Effect of Covid-19 Lockdown on Mobility and Traffic Accidents in Malaysia

With the rapid spread of the coronavirus (COVID-19), the Malaysian government implemented a series of lockdown measures to break the chain of COVID-19 within the community. The lockdown measures were separated into three phases, namely movement control order (MCO), conditional movement control order (CMCO), and recovery movement control order (RMCO). Due to limited research conducted, this paper aims to investigate the effect of COVID-19 lockdown on mobility and traffic accidents in Malaysia. Quantitative data were collected from the internet and the government agency. They were analysed through descriptive and inferential statistics. Descriptive statistics were used to analyse the changes in mobility and the number of traffic accidents in different aspects. Meanwhile, inferential statistics such as simple regression analysis were applied to validate the relationship between mobility and the number of accidents. The results were presented using graphical and tabular methods. The findings show that the mobility dropped by 64% on average during MCO compared to a baseline value computed during the pre-lockdown period. The reduction in mobility during CMCO and RMCO was 40% and 15%, respectively. Next, the regression analysis reveals a strong positive relationship between mobility and the number of traffic accidents. Hence, the reduction in traffic accidents can be concluded as an impact of COVID-19 lockdown. The reduction in the number of accidents during the three lockdown periods was: MCO (73%), CMCO (46%), and RMCO (19%), compared to the average of 2015- 2019. Besides, it was found that the reduction in the number of traffic accidents was greater than the reduction in mobility during the lockdown periods. This suggests that traffic reduction has a multiplicative effect on road safety. Moreover, the findings reveal that the reduction in severe and fatal accidents was greater than the reduction in mobility. This suggests a positive effect of COVID-19 lockdown on the severity of traffic accidents. This study provides an insight into the effect of COVID-19 lockdown on traffic patterns in Malaysia. It also provides important implications for traffic management. © 2023 American Institute of Physics Inc.. All rights reserved.

Effect of Alcohol Intoxication in the Emergency Department on Suicide Mortality

Introduction: Suicide represents a significant worldwide disease burden disproportionately affecting younger patients in their prime working years. Mortality by suicide remains within the five leading causes of death up to the age of 60. Compounding this, alcohol use disorder (AUD) is known to be a risk factor for death by suicide and has been on the rise over the last 20 years, particularly during the COVID-19 pandemic. The emergency department (ED) is often the first point of health care contact for those patients that have suicidal thoughts or behaviours and understanding their acute risk of death by suicide when presenting intoxicated with alcohol remains a challenge for ED physicians. While the chronic disease of AUD elevates their lifetime risk for death by suicide, it has not been established how a presentation for suicidality accompanied by acute alcohol intoxication affects this risk. Method(s): This was a retrospective cohort study using population-based linked health administrative data for adult patients aged 18 or above who presented to Alberta (ED) between 2011 and 2021 for suicidal attempt or self-harm behavior. Patients who were acutely intoxicated with alcohol were identified and analyses compared patients with and without alcohol intoxication. The primary outcome was six-month death by suicide. Categorical variables were summarized using proportions, whereas continuous variables were summarized using means and standard deviations (SD) or medians and interquartile ranges (IQR), as appropriate. Competing risk analysis was performed to explore the cumulative incidence of death by suicide within 180 days after their index ED visit and examine the association between death by suicide and alcohol intoxication. Result(s): Patients presenting to the ED for suicide attempt or self-harm behaviour were intoxicated with alcohol in 30% of cases as determined by diagnostic coding and blood alcohol measurements. Intoxicated patients were more likely to be placed under involuntary mental health hold (26% vs 16%) and had on average a longer length of stay in the ED (411 min vs 277 min) but were less frequently admitted (10.8% vs 15.4%). As a departure from previous literature, those intoxicated with alcohol were more likely to be consulted to psychiatry (15.8% vs 12.6%). Mortality due to suicide in the 6 months following the patient' index ED visit were similar between the intoxicated and non-intoxicated groups (0.3% vs 0.3%) however there was a significant increase in all-cause mortality at 6 months in the nonintoxicated group (1.5% vs 2.1%). Discussion(s): This study examined the patient and ED treatment characteristics of patients presenting to the ED with suicide attempt or self-harm behaviour. It found that the 6-month risk of death by suicide was no different in those who presented with acute alcohol intoxication vs those without. While these results differ from other studies discussing how alcohol use disorder confers a chronically increased risk of death by suicide, they provide new evidence for the emergency department providers to consider when assessing the patient who presents with suicidal behaviours while intoxicated.

