KNOWLEDGE, ATTITUDES, AND THE ROLE OF MEDIA OUTLETS REGARDING COVID-19 IN MEDICAL STUDENTS FROM A PERUVIAN UNIVERSITY

A cross-sectional study was conducted on medical students at a private Peruvian university. The objective was to describe knowledge and attitudes towards COVID-19 and the student’s perception of the role of media outlets and social media. 32% of students did not know that serological tests are preferable to molecular tests to diagnose COVID-19 in the first five days of illness;73% reported being willing to work as a volunteer during the pandemic, and 94% received false information regarding COVID-19 on social media. This study demonstrates that information regarding diagnostic tests should be reinforced and that the high percentage of students willing to volunteer during the COVID-19 pandemic should not be overlooked.

Classroom management, lesson planning, and technology integration ... Oh my!: Ways to cope with online pedagogical practices

This chapter aims to share the results of a study of faculty in teacher preparation programs across the state of Texas to identify ways educator preparation has shifted its instruction as a result of COVID-19. Both quantitative and qualitative data results are shared, along with implications. The research provides some clarity regarding how future educator preparation programs and K-12 classroom teachers can adjust instructional practices as the shift to a virtual learning environment continues. The authors offer suggestions for best practices in virtual instruction for lesson planning, classroom management, and technology integration for K-12 teachers, as well as recommendations for teacher preparation programs to prepare pre-service teachers for successful implementation in those three areas while teaching in a virtual environment. © 2021, IGI Global.

Biomarkers for Thrombosis in COVID-19: A Role for High Sensitivity Troponin-I and Immature Platelet Fraction?

Biomarkers for Thrombosis in COVID-19: A Role for High Sensitivity Troponin-I and Immature Platelet Fraction? Introduction Coronavirus disease 2019 (COVID-19) is associated with increased risk of thrombosis with both venous and arterial thromboembolism observed. While d-dimer elevation has been shown to be associated with thrombosis, this elevation is present in over 50% of COVID-19 infections demonstrating a clear need for more specific biomarkers of thrombosis in this population. While there are a variety of theories to explain the increased risk for thrombosis: all center on Virchow's triad, specifically hypercoagulability and inflammation. Platelets play a significant role in hypercoagulability. Immature platelets, which are thought to be hyper-reactive, may specifically be associated with thrombosis in COVID-19. It would thus be reasonable to expect immature platelet fraction (IPF) and immature platelet count (IPC) to be predictive biomarkers of thrombosis in this population. Beyond hypercoagulability, High-Sensitivity (HS) Cardiac troponin-I can be a biomarker of inflammation and may also be predictive of thrombotic events in COVID-19. The aim of this study was to evaluate the relationship between IPF, IPC, HS cardiac troponin-I and thrombotic events in COVID-19. Methods Using a single center COVID-19 data registry, we extracted all patients with COVID-19 at our single center between May 1, 2020 and January 1, 2021. Patients were stratified into two groups based on thrombotic events during hospitalization, the thrombosis and no thrombosis groups. Biomarker values, including IPF, IPC, platelet counts, d-dimer, and HS cardiac troponin I were extracted. Two-sided Wilcoxon rank test was conducted to test group differences in IPF, IPC, platelet, d-dimer, and HS cardiac troponin-I values. Results There were no significant differences in measurements of IPF at admission, peak IPF, platelet count at admission, peak platelet count, IPC at admission, and peak IPC between the thrombosis and no thrombosis groups. Minimum platelet count values were significantly lower in the thrombosis group compared to the no thrombosis group. D-dimer and troponin values were significantly higher in the thrombosis group than the no thrombosis group. (Table 1) Discussion To our knowledge this is the first study assessing the relationship between IPF, IPC, HS cardiac troponin-I and thrombosis in COVID-19. HS cardiac troponin did appear to be a predictive biomarker for thrombosis in COVID-19. This may be related to vascular inflammation playing a significant role in thrombosis. It may also be secondary to myocardial inflammation associated with severe disease in COVID-19.3 Patients with more severe disease are more prone to thrombosis. Unsurprisingly, our study corroborates evidence in the literature that d-dimer is associated with thrombotic events in COVID-19. On the other hand, IPF and IPC do not appear to be predictive biomarkers for thrombosis in this cohort. This appears consistent with the limited data assessing the relationship between IPF, IPC, and thrombosis outside of COVID-19. This does not dispel the importance of immature platelets in COVID-19, however. IPF and IPC are increased in patients with COVID-19, and our published data indicates they are predictors of COVID-19 severity. However, the relationship between immature platelets and outcomes in acute illness can be complex, as in sepsis, where the trend of IPC is associated with mortality, rather than the initial value. Future studies should delineate the relationship between trends in IPF or IPC and outcomes in COVID-19. Furthermore, it is crucial to define biomarkers of thrombosis and disease severity and mortality in COVID-19 which can potentially guide therapeutic interventions. [Formula presented] Disclosures: No relevant conflicts of interest to declare.

