An Examination of Occupational Therapy Telehealth Service Delivery Among Novice Users During the COVID-19 Pandemic

The COVID-19 pandemic allowed for widespread implementation of telehealth as a delivery method for occupational therapy (OT) services. The purpose of this study was to investigate the perceptions of novice telehealth OT practitioners regarding telehealth as a delivery method for OT services. Quantitative data was collected through a modified version of the Telehealth Usability Questionnaire and analyzed via descriptive statistics. Qualitative data was collected by open-ended questions and analyzed via thematic analysis. OT practitioners' responses revealed four major themes: logistics of telehealth practice, role of client champions, capacity of the OT practitioner, and styles and approaches. The study revealed that OT sessions delivered via telehealth increased access to clients and continuity of services. Client champion engagement, effective coaching strategies, and practitioner flexibility supported the success of OT telehealth sessions. © 2023, University Library System, University of Pittsburgh. All rights reserved.

Outreach activities of the Extreme Energy Events Project

The Extreme Energy Events Project (EEE) represents a breakthrough in outreach activities in Cosmic Ray Physics: high school students are protagonists of an experiment to measure Extensive Air Showers at ground. They start their experience at CERN with the construction of the three high performing Multigap Resistive Plate Chambers constituting the telescope that is then installed inside their school;then they take care of the telescope operation and data analysis. Presently 60 telescopes are installed in Italy and, since 2014, coordinated data taking have been performed during each school year providing a huge amount of candidate muon tracks. Every year hundreds of students and teachers are involved in the activities directly correlated to EEE. The COVID-19 pandemic has strongly affected the experimental activities of the EEE Project. However in the last two years the online activities were strengthened, with an intense programme of collaboration meetings, masterclasses, and hugely successful topical seminars. Starting from the fall of 2021, the improvement of epidemiological situation made it possible to start some of the EEE activities in presence. © Copyright owned by the author(s) under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0)

Variations in classroom ventilation during the COVID-19 pandemic: Insights from monitoring 36 naturally ventilated classrooms in the UK during 2021

Seasonal changes in the measured CO2 levels at four schools are herein presented through a set of indoor air quality metrics that were gathered during the height of the COVID-19 pandemic in the UK. Data from non-intrusive environmental monitoring units were remotely collected throughout 2021 from 36 naturally ventilated classrooms at two primary schools and two secondary schools in England. Measurements were analysed to assess the indoor CO2 concentration and temperature. Relative to UK school air quality guidance, the CO2 levels within classrooms remained relatively low during periods of warmer weather, with elevated CO2 levels being evident during the colder seasons, indicating lower levels of per person ventilation during these colder periods. However, CO2 data from the cold period during the latter part of 2021, imply that the per person classroom ventilation levels were significantly lower than those achieved during a similarly cold weather period during the early part of the year. Given that the classroom architecture and usage remained unchanged, this finding suggests that changes in the ventilation behaviours within the classrooms may have altered, and raises questions as to what may have given rise to such change, in a year when, messaging and public concerns regarding COVID-19 varied within the UK. Significant variations were observed when contrasting data, both between schools, and between classrooms within the same school building;suggesting that work is required to understand and catalogue the existing ventilation provisions and architecture within UK classrooms, and that more work is required to ascertain the effects of classroom ventilation behaviours. © 2022 The Author(s)

Neurodevelopment in Infants with Antenatal or Early Neonatal Exposure to SARS-CoV-2