The spatial and temporal resilience of the tourism and outdoor recreation industries in the United States throughout the COVID-19 pandemic

Accurately quantifying industry resilience is essential to devising effective recovery strategies. Previous research into industry resilience has either quantified the concept with single metrics aggregated across large geographies (e.g., visitation) or used metrics comparing the relative concentration of an industry within a region to the national average (e.g., location quotients). The former set of metrics prohibits spatially targeted recovery efforts while the latter fails during national crises. We propose the measurement of tourism and outdoor recreation industry resilience to COVID-19 based on growth rates in employment, wages, and establishments using publicly accessible time-series data on all counties in the United States. We use these indicators to characterize the spatio-temporal patterns of industry resilience across the country. The indicators can serve as a useful reference for diagnosing and monitoring industry resilience as well as developing targeted policies, programs, and promotion efforts that facilitate more localized response efforts. © 2022 Elsevier Ltd

Going solo during the pandemic: a generational segmentation of solo female travellers

This paper is driven both by a growing appetite for solo female travel;as well as a knowledge gap in the market and literature. The aim is to identify generational differences in women's solo travel motivations, characterize the generational differences in their preferred destination attributes, and ascertain any generational differences in their perceived inhibiting factors to travelling solo post the COVID-19 pandemic. By using the push–pull framework theory as the overarching framework, a survey was administered and 1576 responses from experienced solo female travellers were analysed. The findings revealed the different generations of solo female travellers and their distinctive travel needs (push factor/motivation, pull factor/destination preference, and inhibiting factors/risk & constraint) during the COVID pandemic. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

DIGITAL DIVIDE AND DIFFICULTIES IN ACQUIRING HEALTH RESOURCES IN DISABLED OLDER ADULTS DURING THE PANDEMIC

The digital divide refers to the gap between those who are connected and those who are not connected to the internet and technologies. Although COVID-19 worsens the digital divide and health inequality, few studies have focused on the relationship between digital divide and difficulties in acquiring of health resources during the pandemic. This study aimed to identify the relationship between internet use and difficulties in acquiring health resources among older adults with disabilities during the COVID-19 pandemic. This secondary analysis study included 4,871 older adults aged 55 and older among 7,025 total responders of the 2020 survey of people with disabilities in South Korea. As the results, only 23.7% of older adults with disabilities used the internet. Non-internet users are more likely to have difficulties in acquiring COVID-19-related information (aOR 1.59) and buying and using personal protective equipment (aOR 1.36). However, difficulties in using medical services (aOR 1.21) was not statistically significant. Considering that older adults with disabilities have triple burdens from old age, disabilities, and the digital divide amid COVID-19, healthcare providers need to pay more attention to mitigate gaps between internet users and non-non users among this population. By narrowing the digital divide, decreasing health gaps and increasing well-being among older adults with disabilities will be guaranteed.

An Art-Based Inquiry into the Perception of Tourism Impacts on Their Quality of Life: The Case of Cambodian Host-Children

While host-children are vulnerable to tourism impacts, the tourism literature has neglected how these impacts affect host-children's quality of life (QOL). The concept of QOL is ambiguous, and the influence of a host-guest relationship on residents' QOL has been overlooked. This paper addresses these gaps by exploring how host-children in a developing country perceive tourism impacts on their QOL, focusing on power dynamics in a host-guest relationship. Data were collected from 94 Cambodian host-children using qualitative methods, including drawings and group interviews. The findings revealed Cambodian host-children's perceptions of tourism impacts over five life domains-material, learning opportunity, cultural pride, emotion, and child sex tourism/trafficking. Despite their perception of negative impacts, all host-children believed that tourism had improved their QOL. The paradox of QOL is explained through Bottom-up Spillover Theory incorporated with Social Exchange Theory. Practical implications for post-COVID and directions for future research are suggested.