Teachers' Preparedness and Professional Learning about Using Educational Technologies during the COVID-19 Pandemic

The COVID-19 pandemic has impacted education at multiple levels over the last ten months. One common thread that has remained is the online learning and meeting platform for teachers, students, administrators, and families. This study reports on a survey of 560 K-12 educators across one southernmost part of a south-central state who shared their levels of preparedness during the transition to virtual learning in the Spring of 2020/amid the COVID-19 pandemic. Data analysis revealed that educators continued to focus on professional development during the summer of 2020 in preparation for the new academic year. Additional analysis showed that participants' self-efficacy of using technology to teach online remained high. This demonstrated the resiliency and adaptability of K-12 classroom teachers in the face of immediate changes affecting their pre-conceived notions of how a classroom looks and how learning is obtained.

SPECT/CT Pulmonary Perfusion Studies: Searching for aSolution During a Pandemic

Objectives: COVID-19 has created difficulties for everyone, especially in the medical field. Within Nuclear Medicine, lung ventilation and perfusion (VQ) studies used to rule out pulmonary embolism (PE) have become a challenge with COVID positive patients. SPECT/CT technology provides a potential deeper look into not only physiological butanatomical information. This could prove to be advantageous for patients that are unable to receive the ventilationportion of the study. As a student, 123I have the advantage of seeing multiple protocols for the VQ study at differentinstitutions. One hospital has started doing ventilation exams again. The patient must have tested negative forCOVID-19 from the time of admission to the time of exam to use the ventilation machine. If a patient has not had aCOVID test, the patient must do the ventilation through a single use bag. Absolutely no ventilation studies are doneon COVID positive patients. Two other institutions continue to do lung perfusion only studies on all patientsregardless of COVID status. Therefore, the purpose of this study is to review a SPECT/CT perfusion lung casestudy and evaluate the effectiveness in identifying the possibility of pulmonary embolism. Methods: An institution which is not performing ventilation is using SPECT/CT for lung perfusion only studies.These lung perfusion studies were observed and reviewed. The protocol utilized is as follows: 5 mCi Tc99m MAA, followed by 8 standard spot views taken in a supine position: anterior, posterior, oblique, and lateral views with 600kcounts in a 128 x 128 matrix. The SPECT/CT portion is completed immediately after the perfusion with 15 secondsper step and 60 steps total. CT parameters include mAs: 3, kV: 120, a slice thickness of 2.5mm, and a matrix:512x512. Results: In one case, a 76-year-old female with history of asthma, DVT and shortness of breath was evaluatedusing SPECT/CT perfusion study to rule out PE. The patient received 5.5mCi of Tc99m MAA and subsequent planarimages were taken in the anterior, posterior, and 4 oblique views, followed by SPECT/CT. Images revealed bilateralsegmental perfusion defects which were concerning for pulmonary embolism. While other pathologies were identified on the CT images, the probability of PE could not be estimated from this study . CT information from thestudy was reviewed for abnormalities possibly related to COVID, but nothing was conclusive. The patient was negative for COVID prior to the exam. Conclusions: Continued research is required to decide if SPECT/CT can decrease the need for a ventilation in aVQ scan;however, this hybrid scanner provides an opportunity to perform an alternative perfusion only study with added anatomical information. Even in institutions that continue to perform ventilation exams, there are occasionswhere a SPECT/CT may prove to be beneficial. SPECT/CT adds anatomic information to a physiological study, itsuse in the determination of the probability of PE is still unknown. Another consideration would be the difference inradiation dose from a SPECT/CT lung perfusion study compared to planar VQ. An initial investigation is being doneby one of the institutions described in this abstract.

