Exploring the impact of covid-19 lockdown on learning among higher education students on the copperbelt province, Zambia

Many educational institutions were closed following COVID-19 lockdown. The closure disrupted the smooth running of teaching in educational institutions. Although the impact was felt across the world, it impacted more in low- and middle-income countries due to poor resources for virtual learning. This study explored the barriers to Learning among Higher Education Students during COVID-19 pandemic. The research study utilized an explorative qualitative study approach. Twenty semi-structured interviews were carried out with higher education students. Data were thematically analyzed using the four phases of data analysis in The Silences Framework (TSF) which included researcher review, Silence dialogue, Collective voices, and Researcher reflection. The study found that poor digital literacy, lack of digital learning resources, poor internet connectivity, lack of opportunities for practical lessons and burden of domestic chores were barriers to learning among higher education students during COVID-19 pandemic lockdown. There is need for higher education institutions to invest in ICT to enhance online lesson delivery in challenging pandemic times like COVID-19.

Parsonage-Turner Syndrome After COVID-19 Vaccination in a Child.

Parsonage-Turner syndrome (PTS) is a peripheral neuropathy involving the brachial plexus very rare in childhood. To date, no cases of PTS after COVID-19 vaccination have been reported in children. We report a case of a 15-year-old boy affected by PTS after the second dose of the BNT162b2 (Comirnaty, Pfizer-BioNTech) COVID-19 vaccine.

Plain language summaries: Enabling increased diversity, equity, inclusion and accessibility in scholarly publishing

circle Plain language summaries (PLS) are accessible, short, peerreviewed summaries of scholarly journal articles written in nontechnical language. circle The aim of PLS is to enable a broader audience of experts and non-experts to understand the original article. circle Here, we outline the evidence base for the value and impact of PLS and how they can enable diversity, equity, inclusion and accessibility in scholarly publishing. circle PLS can diversify readership and authorship, address information inequity, include typically under-represented stakeholders and provide an accessible route into scholarly literature.

A simple framework for calibrating hydraulic flood inundation models using crowd-sourced water levels

Floods are the most commonly occurring natural disaster, with the Centre for Research on the Epidemiology of Disasters 2021 report on "The Non-COVID Year in Disasters" estimating economic losses worth over USD 51 million and more than 6000 fatalities in 2020. The hydrodynamic models which are used for flood forecasting need to be evaluated and constrained using observations of water depth and extent. While remotely sensed estimates of these variables have already facilitated model evaluation, citizen sensing is emerging as a popular technique to complement real-time flood observations. However, its value for hydraulic model evaluation has not yet been demonstrated. This paper tests the use of crowd-sourced flood observations to quantitatively assess model performance for the first time. The observation set used for performance assessment consists of 32 distributed high water marks and wrack marks provided by the Clarence Valley Council for the 2013 flood event, whose timings of acquisition were unknown. Assuming that these provide information on the peak flow, maximum simulated water levels were compared at observation locations, to calibrate the channel roughness for the hydraulic model LISFLOOD-FP. For each realization of the model, absolute and relative simulation errors were quantified through the root mean squared error (RMSE) and the mean percentage difference (MPD), respectively. Similar information was extracted from 11 hydrometric gauges along the Clarence River and used to constrain the roughness parameter. The calibrated parameter values were identical for both data types and a mean RMSE value of ~50 cm for peak flow simulation was obtained across all gauges. Results indicate that integrating uncertain flood observations from crowd-sourcing can indeed generate a useful dataset for hydraulic model calibration in ungauged catchments, despite the lack of associated timing information.

Parsonage-Turner Syndrome After COVID-19 Vaccination in a Child

Parsonage-Turner syndrome (PTS) is a peripheral neuropathy involving the brachial plexus very rare in childhood. To date, no cases of PTS after COVID-19 vaccination have been reported in children. We report a case of a 15-year-old boy affected by PTS after the second dose of the BNT162b2 (Comirnaty, Pfizer-BioNTech) COVID-19 vaccine.Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.

Parsonage-Turner Syndrome After COVID-19 Vaccination in a Child.

Parsonage-Turner syndrome (PTS) is a peripheral neuropathy involving the brachial plexus very rare in childhood. To date, no cases of PTS after COVID-19 vaccination have been reported in children. We report a case of a 15-year-old boy affected by PTS after the second dose of the BNT162b2 (Comirnaty, Pfizer-BioNTech) COVID-19 vaccine.

