Robust Task Scheduling for Heterogeneous Robot Teams Under Capability Uncertainty

This article develops a stochastic programming framework for multiagent systems, where task decomposition, assignment, and scheduling problems are simultaneously optimized. The framework can be applied to heterogeneous mobile robot teams with distributed subtasks. Examples include pandemic robotic service coordination, explore and rescue, and delivery systems with heterogeneous vehicles. Owing to their inherent flexibility and robustness, multiagent systems are applied in a growing range of real-world problems that involve heterogeneous tasks and uncertain information. Most previous works assume one fixed way to decompose a task into roles that can later be assigned to the agents. This assumption is not valid for a complex task where the roles can vary and multiple decomposition structures exist. Meanwhile, it is unclear how uncertainties in task requirements and agent capabilities can be systematically quantified and optimized under a multiagent system setting. A representation for complex tasks is proposed: agent capabilities are represented as a vector of random distributions, and task requirements are verified by a generalizable binary function. The conditional value at risk is chosen as a metric in the objective function to generate robust plans. An efficient algorithm is described to solve the model, and the whole framework is evaluated in two different practical test cases: capture-the-flag and robotic service coordination during a pandemic (e.g., COVID-19). Results demonstrate that the framework is generalizable, is scalable up to 140 agents and 40 tasks for the example test cases, and provides low-cost plans that ensure a high probability of success.

Impact of COVID‐19‐Related Air Traffic Reductions on the Coverage and Radiative Effects of Linear Persistent Contrails Over Conterminous United States and Surrounding Oceanic Routes

The radiative effects of the large‐scale air traffic slowdown during April and May 2020 due to the international response to the COVID‐19 pandemic are estimated by comparing the coverage (CC), optical properties, and radiative forcing of persistent linear contrails over the conterminous United States and two surrounding oceanic air corridors during the slowdown period and a similar baseline period during 2018 and 2019 when air traffic was unrestricted. The detected CC during the slowdown period decreased by an area‐averaged mean of 41% for the three analysis boxes. The retrieved contrail optical properties were mostly similar for both periods. Total shortwave contrail radiative forcings (CRFs) during the slowdown were 34% and 42% smaller for Terra and Aqua, respectively. The corresponding differences for longwave CRF were 33% for Terra and 40% for Aqua. To account for the impact of any changes in the atmospheric environment between baseline and slowdown periods on detected CC amounts, the contrail formation potential (CFP) was computed from reanalysis data. In addition, a filtered CFP (fCFP) was also developed to account for factors that may affect contrail formation and visibility of persistent contrails in satellite imagery. The CFP and fCFP were combined with air traffic data to create empirical models that estimated CC during the baseline and slowdown periods and were compared to the detected CC. The models confirm that decreases in CC and radiative forcing during the slowdown period were mostly due to the reduction in air traffic, and partly due to environmental changes.Alternate :Plain Language SummaryContrails produced by aircraft flying in cold but humid air both warm the atmosphere by reducing infrared radiation emitted back into space and cool it by increasing reflected sunlight. Due to the decrease in air traffic during the first months of the COVID pandemic, fewer satellite‐detectable contrails were produced compared to pre‐pandemic times, and thus the radiative effects of contrails were also diminished. But changes in the overall temperature and humidity at aircraft cruise altitudes also affect contrail formation and might explain at least some of the observed decrease in contrail coverage during April and May 2020. Analysis of satellite imagery showed that the thickness and ice‐crystal size of the contrails during the COVID period did not change much from pre‐pandemic contrails. The regional contrail coverage was accurately simulated from a combination of the estimated air traffic activity at cruise altitude and the probable frequency of when atmospheric conditions were favorable for contrail formation. This simulation confirms that most of the decrease in contrails and their radiative effects during the COVID‐related slowdown period were due to the reduction in air traffic, and to a lesser extent to changes in temperature and humidity at cruise altitude during April and May 2020.

Vaccine Acceptance, Knowledge, Attitude and Practices Regarding the COVID-19 Pandemic: Cross-Sectional Study among Dentists in Trinidad and Tobago.