Increasing Computational Protein Design Literacy through Cohort-Based Learning for Undergraduate Students

Undergraduate research experiences can improve student success in graduate education and STEM careers. During the COVID-19 pandemic, undergraduate researchers at our institution and many others lost their work- study research positions due to interruption of in-person research activities. This imposed a financial burden on the students and eliminated an important learning opportunity. To address these challenges, we created a paid, fully remote, cohort based research curriculum in computational protein design. Our curriculum used existing protein design methods as a platform to first educate and train undergraduate students and then to test research hypotheses. In the first phase, students learned computational methods to assess the stability of designed protein assemblies. In the second phase, students used a larger data set to identify factors that could improve the accuracy of current protein design algorithms. This cohort based program created valuable new research opportunities for undergraduates at our institute and enhanced the undergraduates' feeling of connection with the lab. Students learned transferable and useful skills such as literature review, programming basics, data analysis, hypothesis testing, and scientific communication. Our program provides a model of structured computational research training opportunities for undergraduate researchers in any field for organizations looking to expand educational access.

The role of coworking spaces in the changing landscape of future workplace agility: linking boundary organization theory and organizational development models

Purpose: This study aims to illustrate the potential of coworking spaces as one way to achieve optimal workplace arrangements and corporate real estate (CRE) agility, especially for large organizations. The authors suggest understanding coworking spaces from the boundary organization theory and organizational growth model. Design/methodology/approach: This study takes a threefold theoretical approach: conducting a literature review and identifying the gaps in coworking studies for large organizations, applying the organizational boundary theory in tandem with organizational growth models in the context of coworking spaces as a part of the workplace ecology and identifying future research agendas for coworking studies. Findings: This study proposes a conceptual framework of how coworking spaces can be viewed and used as a boundary object throughout the organizational growth phases. Besides, four major future research areas are proposed: case studies and/or empirical evidence of coworking spaces as CRE buffer zones and boundary objects for organizations, coworking space design and different formats of boundary object-infused collaboration, coworking space design and management for its own agility and flexibility and how coworking affects employees’ performance, health and well-being and professional training/mentoring. Practical implications: For large organizations, there is a clear pressure to rethink CRE to increase workplace agility, flexibility and resilience, much accelerated with the recent COVID-19 pandemic. Understanding the effective use of coworking spaces as a part of CRE portfolios will help enhance corporates’ state and ability to reassess, realign and replan their CRE portfolios. Originality/value: Many existing studies about coworking spaces are based on observations and self-reported justification at an individual level. Whether and how coworking can benefit companies at an organizational level is largely unstudied and worth more attention. This study illustrates a new theoretical understanding of how coworking spaces can be a part of CRE portfolios and bring potential benefits of inter and intraorganizational collaboration throughout the phases of organizational growth. © 2022, Emerald Publishing Limited.

Opportunities and Challenges of Implementing a Virtual Acupressure Service for Cancer Patients During COVID-19: A Retrospective Analysis

Methods: The study is a retrospective analysis of a virtual acupressure service administered from May to December 2020 at a National Cancer Institute-designated Comprehensive Cancer Center. A semi-standardized virtual acupressure protocol was developed, consisting of 50 min, one-on-one session between the acupuncturist and patient. At the start of each session, the acupuncturist assessed the patient's symptom burden using the Edmonton Symptom Assessment Scale (0-90), for which higher scores represent greater symptom severity. Changes in ESAS scores from baseline to follow-up were evaluated using paired t-test for patients with follow-up within 14 days of baseline. Acupuncturists held weekly group meetings to discuss challenges and ways to improve the delivery of tele-acupressure. Results: A total of 102 virtual acupressure sessions were administered to 32 unique patients. Most patients were females (90.6%) and white (84.4%), the mean age was 55.7 (range=26-82;SD=15.73), and the most common cancer diagnosis was breast (53.1%). Of 32 patients, 13 had follow up in 14 days or less. For these 13 patients, there was a statistically significant reduction in total symptom burden (-4.85±7.6;p=0.04) from baseline to follow-up. Based on the acupuncturists' experiences, various factors were discussed and considered important in implementing virtual acupressure, including effective communications (e.g., both verbal and nonverbal cues), potential technological barriers (e.g., technology literacy), and healing environment (e.g., physical space and/or virtual background appearing on the screen). Background: Oncology acupuncture service was disrupted by COVID-19, and a virtual acupuncturist-guided, patient self-acupressure intervention was implemented. We explore the potential impact of tele-acupressure on patient-reported symptoms and summarize acupuncturists' experiences on the challenges and opportunities of implementing a virtual acupressure service for cancer patients. Conclusion: Virtual acupressure may be a promising therapy for symptom management, especially when in-person acupuncture service may not be feasible, but further research is needed to rigorously evaluate its safety and efficacy among cancer patients.