Impact of the COVID-19 pandemic and generational heterogeneity on ecommerce shopping styles – A case study of Sacramento, California

The COVID pandemic has accelerated the growth of ecommerce and reshaped shopping patterns, which in turn impacts trip-making and vehicle miles traveled. The objectives of this study are to define shopping styles and quantify their prevalence in the population, investigate the impact of the pandemic on shopping style transition, understand the generational heterogeneity and other factors that influence shopping styles, and comment on the potential impact of the pandemic on long-term shopping behavior. Two months after the initial shutdown (May/June 2021), we collected ecommerce behavioral data from 313 Sacramento Region households using an online survey. A K-means clustering analysis of shopping behavior across eight commodity types identified five shopping styles, including ecommerce independent, ecommerce dependent, and three mixed modes in-between. We found that the share of ecommerce independent style shifted from 55% pre-pandemic to 27% during the pandemic. Overall, 30% kept the same style as pre-pandemic, 54% became more ecommerce dependent, and 16% became less ecommerce dependent, with the latter group more likely to view shopping an excuse to get out. Heterogeneity was found across generations. Pre-pandemic, Millennials and Gen Z were the most ecommerce dependent, but during the pandemic they made relatively small shifts toward increased ecommerce dependency. Baby Boomers and the Silent Generation were bimodal, either sticking to in-person shopping or shifting to ecommerce-dependency during the pandemic. Post-pandemic intentions varied across styles, with households who primarily adopt non-food ecommerce intending to reverse back to in-person shopping, while the highly ecommerce dependent intend to limit future in-store activities. © 2023 The Authors

Acute renal infarction presenting as hypertensive urgency

Case Report: A 46-year-old lady with medical history of hypertension, diabetes mellitus, and peripheral neuropathy was admitted to the hospital with the diagnosis of sepsis without septic shock secondary to a right foot pressure ulcer. Her presentation was non-specific as she was complaining of fatigue, myalgia, fever, and chills. Routine COVID-19 test was done on admission and it came back positive despite her denying having any respiratory symptoms. She was being treated with fluids and antibiotics until her third night of admission. According to the patient, she got up to use the restroom when she suddenly noticed weakness in her lower extremities. She thought it may be due to a muscle spasm;hence, she did not notify the medical team. Later, her nurse was routinely checking the patient's blood pressure when she noted a blood pressure of 220/105 mmHg. She then received a total of 3 doses of intravenous labetalol over three hours;however, her blood pressure continued to be elevated. Patient did endorse right flank pain but it was responding to intravenous fentanyl. The on-call physician then proceeded to perform a full physical examination and noted paleness, weakness, and absent pulses in bilateral lower extremities. A STAT computed tomography (CT) angiogram of the abdominal aorta and iliofemoral arteries was performed and it revealed low-density defects in the right kidney compatible with infarcts, occlusive thrombus in the infrarenal abdominal aorta and extensive bilateral arterial thrombosis. Vascular surgery was immediately consulted and they kept the patient on heparin drip and took her to the operation room within few hours for thrombectomies. Her blood pressure improved following the removal of the thrombus and there were no other documented occurrence of uncontrolled hypertension during her hospitalization. Discussion(s): Acute renal infarction is an arterial vascular event that leads to sudden disruption of blood flow in the renal artery. It can often be diagnosed late due to its rare incidence. In addition, it has a nonspecific clinical presentation that can mimic many common causes. The most common causes of renal infarction include atrial fibrillation, endocarditis, ischemic heart disease, hypercoagulable disorders, and spontaneous renal artery dissection. A case report published by Bourgault M, et al. on renal infarction suggested that around 97% had abdominal/flank pain and 48% of patients had marked uncontrolled hypertension at initial presentation of renal infarction. Our patient did not have any of the afore mentioned risk factors except for a possible hypercoagulable state from her COVID-19 infection and she did present with the two most common presentations. In conclusion, clinicians should have a low threshold for the suspicion of renal ischemia in patients with severe hypertension and flank pain. Copyright © 2023 Southern Society for Clinical Investigation.

Impact of SARS-CoV-2 vaccination and booster on COVID-19 symptom severity over time in the COVID-OUT trial.

