Change in glycaemic control immediately after Covid-19 vaccination in people with type 1 diabetes: What happens after the most recent vaccination?

Aims: We have shown previously in 93 individuals with type 1 diabetes using the FreeStyle Libre flash glucose monitor that the week after their first Covid-19 vaccination, the percent 'time in target range 3.9-10mmol/ l' (%TTR) average went from 55.2%-> 52.4% (effect size -5.1%) with 58% of people recording a fall. 47 (50%) people with HbA1c < 56mmol/mol %TTR went from 69.3-> 63.5 (-8.3%) and 24 (25%) people using insulin+oral treatment 56.7%-> 50.7% (-10.1%). We have now repeated the exercise after the most recent Covid-19 vaccination. Method(s): FreeStyle Libre data and medical records of the same patients from the previous study were examined for the week before and week after their most recent Covid-19 vaccination. () in the results section show change in %TTR as % of the prior value to show effect size. TTR% results from 2 weeks before and after were also considered. Result(s): Median time between vaccines was 38 weeks IQR (37-40). After the latest vaccination average %TTR average went from 51.1%-> 49.8% (-2.5%) with a reduction found in 54% of patients. Impact on the 39 patients with HbA1c < 56mmol/mol -% TTR from 66.2%-> 61.8% (-6.5%) and the 20 (25%) patients using insulin+oral %TTR from 48.2%-> 47.1% (-2.2%). 65% of the patients whose %TTR fell previously, fell again after this vaccination. Fortnight average %TTR 53.5%-> 52.1% (-2.7%) whereas in the previous study across fortnight %TTR 55.4%-> 54.0% (-2.4%). Conclusion(s): The perturbation effect on blood glucose with 1st Covid-19 vaccination was seen again in the latest vaccination but reduced in magnitude, confirming that a significant group of type 1 diabetes individuals' glycaemic control is still being impacted by the Covid-19 vaccination.

Editorial Perspective: When is a 'small effect' actually large and impactful?

Reporting of effect sizes is standard practice in psychology and psychiatry research. However, interpretation of these effect sizes can be meaningless or misleading - in particular, the evaluation of specific effect sizes as 'small', 'medium' and 'large' can be inaccurate depending on the research context. A real-world example of this is research into the mental health of children and young people during the COVID-19 pandemic. Evidence suggests that clinicians and services are struggling with increased demand, yet population studies looking at the difference in mental health before and during the pandemic report effect sizes that are deemed 'small'. In this short review, we utilise simulations to demonstrate that a relatively small shift in mean scores on mental health measures can indicate a large shift in the number of cases of anxiety and depression when scaled up to an entire population. This shows that 'small' effect sizes can in some contexts be large and impactful.

Resiliency among Older Adults Receiving (Roar) Lung Cancer Treatment: A Feasibility Study

