Architectural education challenges and opportunities in a post-pandemic digital age

The current study examines the impact of Covid-19 pandemic on architectural education, focusing on its challenges and implications on students, educators, and institutions, and the opportunities that emerged from the incorporation of online/distance and blended learning in architectural education during the pandemic. Based on observations and literature reviews, this study identifies contemporary challenges and proposes three educational approaches for the transition to a model for architectural education in a digital age considering Covid-19 pandemic opportunities. These educational approaches are based on improving networking, exploration, and flexibility & adaptation, implementing transdisciplinary approach, and integrating information and communication technologies (ICT) in architectural education, in relation to learning design elements. The study presents a model using an instructional approach that provides a vision for post-pandemic architectural education and identifies challenges for educators and institutions for further investigation. This study responds to the call on the pandemic's impact on traditional architectural education.

Anticoagulants as Potential SARS-CoV-2 Mpro Inhibitors for COVID-19 Patients: In Vitro, Molecular Docking, Molecular Dynamics, DFT, and SAR Studies.

In this article, 34 anticoagulant drugs were screened in silico against the main protease (Mpro) of SARS-CoV-2 using molecular docking tools. Idraparinux, fondaparinux, eptifibatide, heparin, and ticagrelor demonstrated the highest binding affinities towards SARS-CoV-2 Mpro. A molecular dynamics study at 200 ns was also carried out for the most promising anticoagulants to provide insights into the dynamic and thermodynamic properties of promising compounds. Moreover, a quantum mechanical study was also conducted which helped us to attest to some of the molecular docking and dynamics findings. A biological evaluation (in vitro) of the most promising compounds was also performed by carrying out the MTT cytotoxicity assay and the crystal violet assay in order to assess inhibitory concentration 50 (IC50). It is worth noting that ticagrelor displayed the highest intrinsic potential for the inhibition of SARS-CoV-2 with an IC50 value of 5.60 µM and a safety index of 25.33. In addition, fondaparinux sodium and dabigatran showed promising inhibitory activities with IC50 values of 8.60 and 9.40 µM, respectively, and demonstrated safety indexes of 17.60 and 15.10, respectively. Moreover, the inhibitory potential of the SARS-CoV-2 Mpro enzyme was investigated by utilizing the SARS-CoV-2 Mpro assay and using tipranavir as a reference standard. Interestingly, promising SARS-CoV-2 Mpro inhibitory potential was attained for fondaparinux sodium with an IC50 value of 2.36 µM, surpassing the reference tipranavir (IC50 = 7.38 µM) by more than three-fold. Furthermore, highly eligible SARS-CoV-2 Mpro inhibitory potential was attained for dabigatran with an IC50 value of 10.59 µM. Finally, an SAR was discussed, counting on the findings of both in vitro and in silico approaches.

Investigating the possible mechanisms of pirfenidone to be targeted as a promising anti-inflammatory, anti-fibrotic, anti-oxidant, anti-apoptotic, anti-tumor, and/or anti-SARS-CoV-2.

Pirfenidone (PFD) is a non-peptide synthetic chemical that inhibits the production of transforming growth factor-beta 1 (TGF-ß1), tumor necrosis factor-alpha (TNF-α), platelet-derived growth factor (PDGF), Interleukin 1 beta (IL-1ß), and collagen 1 (COL1A1), all of which have been linked to the prevention or removal of excessive scar tissue deposition in many organs. PFD has been demonstrated to decrease apoptosis, downregulate angiotensin-converting enzyme (ACE) receptor expression, reduce inflammation through many routes, and alleviate oxidative stress in pneumocytes and other cells while protecting them from COVID-19 invasion and cytokine storm. Based on the mechanism of action of PFD and the known pathophysiology of COVID-19, it was recommended to treat COVID-19 patients. The use of PFD as a treatment for a range of disorders is currently being studied, with an emphasis on outcomes related to reduced inflammation and fibrogenesis. As a result, rather than exploring the molecule's chemical characteristics, this review focuses on innovative PFD efficacy data. Briefly, herein we tried to investigate, discuss, and illustrate the possible mechanisms of actions for PFD to be targeted as a promising anti-inflammatory, anti-fibrotic, anti-oxidant, anti-apoptotic, anti-tumor, and/or anti-SARS-CoV-2 candidate.

COVID-19-Induced Myopericarditis Leading to Cardiac Tamponade: An Unusual Case Presentation.

