VASCULITIS DISEASE ACTIVITY SCORES BEFORE AND DURING THE COVID-19 PANDEMIC: A COMPARISON OF FACE-TO-FACE CLINICIAN SCORING AND PROMS COLLECTED USING REMOTE MONITORING IN A SINGLE-CENTRE COHORT

BackgroundDuring the COVID-19 pandemic, asynchronous consultations were introduced for patients with vasculitis. To assess disease activity without of face-to-face clinical reviews and blood testing, patients submitted patient reported outcome measures (PROMs) via electronic survey forms, which were subsequently triaged by clinicians.Objectives1. To investigate how patients' vasculitis disease activity was affected by the COVID-19 pandemic through retrospective comparison of clinician-assessed scores recorded pre-pandemic with intra-pandemic self-reported patient reported outcome measures (PROMs) and disease scores submitted by patients remotely.2. To assess patients' clinical outcomes, including allocation of follow-up and further management/treatment escalation during this period.3. To validate self-reported BVAS scores against an existing PROM.MethodsThis is a retrospectively study of patients with a known diagnosis of vasculitis under the care of the Nuffield Orthopaedic Centre, Oxford. For the purposes of this study, we included patients with all vasculitis diagnoses.Clinician-reported scores (Bristol Vasculitis Activity score v.3, BVAS) were recorded during in-person clinics pre-pandemic (defined as 01/01/2019-31/12/2019) [1].Patients' self-reported BVAS (SR-BVAS) and AAV-PRO (ANCA-associated vasculitis patient-reported outcomes) scores were submitted by patients via electronic forms containing the requisite questionnaires sent out during-pandemic (defined as 01/12/2020-31/03/22) [2].SR-BVAS has not been validated but was collected to allow clinical comparison to disease activity scores completed by clinicians. Response were stored and analysed in a secure database. Score comparison was performed using Wilcoxon Sign Rank testing. Clinical outcome data was collected from the local Electronic Patient Record. Data analysis was performed in Microsoft Excel and R (version 4.2.1).ResultsWe noted a significantly higher overall level of patient-reported disease activity during the pandemic than was recorded in clinics prior. In the total cohort of all vasculitis patients for whom we had data, the median BVAS increased from 2 pre-pandemic (N = 335, range 0-21) to 6 intra-pandemic (N = 143, range 0-42) (p <0.001). The overall proportion of patients with severe/active disease (defined as BVAS ≥4) increased from 27% to 36% during the pandemic period.In a smaller cohort of 64 patients for whom we had paired pre- and during-pandemic scores, increased disease activity was reported (p<0.01). Notably, the number with a BVAS consistent with severe disease increased from 7 (11%) to 19 (30%).There was a significant positive correlation between SR-BVAS and AAV-PRO (r=0.61, p< 0.001) submitted by patients during-pandemic;however, at low BVAS (≤3), the AAV-PRO ranged widely (28-87)Follow-up data was available for all 64 patients in this cohort: 8/19 (42%) with a during-pandemic SR-BVAS ≥4 were seen in clinic within 3 months (telemedicine or face-to-face).ConclusionPatients reported worsening of vasculitis disease activity during the COVID-19 pandemic. This may be attributable to impacts on well-being or access to healthcare services. We note that disease activity scores in vasculitis may be limited in their ability to capture the whole picture disease activity in the absence of clinical assessment [3]. 42% of patients with self-reported high disease activity were seen within 3 months. There was a significant positive correlation between AAV-PRO and SR-BVAS, suggesting it has some use as a PROM.References[1]Mukhtyar C, Lee R, Brown D, Carruthers D, Dasgupta B, Dubey S, et al.. Ann Rheum Dis. 2009 Dec;68(12):1827–32.[2]Malley T, Jackman J, Manderson S, Saldana Pena L, Evans E, Barrett J, et al. Ann Rheum Dis. 2021 Jun 1;80(Suppl 1):289.[3]Luqmani RA. Nephrology Dialysis Transplantation. 2015 Apr 1;30(suppl_1):i76–82.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

Comparing Ankylosing Spondylitis Disease Activity during the Covid-19 Pandemic Using Patient-Reported Outcome Measures with Face-Toface Clinical Evaluation of Disease Scores Prepandemic