Background. Antenatal and neonatal viral exposure may put the developing brain at risk for abnormal neurodevelopment. A clinical follow-up program was created in the Congenital Infection Program at Children's National Hospital to follow infants with in utero or early life exposure to SARS-CoV-2. The aim of this study was to determine if infants with early SARS-CoV-2 exposure have abnormal neurodevelopment in infancy. Methods. We performed a retrospective review of all infants evaluated in the follow-up program between 3/2020 - 11/2021. Demographic details, SARS-CoV-2 infection/ testing data, pregnancy/birth data, and specialty consult and NICU records were extracted from infants' medical charts. Infants were divided into 3 SARS-CoV-2 exposure groups: 1) antenatal exposure to symptomatic mother, 2) antenatal exposure to asymptomatic mother, 3) neonatal infection. All infants received a neurologic exam and developmental screening with the Ages and Stages Questionnaire (ASQ) in 5 domains (Communication, Gross Motor, Fine Motor, Problem Solving, Personal-Social) during their evaluation. The ASQ accounts for prematurity. Outcomes of interest were an abnormal neurologic exam or ASQ scores close to or below suggested cut-offs. Multivariate analysis was used to study correlations between exposure group and neurodevelopmental outcomes. Results. Thirty-five infants were seen for up to 3 outpatient visits. Most infants (83%) were exposed in utero - 16 to symptomatic mothers (Group 1) and 12 to asymptomatic mothers (Group 2);1 chart did not have symptom data. Six were exposed only as a neonate (Group 3). Group 1 had abnormal neurologic exams at mean (SD) age 112 (24) days (Table 1) and ASQ scores close to or below cut-offs for all domains (Fig. 1) more frequently than Groups 2 or 3. Group 1 was more likely to score below any ASQ cutoff compared to Group 2 (P=.04);of the 5 domains, differences were significant for Fine Motor (P=.01) and Personal-Social (P=.02). Conclusion. Early SARS-CoV-2 exposure may impact infant development, especially among those exposed in utero to a symptomatic mother. Vaccination and other precautions to reduce spread and symptoms may protect against early neurodevelopmental delays. Future work should prioritize longitudinal follow-up of children with early SARS-CoV-2 exposure. (Table Presented).

Relationships Between Gratitude and Mental Health Difficulties During the COVID-19 Pandemic in a Southern Region of the United States

Introduction: The extensive disruptions of the COVID-19 pandemic have led to heightened concerns about mental health sequelae. There has been significant interest in identifying factors associated with psychosocial vulnerability or resilience. Aims: This study examined associations of trait grat-itude with mental health difficulties among community residents in a southern state of the US. Methods: In this cross-sectional online investigation, 543 adults were assessed during an earlier phase of the pandemic, characterized by the reopening of facilities but mounting infection rates. Participants were evaluated using a validated measure of trait gratitude and clinically relevant screening assessments of depression, anxiety, and trauma symptoms. Results: After adjusting for a range of pandemic-associated burdens and sociodemographic factors, multivariable analyses indicated that gratitude was significantly related to diminished levels of depression, anxiety, and trauma. These effects remained significant after additional adjustment for other psychosocial resources (religiousness and perceived support). Conclusions: Findings provide novel information regarding relationships between gratitude and reduced mental health difficulties among community residents during a stressful period early in the pandemic. Results set the stage for longitudinal research. A disposition to identify and appreciate beneficial experiences might contribute to more favorable adaptation to communal crises, and warrants further investigation.

Outreach and educational activities within the EEE cosmic ray network

The Extreme Energy Events (EEE) network consists in a sparse array of telescopes based on Multigap Resistive Plate Chambers, installed in high school buildings all over the Italian territory and at CERN. Besides the many research activities concerned with extensive air shower detection, long distance correlation studies and additional physics results obtained during the last decade, the EEE project is extensively employed for educational and outreach activities, constituting a unique opportunity to promote a fruitful and close collaboration between students, high-school teachers and researchers. The involvement is at all levels, from the construction of the chambers during short stages at CERN over the past 15 years, with the participation of several hundred high-school students and teachers, to the installation, monitoring and data taking with the telescopes by high-school teams, to masterclasses, physics lectures, data analysis sessions and joint discussions on the results and their interpretation. Recent developments of the EEE network led to the installation and use of additional detectors in the Arctic region and on board of sailing ships, to measure the cosmic ray flux over large latitude intervals. Periodical remote and in presence (pre-Covid era) meetings allowed in these years a large participation (several thousand people) from the high-school community to the EEE activities. National and local outreach initiatives in cosmic ray physics are also carried out around Italy by the EEE network, as a contribution to the dissemination of science among young people. © Copyright owned by the author(s) under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0)

