Virtually the Same? Evaluating the Effectiveness of Remote Undergraduate Research Experiences.

In-person undergraduate research experiences (UREs) promote students' integration into careers in life science research. In 2020, the COVID-19 pandemic prompted institutions hosting summer URE programs to offer them remotely, raising questions about whether undergraduates who participate in remote research can experience scientific integration and whether they might perceive doing research less favorably (i.e., not beneficial or too costly). To address these questions, we examined indicators of scientific integration and perceptions of the benefits and costs of doing research among students who participated in remote life science URE programs in Summer 2020. We found that students experienced gains in scientific self-efficacy pre- to post-URE, similar to results reported for in-person UREs. We also found that students experienced gains in scientific identity, graduate and career intentions, and perceptions of the benefits of doing research only if they started their remote UREs at lower levels on these variables. Collectively, students did not change in their perceptions of the costs of doing research despite the challenges of working remotely. Yet students who started with low cost perceptions increased in these perceptions. These findings indicate that remote UREs can support students' self-efficacy development, but may otherwise be limited in their potential to promote scientific integration.

Diamond-blackfan anemia in an adult

Case Report: A 25-year-old woman with history of Diamond-Blackfan anemia (DBA) presented with a 3- week history of weakness and fatigue. The patient was in her usual state of health until 3 weeks prior when she was diagnosed with COVID-19, at which time she experienced cough, congestion, weakness, and fatigue. She reported that the cough and congestion improved after a few days, but the fatigue and weakness progressively worsened. Admission labs were notable for a hemoglobin of 5.5 g/dL with a MCV of 119.3 fL. She received 2 units of packed RBCs with improvement in hemoglobin to 8.9 g/dL. The patient was diagnosed with DBA at birth via bone marrow biopsy and had been stable on chronic prednisone with a baseline hemoglobin around 8 g/dL. Prior to this admission, she has only required one transfusion at 3 months old. Her outpatient management involved close monitoring of her hemoglobin and increasing/decreasing prednisone based on her trending hemoglobin. She had been stable on 15 mg/day of prednisone for the past few years. Her hematologist was consulted, and the decision was made to increase her dose of prednisone to 20 mg/day resulting in resolution of symptoms and stabilization of her hemoglobin level. Discussion(s): We present a rare case of DBA with worsening anemia in the setting of a recent COVID-19 infection. The literature regarding the risk and complications of COVID-19 in these patients is severely limited, with no current data on disease management, outcomes, or predictors of morbidity. DBA is a rare, congenital erythroid red cell aplasia that typically presents in infancy with an estimated incidence of 5 cases per 1 million births. DBA is characterized by progressive macrocytic anemia, congenital malformations, and increased risk of endocrine dysfunction and malignancies. Glucocorticoids are the first-line therapy for DBA, although the exact mechanism of how they stimulate erythropoiesis in DBA remains unknown. In terms of patient prognosis, approximately 40% are steroid-dependent, 40% are transfusiondependent, and 20% go into remission by age 25 years. Copyright © 2023 Southern Society for Clinical Investigation.