BACKGROUND: This study's aim was to assess Trinidad and Tobago dentists' vaccine acceptance, knowledge, attitude and practices regarding the COVID-19 pandemic. METHODS: All dentists registered with the Trinidad and Tobago Dental Association were invited to complete an online anonymous questionnaire between June and October 2021. RESULTS: A total of 46.2% of dentists responded. The majority of respondents had excellent knowledge of COVID-19 (94.8%), use of personal protective equipment (98.7%) and N95 masks (93.5%), but had poor knowledge about the reuse of N95 masks (27.5%). A total of 34.9% were comfortable providing emergency care to positive or suspected cases of COVID-19, and 64.5% were afraid of becoming infected from a patient. PPE usage was reported at 97.4% and 67.3% for N95 masks. All surfaces of waiting areas were disinfected every 2 h by 59.2%. A total of 90.8% agreed to be vaccinated straight away if a vaccine were made available. CONCLUSION: Dentists in Trinidad and Tobago have good levels of knowledge, attitude, practices regarding COVID-19. Dentists also have high levels of vaccine acceptance and can play a role in advocating for the COVID-19 vaccine.

Robust Task Scheduling for Heterogeneous Robot Teams Under Capability Uncertainty

This article develops a stochastic programming framework for multiagent systems, where task decomposition, assignment, and scheduling problems are simultaneously optimized. The framework can be applied to heterogeneous mobile robot teams with distributed subtasks. Examples include pandemic robotic service coordination, explore and rescue, and delivery systems with heterogeneous vehicles. Owing to their inherent flexibility and robustness, multiagent systems are applied in a growing range of real-world problems that involve heterogeneous tasks and uncertain information. Most previous works assume one fixed way to decompose a task into roles that can later be assigned to the agents. This assumption is not valid for a complex task where the roles can vary and multiple decomposition structures exist. Meanwhile, it is unclear how uncertainties in task requirements and agent capabilities can be systematically quantified and optimized under a multiagent system setting. A representation for complex tasks is proposed: agent capabilities are represented as a vector of random distributions, and task requirements are verified by a generalizable binary function. The conditional value at risk is chosen as a metric in the objective function to generate robust plans. An efficient algorithm is described to solve the model, and the whole framework is evaluated in two different practical test cases: capture-the-flag and robotic service coordination during a pandemic (e.g., COVID-19). Results demonstrate that the framework is generalizable, is scalable up to 140 agents and 40 tasks for the example test cases, and provides low-cost plans that ensure a high probability of success.

Virtual Management of Chronic Conditions During the COVID-19 Pandemic: Insights From Primary Care Providers and Clinical Pharmacists.

INTRODUCTION: The abrupt change in care delivery caused by the coronavirus disease 2019 pandemic may have left some patients, particularly those with chronic conditions, unable to receive timely and appropriate routine care. Understanding the effect of the pandemic and the switch to virtual care for patients with chronic conditions requires in-depth qualitative feedback from providers who care for these patients. MATERIALS AND METHODS: We interviewed 13 primary care providers and clinical pharmacists from the Veterans Health Administration. Interviews elicited experiences managing patients with chronic conditions, specifically diabetes and hypertension, during the coronavirus disease 2019 pandemic. We employed a rapid analytic approach for data analysis. RESULTS: In general, interview participants maintained that most patients' chronic conditions could be managed remotely without significant disruption. However, patients who lack familiarity with technology and/or reliable broadband access, patients not compliant with recommended self-assessments, and older patients with hearing loss or cognitive disorders may be more difficult to manage virtually. Although providers reported minimal disruptions to care because of the pandemic, they did note that the closure of labs and experiences of social isolation may have negatively impacted patients. Providers suggested optimizing virtual management through more robust patient instruction on virtual care technology, increased use of Veterans Affairs home health services, and removing institutional barriers that may de-incentivize virtual care modalities. CONCLUSIONS: For many patients with chronic conditions, virtual care is a promising approach to provide ongoing management in primary care. However, more tailored strategies may be needed to care for sicker, more vulnerable patients.

COVID vaccination can be performed in patients with a history of allergic reactions to the vaccines or their components: experience from a specialist clinic in South Australia.