PURPOSE/HYPOTHESIS: Poor physical performance and negative mood are two risk factors for functional decline among older adults with lung cancer. Yet, targeted interventions to maintain independence prevent functional decline are not well studied. Our primary objective was to assess the feasibility of a novel virtual health physical therapy (PT) plus progressive muscle relaxation (PMR) intervention with longitudinal microbiome biospecimen collection delivered to older adults with advanced lung cancer. Secondary objectives were to characterize functional status and clinical factors pre and post-study intervention. NUMBER OF SUBJECTS: We accrued adults aged >=60 years with advanced non-small cell or extensive-stage small cell lung cancer receiving treatment at The Ohio State University James Comprehensive Cancer Center (OSU-JCCC) in the Thoracic Oncology department (N=22). There were no exclusion criteria pertaining to Eastern Cooperative Oncology Group (ECOG) performance status, laboratory values, prior cancer diagnoses, presence of comorbidities, or brain metastases. MATERIALS AND METHODS: Participants were asked about functional status, symptoms, mood through the PHQ-9, GAD-7, POMS, and acceptability questions about the program. PT evaluation and assessment included SPPB and 2- or 6-minute walk test outcomes. The study sought to collect gut microbiome samples for every in-person visit and activity monitoring data (Actigraph) on a subset. Feasibility was defined as successfully collecting specimens, wearing an Actigraph activity monitor, and adhering to the intervention. PT and psychologists evaluated participants in-person at the first and final visit. The rest of the 12-week intervention was conducted via virtual health. Physical therapy intervention consisted of endurance, strength, and flexibility exercises. RESULT(S): In total, 22 patients consented and 18 started the intervention (81.8%). Seven microbiome samples were collected from four participants. Six patients collected activity monitoring data. Among the 18 participants, 11 participants (61.1%) completed 70% or more of all the intervention visits. The SPPB data show a moderate effect size (Cohen's d=0.24) from pre- to post-data. On average patients improved by 1.8 total points on the SPPB. Patients demonstrated improvement on timed walk tests throughout intervention from an average of 108 feet pre-intervention to an average of 138.4 feet post intervention. CONCLUSION(S): Despite the challenges of the COVID-19 pandemic, longitudinal biospecimen and correlative data collection were feasible in the context of PT and PMR intervention among older adults with advanced lung cancer. Virtual physical therapy interventions can be safely delivered to improve physical performance as demonstrated by a moderate effect size for the SPPB in this patient population. CLINICAL RELEVANCE: Based on the feasibility study results, delivering a virtual PT intervention to older patients with lung cancer can improve SPPB score leading to decreased frailty and improve quality of life among patients.

Early Use of Ibuprofen in Moderate Cases of COVID-19 Might be a Promising Agent to Attenuate the Severity of Disease: A Randomized Controlled Trial

Introduction: Critically ill COVID-19 patients undergoing cytokine storm are believed to have a worse prognosis and increased fatality rate. Ibuprofen is a non-steroidal anti-inflammatory drug (NSAIDs) that might prove beneficial for the early management of COVID-19 due to its immunomodulatory effects. This study aimed to assess the efficacy and safety of the early use of ibuprofen to attenuate the severity of the course of COVID-19 and improve outcomes in patients diagnosed with a moderate case of COVID-19 disease. Method(s): This randomized, double-blinded prospective study was conducted from January, 2022 to May, 2022, which included a total sample size of 180 patients with moderate cases of COVID-19. The number of patients transferred to intensive care was used as a primary outcome with a proposed large effect size (0.8), alfa =0.05, and power=0.80, so 90 cases were included in each group. Secondary outcomes were inflammatory markers: C-Reactive Protein (CRP), serum ferritin, and interleukin-6 (IL-6), duration of hospital stay, and need for ICU admission. Result(s): One hundred eighty patients with moderate case of COVID-19 disease were divided in a 1: 1 ratio to receive ibuprofen (IG) or paracetamol (CG). The average age of the included patients was almost 41 years. Statistically significant differences were reported between both groups in terms of improvement in cough symptoms and lymphopenia in IG compared to CG (p= 0.034 and p= 0.044, respectively). Regarding secondary outcomes, statistically, significant differences were reported between the study's groups in terms of the mean number of patients transferred to the ICU in IG compared to the CG (p =0.0.047) and duration of hospitalization (p =0.013), with no significant differences (p > 0.9999) in the occurrence of side effects. Concerning the follow-up of the cytokine storm marker, there was a statistically significant reduction in serum cytokine marker compared to the baseline value (P < 0.05) in the same group. No statistically significant differences were observed when comparing both groups together in terms of serum ferritin level (p =0.570), serum IL-6 level (p =0.580), and CRP level (p =0.401). Conclusion(s): It can be concluded that early use of ibuprofen as adjuvant therapy in COVID-19 management is effective and safe to attenuate the severity of diseases and improve outcomes. Trial Registration: Project manager for the Pan African Clinical Trial Registry PACTR202202880140319. Registered 9th February, 2022-Retrospectively registered, (https://pactr.samrc.ac.za/).Copyright © 2023 Sobhy et al.