Background/Aims During the COVID-19 pandemic, asynchronous consultations were introduced for patients with ankylosing spondylitis (AS). To assess disease activity in the absence of face-to-face clinical review and blood testing, patients submitted patient-reported outcome measures (PROMs) via electronic survey forms which were subsequently triaged by clinicians. We compared pre-pandemic clinician-reported scores with intra-pandemic self-reported scores and assessed clinical outcomes including allocation of follow-up and further management/ treatment escalation. Methods Clinician-reported scores were obtained in-person pre-pandemic (defined as 01/01/2019-01/03/2020). Self-reported BASDAI scores were submitted by patients via electronic forms sent out duringpandemic (defined as 01/12/2020-31/03/22). The responses were stored and analysed in a secure database. These scores are analogous to disease activity scores completed by clinicians during outpatient appointments. Score comparison was performed using Wilcoxon Sign Rank testing. We used the need for a follow-up within 3 months as target for those with severe disease. Data analysis was performed in Microsoft Excel and R (version 4.2.1). Results We noted a significantly higher overall level of patient-reported disease activity during the pandemic. In the total cohort of AS patients, the median BASDAI Score collected during-pandemic increased from 5.30 (n=124, range 0-10) compared to 2.80 pre-pandemic (n=590, range 0-12) (p<0.001). The proportion of patients with severe/active disease (defined as BASDAI >4) increased from 36% pre- to 65% during pandemic. In a smaller cohort of 34 patients for whom we had both pre- and during-pandemic scores, all patient parameters worsened during the pandemic. Notably, median BASDAI increased from 2.65 to 5.62 (p<0.0001). Patients with severe AS increased from 10 (29.4%) to 21 (61.8%) intra-pandemic. Follow-up data was available for 12/21 patients with severe AS during-pandemic. 7/12 patients (58%) received a follow-up appointment within one month;11/12 (91%) were seen within three months. On subsequent clinician assessment, only 7 (58%) of patients with self-reported severe AS were felt to have active disease;treatment was escalated for 3 patients. Conclusion There was a significantly higher reported level of AS disease activity during the COVID-19 pandemic, with 62 % of patients qualifying for biologic therapy (BASDAI >4). In a focussed sample, 91% of patients with new severe disease during-pandemic were followed up within the target of 3 months. The BASDAI score is independent from clinical examination and inflammatory markers, and therefore self-reported score should reliably reflect a patient's perception of disease activity. Further work is required to determine the reason for the increased disease activity observed during pandemic, and for the disparity between clinician impression and score results.

Evaluating the Use of Patient Reported Outcome Measures to Assess Intra-Pandemic Psoriatic Arthritis Disease Activity and Comparing Them with Pre-Pandemic Clinical Assessments

Background/Aims In our department, patient reported outcome measures (PROMs), including RAPID-3 and PSAID12, were employed during the COVID-19 pandemic in asynchronous consultations for patients with psoriatic arthritis (PsA). We compared pre-pandemic DAS28-CRP with intrapandemic PROMs to assess changes in disease activity since the pandemic. Whilst previous studies have primarily compared PsA PROMs with clinician-assessed scores (e.g. PASDAS), we compare PsA PROMs with clinicians' overall assessment of disease activity;this judgement considers PROMs, serology studies and individual patient feedback. Finally, we assess whether patients with PROMs indicating active disease were followed up appropriately. Methods Clinician-assessed scores were collected between 01/01/2019-01/03/ 2020 (''pre-pandemic''). Between 01/12/2020-31/03/2022 (''intrapandemic''), patient data from electronic surveys were analysed in a secure database for calculation of PROMs. These data, alongside blood results and patient comments, informed clinicians' triage decisions. Clinical outcome data were collected from electronic patient records;>=3 months follow-up appointment allocation was the target for patients with active disease (moderate/high disease activity). Data analysis was performed using r (version 4.2.2). Results In our pre-pandemic cohort (n=393), 79.8% of patients were in remission (per DAS28-CRP). Conversely, the intra-pandemic cohort (n=231) showed remission rates of 14.3% (per PSAID12) and 0% (RAPID-3). Indeed, 33.7% (based on PSAID12) vs 75.8% (RAPID-3) had moderate/ high disease activity. These results were validated in a paired cohort (n=38, score recorded in both windows). Disease activity worsened during the pandemic for 63.2% (PSAID12) and 97.4% (RAPID-3) of patients. PSAID-12 correlated positively with RAPID-3 (r=0.52, p<0.001), especially when RAPID-3 >=6.5 (r=0.75, p<0.001). When comparing PROMs with clinicians' assessment of PsA activity in our paired cohort, PSAID12 and RAPID-3 accurately reflected disease status in 70.6% and 58.8% of patients respectively. 3/9 and 9/27 patients with active disease, based on PSAID12 and RAPID-3 respectively, were seen within three months. Conversely, 7/10 patients who clinicians had deemed to have active disease were seen within three months. Conclusion Despite approximately 80% of patients being in pre-pandemic remission, the majority reported active intra-pandemic PsA. Whilst RAPID-3 skewed patients towards active disease, PSAID12 skewed patients towards remission/low disease activity. PSAID-12 and RAPID- 3 have been previously correlated;however, here we suggest that they could be used interchangeably in patients with high disease activity. PSAID-12 was a better predictor of clinicians' assessment of disease activity, although neither PROM correlated well with >=3 months followup appointment allocation. Although RAPID-3 and PSAID12 helped inform clinicians' decisions, neither alone sufficiently reflects patients' disease states. Remote management is practicable, but future studies should validate these findings across a larger cohort and assess the utility of different PROMs across PsA disease activity categories. Furthermore, multivariate analysis is warranted to ascertain which (combination of) variable(s) (e.g., PROMs, serology results, tender/ swollen joint count) best correlates with clinician judgement.