Severe hypernatremia in soft drink ketoacidosis and hyperglycemic hyperosmolar state at the onset of type 2 diabetes mellitus: a case series of three adolescents

Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are diabetic emergencies. Some patients with a hyperglycemic crisis can present with an overlap of DKA and HHS. The coexistence of DKA and HHS is associated with higher mortality than in isolated DKA and HHS. In addition, electrolyte derangements caused by global electrolyte imbalance are associated with potentially life-threatening complications. Here, we describe three cases of mixed DKA and HHS with severe hypernatremia at the onset of type 2 diabetes mellitus. All patients had extreme hyperglycemia and hyperosmolarity with acidosis at the onset of diabetes mellitus. They consumed 2 to 3 L/d of high-carbohydrate drinks prior to admission to relieve thirst. They showed severe hypernatremia with renal impairment. Two patients recovered completely without any complications, while one died. Severe hypernatremia with mixed DKA and HHS is rare. However, it may be associated with excess carbohydrate beverage consumption. Reduced physical activity during the COVID19 pandemic and unhealthy eating behaviors worsened the initial presentation of diabetes mellitus. We highlight the impact of lifestyle factors on mixed DKA and HHS.

Comprehensive meta-analysis of COVID-19 mortality rates for 22 cancer subtypes from the Reboot: COVID-Cancer Project, an interactive resource with aggregated data from 21,839 cancer patients

Introduction: The COVID-19 pandemic continues to disproportionately impact people with cancer. Mortality estimates among cancer patients vary and are influenced by numerous factors including cancer type, treatment, disease stage, and patient demographics. To date, attempts to explore these associations have been limited by small cohorts. Methods: Here, we present a meta-analysis of data available through the Reboot: COVID-Cancer Project, a living and freely available resource that includes published clinical studies that report outcomes for cancer patients with COVID-19. Studies were identified using targeted search queries in PubMed, MedRxiv, BioRxiv, and the SSRN eLibrary, followed by rule-based approaches and extensive manual validation and data extraction. The data is updated monthly and can be explored through an interactive dashboard as well as downloaded. Case fatality rates (CFR;the number of deaths per 100 confirmed cases during the study period) were calculated using a random-effects model. Study heterogeneity and sample size bias was assessed using the Egger regression test. Results: As of December 18, 2020, the resource contained 225 publications comprising 21,839 cancer patients with COVID-19. Of these, there was sufficient sample size to quantify CFRs for 22 cancer types across 19,147 patients from 109 publications. The pooled CFR among all cancer patients was 27% (95% CI: 25-30%). For solid tumors and hematological malignancies, the CFRs were 23% (95% CI: 20-25%) and 30% (95% CI: 27-33%), respectively. Within solid tumors, patients with lung (CFR: 32%, 95% CI: 27-36%), prostate (CFR: 30%, 95% CI: 17-43%), and central nervous system (CFR: 27%, 95% CI: 18-36%) malignancies had relatively high CFRs, whereas patients with breast (CFR: 10%, 95% CI: 7-14%) and thyroid (CFR: 5%, 95% CI: 1-11%) malignancies had relatively low CFRs. Among patients with hematological malignancies, CFRs ranged from 10% (95% CI: 3-18%) in patients with chronic myelogenous leukemia to 39% (95% CI: 20-57%) in patients with acute myeloid leukemia. Discussion: We observed significant heterogeneity of COVID-19 CFRs between cancer subtypes. This may in part reflect differences in patient demographics, treatment history, or disease state. Subtype-specific analysis can stratify cancer patients by risk for COVID-19 mortality and advise management strategies. The Reboot: COVID-Cancer Project provides an accessible means to evaluate subtype-specific COVID-19 fatality rates on a by-publication basis.