RESPIRATORY DISEASE FACTORS LINK WITH REDUCED SARS-CoV-2 SUSCEPTIBILITY IN PWH

Background: Despite favorable vaccine responses of people with HIV (PWH), susceptibility to SARS-CoV-2 (SCv2) infection and increased risk of COVID-19 in immunocompromised PWH continue to be of concern. Here, we searched the Swiss HIV Cohort Study (SHCS) with>9500 actively enrolled, optimally treated PWH to identify factors associated with SCv2 infection in the pre-and postvaccination area. Method(s): We utilized information on SCv2 events reported to the SHCS in 2020 -2021. To detect asymptomatic infection, we screened pre-pandemic (2019) and pandemic (2020-2021) bio-banked plasma for SCv2 antibodies (Ab). SCv2+ and matched SCv2- PWH were additionally screened for Abs to circulating human coronaviruses (HCoV). Data were compared to HIV negative (HIV-) controls. SCv2 data and >26 behavioral, immunologic and disease-parameters available in the SHCS data base were analyzed by logistic regression, conditional logistic regression, and Bayesian multivariate regression. Result(s): Considering information on the SCv2 status of 6270 SHCS participants, neither HIV-1 viral load nor CD4+ T cell levels were linked with increased SCv2 infection risk. COVID-19-linked hospitalization (87/982) and case fatality rates (8/982) were low, but slightly higher than in the general Swiss population when stratified by age. Compared to HIV-, PWH had lower SCv2 IgG responses (median effect size= -0.48, 95%-Credibility-Interval=[-0.7, -0.28]). Consistent with earlier findings, high HCoV Abs pre-pandemic (2019) were associated with a lower risk of a subsequent SCv2-infection and, in case or infection, with higher Ab responses. Examining behavioral factors unrelated to the HIV-status, people living in single-person households were less at risk of SCv2 infection (aOR= 0.77 [0.66,0.9]). We found a striking, highly significant protective effect of smoking on SCv2 infection risk (aOR= 0.46 [0.38,0.56], p=2.6*10-14) which was strongest in 2020 prior to vaccination and was even comparable to the effect of early vaccination in 2021. This impact of smoking was highly robust, occurred even in previous smokers and was highest for heavy smokers. Conclusion(s): Our unbiased cohort screen identified two controversially discussed factors, smoking and cross-protection by HCoV responses to be linked with reduced susceptibility to SCv2, validating their effect for the general population. Overall weaker SCv2 Ab responses in PWH are of concern and need to be monitored to ensure infection- and vaccine-mediated protection from severe disease.

A comparative analysis of instructional delivery methods in a higher education institution in the United Arab Emirates

This comparative quantitative study aims at investigating whether instructional delivery methods, such as online, hybrid, blended learning and face-to-face delivery methods, had an effect on students' grades when teaching mathematics to English language learners in a higher education Institution in the United Arab Emirates. Final course grades, in GPA format, of 574 students were collected over the course of three academic years. Assumptions of analysis of variance (ANOVA), post hoc tests, effect sizes Cohen's d were examined. The statistically significant difference across four different instructional delivery methods showed effect sizes that grew from medium to large to very large when increasing the amount of online instruction. These findings surpass other studies and suggest a high practical significance. The consequences of COVID19 on instructional delivery methods had a favourable effect on students' grades. Higher education institutions in the UAE may use these findings for future planning, even beyond the pandemic. Recommendations are made for further research to include more variables and other disciplines.

Back from the Future: Mediation and Prediction of Events Uncertainty through Event-Driven Models (EDMs)

The event-driven model (EDM) is an emerging concept in human behavioural research, and understanding how EDMs can promote theory development remains a fundamental quest of predictive science. Traditionally, researchers have heavily depended upon theory confirmation and the inclusion of mediating constructs to clarify uncertainty associated with plausible events (e.g. political, socio-economic, technological, environmental). Though this approach has pushed the field forward, it has also steered mediation research towards largely ignoring the fundamental role of prediction as a key for better understanding future events represented by EDMs. Additionally, emerging research using partial least squares structural equation modelling to execute prediction-oriented analysis continues to overlook problematic endogeneity bias and plausible type IV errors due to omitted paths and neglect of indirect effect size estimation in mediation models that embrace the transmittal or segmentation mediation approaches. We aim to introduce prediction as a fundamental option for estimating EDMs and recommend that researchers employ the segmentation mediation approach when estimating EDMs. We further emphasize a novel direct and indirect (v) effect size measure, types of prediction and cases when they are useful. Best practices and practical implications are provided to foster a more useful interpretation of findings.