BACKGROUND: SARS-CoV-2 vaccination has decreasing protection from acquiring any infection with emergence of new variants; however, vaccination continues to protect against progression to severe COVID-19. The impact of vaccination status on symptoms over time is less clear. METHODS: Within a randomized trial on early outpatient COVID-19 therapy testing metformin, ivermectin, and/or fluvoxamine, participants recorded symptoms daily for 14 days. Participants were given a paper symptom diary allowing them to circle the severity of 14 symptoms as none (0), mild (1), moderate (2), or severe (3). This is a secondary analysis of clinical trial data on symptom severity over time using generalized estimating equations comparing those unvaccinated, SARS-CoV-2 vaccinated with primary vaccine series only, or vaccine-boosted. RESULTS: The parent clinical trial prospectively enrolled 1323 participants, of whom 1062 (80%) prospectively recorded some daily symptom data. Of these, 480 (45%) were unvaccinated, 530 (50%) were vaccinated with primary series only, and 52 (5%) vaccine-boosted. Overall symptom severity was least for the vaccine-boosted group and most severe for unvaccinated at baseline and over the 14 days (P < 0.001). Individual symptoms were least severe in the vaccine-boosted group including: cough, chills, fever, nausea, fatigue, myalgia, headache, and diarrhea, as well as smell and taste abnormalities. Results were consistent over delta and omicron variant time periods. CONCLUSIONS: SARS-CoV-2 vaccine-boosted participants had the least severe symptoms during COVID-19 which abated the quickest over time.

Four Months Physical, Psychosocial, and Neurocognitive Follow-up of Multisystemic Inflammatory Syndrome in Children (Mis-C) after Picu Admission: A National Prospective Cohort Study

BACKGROUND AND AIM: Outcome of the novel COVID-19 related disease "Multisystemic Inflammatory Syndrome in Children (MIS-C)" is still largely unknown. We aimed to assess physical, psychosocial, and neurocognitive functioning in MIS-C survivors after PICU admission. METHOD(S): A national prospective cohort study including MIS-C children (0-17 years) admitted to one of the 7 PICUs in The Netherlands. Children were tested 3-6 months after PICU admission in a multidisciplinary follow-up program through a semi-structured interview, validated questionnaires for psychosocial outcomes, in both children and their parents, and validated neurocognitive tests in children. RESULT(S): Between March 2020 and June 2021, 49 MIS-C children attended follow-up after median 4 months (IQR 3-5) at median age 11.6 years (IQR 9.3-15.6). At follow-up, PCPC and POPC scores were normal in all children, 21 (43%) children reported impaired exercise intolerance and 20% worsening sleeping behaviour. Physical and school functioning quality of life scores were worse compared with norm data. General intelligence and verbal memory scores were comparable to norm data (N=44), whereas visual memory, sustained attention, and planning were significantly lower in a subgroup of 29 patients. Parents reported less posttraumatic stress and depressive symptoms compared with norms. CONCLUSION(S): After PICU admission, exercise intolerance, sleeping, physical and school functioning problems were reported. Overall intelligence and neurocognitive scores were normal, with subtle deviants in some neurocognitive functions indicating integration and sustained attention problems. This yields for a longer-term follow-up to assess MIS-C survivors functioning.

Safety, Tolerability, and Viral Pharmacodynamics of the IgG Monoclonal Antibody Sotrovimab Administered via Intramuscular Injection for the Treatment of Early Mild-to-Moderate COVID-19