Coronavirus disease 2019 (COVID-19) can manifest differently in different patients, ranging from asymptomatic carriers to acute respiratory distress syndrome (ARDS). Cardiac involvement may occur with COVID-19 even without respiratory tract signs and symptoms of infection. Cardiac manifestations like heart failure (HF), myopericarditis, and cardiac arrhythmias are commonly reported. Cardiac injury with troponin leak is associated with increased mortality in COVID-19, and its clinical and radiographic features are difficult to distinguish from those of HF. COVID-19 is also known to cause pericardial inflammation, likely via direct cytotoxic effects or immune-mediated mechanisms. However, the definite mechanism is still unclear. We present here a case of myopericarditis complicated by pericardial effusion and cardiac tamponade in a COVID-19 infected patient with minimal pulmonary involvement.

SARS-CoV-2 infection- induced growth factors play differential roles in COVID-19 pathogenesis.

AIMS: Biologically active molecules cytokines and growth factors (GFs) are critical regulators of tissue injury/repair and emerge as key players in COVID-19 pathophysiology. However, specific disease stage of GFs dysregulation and, whether these GFs have associations with thromboembolism and tissue injury/repair in COVID-19 remain vague. MAIN METHODS: GF profiling in hospitalized moderate (non-ICU) and critically ill (ICU) COVID-19 patients was performed through legendPlex assay. KEY FINDINGS: Investigation revealed profound elevation of VEGF, PDGFs, EGF, TGF-α, FGF-basic, and erythropoietin (EPO) in moderate cases and decline or trend of decline with disease advancement. We found strong positive correlations of plasma VEGF, PDGFs, and EPO with endothelial dysfunction markers P-selectin and sCD40L. Interestingly, the HGF and G-CSF were upregulated at the moderate stage and remained elevated at the severe stage of COVID-19. Moreover, strong negative correlations of PDGFs (r2 = 0.238, P = 0.006), EPO (r2 = 0.18, P = 0.01) and EGF (r2 = 0.172, P = 0.02) and positive correlation of angiopoietin-2 (r2 = 0.267, P = 0.003) with D-dimer, a marker of thromboembolism, was observed. Further, plasma PDGFs (r2 = 0.199, P = 0.01), EPO (r2 = 0.115, P = 0.02), and EGF (r2 = 0.108, P = 0.07) exhibited negative correlations with tissue injury marker, myoglobin. SIGNIFICANCE: Taken together, unlike cytokines, most of the assessed GFs were upregulated at the moderate stage of COVID-19. The induction of GFs likely occurs due to endothelial dysfunction and may counter the adverse effects of cytokine storms which is reflected by inverse correlations of PDGFs, EPO, and EGF with thromboembolism and tissue injury markers. The findings suggest that the assessed GFs play differential roles in the pathogenesis of COVID-19.

Change Management and Innovation Practices during Pandemic in the Middle East E-Commerce Industry

This study highlights the appropriateness of innovation management principles to successfully manage radical change in the e-commerce industry during the COVID-19 period. The study focuses on transforming delivery platforms in the context of popular e-commerce organizations in the U.A.E. We conducted the study through interviews, and the results reflect the development of three major themes (shifting consumer behavior, implementation of innovation, and innovation for effective change management) since the beginning of the COVID-19 pandemic. During the transition stage, critical aspects concerning product delivery have emerged to stabilize logistics performance with sustainability. The study suggests that firms need to be faster and more flexible to address the market uncertainty through innovative practices. Similar organizations can use this study to develop mechanisms to improve their delivery systems. Additionally, the study also argues that collaborative innovation significantly contributes to the enhancement of consumers' well-being and boosts economic growth.

Efficiency of Soybean Products in Broiler Chicken Nutrition.