Endothelial dysfunction in the post-COVID-19 period: A meta-analysis

Background: Coronavirus disease (COVID)-19 is an entity characterized by a cytokine storm and profound endotheliitis. Although several reports have pointed to the presence of endothelial dysfunction in the acute phase, data is accumulating regarding a possible prolonged adverse effect of COVID-19 on endothelial function. Purpose(s): This systematic review and meta-analysis aims to evaluate the degree of endothelial impairment, assessed by flow-mediated dilation (FMD) of the brachial artery, in individuals recovering from COVID-19. Method(s): We conducted a systematic literature search for studies assessing FMD between in patients post-COVID-19 and controls. Exclusion criteria consisted of the absence of a control group, measurement of FMD only during the acute phase of the disease, and not reporting FMD in % change. Effect sizes were pooled via random-effect model and the results are expressed as uncorrected standardized mean difference (SMD), using the Cohen's d as the effect size metric, with 95% confidence intervals (CI). Between-study heterogeneity was assessed through the calculation of I2. Subgroup analysis according to follow-up duration and the presence of cardiovascular risk factor-matched controls was also carried out. Result(s): Database search identified 51 studies. Following the application of the exclusion criteria, 7 studies were included in the meta-analysis (post-COVID-19: 342 subjects, Control: 273 subjects). Compared to controls, patients post-COVID-19 had significantly lower FMD% values (SMD: -1.06, 95% CI: -1.74 to -0.38, p<0.01, I2: 86%) (Figure 1). Results remained unaffected after exclusion of any single study using the leave-oneout method. Subgroup analysis revealed no significant differences in FMD between post-COVID-19 patients and controls according to follow-up duration or the presence of cardiovascular risk factor-matched control group. Conclusion(s): Flow-mediated dilation of the brachial artery, indicative of endothelial dysfunction, was significantly reduced in post-COVID-19 subjects compared to non-infected controls. This finding may be an alarming sign towards a higher risk of incident cardiovascular events. (Figure Presented) .

HLA-A*03:01 is associated with systemic side effects in COVID-19 vaccination

In the last two years, billions of individuals worldwide have been safely vaccinated against SARS-CoV-2, the virus that causes COVID-19. However, a substantial number of people experience mild to moderate side effects, which may hamper vaccine and booster uptake;understanding the processes underlying differential responses to these vaccines can help to improve global vaccination efforts. Variation in HLA has been linked to disease outcome in COVID-19, and HLA-A*03:01 has previously been reported to increase risk for side effects following vaccination. Here, we expand on those findings, examining HLA variation for association with vaccine side effects in 6470 patients of European ancestry from the United States. In our cohort, ~30% of individuals experienced systemic side effects (e.g., fever, chills, headache) after their initial vaccination series, while that proportion climbed to >60% in individuals receiving booster doses. We confirm the association of HLA-A*03:01 with systemic side effects to COVID-19 vaccines, particularly the Pfizer-BioNTech vaccine (OR = 1.52 [95% CI 1.23-1.97], p = 0.002). We observed similar effect size of this allele in individuals reporting side effects from the initial series or boosters (OR = 1.25 [95% CI 1.15-1.53];p>0.0001), but comparatively higher effect size in individuals who subsequently experienced breakthrough infections (OR = 2.11 [95% CI 1.12-4.31];p = 0.04). Our results confirm prior reports regarding HLA association with vaccine side effects, and suggest that the immunopathology underlying the HLAA* 03:01 association with side effects may increase those individuals' propensity for breakthrough infections after vaccination. Our results highlight the need to explore the functional mechanisms underlying this association to improve vaccine design and implementation strategies against emergent SARS-CoV-2 variants.