MISLEADING FEVERS: A CASE OF MULTISYSTEM INFLAMMATORY SYNDROME IN ADULTS DUE TO COVID-19

SESSION TITLE: Management of COVID-19-Induced Complications SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/19/2022 12:45 pm - 1:45 pm INTRODUCTION: Multisystem inflammatory syndrome in children (MIS-C) is a systemic condition that causes multi-organ dysfunction accompanied by fever and extremely elevated inflammatory markers. This syndrome been primarily identified in children or adolescents similar to Kawasaki disease. The hallmark of this illness includes life-threatening complications such as shock and cardiac dysfunction. As the cases of COVID-19 continue to increase worldwide, a form of MIS-C can present in adults known as multisystem inflammatory syndrome in adults (MIS-A). We describe a case of MIS-A after exposure to COVID-19. CASE PRESENTATION: A 28-year-old Hispanic male with no medical history presented with 3 days of persistent fever, diarrhea, and fatigue. He was unvaccinated for COVID-19 but had mild disease three months prior, which did not require hospitalization. Vitals were remarkable for tachycardia and constant fever of up to 103.5 F. Labs were notable for leukocytosis of 26.0 k/uL, CRP of 43 mg/dL, and procalcitonin of 90 ng/mL. Computed tomography with intravenous contrast of his chest revealed multifocal nodular and consolidative airspace disease of the right upper and middle lobes with mediastinal and hilar lymphadenopathy. Echocardiogram revealed ejection fraction (EF) of 29% without wall-motion abnormalities. PCR test for COVID-19 was negative and his infectious work-up was unrevealing. His course was further complicated by shock requiring pressors, intubation, and renal replacement therapy. Despite antibiotics, he did not improve. He was started on pulse dose steroids and intravenous immunoglobulin (IVIG), which decreased his CRP to 34 mg/dL and procalcitonin to 51 ng/mL. He was weaned off the ventilator and pressor support with EF recovery to 51%. He was eventually discharged home without further needs. DISCUSSION: While limited data exists, adult patients of all ages with prior SARS-CoV-2 infection can develop MIS-A. Preliminary reports suggest increased incidence among African American, Hispanic, and Asian ethnic groups. Diagnosis includes one primary and two secondary clinical criteria with two supporting laboratory evidence. Primary criteria includes cardiac dysfunction or rash with conjunctivitis. Secondary criteria includes neurological signs, shock, gastrointestinal disease, or thrombocytopenia. Lab markers include elevated CRP, ferritin, IL-6, ESR, or procalcitonin with a positive SARS-Cov-2 PCR, serology, or antigen detection. Treatment consists of steroids, IVIG, and supportive care based on case reports. There are no current evidence-based guidelines. The best preventative measures include COVID-19 vaccination CONCLUSIONS: MIS-A is a rare complication of unvaccinated COVID-19 cases. Diagnostic criteria include one primary and two secondary clinical signs with supporting lab data. Treatment includes steroids, IVIG, and supportive care. Reference #1: Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. The Lancet. 2020;395(10237):1607-1608. doi:10.1016/s0140-6736(20)31094-1 Reference #2: Kunal S, Ish P, Sakthivel P, Malhotra N, Gupta K. The emerging threat of multisystem inflammatory syndrome in adults (mis-A) in COVID-19: A systematic review. Heart & Lung. 2022;54:7-18. doi:10.1016/j.hrtlng.2022.03.007 Reference #3: Morris SB, Schwartz NG, Patel P, et al. Case series of multisystem inflammatory syndrome in adults associated with SARS-COV-2 infection — United Kingdom and United States, March–August 2020. MMWR Morbidity and Mortality Weekly Report. 2020;69(40):1450-1456. doi:10.15585/mmwr.mm6940e1 DISCLOSURES: No relevant relationships by Sadaf Afraz No relevant relationships by Christine Girard No relevant relationships by Jose Rivera No relevant relationships by Ivan Romero-Legro No relevant relationships by Amy Van

Correction: Identifying key determinants and dynamics of SARS-CoV-2/ACE2 tight interaction.

[This corrects the article DOI: 10.1371/journal.pone.0257905.].

"How Do We Do This at a Distance?!" A Descriptive Study of Remote Undergraduate Research Programs during COVID-19.

The COVID-19 pandemic shut down undergraduate research programs across the United States. A group of 23 colleges, universities, and research institutes hosted remote undergraduate research programs in the life sciences during Summer 2020. Given the unprecedented offering of remote programs, we carried out a study to describe and evaluate them. Using structured templates, we documented how programs were designed and implemented, including who participated. Through focus groups and surveys, we identified programmatic strengths and shortcomings as well as recommendations for improvements from students' perspectives. Strengths included the quality of mentorship, opportunities for learning and professional development, and a feeling of connection with a larger community. Weaknesses included limited cohort building, challenges with insufficient structure, and issues with technology. Although all programs had one or more activities related to diversity, equity, inclusion, and justice, these topics were largely absent from student reports even though programs coincided with a peak in national consciousness about racial inequities and structural racism. Our results provide evidence for designing remote Research Experiences for Undergraduates (REUs) that are experienced favorably by students. Our results also indicate that remote REUs are sufficiently positive to further investigate their affordances and constraints, including the potential to scale up offerings, with minimal concern about disenfranchising students.