The study aimed to determine the overall effect of replacing soybean meal completely with soybean expeller cake or extruded full-fat soybean in feed rations for broiler chickens on their carcass composition and meat quality. The experiment involved one hundred and twenty Ross 308 broiler chickens randomly allocated to three equinumerous groups (SBM, SEC, EFS). Each group was divided into five subgroups-each consisting of eight birds of both sexes (1:1). From Day 1 to Day 21 of life the birds were fed with loose starter rations, and from Day 22 to Day 42 they were fed grower rations based on a wheat meal, protein products and mineral and vitamin admixtures. The experimental factor was a protein raw material comprising: SBM group-soybean meal from GM (genetically modified) seeds, SEC-soybean expeller cake from n-GM seeds, and EFS-extruded full-fat soybean from n-GM seeds. The experimental diets were isocaloric and isonitrogenous. It was demonstrated that replacing soybean meal with SEC or EFS in feed rations for broiler chickens led to a significant (p < 0.05) weight gain on Day 42 of rearing by 4.57% and 2.88%, respectively. The chickens fed diets with EFS had worse (more than 4.14%) feed conversion rate (FCR) in comparison to the others (p < 0.05). Broiler chickens from the SBM and SEC groups showed a higher share of breast and leg muscles (by 4.74% and 7.54%) and a lower share of abdominal fat (by 31.1%) and skin with subcutaneous fat (by 18.8% and 13.4%) in comparison with birds from the EFS group (p < 0.05). The highest content of intramuscular fat with the best fatty acids profile was determined in the muscles of birds fed with diets containing EFS, while the muscles of chickens receiving SEC scored the highest. The results provide grounds for recommending SEC in broiler chicken nutrition as it allowed for obtaining the best production and slaughter results, whereas-from the point of view of the human diet-EFS should be recommended since it best modified the lipid fraction of muscles.

Web-based and paper-based examinations: Lessons learnt during the COVID-19 pandemic lockdown.

OBJECTIVES: This study describes the process of remote assessment in medical education during the COVID-19 lockdown and shares data-driven experiences in resolving emerging concerns. METHODS: We analysed the data of end-of-course paper-based exams (PBEs) and web-based exams (WBEs) conducted during the academic year 2019/2020. Twelve end-of-block exams were included. There were four exams each for the first-, second-, and third-year students. Eight exams were conducted as PBEs, and four were administered as WBEs. We compared the mean scores of PBEs and WBEs between exams and batches. Additionally, we compared the PBE and WBE scores obtained by 10 high-performance and 10 lowest-achieving students. RESULTS: Variations were found in the scores of students from each of the three batches in PBEs or WBEs. In a few instances, the difference was statistically significant. No specific trend or pattern was detected in the difference between the scores of PBEs and WBEs. The mean score for the WBEs was intermediate among the means of PBEs for the first- and second-year students, but lower for the third-year students. Individual students' marks in different exams consistently showed a positive correlation. The correlation was always high for PBEs (r = 0.782, 0.847). CONCLUSION: The present study showed that average and individual scores in WBEs and PBEs are comparable. Although there were some variations between the results of the two assessment modalities, no remarkable trend or pattern was observed. WBEs offer an ideal approach for formative assessment, progress testing, and the low-weight, but frequent, nature of continuous assessment.

First presentation of portal hypertension complicated by hepatopulmonary syndrome.

Hepatopulmonary syndrome (HPS) is a serious complication of chronic liver disease, characterised by portal hypertension and arterial hypoxaemia due to intrapulmonary vascular dilatation. We report an unusual case in which a 27-year-old man had a first presentation of portal hypertension and cirrhosis complicated by HPS. This patient presented with progressive dyspnoea on exertion and deterioration in mobility, with a type 1 respiratory failure and increased oxygen demand. A bubble echocardiogram showed a possible right-to-left shunt, CT aortogram displayed evidence of portal hypertension and cirrhosis, and liver biopsy findings were consistent with alpha-1 antitrypsin deficiency. The patient's increased oxygen demand was subsequently treated with continuous positive airway pressure before he was discharged with 8 L home oxygen. With no current established medical therapy for HPS, the patient was assessed for liver transplantation and a decision was made in favour of this.

Ocular Manifestations of Post-Acute COVID-19 Syndrome, Upper Egypt Early Report.

PURPOSE: To evaluate the ocular manifestations of post-acute COVID-19 syndrome. METHODS: A retrospective, comparative study included 100 patients who had recovered from COVID-19 and 100 controls who were recruited by stratified randomization from hospital registration system and analyzed regarding history, full ophthalmological examination, general examination including internal medicine and neurological evaluation. Laboratory tests were done. RESULTS: Mean±SD of age were 55.5 ± 6.2 in COVID group vs 56.5 ± 5.8 in control group; P value = 0.7. In COVID group, 57 patients (57%) were males vs 51 patients (51%) in control group (P value = 0.39), the other compared parameters including history and risk factors showed non-significant difference except for ESR and D-dimer which were elevated in COVID group. In COVID group, 5 patients (5%) were having retinal vascular occlusion, 2 patients (2%) were having anterior ischemic optic neuropathy AION, 3 patients (3%) were having uveitis and 2 patients (2%) were having central serous chorioretinopathy CSCR. While in control group, 2 patients (2%) were having retinal vascular occlusion, and none had AION, uveitis or CSCR (P value = 0.006). CONCLUSION: Post-acute COVID-19 syndrome could affect the eyes in the form of coagulation problems, neurological morbidities, and other manifestations. This necessitates meticulous follow-up of recovered patients from COVID-19.