BACKGROUND: The development of vaccines against SARS-CoV2 has been a key public health response to the COVID-19 pandemic. However, since their introduction, there have been reports of anaphylactic reactions to vaccines in individuals with history of allergic reactions to other vaccines, excipients or to COVID vaccines. AIM: A dedicated adult COVID vaccine allergy clinic with a standardised allergy testing protocol was set up to investigate safety and suitability of available COVID vaccines in Australia. METHODS: Patients referred to a state-wide COVID-19 vaccine allergy clinic between March and August 2021 with a history of allergy underwent skin-prick testing and intradermal testing to both available vaccine formulations (BNT162b2 and ChAdOx1-S), excipients (polyethylene glycol and polysorbate 80), excipient-containing medications and controls. Basophil activation testing was conducted in few subjects with convincing history of immediate type reactions. RESULTS: Fifty-three patients underwent testing for possible excipient allergy (n = 19), previous non-COVID vaccine reaction (n = 13) or previous reaction to dose 1 of COVID-19 vaccine (n = 21). Patients were predominantly female (n = 43, 81%), aged 18-83 (median 54) years. Forty-four patients tested negative and 42 of these received at least their first dose of a COVID-19 vaccine. Nine patients tested positive to excipients or excipient-containing medication only (n = 3), or vaccines (n = 6). Five patients were positive to just BNT162b2, 3/5 have been vaccinated with ChAdOx1-S. One who was skin test positive to both vaccines, but negative BAT to ChAdOx1-S was successfully vaccinated with ChAdOx1-S. CONCLUSION: Even in a high-risk population, most patients can be vaccinated with available COVID-19 vaccines. This paper reports local experiences using a combined allergy testing protocol with skin testing and BAT during the pandemic.

Safety and immunogenicity of intramuscular, single-dose V590 (rVSV-SARS-CoV-2 Vaccine) in healthy adults: Results from a phase 1 randomised, double-blind, placebo-controlled, dose-ranging trial.

BACKGROUND: Vaccines against COVID-19 are needed to overcome challenges associated with mitigating the global pandemic. We report the safety and immunogenicity of V590, a live recombinant vesicular stomatitis virus-based COVID-19 vaccine candidate. METHODS: In this placebo-controlled, double-blind, three-part phase 1 study, healthy adults were randomised to receive a single intramuscular dose of vaccine or placebo. In Part 1, younger (18-54 years) and, in Part 2, older (≥55 years) adults seronegative for SARS-CoV-2 nucleocapsid received one of four V590 dose levels (5.00 × 105; 2.40 × 106; 1.15 × 107; or 5.55 × 107 plaque-forming units [pfu]) or placebo. In Part 3, a single V590 dose level (5.55 × 107 pfu) or placebo was administered to younger SARS-CoV-2 seropositive adults. Primary endpoints included adverse events (AEs) and for Parts 1 and 2 anti-SARS-CoV-2 serum neutralising antibody responses measured by 50% plaque reduction neutralisation (PRNT50) assay at Day 28. Registration NCT04569786 [P001-02]. FINDINGS: 232 participants were randomised and 219 completed the study. In seronegative participants, anti-SARS-CoV-2 spike-specific antibody responses to V590 were low and comparable to placebo across the lower dose levels. At the highest dose level (5.55 × 107 pfu), anti-SARS-CoV-2 spike-specific PRNT50 was 2.3-fold higher than placebo. The most frequently reported AEs were injection-site pain (38.4%), headache (15.1%) and fatigue (13.4%). INTERPRETATION: V590 was generally well-tolerated. However, Day 28 anti-SARS-Cov-2 spike-specific antibody responses in seronegative participants following a single intramuscular administration of V590 were not sufficient to warrant continued development. FUNDING: The study was funded by Merck Sharp & Dohme LLC., a subsidiary of Merck & Co., Inc., Rahway, NJ, USA.

Effectiveness of a web-based virtual journal club to promote medical education (Web-Ed): protocol of a multicentre pragmatic randomised trial.