Patient satisfaction and patient costs associated with telephone clinic appointments in Inflammatory Bowel Disease (IBD) following the pandemic

Background: Prior to the COVID-19 pandemic, conventional management of outpatient care in IBD predominantly revolved around face-to-face clinic appointments. In the changing landscape of care provision during the pandemic, appointments were conducted almost exclusively through telephone consultation. An electronic questionnaire was developed to assess patient satisfaction and patient costs. Method(s): A pilot was carried out with 15 patients to identify any technical issues with e-mail delivery of the questionnaire and gauge face validity of the questionnaire content. 1400 patients registered with the TrueColours-IBD remote digital monitoring system were sent the questionnaire link via e-mail in May 2021. No demographic data were collected by design, in order to avoid the perception of bias and ensure freedom of expression through anonymity. Result(s): 506 responses were received including 21 duplicates which were excluded, totalling 485 valid responses. 408/485 patients reported having a telephone appointment with the IBD service since March 2020, 484/485 reported having had a face-to-face appointment in the past. 348/408 (86%) were either 'very satisfied' or 'somewhat satisfied' with their most recent telephone consultation, while 22 (6%) were either 'very dissatisfied' or 'somewhat dissatisfied'. 247/408 (61%) were also either 'very satisfied' or 'somewhat satisfied' with the ease of accessing further care if required, compared to 33/408 (8%) who were either 'very dissatisfied' or 'somewhat dissatisfied'. Given the choice, 195/408 (48%) patients preferred to receive a telephone appointment in the future;147/408 (36%) would opt for face-to-face and 66/408 (16%) stated no preference, all with the option of changing that choice if needed. Telephone appointments were associated with a mean total patient time off-work or leisure of 23 minutes (S.D. 51, n=408) compared to 190 minutes (S.D. 96, n=484) for face-to-face appointments. The average cost of time off work or leisure associated with telephone appointments was 5.55 (S.D. = 15.74, n=408), compared to 43.42 (S.D. = 31.27, n=484) for face-to-face appointments (Table 1). Costs of transport add further to face-to-face appointment costs. Greater proportions of patients had a companion for their face-to-face appointment and required childcare compared to telephone consultations (Table 2), which again increases the difference in costs. Conclusion(s): Almost half of surveyed patients stated a preference for telephone appointments, although a third still preferred traditional follow-up. An evolution of care pathways is supported by patient preference and the statistically significant time and cost savings to patients receiving telephone appointments. (Figure Presented).

