on day 50 (p=0.003). Importantly, active treatment with either anti-CD38 monoclonal antibodies or belantamab mafodotin and lymphopenia at the time of vaccination were independent prognostic factors for suboptimal antibody response following vaccination in MM (p<0.05). Disease-related immune dysregulation and therapy-related immunosuppression were involved in the low humoral response in patients with WM. Importantly, active treatment with either rituximab or Bruton's Tyrosine Kinase inhibitors (BTKIs) was proven as an independent prognostic factor for suboptimal antibody response following vaccination in WM (p<0.05). Regarding adverse events, 33% and 31.6% patients reported mild reactions after the first and second dose of the BNT162b2 vaccine, respectively;32.8% patients vaccinated with the first dose of AZD1222 also presented with local reactions. Conclusion: Patients with MM and WM have a low humoral response following SARS-CoV-2 vaccination, especially those who are under treatment with anti-CD38-, anti-BCMA-, anti-CD20- or BTKIs-based regimens. This result suggest that these patients have to continue the protective measures ag inst SARS-CoV-2 as they are at high risk for COVID-19. Further studies on the kinetics of immune subpopulations following COVID-19 vaccination will elucidate the underlying immune landscape and determine the potential need for additional booster vaccine doses or protective administration of antibodies against SARS-CoV-2 in MM/WM patients with poor response after full vaccination. Disclosures: Terpos: Janssen-Cilag: Consultancy, Honoraria, Research Funding;BMS: Honoraria;Celgene: Consultancy, Honoraria, Research Funding;Genesis: Consultancy, Honoraria, Research Funding;GSK: Honoraria, Research Funding;Takeda: Consultancy, Honoraria, Research Funding;Sanofi: Consultancy, Honoraria, Research Funding;Novartis: Honoraria;Amgen: Consultancy, Honoraria, Research Funding. Gavriatopoulou: Janssen: Honoraria;Takeda: Honoraria;Sanofi: Honoraria;Karyopharm: Honoraria;Genesis: Honoraria;GSK: Honoraria;Amgen: Honoraria. Kastritis: Amgen: Honoraria, Research Funding;Janssen: Honoraria, Research Funding;Genesis: Honoraria;Takeda: Honoraria;Pfizer: Honoraria. Dimopoulos: Janssen: Honoraria;BeiGene: Honoraria;Takeda: Honoraria;Amgen: Honoraria;BMS: Honoraria.
ABSTRACT
Background: The SARS-CoV-2 pandemic has caused innumerable social and economic consequences, has stressed health care systems, affecting the delivery of health care and raising concerns that many patients may have suffered delays in therapy and in the diagnosis of serious conditions, such as hematologic and other malignancies. This effect may be more pronounced in older patients, who are at higher risk for COVID-19 complications, but which may also be affected by social isolation and distancing, difficulties in reaching health care facilities and fear of acquiring the infection. Myeloma patients are a vulnerable, mostly elderly population who may have been affected in terms of diagnosis and treatment delivery during the pandemic. There is a concern that diagnosis may be delayed, potentially presenting with more advanced disease or more often with severe complications. Aims: To provide evidence for the care of patients with myeloma, during the COVID-19 era, we compared the characteristics of newly diagnosed patients during 2020 and 2019 (i.e pre COVID-19 pandemic). Methods: We compared baseline characteristics and short-term outcomes of newly diagnosed MM patients who were diagnosed and started therapy in a tertiary referral center (Department of Clinical Therapeutics, Athens) during two calendar periods, 2019 and 2020. Initial restrictive measures were first implemented in Greece in mid-February 2020 and national lockdown in mid-March. Data were collected through our prospectively maintained database that includes all patients with a diagnosis of myeloma in our center. Since the beginning of the pandemic in Greece, our department implemented preventive measures and operating procedures to ensure continuous delivery of care and reduce the risk of COVID-19 infection. Results: In 2019,125 MM patients with a new diagnosis of symptomatic disease started therapy vs101 in 2020. The distribution of new cases per month was similar between the two years (p=0.542). Gender distribution was similar, but patients diagnosed in 2020 were slightly older (median 69 vs 66 years for 2019, p=0.084). There were no differences in baseline anemia, renal function, need for dialysis or ISS stage;however, slightly more patients had high risk cytogenetics in 2020 vs 2019 (37% vs 27%, p=0.129). The median time from the first test for the diagnosis to start of therapy was15 days in 2019 vs 8 days in 2020. First line therapies were similar with the majority receiving a PI plus IMiD combination (mostly VRD: 70% in 2019 vs 76% in 2020). Radiotherapy due to MM-related complications was required in 2.4% vs 4% of patients in 2019 and 2020 respectively. Early mortality (death <3 months from start of therapy) was 2.4% in 2019 and 5% in 2020 (p=0.314). The number of autologous transplants was slightly smaller in 2020 vs 2019 (54 vs 61). Infection rates during induction, which may have been affected by the use of social distancing and protective measures, was similar (15% vs16%);however, less patients required hospitalization for infection management in 2020 (in 8% vs16% in 2019). Very few cases of COVID-19 occurred among our MM patients and in only one newly diagnosed MM patient. Summary/Conclusion: Despite the pandemic, we did not observe significant delays or changes in the characteristics of patients that were diagnosed with myeloma between 2019 and 2020 in our center, neither in the short-term outcomes of our patients. Despite the pandemic it is possible to maintain delivery of high-quality specialized care in patients with myeloma.