Effects of COVID-19 treatments on cancer: A machine learning approach to synthesize clinical evidence at scale

Introduction: More than 200 treatments have been tested for COVID-19 in over 7000 clinical trials. Most of these treatments are repurposed generic drugs, many of which have been studied extensively for the treatment of cancer. As cancer patients are particularly vulnerable, there is a need to understand how COVID-19 treatments might affect a patient's cancer. As part of the Reboot: COVID-Cancer Project, a living and freely available resource of clinical studies that report outcomes for cancer patients, we have developed a semi-automated pipeline to identify all relevant published clinical studies and registered clinical trials where COVID-19 drugs were tested for the treatment of cancer. Methods: Published clinical studies were assembled using targeted search queries in PubMed, rule-based approaches, and machine learning models. Machine learning models applied to natural language processing tasks were used to predict the drug, cancer type, study type, and therapeutic association. We used domain-specific rules and post-processing steps to further refine results, including determining whether a drug was used alone or in combination. Registered clinical trials were compiled from clinicaltrials.gov using targeted search queries, automated mapping, and rule-based screening. We extracted key information about each trial, such as the drug, cancer type, phase, location, trial status, age, gender, and availability of results. We applied our pipeline to a curated set of 202 drugs being tested for the treatment of COVID-19 in at least two interventional clinical trials worldwide, of which 27 are FDA-approved drugs that are standard of care for cancer, and 115 are FDA-approved drugs primarily used for non-cancer indications. Results: We found 28,138 published clinical studies and 9,118 registered clinical trials where the 202 drugs were tested for cancer. The published clinical studies include 5,286 case studies, 2,559 randomized controlled trials (RCTs), and 20,294 non-RCT clinical trials or observational studies. In 37% of the cases, the drug was used alone and not in combination. Lymphoid cancers were the most commonly tested, comprising 30% of studies. Possible benefit of the drug was found in 64% of publications. Of the 115 FDA-approved non-cancer drugs being tested for COVID-19, there is at least one published clinical study for 84 (73%) drugs. An additional 12 FDA-approved non-cancer drugs have been tested for the treatment of cancer in clinical trials, but have no results reported. Of the registered clinical trials, 39% are currently active, 66% are Phase 2 or later, and lymphoid cancers are again the most common, representing 29% of the trials. Discussion: Given the interconnection between COVID-19 and cancer, it is essential to understand how drugs used for COVID-19 might impact a patient's cancer. We have created a living resource for rapid review of information. The datasets are updated monthly and are freely available via an interactive dashboard.

Work in Progress: Development and Evaluation of Self-Contained, Shippable Outreach Experiments for Online Implementation in K-12 Classrooms

Due to COVID-19, more students are transitioning to online classrooms. This poses a problem for STEM educators as students are limited in their ability to learn about the scientific process or scientific thinking through hands-on experimentation. Additionally, outreach programs that are designed to increase interest and participation in STEM face a challenge of not being able to enter the physical classroom for activities. To address these needs, a program was developed to create self-contained experimental kits that could be shipped to students' homes. This allows students to gain the same outreach experience that they might have had in the classroom without leaving the safety of their home. Additionally, it removes the burden on parents of having to purchase outreach materials. The contents of the kits were designed with the following constraints: 1) experiments must be easy to complete with minimal instructions, 2) there must be a limited mess and 3) they must be easily and inexpensively shipped. With these constraints, four experiments were developed: analyzing the pH of household acids and bases using a red cabbage indicator (chemical engineering), building a popsicle-stick bridge (civil engineering), creating a drinking-straw prosthetic hand (biomedical engineering), and assembling an automatic LED night light (electrical engineering). The instructional guides to the kits include background information about the STEM topic, methods for completing the experiment, tables for data collection, and/or analysis questions about the data. To ensure the clarity of the instructions, recommendations were taken from a non-target audience to refine the materials. The kits were piloted on college-aged peers who have varying degrees of expertise in the subjects. Peers were asked to assess the clarity of the activity, provide feedback on the quality of the experiment, and complete questions for the pretest and posttest on the topic matter covered in the instructional guides. Results from this study will be used to refine the outreach kits prior to implementation with K-12 students. While originally designed to address the limitations in place due to COVID-19, this project can expand the outreach program to areas where in-person programs can be challenging. With considerate development, expansion to Appalachian regions can provide students with more exposure to STEM, while also allowing them to interact with engineering students from the University of Kentucky. © American Society for Engineering Education, 2021