INTRODUCTION: A journal club (JC) is a commonly used medical educational tool. Videoconferencing technology can facilitate the delivery of JCs, however, there remains no evidence on the role of web-based virtual JCs in promoting the acquisition and retention of medical knowledge. The Web-Ed trial aims to evaluate the educational benefits, feasibility and acceptability of web-based virtual JCs compared with traditional face-to-face ones. METHODS AND ANALYSIS: Web-Ed is a multicentre pragmatic parallel-group randomised trial across teaching hospitals within the UK National Health Service (NHS). We will enrol qualified doctors or medical students who are >18 years old, proficient in English and able to use online videoconferencing software. Block randomisation will be used to allocate participants in 1:1 ratio to either intervention group. Both groups will be presented with the same educational material and follow a standardised JC structure hosted by nominated moderators and medical faculty members.The primary outcome is the difference in participants' knowledge acquisition and retention 7 days after the JCs evaluated using standardised multiple-choice questions. We will report secondarily on the feasibility and acceptability of the JCs using Likert scale questionnaires. Assuming a 30% drop-out rate, we aim to enrol 75 participants to detect a 20% improvement in knowledge acquisition at 80% power and 5% significance. We will report using mean difference or risk ratio with 95% CIs and assess significance using parametric/non-parametric testing. Where relevant, we will adjust for predetermined characteristics (age, grade of training and session duration) using multivariate regression analyses. ETHICS AND DISSEMINATION: Web-Ed was designed by doctors in training to address their learning needs and evaluate the preferred mode of learning. The trial results will be published in peer-reviewed journals and presented at relevant scientific conferences. The trial has been approved by the NHS Health Regulation Authority (21/HRA/3361). TRIAL REGISTRATION NUMBER: ISRCTN18036769.

Patent foramen ovale (pfo) closure service evaluation: remote mdt, local anaesthesia and intracardiac echo (ice) during the covid-19 pandemic

60 Table 1Basic characteristics and vascular risk factors in two groupsCharacteristics Closure group (n=38) MM group (n=40) P value Median age 45 54 0.001 Age range 21-65 23-79 Highest age group 30-39 (n=12) & 50-59 (n=12) 50-59 (n=14) Males 23 (61%) 25 (62%) 0.43 Females 15 (39%) 15 (38%) Diabetes 2 (5%) 8 (20%) 0.02 Hypertension 6 (15%) 18 (45%) 0.002 Current smokers 6 (15%) 5 (12.5%) 0.41 Ex-smokers 4 (11%) 4 (10%) 0.46 Hyperlipidaemia 13 (34%) 23 (57%) 0.018 60 Figure 1PFO MDTs outcome closure group 48% (n=38), Medical Management group 51% (n=40) and one patients is waiting to be reviewed to decide about the closure[Figure omitted. See PDF] 60 Figure 2RoPE score is used to identify the patients whose PFOs are likely to be pathogenic rather than incidental. The score involves multiple variables based on vascular risk factors such as diabetes, hypertension, prior history of stroke or TIA and smoking history as well as patientsage and stroke features (cortical and non cortical infarcts)[Figure omitted. See PDF]ConclusionPFO closures at NUH were deemed to be safe day case procedures with no pressure placed on either the TOE or GA services by performing cases under LA and using ICE during the COVID-19 pandemic. A robust and evidence-based practice was followed to choose the suitable patients for the procedure in structured MDT meetings ensuring equitable access for all surrounding hospitals.Conflict of InterestNone

AstraZeneca ChAdOx1-S COVID-19 vaccine can be safely administered in patients with EDTA allergy.

BACKGROUND: Immediate hypersensitivity reactions to COVID-19 vaccines have been postulated to be linked to their excipients, such as polyethylene glycol (PEG) in Pfizer Comirnaty, or polysorbate 80 and ethylenediaminetetracetic acid (EDTA) in AstraZeneca ChAdOx1-S [recombinant] (Vaxzevria). These excipients are found in a range of other products, including injectable and oral medications as well as intravenous radiocontrast media (RCM) and various cosmetic products. Patients with proven excipient allergy may be advised to avoid a COVID-19 vaccine containing that excipient and/or potentially cross-reactive excipients. This may result in individual patients not receiving vaccines, especially if an alternate option is not available, and on a broader level contribute to vaccine hesitancy. We present two cases of previously confirmed EDTA anaphylaxis with positive intradermal testing, who had negative Vaxzevria vaccine in-vivo testing and subsequently tolerated the vaccine. CASE 1: A patient with history of anaphylaxis to RCM and local anaesthetics (LA) had positive intradermal test (IDT) to EDTA nine years earlier. Skin testing to Vaxzeria vaccine (up to 1:10 IDT), Comirnaty vaccine (up to 1:10 IDT) and EDTA 0.3 mg/mL IDT were negative. However, following EDTA 3 mg/ml IDT, he developed immediate generalised urticaria without anaphylaxis. Basophil activation testing was negative to disodium EDTA, Vaxzevria and Cominarty vaccines. Given the negative in-vitro and in-vivo testing to Vaxzevria vaccine, he proceeded to Vaxzevria immunisation and tolerated both doses. CASE 2: A patient with history of anaphylaxis to RCM had positive skin testing to EDTA and RCM containing EDTA six years earlier. Following referral to COVID19 vaccine clinic, Vaxzevria vaccine (1:10 IDT) and Cominarty vaccine (1:10 IDT) were negative whilst EDTA was positive at 0.3 mg/mL IDT. He subsequently tolerated both Vaxzevria vaccinations. CONCLUSION: Excipient allergy does not necessarily preclude a patient from receiving a vaccine containing that excipient. Allergy testing can help identify excipient-allergic patients who may still tolerate vaccination, which is important in situations where COVID-19 vaccination options are limited.