In Vitro Suppression of Feline Infectious Peritonitis Virus Infection by Ribonucleoside Analog Eidd-1931

The ribonucleoside analog EIDD-1931 is an RNA polymerase inhibitor and a broad-spectrum antiviral nucleotide that has been shown to inhibit replication of RNA viruses such as hepatitis C virus, Ebola virus, and human and animal coronaviruses. To assess the ability of EIDD-1931 to suppress feline infectious peritonitis virus (FIPV) replication in vitro, a feline macrophage cell line (fcwf-4) was infected with FIPV for 2 h and exposed to a range of EIDD-1931 concentrations, and the cells were cultured with agarose overlays for 96 h before using visual cell imaging to quantitate reduction in viral cytopathic effects (CPEs). An IncuCyte (Sartorius, Essen BioScience, USA) instrument was used to quantify cell confluence after fixation and crystal violet staining. The results showed that 100 nM and 10 nM concentrations of EEID-1931 significantly reduced the viral CPEs when compared with infected cultures without the drug (Figure 1). In addition, these drug concentrations were not cytopathic to the cultured fcwf-4 cells. Based on these findings: (1) the ribonucleoside analog EIDD-1931 is effective at suppressing FIPV replication in cells;and (2) the drug does not kill fcwf-4 cells at concentrations with strong antiviral activity. Thus, EIDD-1931 warrants further evaluation as a new agent for treatment of FIP in cats.

Growing health: building partnerships in healthcare and food systems for improved food access in Appalachia

"Hospitals not only provide access to healthcare services in rural areas;they also serve as major employers and economic drivers. The goal of this pilot study was to improve our understanding of how a rural healthcare system in Appalachian Kentucky could be leveraged to expand access to fresh fruits and vegetables. We conducted 11 semi-structured interviews with food system and healthcare stakeholders in Hazard, Kentucky, to (1) improve our understanding of key barriers to accessing and utilizing fresh produce for healthcare worker and patient populations, (2) identify models for direct-to-consumer market channels and farm-to-institution programming in collaboration with a local hospital, and (3) explore the potential of those models to foster greater consumption of fruit and vegetables among community members. Stakeholders emphasized the need for staff support and funding during program development and discussed the difficulty in maintaining prior local food and health promotion efforts when pilot funding expired. Other considerations included the importance of community ownership, robust communication and coordination among stakeholders, and attunement to the opportunities and challenges of a hospital-based approach. Direct farm-to-consumer models were considered feasible but would require accommodation for low-income consumers, such as vouchers, sliding-scale payment methods, or ""double dollar"" programs. Farm-to-hospital initiatives were discussed in the context of the COVID-19 pandemic and reduced hospital cafeteria usage, which may limit the success of some events but highlights the potential for to-go options such as pre-prepared salads, lightly processed snacks, and medically tailored meal kits. Results of this study illustrate the challenges and opportunities of leveraging a rural hospital as an anchor institution for expanding local food system development in rural Appalachia. This study also offers insights into the intersections of health, culture, and economy in an Appalachian community, and provides a framework for expanding local food system initiatives."

Comparison of Analgesic Efficacy in Attenuating Spontaneous Pain Behaviors in Rats (Rattus norvegicus)