Determination of anxiety levels of female and male athletes for catching corona virus

Background: The Covid-19 epidemic has greatly changed the lifestyles and habits of millions of people around the world, and it has been observed that these changes have become permanent. Aim: The aim of our research is to examine the anxiety levels of female and male athletes for catching the new type of corona virus (Covid-19). Method: The survey method, one of the quantitative research models, was used in the study. The population of the research consisted of athletes (n=198) who were actively involved in sports in various sports clubs and in various branches in the districts of Istanbul, on the European side (Bakirköy, Göngören, Zeytinburnu). The data were collected online by applying the survey technique. The New Type Coronavirus (Covid-19) Anxiety Scale of the athletes (SYTKYKÖ) was used as a data collection tool. As a statistical procedure, it was determined that the data did not show normal distribution and Mann Whitney U, Kruskal Wallis-H analyzes from non-parametric tests were used. Findings: It is seen that there is a difference between the anxiety levels of catching Covid-19 according to the gender of the athletes, their education level, the status of people around them catching covid-19, the level of chronic disease, and their training status. There was no difference between the anxiety levels of catching Covid-19 according to the age, sports branch and years of doing sports of the participants. Result: As a result, it was concluded that the anxiety levels of the athletes of catching Covid-19 were high.

SARS-COV-2-INDUCED SECONDARY ADRENAL INSUFFICIENCY

TOPIC: Critical Care TYPE: Medical Student/Resident Case Reports INTRODUCTION: SARS-CoV-2 has been known to be primarily linked to pulmonic pathology. Endocrine complications of COVID-19 continue to remain elusive. Specifically, adrenal insufficiency in COVID-19 has been thought to be acquired through steroid use. This case describes a 46-year-old woman who suffered from mild COVID-19 illness without hypoxia or prolonged steroid therapy who developed secondary adrenal insufficiency. CASE PRESENTATION: This 46-year-old female presented to the emergency department with hypoglycemia of 40mg/dL. She had associated symptoms of nausea, fatigue, poor oral intake for 2 days. Her past medical history is significant for scleroderma with pulmonary hypertension, Raynaud's phenomenon, and mild COVID-19 infection four weeks prior to current admission. She was treated with Remdesivir and one dose of dexamethasone. She was discharged home without supplemental oxygen. Vital signs were significant for a low blood pressure at 90/50 and the patient was admitted to the ICU. Physical exam was unremarkable. Her initial labs were significant for hyponatremia (131 mmol/L), and hypoglycemia (40 mg/dL). Further lab work showed a low morning cortisol level of 2.1ug/dL (6-18) and ACTH of 4.2pg/mL (10-50). Her subsequent cosyntropin stimulation test showed low cortisol levels at 1.3 (6-18), 5.4 (8), and 7.9 (16) respectively, indicating adrenal insufficiency. Her other labs were normal including TSH, aldosterone, and renin level. Adrenal autoantibodies to 21-hydroxylase and 17-alpha hydroxylase were negative. She had a CT scan of the abdomen which showed no adrenal lesions. She was started on hydrocortisone 10mg twice daily with rapid resolution of all her symptoms. DISCUSSION: Adrenal insufficiency in COVID-19 typically occurs in the setting of hypothalamic-pituitary-adrenal (HPA) axis suppression due to steroid use. True secondary adrenal insufficiency is rare. SARS-CoV-2 infection has not been known to directly attack the adrenal glands. However, SARS-CoV-2 could induce an autoimmune response against ACTH via molecular mimicry. Another prevailing theory is that thromboembolic events at the adrenal level result in impaired hormone production. Initial assessment starts with AM cortisol and ACTH. If low, patients should undergo corticotropin stimulation testing as the gold standard of diagnosis. A complete work up should include an assay of autoantibodies. Lastly, investigation of potential adrenal lesions should be explored with contrast-enhanced CT scan or MRI. Treatment is straightforward: supplementation of glucocorticoids, 2-3 times daily. CONCLUSIONS: No algorithm currently exists to detect adrenal insufficiency;clinical suspicion should guide further work-up. As COVID-19 adrenal insufficiency has an unclear prognosis, the treatment course is also uncertain. As a patient's symptoms and labs normalize, there is a possibility to discontinue treatment altogether. REFERENCE #1: Heidarpour M, Vakhshoori M, Abbasi S, Shafie D, Rezaei N. Adrenal insufficiency in coronavirus disease 2019: A case report. J Med Case Rep. 2020;14(1):10-13. REFERENCE #2: Scaroni C, Armigliato M, Cannavò S. COVID-19 outbreak and steroids administration: are patients treated for Sars-Cov-2 at risk of adrenal insufficiency? J Endocrinol Invest. 2020;43(7):1035-1036. REFERENCE #3: Bellastella G, Maiorino MI, Esposito K. Endocrine complications of COVID-19: what happens to the thyroid and adrenal glands? J Endocrinol Invest. 2020;43(8):1169-1170. DISCLOSURES: no disclosure on file for Justin Dolan;No relevant relationships by Andrew Kim, source=Web Response No relevant relationships by Amy Van, source=Web Response