Inflammation of sars-cov2-infected human pluripotent stem cell-derived cardiomyocytes and the effects and side effects of remdesivir

Introduction: The global pandemic of the coronavirus 2019 disease (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In addition to respiratory failures, COVID-19 patients exhibited cardiac complications. Studies observed the direct infection and replication of SARS-CoV2 in human pluripotent stem cell-derived cardiomyocytes (hPSC-CMs) accompanied by cytopathic effects. However, the underlying mechanisms of SARS-CoV-2-mediated CM death remain poorly understood. In addition, the therapeutic potential of remdesivir (RDV) on CMs has yet to be answered. Methods and Results: We confirmed that SARS-CoV-2 is infectious to and effectively replicates in hPSC-CMs and is cytopathic to hPSC-CMs. We also found that RDV effectively inhibited viral replication at a concentration of 50 nM. RNA-seq analyses demonstrated that expression of immune responsive genes was elevated in SARS-CoV-2 infected hPSC-CMs. Immunostaining and an ELISA assay further revealed formation of inflammasomes and secretion of inflammasome-mediated cytokines, such as IL-1β, IL-18, and IL-6 in SARS-CoV-2 infected hPSC-CMs. RNA-seq analyses showed gene profile changes in SARS-CoV-2 infected hPSC-CMs corroborating with activation of inflammatory signals and cell death pathways. While gene profiles of 0.1 μM RDV-treated SARS-CoV-2-infected hPSC-CMs showed reversal of such changes, a high dose (10 μM) RDV-treated CoV-2-infected hPSC-CMs showed changes in 44% of genes expressed compared to non-RDVtreated CoV2-infected hPSC-CMs. Among those, expression of protein stability related genes, such as genes associated with autophagy and protein ubiquitination increased while expression of antiviral responsive genes decreased. In addition, a high dose of RDV inhibited expression of mitochondrial genes, particularly MitoComplex I and V compositions, which are related to energy production. Conclusions: This study demonstrates that SARS-CoV2 induced inflammasome in hPSC-CMs, which can underlie cardiac damage in addition to direct cytopathic effects. In addition, RDV can reduce inflammasome when introduced early after SARS-CoV2 infection while a high-dose can aggravate cytopathic effects by potential toxicity to mitochondria.

Does working from home work? Experience of working from home and the value of hybrid workplace post-COVID-19

Purpose This study aims to understand how knowledge workers working from home during COVID-19 changed their views on physical work environments and working-from-home practices. Design/methodology/approach This study conducted a survey targeting workers in the USA recruited via Amazon Mechanical Turk. A total of 1,651 responses were collected and 648 responses were used for the analysis. Findings The perceived work-life balance improved during the pandemic compared to before, while the balance of physical boundaries between the workplace and home decreased. Workplace flexibility, environmental conditions of home offices and organizational supports are positively associated with productivity, satisfaction with working from home and work-life balance during the pandemic. Research limitations/implications While the strict traditional view of "showing" up in the office from Monday through Friday is likely on the decline, the hybrid workplace with flexibility can be introduced as some activities are not significantly affected by the work location, either at home-based or corporate offices. The results of this study also highlight the importance of organizations to support productivity and satisfaction in the corporate office as well as home. With the industry collaboration, future research of relatively large sample sizes and study sites, investigating workers' needs and adapted patterns of use in home-based and corporate offices, will help corporate real estate managers make decisions and provide some level of standardization of spatial efficiency and configurations of corporate offices as well as essential supports for home offices. Originality/value The pandemic-enforced working-from-home practices awaken the interdependence between corporate and home environments, how works are done and consequently, the role of the physical workplace. This study built a more in-depth understanding of how workers who were able to continue working from home during COVID-19 changed or not changed their views on physical work environments and working-from-home practices.