Development patterns of olfactory disorders in Covid-19 patients, Aden, Yemen

Background: Covid-19 is characterized as a global pandemic and health emergency. Post viral olfactory dysfunction maybe conductive due to swelling of the mucosa in the olfactory cleft, or sensorineural impairment due to degeneration of olfactory neuroepithelium. Objective: To delineate the different development patterns of olfactory disorders in Covid-19 patients. Materials and method: This was a descriptive prospective study conducted in Aden. Seventy ENT patients underwent Covid-19 testing by real-time PCR in the Center of Covid-19 during June 1 to August 31, 2020 Data were collected and analyzed by SPSS software version 17 and the results were presented as mean values with the standard deviation (SD), frequencies and percentage. The statistical signifi- cance of differences between data was evaluated using Fisher test. A level of significance of p < 0.05 was used. Results: Among the 70 patients, (78.6%) were females and (21.4%) were males. Their age ranged between 18-51 years and the mean age was 29.2±8.8 years. The largest age group of patients was 21-30 years (41.9%) followed by 31-40 years (27.1%). Generalized body ache was the most common nonspecific symptom (24.3%). High nonspecific symptoms occurred more in female patients, (p > 0.05). Comorbid conditions were diabetes mellitus in (11.4%) patients and hypertension in (7.1%). Anosmia was found in (85.7%) and hyposmia in (14.3%) patients. Parosmia was the most common development pattern of olfactory disorders in covid-19 patients 24 (34.2%). Full recovery was found in 14.3% of patients. Conclusion: The situation of a significantly higher proportion of patients with anosmia followed by hyposmia supports the need for ENT health care for patients with Covid-19 diseases. [ABSTRACT FROM AUTHOR] Copyright of Middle East Journal of Family Medicine is the property of Medi+WORLD International Pty. Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Challenges of personal protective equipment use among ophthalmologists during the COVID-19 pandemic: A multicenter international study.

PURPOSE: To explore the possible challenges and difficulties of using Personal Protective Equipment (PPE) in ophthalmic practice during the Coronavirus disease 2019 (COVID-19) pandemic. METHODS: This is a multicenter, international survey among practicing ophthalmologists across different countries. The survey was conducted from September 9th to October 24th, 2020. It included a total of 23 questions that navigated through the currently adopted recommendations in different clinical situations. The survey also assessed the convenience of using various PPE in ophthalmic practice and addressed the clarity of the examination field while using various PPE during clinical or surgical procedures. RESULTS: One hundred and seventy-two ophthalmologists completed the survey (101 from Egypt, 50 from the USA, and 21 from four other countries). The analysis of the responses showed that most ophthalmologists use face masks without significant problems during their examinations, while face shields followed by protective goggles were the most inconvenient PPE in the current ophthalmic practice. Moreover, most of the participants (133, 77.3%) noticed an increase in their examination time when using PPE. Furthermore, a considerable percentage of the respondents (70, 40.7%) stopped using one or more of the PPE due to inconvenience or discomfort. CONCLUSIONS: Due to the unique nature of the ophthalmic examination, certain PPE are not ophthalmologist-friendly. Innovative PPE should be tailored for prompt, more convenient, and clearer ophthalmological practice.

Potential predictors of outcomes among hospitalized COVID-19 patients treated with convalescent plasma: a single-center study.

Background: The coronavirus disease 2019 pandemic is a major international public health crisis, which has led to over 3 million deaths as of April 2021. Several therapeutics have been tried for this deadly illness including antivirals, immunosuppressive agents and convalescent plasma (CP). In this study, we present our inner-city safety net hospital experience with CP therapy. Methods: This was a retrospective chart review of hospitalized patients with confirmed COVID-19 who were treated with CP. Results: A total of 60 patients received CP during the study period. The mean age for patients in this study was 58.95 years. The most common presenting symptoms were shortness of breath (85%) and cough (73%). Hypertension (65%) and diabetes mellitus (55%) were the most common comorbidities in our patients. In our multivariate regression analysis, male sex, nausea and loss of appetite at presentation were associated with improvement in oxygenation after CP. Total survival time, history of obstructive airway disease, home use of angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers were associated with decreased survival, whereas Hispanic ethnicity showed a trend towards lower survival after CP therapy. Conclusions: Our study highlights several important characteristics of inner-city safety net hospital patient population who might benefit from CP therapy.