Significant analgesic shortages and price increases have occurred since the COVID-19 pandemic, having direct implications on available treatment options thus impacting animal wellbeing, repeatability, and biomedical research. Traditionally, multimodal treatments (e.g., systemic with local analgesic) and opioids (e.g., buprenorphine) are recommended for mitigating major postoperative pain in rodents, although, in extenuating circumstances, other analgesics like nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g., meloxicam) must be used instead. However, the analgesic efficiency in attenuating spontaneous pain behaviors across treatment options has not been extensively evaluated in the rat laparotomy pain model. Here, we investigated whether extended-release buprenorphine (XR) was more effective at mitigating spontaneous pain behaviors in postoperative rats compared to other analgesic regimens. We hypothesized that XR would have the greatest analgesic effects in minimizing spontaneous pain behaviors and male XR rats would maintain longer therapeutic concentrations than other experimental groups. Sprague-Dawley rats (male n = 33;female n = 40) were randomly assigned by sex to 1 of 6 experimental groups: XR (0.65 mg/kg), buprenorphine (0.01 mg/kg), meloxicam (2 mg/kg), meloxicam with local bupivacaine (2 mg/kg and < 2 mg/kg, respectively), saline (5 mL/kg), and unoperated control. After subcutaneous drug administration, a 3-cm midline incision was made, penetrating the peritoneal cavity under isoflurane anesthesia. Spontaneous pain behaviors were evaluated using a subjective pain score, the open field arena test, and the burrowing test at baseline, 2, 24, 48, 72, and 168 hr postlaparotomy. Clinical observations were recorded daily and a gross necropsy was performed. Blood was collected for pharmacokinetic analysis from a separate cohort receiving identical analgesic doses (male n = 17;female n = 23). All groups displayed spontaneous pain behaviors as measured 2 hr postlaparotomy despite preemptive analgesic treatment (P < 0.02) and having therapeutic drug plasma concentrations. This study provides support that a multidimensional approach is warranted when investigating the analgesic efficacy and suggests more sensitive, objective outcome measures of spontaneous pain are needed.

Analysis of the restoration of cardiology diagnostics scope in the Russian Federation during the COVID-19 pandemic: results of the Russian segment of the INCAPS COVID 2 study under the auspices of the International Atomic Energy Agency

Aim. To assess the changes in cardiology diagnostics scope in the Russian Federation during the coronavirus disease 2019 (COVID-19) pandemic. Material and methods. In an online survey organized by the Division of Human Health of the International Atomic Energy Agency (IAEA), including questions about changes in the workflow of diagnostic laboratories and the scope of cardiac diagnostics from March 2019 (pre-pandemic) to April 2020 (first wave of the pandemic) and April 2021 (recovery stage), 15 Russian medical centers from 5 cities took part. Results. The decrease in the diagnostics scope by April 2020 by 59,3% compared to March 2019, by April 2021, stopped and was replaced by growth (+7,1%, the recovery rate, 112,1%). The greatest increase was in routine examinations, such as echocardiography (+11,6%), stress echocardiography (+18,7%), stress single photon emission computed tomography (+9,7%), and to a lesser extent resting computed tomography angiography (+7,0%) and magnetic resonance imaging (+6,6%). The performance of stress electrocardiography, stress magnetic resonance imaging and positron emission tomography for the diagnosis of endocarditis in April 2021 compared to March 2019 decreased by 10,3%, 63,2% and 62,5%, respectively. Conclusion. Due to the resumption of patient admissions for cardiac examinations during the ongoing COVID-19 pandemic, with the anti-epidemic measures taken and certain changes in the workflow, there has been a recovery in the diagnostics scope in most of the included centers. Copyright © 2022, Silicea-Poligraf. All rights reserved.

Covid-19 Vaccination Status and Menstrual Cycle Length in the Apple Women's Health Study