Molecular dynamics simulation of interaction between nanorod and phospholipid molecules bilayer

Natural and artificially prepared nanorods' surfaces have proved to have good bactericidal effect and self-cleaning property. In order to investigate whether nanorods can kill the enveloped virus, like destroying bacterial cell, we study the interaction between nanorods and virus envelope by establishing the models of nanorods with different sizes as well as the planar membrane and vesicle under the Dry Martini force field of molecular dynamics simulation. The results show that owing to the van der Waals attraction between nanorods and the tail hydrocarbon chain groups of phospholipid molecules, the phospholipid molecules on virus envelope are adsorbed to nanorods on a large scale. This process will increase the surface tension of lipid membrane and reduce the order of lipid molecules, resulting in irreparable damage to planar lipid membrane. Nanorods with different diameters have different effects on vesicle envelope, the larger the diameter of nanorod, the weaker the van der Waals effect on the unit cross-sectional area is and the smaller the degree of vesicle deformation. There is synergy between the nanorods in the nanorod array, which can enhance the speed and scale of lipid adsorption. The vesicle adsorbed in the array are difficult to desorb, and even if desorbed, vesicle will be seriously damaged. The deformation rate of the vesicle adsorbed in the nanorod array exceeds 100%, implying that the nanorod array has a strong destructive effect on the vesicle. This preliminarily proves the feasibility of nanorod array on a surface against enveloped virus, and provides a reference for the design of corresponding nanorods surface.

Efficacy Of Distance Learning For Cardiopulmonary Resuscitation Training Utilizing Smartphone App And Mannikin Delivery-collection System

Aim of the study: Effective CPR training is important for provision of high-quality bystander cardiopulmonary resuscitation (CPR). However, the COVID-19 pandemic has hindered conventional face-to-face CPR training. To overcome the limitation, we developed a distance learning CPR training course (HEROS-Remote) that utilized a smartphone app and a delivery-collection system for CPR training manikins. The objective of the study was to evaluate the efficacy of the HEROSRemote course by comparing chest compression quality between trainees who participated in the conventional CPR training (C-training) and HEROS-Remote course (R-training). Method(s): The non-inferiority trial included adult nonhealthcare providers who applied for CPR training. Both groups underwent 2-minute post-training chest compression test followed by course survey on trainees' course and delivery system satisfaction. The primary outcome of the study was mean chest compression depth during the 2-minute post-training test. Result(s): A total of 180 trainees were enrolled with 90 trainees for each training group. There was no statistically significant difference in chest compression depth between R-training and C-training groups (67.4 vs. 67.8, p=0.78) as well as proportion of adequate chest compression depth, chest compression rate, proportion of chest compressions with complete chest recoil and chest compression score (90.8 vs. 92.1, p=0.69;110.8 vs. 110.4, p=0.60;89.8 vs. 94.7, p=0.05;92.7 vs. 95.5, p=0.16, respectively). In the R-training group, 90.0% of the trainees were satisfied with the course, 96% responded that the delivery system was satisfactory and convenient. Conclusion(s): The R-training course was noninferior to the C-training course. The distance learning CPR training method utilizing smartphone app and mannikin delivery-collection system had high user satisfaction and was logistically feasible.

Antibiotic Prescription Trends of Patients with COVID-19: Analysis of National Health Insurance Data in Republic of Korea

Background. Although COVID-19 is a viral infection, it is known that antibiotics are often prescribed due to concerns about combined bacterial infection. Therefore, we aimed to analyze how many patients with COVID-19 received the antibiotic prescription as well as what kinds of factors contributed to it using the National Health Insurance database. Methods. We retrospectively reviewed claims data for adults 19 years of age and older hospitalized for COVID-19 from December 1, 2019 to December 31, 2020. According to severity classification of the National Institutes of Health guidelines, we calculated not only the proportion of patients receiving antibiotics but also days of treatment per 1000 patient days. In addition, we investigated the factors contributing to antibiotic use by linear regression analysis. Results. Of the 55,228 patients, 47% were male, 55% were older than 50 years of age, and most patients (89%) had no underlying diseases. The majority (84%, 46,576) were classified as having mild to moderate illness, with 11% (6,168) and 5% (2,484) having severe and critical, respectively. Antibiotics were prescribed in a total of 27% (15,081). While 74% of patients with severe illness and 88% of those with critical illness received antibiotic treatment, even 18% of mild to moderate cases were prescribed antibiotics. Fluoroquinolones were the most commonly prescribed antibiotics (8,348), followed by third generation cephalosporins (5,729) and beta-lactam/betalactamase inhibitors (3,822) as shown in Figure 1. Older age, severity of disease and underlying medical conditions contributed to overall prescription rates as well as days of antibiotic use significantly (Table 1). Conclusion. Although most of COVID-19 patients had mild to moderate illness, more than a quarter were prescribed antibiotics. Judicious use of broad-spectrum antibiotics is necessary for COVID-19 patients, considering the severity of disease and the risk of bacterial co-infection.