Knowledge, Attitude, and Practices of Dentists in Caribbean Countries during the COVID-19 Pandemic: A Multicenter Cross-Sectional Study.

BACKGROUND: The COVID-19 pandemic has affected dentists globally, both financially and mentally. This study aimed to determine the knowledge, attitude, and practices of dentists in Caribbean countries during the COVID-19 pandemic. METHODS: A non-probability sample was obtained from dentists in more than ten different Caribbean countries. They were invited to complete a self-reported questionnaire, which was conducted from December 2020 to March 2021. Ethics approval was sought and an exemption was received from the UWI ethics committee. RESULTS: One hundred and fifty-two dentists responded. More than one-third (38.8%) were in the >35-45 age group, and 58.6% were females. Most (84.9%) were general dentists and 75% were stressed by the COVID-19 situation with 80.9% being affected financially. The majority, 94.7%, believed that the highest risk of transmission of COVID-19 was via aerosol-generating procedures and 87.5% were worried about contracting it clinically. The majority (69.1%) were willing to receive the vaccine, the main reason reported for vaccine hesitancy was due to the possible side effects (35.3%). Most (75%) consumed alcohol. When the locus of control was determined, 54.6% felt they were in control of protecting themselves while 52% felt that external factors controlled their lives. CONCLUSIONS: The findings suggest that most dentists in the Caribbean were knowledgeable about COVID-19 and followed current guidelines in their practice and were willing to receive the vaccine.

Inequalities in British University League Tables: The COVID-19 Pandemic and Halo Effects

This essay explores the impact of the COVID-19 pandemic on the position of British universities in league tables. We argue that the pandemic has increased the inequalities between them. Through the analysis of the three core functions of universities -- internationalization, research, and teaching, we predict that the gap between top-tier and second-tier universities will widen, mainly due to the former's halo effect.

Awake Prone Positioning Strategy for Nonintubated Hypoxic Patients with COVID-19: A Pilot Trial with Embedded Implementation Evaluation.

Rationale: Prone positioning is an appealing therapeutic strategy for nonintubated hypoxic patients with coronavirus disease (COVID-19), but its effectiveness remains to be established in randomized controlled trials. Objectives: To identify contextual factors relevant to the conduct of a definitive clinical trial evaluating a prone positioning strategy for nonintubated hypoxic patients with COVID-19. Methods: We conducted a cluster randomized pilot trial at a quaternary care teaching hospital. Five inpatient medical service teams were randomly allocated to two treatment arms: 1) usual care (UC), consisting of current, standard management of hypoxia and COVID-19; or 2) the Awake Prone Positioning Strategy (APPS) plus UC. Included patients had positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing or suspected COVID-19 pneumonia and oxygen saturation less than 93% or new oxygen requirement of 3 L per minute or greater and no contraindications to prone positioning. Oxygenation measures were collected within 48 hours of eligibility and included nadir oxygen saturation to fraction of inspired oxygen (S/F) ratio and time spent with S/F ratio less than 315. Concurrently, we conducted an embedded implementation evaluation using semistructured interviews with clinician and patient participants to determine contextual factors relevant to the successful conduct of a future clinical trial. The primary outcomes were drawn from an implementation science framework including acceptability, adoption, appropriateness, effectiveness, equity, feasibility, fidelity, and penetration. Results: Forty patients were included in the cluster randomized trial. Patients in the UC group (n = 13) had a median nadir S/F ratio over the 48-hour study period of 216 (95% confidence interval [95% CI], 95-303) versus 253 (95% CI, 197-267) in the APPS group (n = 27). Patients in the UC group spent 42 hours (95% CI, 13-47) of the 48-hour study period with an S/F ratio below 315 versus 20 hours (95% CI, 6-39) for patients in the APPS group. Mixed-methods analyses uncovered several barriers relevant to the conduct of a successful definitive randomized controlled trial, including low adherence to prone positioning, large differences between physician-recommended and patient-tolerated prone durations, and diffusion of prone positioning into usual care. Conclusions: A definitive trial evaluating the effect of prone positioning in nonintubated patients with COVID-19 is warranted, but several barriers must be addressed to ensure that the results of such a trial are informative and readily translated into practice.