Objective: To prospectively determine whether COVID-19 vaccination is associated with change in menstrual cycle length following vaccination. Material(s) and Method(s): We conducted a longitudinal analysis within a subgroup of 13,018 participants in the Apple Women's Health Study (AWHS) who enrolled between November 2019 and December 2021, having met the following eligibility criteria: were living in the U.S., met minimum age requirements for consent, were English speaking, actively tracked their menstrual cycles, and responded to the COVID-19 vaccination update survey. Cycles tracked when participants were not pregnant, lactating, or using hormonal contraceptives were included. We used conditional linear regression and multivariable linear mixed-effects models with random intercepts to estimate the covariate-adjusted difference in mean cycle length, measured in days, between pre-vaccination cycles and post-vaccination cycles within vaccinated participants, and between vaccinated and unvaccinated participants. We present Bonferroni-adjusted confidence intervals to account for multiple comparisons. Result(s): A total of 120,815 cycles (median = 10 cycles per participant;interquartile range: 4-21) from 9,295 women (8,129 vaccinated;1,160 unvaccinated) were included. Forty-eight percent of participants received the Pfizer-BioNTech vaccine, 32% received Moderna, and 7% received Johnson & Johnson/Janssen. We found no evidence of a difference between mean menstrual cycle length in the unvaccinated and vaccinated participants prior to vaccination (0.16 days, 95% CI: -0.44, 0.75). Among vaccinated women, COVID-19 vaccination was associated with a small increase in cycle length for cycles containing the first dose (0.47, 95% CI: 0.17, 0.76) and cycles containing the second dose (0.36, 95% CI: 0.06, 0.65) of Pfizer-BioNTech or Moderna vaccines compared with pre-vaccination cycles. Cycles containing the single dose of Johnson & Johnson/Janssen were, on average, 1.22 days longer (95% CI: 0.41, 2.03) than pre-vaccination cycles. Post-vaccination cycles returned to average pre-vaccination length, with a 0.11 (95% CI: -0.17, 0.38) day increase in mean cycle length in the first cycle following vaccination, 0.12 (95% CI: -0.15, 0.40) in the second, -0.22 (95% CI: -0.50, 0.05) in the third, and -0.25 (95% CI: -0.52, 0.02) in the fourth cycle post-vaccination. Conclusion(s): COVID-19 vaccination was associated with an immediate short-term increase in menstrual cycle length. However, the magnitude of this increase diminished in cycles following vaccination, and no association with cycle length persisted over time. Impact Statement: Menstrual cycle change following COVID-19 vaccination appears temporary and should not discourage women from becoming vaccinated. Copyright © 2022

Improving Intranasal Naloxone Distribution for Harm Reduction in Emergency Departments

Introduction: The COVID19 pandemic has exacerbated the opioid epidemic in Ohio, with increased numbers of opioid overdoses recentl recorded. Emergency departments (EDs) commonly serve as a first point of medical contact for those with opioid overdose and those at risk for overdose. Access to addiction treatment and harm reduction resources within EDs is critical in preventing opioid overdoses and related deaths. Nationwide efforts to increase medication for opioid use disorder (MOUD) access have been underway largely through the use of buprenorphine-based medications;other strategies such as distribution of intranasal naloxone kits (i.e. Narcan) in the ED have not received as much attention. Since 2015, The Ohio State University Wexner Medical Center (OSU) at both its community and main campus hospitals has sought to increase the distribution of intranasal naloxone kits to those at risk of opioid overdose. Due to low distribution rates at these sites, in 2019 these kits were provided free-of-charge through the Ohio Department of Health Project DAWN (Deaths Avoided with Naloxone) initiative. Despite education efforts and staff training, these resources remain severely underutilized, with the community hospital outperforming the main hospital. Method(s): In a medical student driven project, the frequency of intranasal naloxone distribution to qualifying patients was tracked over a six-month period from January to June 2021. Inclusion criteria for eligible patients included those presenting with a chief complaint of opioid overdose, withdrawal, or those with history of OUD. In an effort to determine why distribution remains underutilized, a qualitative internet-based survey was deployed to nursing staff and prescribers (advanced practice practitioners, resident and attending physicians). To determine the perception of intranasal naloxone use for harm reduction and barriers to distribution, the survey queried the importance, perceived need, indications, and ability to distribute intranasal naloxone in a combination of yes/no and free-text responses. Result(s): Over the six-month study period, < 10% of more than 500 eligible patients received intranasal naloxone kits at both campuses. In total, 72 providers were interviewed, 27 of whom were prescribers and 45 were nurses. All participants completed the survey in its entirety. Survey results indicated that despite an adequate knowledge base, significant logistical barriers to distribution remained. This included not knowing the process required to order and dispense kits, a lack of clearly defined roles in the distribution process, and logistical issues in the physical location of kits throughout the ED. Conclusion(s): Despite willing and knowledgeable providers, logistical issues slowed intranasal naloxone distribution in a patient population more likely to leave against medical advice and less likely to interact with medical providers. This implies that even for those for whom a kit is ordered they may not have it in hand when leaving the ED, missing a rare opportunity to provide harm reduction devices to those most in need. Efforts are underway to improve distribution of the intranasal naloxone kits, including additional orientation for off-service interns, the development of a best practice advisory, and the utilization of standing orders.