Investigating How University Students in the United States Encounter and Deal with Misinformation in Private WhatsApp Chats during COVID-19

Misinformation can spread easily in end-to-end encrypted messaging platforms such as WhatsApp where many groups of people are communicating with each other. Approaches to combat misinformation may also differ amongst younger and older adults. In this paper, we investigate how young adults encountered and dealt with misinformation on WhatsApp in private group chats during the first year of the COVID-19 pandemic. To do so, we conducted a qualitative interview study with 16 WhatsApp users who were university students based in the United States. We uncovered three main findings. First, all participants encountered misinformation multiple times a week in group chats, often attributing the source of misinformation to be well-intentioned family members. Second, although participants were able to identify misinformation and fact-check using diverse methods, they often remained passive to avoid negatively impacting family relations. Third, participants agreed that WhatsApp bears a responsibility to curb misinformation on the platform but expressed concerns about its ability to do so given the platform's steadfast commitment to content privacy. Our findings suggest that conventional content moderation techniques used by open platforms such as Twitter and Facebook are unfit to tackle misinformation on WhatsApp. We offer alternative design suggestions that take into consideration the social nuances and privacy commitments of end-to-end encrypted group chats. Our paper also contributes to discussions between platform designers, researchers, and end users on misinformation in privacypreserving environments more broadly. © 2022 by The USENIX Association. All Rights Reserved.

PopupBot, a Robotic Pop-up Space for Children: Origami-based Transformable Robotic Playhouse Recognizing Children's Intention

To help people use their limited space efficiently, we propose an origami-based transformable robotic space called 'PopupBot.' Specifically, we developed a robotic playhouse for children. A large origami structure with a bellows pattern is controlled by a servo motor and transforms into various types of furniture. For natural child-robotic space interaction, PopupBot perceives the child's intention for the space through speech recognition and provides appropriate space by inferring the space type matching the intention. We expect the PopupBot to provide a new space for people who suffer from staying in limited space especially due to the COVID-19 pandemic. © 2022 IEEE.

Risk factors for the deterioration of patients with mild COVID-19 admitted to a COVID-19 community treatment center

Background: The rapid increase in the number of coronavirus disease (COVID-19) patients led to the operation of COVID-19 facilities for patients with mild COVID-19 in South Korea. We analyzed the correlation and effect of risk factors associated with the worsening of patients with mild COVID-19 leading to their transfer from a community treatment center to a hospital. Methods: This retrospective cohort observational study included 1,208 COVID-19 patients with mild symptoms who were admitted to the Namsan Community Treatment Center between June 2020 and January 2021. A chi-square test was performed to examine the differences in the transfer rate by age, sex, nationality, presence of symptoms at admission, and season, and a multivariable logistic regression analysis was performed to examine the association of variables to the hospitalization rate. Results: Of the 1,208 patients, 212 (17.5%) were transferred to a hospital due to clinical deterioration. Increasing odds of hospital transfer were associated significantly with higher age and presentation in autumn, whereas sex and symptomatic illness at admission did not show a statistically significant association. Conclusion: The findings indicate the importance of the initial risk classification of COVID-19 patients based on thorough assessment and close monitoring, timely allocation of appropriate resources to high-risk groups that are likely to develop severe disease, and reduction of medical resource wastage and limiting of administrative force to ensure that patients receive the best treatment.