Background. There is a continued need for therapeutics for the treatment of COVID-19, including intramuscular (IM) agents, which will enable broader use across a variety of healthcare delivery settings. Methods. COMET-PEAK (NCT04779879) is a 3-part study evaluating the safety, tolerability, pharmacokinetics (Part A), and viral pharmacodynamics (PD) of sotrovimab as treatment in adults >= 18 years with early mild/moderate COVID-19. In Parts B and C, the safety, tolerability and viral PD of sotrovimab administered as a 500 mg intravenous (IV) infusion or as a 500 mg or 250 mg IM injection, respectively, was evaluated. The primary objective for Parts B and C was to compare the virologic response of sotrovimab IM to IV, with an endpoint of mean area under the curve (AUC) of SARS-CoV-2 viral load as measured by qRT-PCR from Day 1 to Day 8 (AUCD1-8) in nasopharyngeal swabs and predefined 90% confidence interval (CI) limits of 0.5-2.0 indicating equivalence. Results. A total of 167 and 157 participants were enrolled in Part B and C, respectively, from February-July 2021. The median age of participants was 47 and 42 years in Part B and C, respectively, and ~50% had >= 1 risk factor for progression to severe disease. The viral load at baseline and through Day 29 of follow-up for each arm is shown in Table 1 and Figure 1. The primary objective was met for both study parts: the ratio of the least square geometric mean viral load AUC(D1-8) of sotrovimab IM vs IV was 1.04 (90% CI, 0.98, 1.09) and 1.02 (90% CI, 0.94, 1.11), for Part B and C, respectively. Through Day 29 of follow-up, the most common adverse event was injection site reactions (ISRs) in the IM arms. A total of 10 (12%) participants in the 500 mg IM group and 4 (5%) participants in the 250 mg IM group experienced an ISR, all Grade 1. Serious adverse events were uncommon, and related to COVID-19 progression, including one death in the 250 mg IM arm (Table 2). ISRs aside, there were few treatment-related AEs (2/84 IV, 1/82 IM) in Part B, none serious. Conclusion. IM administration of sotrovimab 500 mg and 250 mg each demonstrated equivalence to 500 mg sotrovimab IV in viral load assessments. Overall, there were no treatment-related serious AEs and sotrovimab was well tolerated. An 500 mg IM formulation will allow for expanded treatment potential with sotrovimab.

Viral resistance analysis in the COMET-PEAK study: sotrovimab treatment in participants with mild-to-moderate COVID-19

Background. Sotrovimab is a human monoclonal antibody targeting a conserved region of the SARS-CoV-2 spike (S) protein. COMET-PEAK was a 3-part, phase 2 study that evaluated intravenous (500 mg) and intramuscular (500 mg and 250 mg) administration of sotrovimab in outpatients (n=353) with mild-to-moderate COVID-19. We assessed amino acid substitutions in the SARS-CoV-2 S protein and circulating variants of concern/interest (VOC/VOI) in COMET-PEAK participants (enrolled Feb-July 2021). Methods. Mid-turbinate (Part A) or nasopharyngeal (Part B/C) samples were obtained from all participants at Baseline and Post-Baseline visits. Next generation sequencing of the SARS-CoV-2 S gene was conducted using Illumina MiSeq with a >=5% allelic frequency cut-off for samples with a viral load above 3.0 log10 copies/mL. Baseline, post-baseline and treatment-emergent (TE) substitutions were assessed, and prevalence of VOC/VOI was evaluated. Phenotypic analyses of epitope substitutions were conducted using a pseudotyped virus assay. Results. In total, 282/353 participants had sequencing results for >=1 visit (253 baseline, 248 post-baseline), and 219 had paired baseline and post-baseline sequences;among these, 149 (68%) had TE substitutions in the S protein (26 [12%] in the epitope). E340K was the predominant TE substitution in the epitope (15 [7%]). Across all arms 92/245 (38%) experienced virologic rebound, 8 of whom (Part A: 2;Part B: 2;Part C: 4) had TE substitutions in the epitope;none had evidence of clinical progression to severe disease. Prevalence of VOC/VOI or single amino acid substitutions of concern was 94% (266/282);the most frequent were Alpha (Part A: 8/16 [50%];Part B: 75/128 [59%]) and Delta (Part C: 99/122 [81%]). Of 7 participants with evidence of clinical progression, none had S protein substitutions in the epitope and all hadVOC/VOI (3Alpha, 3 Delta, 1 Gamma). Sotrovimab effectively neutralized most epitope substitutions tested in vitro;P337L and E340A/K/V conferred significantly reduced susceptibility. Conclusion. There was no evidence that sotrovimab epitope substitutions were associated with clinical progression or virologic rebound. These data are consistent with those from the COMET-ICE study.

The affective dimension of crisis subjects: Teaching Environmental Communication through intersecting crises

Confronting the existential threat of climate and ecological crises in undergraduate teaching presents complex challenges. Educators in environmental and climate change studies rightly communicate the scale and urgency of these unfolding crises, yet at times fail to take into account the emotional and mental health impacts upon students acquiring this knowledge. This article examines the affective dimensions of learning in ‘crisis subjects'. It draws insights from case study research on the experience of Australian university teachers and students in a subject called Environmental Communication, delivered during a period of intersecting crises: climate-change driven drought, catastrophic bushfires, and the emergence of Covid-19. The psychoanalytic concept of ‘difficult knowledge' (Britzman, 1998;2004) is taken up to shed light on the inherent challenges of teaching and learning in this context. Many students in the study were deeply affected by their learning experience, and recognise its importance, but also struggle to integrate it with anticipated future roles. The authors argue that students and educators need new knowledge, capacities and resources to address the affective dimension of teaching and learning and to grapple with the collective social trauma of the climate crisis. © 2022, Adult Learning Australia. All rights reserved.