Consequences of school closure on access to education: Lessons from the 2013-2016 Ebola pandemic.

The COVID-19 pandemic has seen an unprecedented shutdown of society. Among the various safety measures taken, much attention has been given to school closure as a non-pharmaceutical mitigation tool to curb the spread of the disease through ensuring "social" (physical) distancing. Nearly 1.725 billion children in over 95% of countries worldwide have been affected by school closures implemented in April 2020 as the virus continued to spread. In the field of education, policymakers' attention has been directed at keeping students on board through remote learning and addressing the immediate needs of schools upon reopening. The study presented in this article focuses on who remains absent after schools resume. Using publicly available survey data from the USAID Demographic Health Surveys Program and the UNICEF Multiple Indicator Cluster Survey from before and after the 2013-2016 Ebola pandemic in Guinea and Sierra Leone in West Africa, the author examined changes in school enrolment and dropout patterns, with targeted consideration given to traditionally marginalised groups. At the time, schools closed for between seven to nine months in the two countries; this length and intensity makes this Ebola pandemic the only health crisis in the recent past to come close to the pandemic-related school closures experienced in 2020. The author's findings suggest that post-Ebola, youth in the poorest households saw the largest increase in school dropout. Exceeding expected pre-Ebola dropout rates, an additional 17,400 of the poorest secondary-age youth were out of school. This evidence is important for minimising the likely post-COVID-19 expansion in inequality. The author's findings point to the need for sustainable planning that looks beyond the reopening of educational institutions to include comprehensive financial support packages for groups most likely to be affected.

Conséquences de la fermeture des écoles sur l'accès à l'éducation : les enseignements de la pandémie d'Ebola de 2013 à 2016 ­ La pandémie de COVID-19 a infligé un arrêt sans précédent à la société. Parmi les diverses mesures de sécurité qui ont été prises, une attention particulière à été accordée à la fermeture des écoles devenue un outil non pharmaceutique pour freiner la propagation de la maladie par le biais d'une distanciation « sociale ¼ (physique) ainsi garantie. Près de 1,725 milliard d'enfants dans plus de 95 % des pays du monde entier ont été concernés par les fermetures d'établissements scolaires entrées en vigueur en avril 2020, alors que le virus continuait de se propager. Dans le domaine de l'éducation, les politiques se sont appliquées à permettre aux écoliers de continuer à étudier au moyen de l'apprentissage à distance et à répondre aux besoins immédiats des écoles lors de leur réouverture. L'étude présentée dans cet article est essentiellement consacrée à ceux qui restent absents une fois que l'école a repris. S'appuyant sur des données accessibles au public du Programme d'enquêtes démographiques et sanitaires de l'USAID (l'Agence des États-Unis pour le développement international) et l'Enquête par grappes à indicateurs multiples de l'UNICEF avant et après la pandémie d'Ebola de 2013­2016 en Guinée et en Sierra Leone, en Afrique de l'Ouest, l'auteur s'est penché sur les changements concernant les inscriptions dans les établissements scolaires et les schémas d'abandon de la scolarité en portant une attention particulière aux groupes traditionnellement marginalisés. À cette époque-là, les écoles ont fermé leurs portes pendant sept à neuf mois dans les deux pays. La durée et l'intensité de ces fermetures ont fait de la pandémie d'Ebola la seule crise sanitaire du passé récent à se rapprocher en la matière de celle de COVID-19 en 2020. Les conclusions de l'auteur indiquent qu'après la pandémie d'Ebola, la plus forte hausse des abandons scolaires a été enregistrée chez jeunes des foyers les plus démunis. Dépassant les taux d'abandon d'avant Ebola auxquels on s'attendait, 17 000 écoliers supplémentaires faisant partie des plus pauvres au niveau de l'enseignement secondaire ont abandonné l'école, une preuve importante pour œuvrer à réduire au minimum l'augmentation probable des inégalités après la pandémie de COVID-19. Les conclusions de l'auteur montrent qu'il est nécessaire de planifier durablement en se projetant au-delà de la réouverture des écoles afin d'inclure de vastes aides financières pour les groupes qui seront probablement touchés.