A survey of hospice day services in the United Kingdom & Republic of Ireland : how did hospices offer social support to palliative care patients, pre-pandemic?

INTRODUCTION: Social support is described by patients and other stakeholders to be a valuable component of palliative day care. Less is known about the range of hospice services that have been used in practice that facilitate social support. An online survey aimed to gain an overview of all hospice day services that facilitated social support for adults outside of their own homes. METHODS: An online survey was distributed via email to people involved in managing hospice day services. Questions were asked on hospice characteristics, including staff and volunteer roles. Respondents were asked to identify services they felt offered social support to patients. Data collection took place between August 2017 and May 2018. RESULTS: Responses were received from 103 hospices in the UK and ROI (response rate 49.5%). Results provide an overview of hospice day and outpatient services that offer social support to patients. These are: multi-component interventions, activity groups, formal support groups, befriending, and informal social activities. Multi-component interventions, such as palliative day care, were the most commonly reported. Their stated aims tend to focus on clinical aspects, but many survey respondents considered these multicomponent interventions to be the 'most social' service at their hospice. The survey also identified a huge variety of activity groups, as well as formal therapeutic support groups. Informal 'social-only' activities were present, but less common. Over a third of all the services were described as 'drop in'. Most responding hospices did not routinely use patient reported outcome measures in their 'most social' services. CONCLUSIONS: The survey documents hospice activity in facilitating social support to be diverse and evolving. At the time of data collection, many hospices offered multiple different services by which a patient might obtain social support outside of their own home and in the presence of other patients.