Progress Towards Hcv Elimination in the Country of Georgia: Insights from Modelling and National Survey

Background: A national serosurvey in 2015 found the country of Georgia had high hepatitis C virus (HCV) prevalence, with 5.4% of adults (~150,000 people) chronically infected. In April 2015, Georgia launched a national program to eliminate HCV infection (reduce prevalence by 90%). We developed an HCV transmission model to capture current and historical dynamics of HCV infection in Georgia, and project long-term impact of the elimination program. A follow-up serosurvey in 2021 provided data used to validate the model and update impact projections. Method(s): The original model was calibrated to the 2015 serosurvey and surveys among people who inject drugs (PWID), accounting for age, sex, PWID status, and liver disease state. We compare model projected prevalence overall and by age group, sex, and among ever injected drugs to 2021 serosurvey prevalence, and weight the parameter sets to match the serosurvey results. We used logistic regression to assess which input parameters or model characteristics affect fit. We used program data on 77,168 persons treated May 2015-February 2022 to estimate current incidence of HCV infection, cases and deaths averted. We project the impact of reductions in treatment rates during the COVID-19 epidemic. Result(s): The original modelled adult hepatitis C prevalence for 2021 (2.7%, 1.9-3.5%) was higher than the observed serosurvey prevalence (1.8%, 1.3-2.4%);across all groups uncertainty bounds overlap. Parameter sets that fit the 2021 serosurvey data suggest the model overestimated the initial burden of infection. Weighted Hepatitis C incidence in March 2022 is estimated to be 0.05 (95% credible interval (CrI) 0.03-0.11) per 100 person-years in general population, and 1.14 (0.08-6.4) per 100 person-years in PWID, a 60% decrease since 2015. As of March 2022, 9,186 (5,396-16,720) infections and 842 (489-1324) deaths have been averted, with benefit accumulating to 26,154 (15,850-47,627) infections and 3,971 (2,516-5,536) deaths averted if tracked to 2030. Treatment numbers went from 996/ month in 2019 to 406/month March 2020-February 2022 during the COVID-19 pandemic, resulting in 14,127 fewer treatments, 471 (242-817) fewer infections averted by March 2022. At 406 treatments/month, elimination can be reached in 2031. Conclusion(s): HCV prevalence reduction due to treatment and prevention interventions was greater than originally projected, but treatment numbers must still increase in order to reach HCV elimination by 2030.

Interdisciplinary chronic pain rehabilitation program modifications for COVID-19: Preliminary evidence regarding dosage and telemedicine

Patients with chronic pain may be disproportionately impacted by the COVID-19 pandemic due, in part, to shared risk factors for both chronic pain and COVID-19 infection. At the same time, the pandemic has increased barriers to participating in interdisciplinary chronic pain rehabilitation programs (ICPRPs). The present study provides preliminary evidence regarding the effects of two ICPRP modifications-reduced program dosage and delivery via telemedicine-designed to increase access during the initial COVID-19 surge but with implications beyond the pandemic. Design(s): Retrospective cohort comparison evaluating pain severity, pain interference, and beliefs relating pain and disability for groups completing 4-week (110-hour) versus 3-week (73-hour) and in-person versus telemedicine ICPRP formats. Subjects: 103 patients who completed an ICPRP at an academic medical center between April 2019 and July 2021. Result(s): The 4-week, in person;3-week, in-person;and 3-week, telemedicine programs were all effective in decreasing pain severity, pain interference, and beliefs relating pain and disability. Compared to the 4-week, in-person version, however, the 3-week, in-person program proved less effective in reducing pain interference and beliefs equating pain with impairment. The 3-week, telemedicine format, in turn, was less effective than the 3-week, in-person version in decreasing beliefs associating pain and disability. Conclusion(s): Decreasing program dosage and offering participation via telemedicine may be viable strategies for increasing access to ICPRPs, but may result in reduced program effectiveness in certain domains. The study's uncontrolled design and small telemedicine group underscore the need for randomized, controlled trials comparing different ICPRP dosages and modalities. Copyright © 2022 Nova Science Publishers, Inc.