COVID-19 Stressors among Dental Academics at UWI—A Caribbean Perspective

COVID-19 is a pandemic that has affected health care personnel worldwide. Dentists have a high risk of contracting COVID-19 given the face-to-face contact required in daily interactions with their patients. This study aimed to determine the stressors experienced by academic dentists due to the COVID-19 situation in Trinidad and Jamaica. All academic staff at the University of the West Indies (UWI) dental schools (St. Augustine and Mona campuses) were invited to complete a self-reported questionnaire, which was conducted for one month from May to June 2020. Thirty-two dental academics responded and the response rate was 61.54%. More than a third (34.4%) were in the 25–35 age group, 71.9% were females. The most common speciality (20.7%) was restorative dentistry. Just over one-third (38.7%) had been in academia for 5–10 years. Most (40.6%) were apprehensive about infecting their family. When the locus of control was determined, just over half (53.1%) felt they were in control of protecting themselves while 34.4% felt that external factors controlled their lives. The findings suggest that academic staff at UWI dental schools (Trinidad and Jamaica) were stressed by the COVID-19 situation. The vast majority were worried about infecting their families.

Interim Results of a Phase 1-2a Trial of Ad26.COV2.S Covid-19 Vaccine.

BACKGROUND: Efficacious vaccines are urgently needed to contain the ongoing coronavirus disease 2019 (Covid-19) pandemic of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A candidate vaccine, Ad26.COV2.S, is a recombinant, replication-incompetent adenovirus serotype 26 (Ad26) vector encoding a full-length and stabilized SARS-CoV-2 spike protein. METHODS: In this multicenter, placebo-controlled, phase 1-2a trial, we randomly assigned healthy adults between the ages of 18 and 55 years (cohort 1) and those 65 years of age or older (cohort 3) to receive the Ad26.COV2.S vaccine at a dose of 5×1010 viral particles (low dose) or 1×1011 viral particles (high dose) per milliliter or placebo in a single-dose or two-dose schedule. Longer-term data comparing a single-dose regimen with a two-dose regimen are being collected in cohort 2; those results are not reported here. The primary end points were the safety and reactogenicity of each dose schedule. RESULTS: After the administration of the first vaccine dose in 805 participants in cohorts 1 and 3 and after the second dose in cohort 1, the most frequent solicited adverse events were fatigue, headache, myalgia, and injection-site pain. The most frequent systemic adverse event was fever. Systemic adverse events were less common in cohort 3 than in cohort 1 and in those who received the low vaccine dose than in those who received the high dose. Reactogenicity was lower after the second dose. Neutralizing-antibody titers against wild-type virus were detected in 90% or more of all participants on day 29 after the first vaccine dose (geometric mean titer [GMT], 212 to 354), regardless of vaccine dose or age group, and reached 96% by day 57 with a further increase in titers (GMT, 288 to 488) in cohort 1a. Titers remained stable until at least day 71. A second dose provided an increase in the titer by a factor of 2.6 to 2.9 (GMT, 827 to 1266). Spike-binding antibody responses were similar to neutralizing-antibody responses. On day 15, CD4+ T-cell responses were detected in 76 to 83% of the participants in cohort 1 and in 60 to 67% of those in cohort 3, with a clear skewing toward type 1 helper T cells. CD8+ T-cell responses were robust overall but lower in cohort 3. CONCLUSIONS: The safety and immunogenicity profiles of Ad26.COV2.S support further development of this vaccine candidate. (Funded by Johnson & Johnson and the Biomedical Advanced Research and Development Authority of the Department of Health and Human Services; COV1001 ClinicalTrials.gov number, NCT04436276.).