BP CONNECT: REFERRING UROGYNECOLOGY PATIENTS WITH HIGH BLOOD PRESSURE FOR PRIMARY CARE FOLLOW-UP

Introduction: Elevated blood pressure (BP) is the leading modifiable risk factor for cardiovascular disease (CVD), the leading cause of death in women. Timely referral to primary care from subspecialty care occurs infrequently. BP Connect, a staff protocol for specialty clinics, almost doubled timely primary care follow-up for rheumatology patients with elevated BP (AOR 1.9, 1.4 - 2.5;from 29% to 42%). Objective: To evaluate the feasibility and impact of implementing BP Connect in urogynecology and gynecology clinics. Methods: In two academic urogynecology and gynecology clinics, the BP Connect intervention trained medical assistants and nurses to Check (re-measure) BPs above 140/90, Advise patients of links between BP and CVD, and Connect patients with confirmed high BP for timely primary care follow-up. Implementation included (1) tailored staff engagement focus groups;(2) staff education defining elevated BP (above 140/90) and CVD risk;(3) electronic health record (EHR) alerts prompting staff to re-measure elevated BPs and order timely (within 4 weeks) follow-up for confirmed high BP;(4) staff feedback (monthly audits);and (5) patient education and tools (brochure and BP log). Clinic staff were surveyed pre- and post-implementation about confidence and comfort with BP discussion and referral. Descriptive analyses compared rates of BP re-measurement, offers for and fulfillment of timely primary care follow-up in the 6 months before (08/2020-02/2021) and after (02/2021-08/2021) BP Connect implementation. Multivariable logistic regression, controlling for age, insurance, hypertension, and CVD, evaluated impacts on timely primary care follow-up. Results: BP was elevated in 676 pre-implementation and 708 post-implementation visits. Table 1 describes demographic and relevant medical history for these patient visits. The only statistically significant difference between the pre- and post-implementation visits was a higher proportion insured by Medicaid during pre-implementation (16% vs. 10%). The rate of BP re-measurement increased from 19% pre- to 75% post-implementation (p less than .0001). During postimplementation, among visits where patients had confirmed high BP, staff provided patient education in 83% and offered referral for primary care follow-up in 60% of instances. Overall, the rate of timely primary care follow-up for high BP increased from 28% before to 48% after implementation (p less than .0001) despite implementation during the COVID pandemic. BP Connect implementation resulted in a 12-fold increase in BP re-measurement among patients with high BP and a 2-fold increase in timely follow-up with primary care (Table 2). Staff confidence to do something about high BP increased from 27 to 67%;comfort discussing high BP with patients increased from 27 to 83%, and comfort coordinating referral to primary care for high BP increased from 9 to 42% (all p less than .05). Conclusions: BP Connect implementation was feasible in academic urogynecology and gynecology clinics and doubled the likelihood of patients with high BP having timely primary care follow-up without creating undue burden on subspecialty clinics. The impact of BP Connect in urogynecology and gynecology clinics on timely primary care follow-up was almost identical to that seen in the rheumatology clinics where the intervention was initially developed and tested. Future work will examine adaptation and expansion of BP Connect to other specialties and health systems (Table Presented).

Bebtelovimab, Alone and Together with Bamlanivimab and Etesevimab, as a Broadly Neutralizing Monoclonal Antibody Treatment and a Slow Intravenous Push Option for Ambulatory COVID-19

RATIONALE: Bebtelovimab is a potent, fully human monoclonal antibody targeting the S-protein of SARS-CoV-2, with broad neutralizing activity to all variants of concern (including Omicron), based on non-clinical assays. This study aimed to evaluate the efficacy and safety of bebtelovimab alone (BEB) or together with bamlanivimab (BAM) and etesevimab (ETE) for the treatment of mild-tomoderate COVID-19, delivered via slow intravenous push.METHODS : This portion of the phase 2 BLAZE-4 trial (NCT4634409) enrolled 706 patients (between May and July 2021) with mild-tomoderate COVID-19 within 3 days of first laboratory diagnosis of SARS-CoV-2 infection. Patients at low-risk for severe COVID-19 were randomized 1:1:1 (double-blinded) to placebo, BEB 175 mg, or BEB 175 mg+BAM 700 mg+ETE 1400 mg (BEB+BAM+ETE). Patients at high-risk for severe COVID-19 were randomized 1:1 (open-label) to BEB or BEB+BAM+ETE;a subsequent treatment arm enrolled patients to BEB+BAM+ETE using CDC expanded criteria for high-risk. All treatments were administered intravenously over ≥30 seconds (open-label BEB) or ≥6.5 minutes (all other treatment arms). For the placebo-controlled population (termed low-risk), the primary endpoint was the proportion of patients with persistently high viral load (PHVL) (log viral load >5.27) on Day 7. For the open-label population (termed high-risk), the primary endpoint was safety outcomes and statistics were descriptive. RESULTS : Baseline sequencing data was available for 611 patients, 90.2% (n=551) aligned with a variant of interest or concern (WHO designation), with the majority infected with Delta (49.8%) and Alpha (28.6%) variants. For the low-risk population, active treatment arms had a numerically lower proportion of patients with PHVL compared to placebo, albeit not at a level of statistical signficance (see Table). Viral load-area under the curve analysis from baseline to Day 11 showed signficant reduction for patients treated with BEB compared to placebo. Time to sustained symptom resolution was significantly improved among patients who received BEB relative to placebo. As expected, the incidence of COVID-19-related hospitalization or all-cause deaths by day 29 were similar within the low-risk population. Overall, results were similar between patients in low-risk and high-risk populations receiving active treatment (see Table). The majority of treatment emergent adverse events (AEs) were mild-to-moderate in low-risk (n=36/380,9.5%) and high-risk patients (n=46/326,14.1%). Serious AEs were reported in 7/326 (2.1%) high-risk patients;none were reported in low-risk patients.CONCLUSION: The safety and efficacy data support the further development of bebtelovimab delivered via slow intravenous push of at least 30 seconds. (Table Presented).