Spike in Rhino-Orbital-Cerebral Mucormycosis Cases Presenting to a Tertiary Care Center During the COVID-19 Pandemic.

Objective: To determine if there was an increase in the rate of cases presenting with rhino-orbital-cerebral mucormycosis (ROCM) to a tertiary care center during the first wave of the coronavirus disease 2019 (COVID-19) pandemic and the characteristics of the presenting cases. Methods: Retrospective observational study reviewing ROCM cases presenting from March 25 until September 25, 2020. Cases fulfilling the clinical, radiological, and pathological/microbiological criteria for diagnosis with ROCM were included. The number of cases presenting during the designated interval, their COVID-19 status, comorbidities, and clinical presentation were analyzed. The number of cases during the corresponding interval in the previous 3 years was used as reference to detect if there was a recent spike. Results: Of the 12 ROCM cases identified, 5 had a concurrent positive reverse transcription PCR (RT-PCR) test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 1 had a prior positive result, and 6 did not have concurrent nor prior positive test results. Nine of the 12 cases had poorly controlled diabetes mellitus, and 2 cases had a hematological malignancy. All cases had orbital invasion, and eight cases had cerebral invasion. The number of cases identified during the interval is much higher than the numbers presenting in the prior 3 years during equivalent intervals (range, one to two cases) than those reported in the literature in different settings in the pre-pandemic era. Conclusions: There is an increased rate of ROCM cases presenting to our center during the first wave of the COVID-19 pandemic. This is a preliminary report, and further studies are needed to corroborate the findings and explain possible underlying links.

Imaging spectrum of acute invasive fungal rhino-orbital-cerebral sinusitis in COVID-19 patients: A case series and a review of literature.

BACKGROUND: The incidence of devastating opportunistic coinfections in patients with COVID-19 infection, their imaging features and their morbidity and mortality consequences need to be unraveled. METHODS: This is a case series presenting the radiologic features and clinical presentation of acute invasive fungal rhino-orbital-cerebral sinusitis (AIFS) in eight hospitalized patients with confirmed COVID-19 infection. RESULTS: Our patient cohort presented with symptoms of the invasive fungal disease within 12-35 days from their initial presentation with COVID-19 infection. The cross-sectional imaging features of AIFS associated with COVID-19 infection do not differ from those reported in the literature for AIFS associated with other risk factors, yet our patients had features of aggressive late-stage forms with high morbidity and mortality rate. CONCLUSION: AIFS is a possible encounter in patients with COVID-19 patients and radiologists should be familiar with its imaging features.

Severe SARS-CoV-2 patients develop a higher specific T-cell response.

OBJECTIVES: Assessment of the adaptive immune response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is crucial for studying long-term immunity and vaccine strategies. We quantified IFNγ-secreting T cells reactive against the main viral SARS-CoV-2 antigens using a standardised enzyme-linked immunospot assay (ELISpot). METHODS: Overlapping peptide pools built from the sequences of M, N and S viral proteins and a mix (MNS) were used as antigens. Using IFNγ T-CoV-Spot assay, we assessed T-cell and antibody responses in mild, moderate and severe SARS-CoV-2 patients and in control samples collected before the outbreak. RESULTS: Specific T cells were assessed in 60 consecutive patients (mild, n = 26; moderate, n = 10; and severe patients, n = 24) during their follow-up (median time from symptom onset [interquartile range]: 36 days [28;53]). T cells against M, N and S peptide pools were detected in n = 60 (100%), n = 56 (93.3%), n = 55 patients (91.7%), respectively. Using the MNS mix, IFNγ T-CoV-Spot assay showed a specificity of 96.7% (95% CI, 88.5-99.6%) and a specificity of 90.3% (75.2-98.0%). The frequency of reactive T cells observed with M, S and MNS mix pools correlated with severity and with levels of anti-S1 and anti-RBD serum antibodies. CONCLUSION: IFNγ T-CoV-Spot assay is a reliable method to explore specific T cells in large cohorts of patients. This test may become a useful tool to assess the long-lived memory T-cell response after vaccination. Our study demonstrates that SARS-CoV-2 patients developing a severe disease achieve a higher adaptive immune response.