Identifying key determinants and dynamics of SARS-CoV-2/ACE2 tight interaction.

SARS-CoV-2 virus, the causative agent of Covid-19, has fired up a global pandemic. The virus interacts with the human receptor angiotensin-converting enzyme 2 (ACE2) for an invasion via receptor binding domain (RBD) on its spike protein. To provide a deeper understanding of this interaction, we performed microsecond simulations of the RBD-ACE2 complex for SARS-CoV-2 and compared it with the closely related SARS-CoV discovered in 2003. We show residues in the RBD of SARS-CoV-2 that were mutated from SARS-CoV, collectively help make the RBD anchor much stronger to the N-terminal part of ACE2 than the corresponding residues on RBD of SARS-CoV. This would result in a reduced dissociation rate of SARS-CoV-2 from human receptor protein compared to SARS-CoV. The phenomenon was consistently observed in simulations beyond 500 ns and was reproducible across different force fields. Altogether, our study adds more insight into the critical dynamics of the key residues at the virus spike and human receptor binding interface and potentially aids the development of diagnostics and therapeutics to combat the pandemic efficiently.

"How do we do this at a distance?!" A descriptive study of remote undergraduate research programs during COVID-19 (preprint)

The COVID-19 pandemic shut down undergraduate research programs across the U.S. Twenty-three sites offered remote undergraduate research programs in the life sciences during summer 2020. Given the unprecedented offering of remote research experiences, we carried out a study to describe and evaluate these programs. Using structured templates, we documented how programs were designed and implemented, including who participated. Through focus groups and surveys, we identified programmatic strengths and shortcomings as well as recommendations for improvements from the perspectives of participating students. Strengths included the quality of mentorship, opportunities for learning and professional development, and development of a sense of community. Weaknesses included limited cohort building, challenges with insufficient structure, and issues with technology. Although all programs had one or more activities related to diversity, equity, inclusion, and justice, these topics were largely absent from student reports even though programs coincided with a peak in national consciousness about racial inequities and structural racism. Our results provide evidence for designing remote REUs that are experienced favorably by students. Our results also indicate that remote REUs are sufficiently positive to further investigate their affordances and constraints, including the potential to scale up offerings, with minimal concern about disenfranchising students.

Identifying Key Determinants of SARS-CoV-2/ACE2 Tight Interaction (preprint)

SARS-CoV-2 virus, the causative agent of Covid-19, has fired up a global pandemic. The virus interacts with the human receptor angiotensin-converting enzyme 2 (ACE2) for invasion via receptor binding domain (RBD) on its spike protein. To provide a deeper understanding of this interaction, we performed microsecond simulations of the RBD-ACE2 complex for SARS- CoV-2 and compared it with the closely related SARS-CoV discovered in 2003. We show residues in the RBD of SARS-CoV-2 that were mutated from SARS-CoV, collectively help make RBD anchor much stronger to the N-terminal part of ACE2 than the corresponding residues on RBD of SARS-CoV. This would result in reduced dissociation rate of SARS-CoV-2 from human recep- tor protein compared to SARS-CoV. This phenomenon was consistently observed in simulations beyond 500 ns and was reproducible across different force fields. Altogether, our study shed light on the key residues and their dynamics at the virus spike and human receptor binding interface and advance our knowledge for the development of diagnostics and therapeutics to combat the pandemic efficiently.