Labapalooza: What Happens When Students Return to In-Person Laboratories After Taking Laboratories Online for a Year?

Due to the COVID-19 pandemic, in-person undergraduate chemistry laboratories at North Carolina State University were not available to students during the 2020-2021 academic year and were replaced with online laboratories. With the return to in-person laboratories in the fall semester of 2021, there was widespread concern among the faculty that chemistry majors might struggle with the application of concepts and techniques that they learned online in the in-person lab environment. An event to bring students back to campus for a day was designed by the faculty in charge of teaching organic and analytical chemistry laboratories with extensive input from students. Participants were asked to choose the lab techniques that they wanted to review, were given agency to choose the day and time of the gathering, and were encouraged to suggest a name for the event. In this paper we describe the outcomes regarding student choices, participation, and self-assessed efficacy before and after testing in person the lab techniques that had been learned online.

BAMLANIVIMAB PLUS ETESEVIMAB for the TREATMENT of COVID-19 in PEDIATRIC PATIENTS

Background: There are no authorized or approved treatments in the US for COVID-19 in patients <12 years of age. SARS-CoV-2 neutralizing monoclonal antibodies bamlanivimab and etesevimab together (BAM+ETE) reduce COVID-19 related hospitalization and all-cause mortality in patients ≥12 years of age with mild to moderate COVID-19. Herein, we present the pharmacokinetic (PK), safety, and efficacy results from an open-label Phase III clinical trial addendum (BLAZE-1, NCT04427501) investigating weight-based dosing of BAM+ETE in pediatric patients at increased risk for severe COVID-19. Methods: A total of 91 pediatric patients (<18 years of age) were evaluated for PK. Pediatric patients weighing ≥40kg received 700mg BAM+1400mg ETE. Pediatric patients weighing less than 40kg received weight-based dosing to match the exposures observed in adults and adolescents (12 to <18 years of age) who received the authorized dose of 700mg BAM+1400mg ETE. Twenty additional adolescent patients (12 to <18 years of age) received BAM+ETE in controlled BLAZE-1 cohorts and were included in safety and efficacy analyses. All ambulatory patients had mild to moderate COVID-19 upon enrollment, at least one risk factor for severe COVID-19, and received treatment within 3 days of a positive SARS-CoV-2 test. The primary objective was to characterize the pharmacokinetics of weight-based dosing of BAM+ETE in pediatric patients. Results: Of the 111 pediatric patients who received BAM+ETE, the median age was 12 and age distribution was 12 to <18 (n=60), 6 to <12 (n=36), 2 to <6 (n=10), and 0 to <2 (n=5). Overall, 47.7% were female, 19.1% were Hispanic/Latino, and 62.4% were Black/African American. In patients receiving weight-based dosing, the AUC for both BAM and ETE in pediatric patients was similar (within 90% interval) to adults (Figure). For all pediatric patients, there were no reports of hospitalizations, serious adverse events, or deaths. At Day 7, pediatric patients had a change in viral load from baseline of-4.10 (normalized baseline viral load of 6.41) as compared to-3.65 (normalized baseline viral load of 6.75) in adult patients. The median time to complete symptom resolution was 5 days for all pediatric patients. Conclusion: The weight-based doses administered to pediatric patients provided similar drug exposures when compared to adult patients who received the authorized dose of 700 mg BAM+1400mg ETE. Treatment in pediatric patients was well-tolerated and resulted in favorable viral load reduction and symptom resolution.