Nuclear Medicine Radiation Exposure and COVID-19Pertaining to V/Q Lung Studies;A TechnologistPerspective

Objectives: Nuclear medicine technologists experience various exposures throughout a typical workday. However, the introduction of Covid-19 to the work environment has produced a new hazard that needs to be addressed.Occupational exposure is currently limited to 50 mSv per year according to the Nuclear Regulatory Commission(NRC) which can be received from a source or machine. Conversely, there is no limit on COVID-19 exposure and the guidelines on proper personal protective equipment (PPE) usage are continually being updated during thecurrent pandemic. One of the most common studies in Nuclear Medicine is the Ventilation/Perfusion (V/Q) Lungscan which also poses as one of the biggest exposure risks to nuclear medicine technologists regarding bothradiation and COVID-19. Patient cooperation is key to a proper ventilation study. If the patient is unable to tolerate the mask or there is not a sufficient seal on the mask, the leaking radiotracer not only adds to the technologist'sradiation burden but also COVID-19 exposure. In addition, the contamination of the Xenon delivery system has prompted new SNMMI guidelines during the pandemic to forego the ventilation portion of the exam. At ourinstitution, the ventilation portion of the study is no longer performed during the pandemic and have switched toperfusion images with SPECT/CT as our new standard of care protocol. The purpose of the study is to review thisalternative lung study and compare imaging time, radiation and COVID-19 exposure. Methods: This retrospective study reviewed the current institutional imaging protocols and SNMMIrecommendations for V/Q studies. The imaging protocols were reviewed and measurements of the total imagingtime, radiation exposure and COVID-19 exposure were assessed. Perfusion SPECT protocol parameters are 15seconds a stop for 120 stops, acquiring on both heads. The CT portion has the low-dose screening chest CTprotocol. Results: The traditional standard protocol at our institution utilized 5 mCi of Tc-99m MAA for the perfusionportion of the study (2.035 mSv) and 20 mCi Xe-133 (0.54 mSv) for a total of 2.575 mSv. Taking advantage of thenew cameras and technology at our institution, we reduced the perfusion dose to 4 mCi of Tc-99m MAA for theperfusion portion of the study (1.63 mSv) and the low-dose CT adds 1.0 mSv for a total of 2.63 mSv. The totalimaging time is < 18 mins for the SPECT/CT and 30-60 mins for the traditional V/Q study. Conclusion: Eliminating the ventilation portion of the exam and performing SPECT/CT provides for a considerably faster exam time with comparable radiation exposure to the patient. Furthermore, it significantly reduces the radiation exposure to atechnologist by decreasing the time spent with the patients, is less reliant of patient cooperation and provides fortechnically better-quality studies. The additional major benefit is reducing the COVID-19 exposure to technologistsduring the pandemic.

Giving everyone a fish: COVID-19 and the new politics of distribution

In response to widescale job losses produced by the COVID.19 pandemic, states have drastically expanded social protections, primarily through cash transfer programs. Drawing from James Ferguson's notion of distributional politics, this reflection analyzes the meaning of this rapid global expansion of the welfare state and the political opportunities it provides. Based on two seemingly disparate cases, South Africa and Canada, I suggest that these expansions provide valuable opportunities for rethinking existing approaches to livelihoods, labour and social protection. These interventions also provide political possibilities through which a more radically redistributive politics can be articulated. In both contexts, state responses have provoked new challenges, dialogues, and experiments in distribution at multiple scales, from the neighbourhood to the nation state. This reflection calls for deeper inquiry into the multiple meanings of cash transfers and the political openings they provide. Finally, it provides guiding questions for future anthropological inquiry into livelihoods and social protection. © 2021 University of Toronto. All rights reserved.

A rise in facial nerve palsies during the coronavirus disease 2019 pandemic.

OBJECTIVE: An increase in spontaneous lower motor neuron facial nerve (VIIth cranial nerve) palsies was seen during the severe acute respiratory syndrome coronavirus 2 outbreak in our emergency clinic. This led us to perform a single-centre cohort review. METHODS: A retrospective review was conducted of VIIth cranial nerve palsies from January to June 2020 and the findings were compared to those cases reviewed in the previous year. The severe acute respiratory syndrome coronavirus 2 incidence of the cohort was compared with that of the Liverpool population. RESULTS: Our VIIth cranial nerve palsy incidence in the 2020 period was 3.5 per cent (30 out of 852), 2.7 higher than last year's rate of 1.3 per cent (14 out of 1081), which was a statistically significant difference (p < 0.01). Two of the 17 patients in our cohort tested positive for severe acute respiratory syndrome coronavirus 2 (11.8 per cent), contrasting with Liverpool's severe acute respiratory syndrome coronavirus 2 incidence (0.5 per cent). CONCLUSION: Severe acute respiratory syndrome coronavirus 2 may be responsible for an increased number of facial nerve palsies; it is important for clinicians to be aware that this may being an initial presentation of the disease.