Identification of warning signs in Malaysian patients having COVID-19 infection who progress to severe form of the illness

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a novel coronavirus, now widely known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has caused 3 major pandemic waves in Malaysia. We aimed to identify the warning signs as indicators that predict the progression of disease. MATERIALS AND METHODS: This is a retrospective cohort study of adult patients more than 12 years of age presenting with laboratory-confirmed COVID-19 admitted in three separate hospitals around the country. RESULTS: Of the 228 patients initially admitted with mild illness, 47 had progressed requiring oxygen. The median time from admission to deterioration was 3 days (IQR 2 - 5). Age more than ≥50years old (median age = 42.5, IQR = 28.8 - 57.0), higher temperature (mean = 37.3, IQR 36.8 - 38.0), MEWS score >3 (9, 19.1%), Neutrophil-to-lymphocyte ratio (NLR) >3.13 , (18, 38.3%) C-reactive protein (CRP) >5. (12, 27.3%), multiple zonal involvement on the chest radiography on admission (2, IQR 1-3) were more common in the deteriorated group on admission. On multivariate analysis, multiple comorbidities (HR = 7.40, 95 percent CI 2.58-21.2, p0.001), presence of persistent fever (HR = 2.88, 95 percent CI 1.15 - 7.2, p = 0.024), MEWS scoring >3 (HR of 6.72 ;95 percent CI 2.81-16.0, p0.001) were associated with progression to severe illness. CONCLUSION: In our cohort, we found that several factors were associated with the severity of COVID19. Early detection of these factors could correctly identify patients who need more intensive monitoring, and early referral for ICU care.

Strategies for Prevention of COVID-19 Transmission in Hospitals

Background. Infection control measures against the coronavirus disease 2019 (COVID-19) within a hospital often rely on expert experience and intuition due to the lack of clear guidelines. This study surveyed current strategies for the prevention of the spread of COVID-19 in medical institutions. Methods. Upon systematic review of the guidelines at the national level, 14 key topics were selected. Six hospitals were provided an open survey that assessed their responses to these topics between August 11 and 25, 2020. Using these data, an online questionnaire was developed and sent to the infection control teams of 46 hospitals in South Korea. The survey was conducted between January 31, 2021, and February 20, 2021. Results. All 46 hospitals responded to the survey, and 24 hospitals (52.2%) had treated 100 or more cases of COVID-19. All hospitals operated screening clinics, and the criteria were respiratory symptoms (100%), fever (97.8%), and epidemiological association (93.5%). It was found that 89.1% (41/46) of hospitals allowed symptomatic patients to visit their general outpatient clinics if fever or respiratory symptoms were not associated with COVID-19. Most hospitals (87.2%;34/39) conducted polymerase chain reaction (PCR) tests for all hospitalized patients. Moreover, 76.1% (35/46) of hospitals implemented preemptive isolation policies for hospitalized patients, of which 97.1% (34/35) were released from isolation after a single negative PCR test. A little over half of the hospitals (58.7%;27/46) treated patients that met the national criteria for release from isolation but consistently had positive PCR results. Of these hospitals, 63% (17/27) used N95/KF94 masks, and 40.7% (11/27) used surgical masks without other personal protective equipment for treating them. Most hospitals (76.9%;20/26) accommodated them in shared rooms when the cycle threshold value of the PCR test was more than a certain value (34.6%;9/26), or after a certain period that satisfied the national criteria (26.9%;7/26). Finally, 76.1% (35/46) of hospitals performed emergency procedures or operations on suspected patients. Conclusion. Various guidelines were being applied by each medical institution, but there was a lack of an explicit set of national guidelines to support them.

Changes in the Distribution of Respiratory Microorganisms before and during the COVID-19 Pandemic, Daegu, Korea

Background: Acute respiratory infection (ARI) is the most common infectious disease in all ages and genders worldwide. Respiratory microorganisms such as respiratory viruses, are commonly responsible for causing ARI. COVID-19 is still prevalent in Korea. The implementation of lockdown and strict control measures, the mandatory wearing of masks, and social distancing are critical steps for controlling the risk of COVID-19 spread. This study was conducted to find out how these changes in daily lives impacted the distribution of respiratory microorganisms. Methods: A retrospective study was conducted to identify the incidence and distribution patterns of ARI-causing respiratory microorganisms before (Period.) and during the COVID-19 pandemic (Period.) in terms of detection method, age, month, and season. In particular, data in Periods. and. were compared for eight major kinds of respiratory microorganisms: adenovirus (AdV), human metapneumovirus (HMPV), human rhinovirus/enterovirus (Rhino/Entero), influenza virus (Flu) A, Flu B, human parainfluenza virus (HPIV) 3, respiratory syncytial virus, and Mycoplasma pneumoniae. Results: A total of 27,191 respiratory specimens were tested, of which 5,513 were obtained from children and adolescents (age groups 1. 5) and 21,678 from adults (age group 6). The overall positive rates for at least one respiratory microorganism in Periods. and. were 23.1% (1,199/5,193) and 4.9% (1,070/21,998), respectively (p < 0.001). The overall positive rates in male and female patients were significantly different (8.7% vs. 7.9%;p = 0.016). On the FilmArray (TM) RP assay, positive rates in all age groups decreased significantly in Period. compared with Period.. AdV, Rhino/Entero, and Flu A were detected in all four seasons, but HMPV and HPIV3 were not detected. The overall positive rates on FilmArray and the Flu antigen test in Period. were significantly decreased. In the COVID-19 test, the positive rates were high in March and April 2020, and decreased thereafter, but these increased again in the winter of 2020/2021. Conclusions: Life changes due to COVID-19 pandemic have had a significant impact on the distribution of respiratory microorganisms;our study results might provide useful information on respiratory virus epidemiology.