A Post-COVID-19 Lifestyle Sport Research Agenda: Communication, Risk, and Organizational Challenges

The cancellations and postponements of large-scale organized sport competitions provided the first indicators of the impact that COVID-19 would have on society. During the pandemic, sport media reporting has focused on cancellations. Although not receiving as much media attention, "lifestyle sports," such as rock climbing, parkour, BMX, kayaking, or skateboarding, were also impacted by COVID-19 in ways that differ from organized team sports. In this commentary, the author draws upon select media reports and subcultural social media posts to highlight two primary impacts of COVID-19: (a) the civic organizational challenges of limiting lifestyle sport participation and (b) the influence on the social and risk-laden experience of these sports. The article concludes by detailing lifestyle sport stakeholder communication, digital sporting communities, the use of social media for organizing lifestyle sport communities, and sport risk communication as fruitful avenues for future research in a postpandemic lifestyle sports.

Radiology Workload Changes During the COVID-19 Pandemic: Implications for Staff Redeployment.

RATIONALE AND OBJECTIVES: Quantify changes in total and by-subspecialty radiology workload due to deferring nonurgent services during the initial COVID-19 pandemic, and describe operational strategies implemented due to shifts in priority. MATERIALS AND METHODS: This retrospective, Institutional Review Board-exempt, study was performed between February 3, 2020 and April 19, 2020 at a large academic medical center. During March 9-15 (intervention period), nonurgent outpatient service deferments began. Five-week periods pre- (baseline) and postintervention (COVID) were defined. Primary outcomes were radiology volume (reports per day) overall and in 11 subspecialty divisions. Linear regression assessed relationship between baseline vs. COVID volumes stratified by division. Secondary outcomes included changes in relative value units (RVUs), inpatient and outpatient volumes. RESULTS: There were 62,791 baseline reports vs. 23,369 during COVID; a 60% overall precipitous volume decrease (p < 0.001). Mean volume decrease pre- and during-COVID was significant (p < 0.001) amongst all individual divisions. Mean volume decrease differed amongst divisions: Interventional Radiology experienced least disruption (29% volume decrease), 7 divisions experienced 40%-60% decreases, and Musculoskeletal, Breast, and Cardiovascular imaging experienced >75% volume decrease. Total RVUs decreased 60% (71,186 baseline; 28,476 COVID). Both outpatient and inpatient report volumes decreased; 72% (41,115 baseline; 11,326 COVID) and 43% (12,626 baseline vs. 6,845 COVID), respectively. In labor pool tracking data, 21.8% (162/744) total radiology employees were reassigned to other hospital duties during the intervention period. CONCLUSION: Precipitous radiology workload reductions impacted subspecialty divisions with marked variation. Data-driven operational decisions during COVID-19 assisted workflow and staffing assignment changes. Ongoing adjustments will be needed as healthcare systems transition operations to a "new normal."

Trainee and Attending Perspectives on Remote Radiology Readouts in the Era of the COVID-19 Pandemic.

RATIONALE AND OBJECTIVES: Social distancing mandates due to COVID-19 have necessitated adaptations to radiology trainee workflow and educational practices, including the radiology "readout." We describe how a large academic radiology department achieved socially distant "remote readouts," provide trainee and attending perspectives on this early experience, and propose ways by which "remote readouts" can be used effectively by training programs beyond COVID-19. MATERIALS AND METHODS: Beginning March 2020, radiologists were relocated to workspaces outside of conventional reading rooms. Information technologies were employed to allow for "remote readouts" between trainees and attendings. An optional anonymous open-ended survey regarding remote readouts was administered to radiology trainees and attendings as a quality improvement initiative. From the responses, response themes were abstracted using thematic analysis. Descriptive statistics of the qualitative data were calculated. RESULTS: Radiologist workstations from 14 traditional reading rooms were relocated to 36 workspaces across the hospital system. Two models of remote readouts, synchronous and asynchronous, were developed, facilitated by commercially available information technologies. Thirty-nine of 105 (37%) trainees and 42 of 90 (47%) attendings responded to the survey. Main response themes included: social distancing, technology, autonomy/competency, efficiency, education/feedback and atmosphere/professional relationship. One hundred and forty-eight positive versus 97 negative comments were reported. Social distancing, technology, and autonomy/competency were most positively rated. Trainees and attending perspectives differed regarding the efficiency of remote readouts. CONCLUSION: "Remote readouts," compliant with social distancing measures, are feasible in academic radiology practice settings. Perspectives from our initial experience provide insight into how this can be accomplished, opportunities for improvement and future application, beyond the COVID-19 pandemic.