Network Delay Modelling and Optimization of Internet-Based Distributed Test Platform for Fuel Cell Electric Vehicle Powertrain System

The accelerated global progress in the research and development of automobile products, and the use of new technologies, such as the Internet, cloud computing and big data, to coordinate development platforms in different regions and fields, can reduce the duration and cost of development and testing. Specifically, in the context of the current coronavirus disease (COVID-19) pandemic, which has caused great obstacles to normal logistics and transportation, personnel exchanges and information communication, platforms that can support global operation are significant for product testing and validation, because they eliminate the need for the transportation of personnel and equipment. Therefore, the establishment of a distributed test and validation platform for automotive powertrain systems, which can integrate software and hardware testing, is important in terms of both scientific research and industrialization. The main technical difficulties associated with such test and validation platforms include data transmission and the control of the transmission effect. A distributed test and validation platform for a fuel cell electric vehicle powertrain system is proposed herein. The two-time-scale Markov chain is used to simulate the delay between two places (China and Germany), and the least-squares support vector machine (LSSVM) method is used to optimize the transmission effect. The results show that the two-time-scale Markov chain model can effectively simulate the delay between two nations, and that its probability distribution is close to the measured value. The LSSVM method is effectively optimized for all four indicators (velocity, fuel cell output power, battery output power and electric motor output torque). This method can be effectively used in the remote development test validation of vehicle powertrain system. © 2021 SAE Technical Papers. All rights reserved.

An aluminum hydroxide:CpG adjuvant enhances protection elicited by a SARS-CoV-2 receptor-binding domain vaccine in aged mice

[Figure: see text].

Canadian perspective on managing multiple myeloma during the COVID-19 pandemic: lessons learned and future considerations.

The coronavirus disease 2019 (covid-19) pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 has necessitated changes to the way patients with chronic diseases are managed. Given that patients with multiple myeloma are at increased risk of covid-19 infection and related complications, national bodies and experts around the globe have made recommendations for risk mitigation strategies for those vulnerable patients. Understandably, because of the novelty of the virus, many of the proposed risk mitigation strategies have thus far been reactionary and cannot be supported by strong evidence. In this editorial, we highlight some of the risk mitigation strategies implemented at our institutions across Canada during the first wave of covid-19, and we discuss the considerations that should be made when managing patients during the second wave and beyond.

A Proactive and Practical COVID-19 Testing Strategy

To reopen the economy safely during the COVID-19 pandemic, governments need the capability to proactively identify new and often asymptomatic infections, as well as contact tracing. Policymakers and public health professionals need a sampling-testing method that can achieve broad population coverage without overwhelming medical workers. We observe that COVID-19 high-risk groups are located in the hubs and cliques of our geo-social network, formed by the close encounters of people during daily life. These individuals are the de facto "canary in a coal mine". We propose that nations offer free and anonymous testing service to them. With open-source computer algorithms and datasets, only a small fraction of the population selected for COVID-19 testing can cover the majority of high-exposure-risk individuals. A 0.3% sampled testing for a megacity covers 3/4 of entire population. A 3% sampled testing for a rural town covers 3/4 of entire population. With government oversight and public consent, this approach can serve each province/state or city/township for decentralized daily testing. However, to protect privacy, we recommend constructing the geo-social network of anonymized cellphones, not named individuals. This infrastructure should be dismantled once the pandemic is over. This can be achieved by policymakers, health workers, and engineers together. IEEE