Meta analysis of mental health status of Chinese college students during new coronavirus pneumonia

This article mainly studies the mental health status and influencing factors of Chinese college students based on SCL-90 during the new crown pneumonia epidemic. Retrieve documents on the mental health of Chinese college students during the period of COVID-19 from databases such as CNKI, Weipu, Wanfang Data Knowledge Service Platform, Chinese Biology Literature Database, Cochrane Library, PubMed, and Web of Science. Using RevMan 5.4 software to meta-analyze the literature, to study the mental health of Chinese college students during the period of COVID-19. The results showed (1) During the period of the new crown pneumonia epidemic, only the terrorist factor scores of college students were higher than the national college student norm, and the scores of other factors were lower than the national college student norm. Only the paranoid and psychotic factors were statistically significant, and the effect sizes of other factors were all No statistical significance (P>0.05). (2) The scores of all factors of college students during the period of the new coronary pneumonia epidemic were higher than those of SARS college students. Except for anxiety and terror factors, the effect sizes of other factors were not statistically significant (P>0.05). (3) Factors such as gender, ethnicity, discipline, place of origin, and major have an impact on the research results. During the new crown pneumonia epidemic, universities in our country were under the influence of certain psychological stress. For students of different genders, ethnicities, disciplines, and majors, different programs were adopted in the content and methods of psychological assistance. © 2022 IEEE.

Comparison of the 1-minute sit-to-stand test with the 6- minutes walk test for the evaluation of the functional status of post-COVID-19 patients

The assessment of functional capacity in severe post-COVID-19 patients, after hospitalization, is essential for estimating functional consequences, disability and exertional desaturation. To date, the 6-minutes walk test (6WMT) and the 1-minute sit-to-stand test (1STST) have been the most commonly used tests. The aim of this study is to investigate the relationship and discuss the utility of the 1STST compared to the 6MWT for follow-up evaluation of the functional status of severe post-COVID-19 patients. A cross-sectional study was performed in a post-COVID-19 public care clinic. A total of 55 patients (mean age: 57.85, SD 12.65) were evaluated. Functional performance was evaluated by 1STST and 6MWT. Both tests were performed 6 months after hospital discharge, on the same day, 1 hour apart. During the tests, the severity of dyspnea (by Modified Borg Scale), heart rate and pulse oxygen saturation (by pulse oximeter) were measured. A significant positive correlation was observed between 1STST and 6MWT (r = 0.30, p =. 026, 95% CI = [0.04, 0.53]). The correlation coefficient between the two tests was 0.30, indicating a moderate effect size. Also, the differences on the severity of dyspnea, heart rate and pulsed oxygen saturation between the two tests were not statistically significant (p =. 061;p =. 169;p =. 965). The 6MWT requires technical execution conditions that are not always easy to meet. Considering the statistically significant relationship between the 1STST and 6MWT, the 1STST may be used for a quick and alternative measurement of the functional assessment in post-COVID-19 patients.

Impact of breathlessness on quality of life and healthcare use in Australia

Background and Aim: This study aimed to understand the impact of breathlessness on quality of life, productivity loss and healthcare use of Australian adults. Method(s): The National Breathlessness Survey was a nationwide cross-sectional web-based survey in Oct 2019, recruiting Australians aged >=18 years stratified by age-group, gender and state of residence. Severity of breathlessness using the modified Medical Research Council (mMRC) dyspnoea scale (0-5), quality of life (QoL) using EQ-VAS and EQ-5D-5L, and healthcare use (HCU) and productivity loss associated with having a "breathing problem" in the past 12 months were analysed. Quintile regression was conducted to analyse QoL and binary logistic regression for HCU and productivity loss outcomes. Effect sizes were adjusted for age, gender, Indigenous background, self-reported heart and lung disease, high PHQ-4 score, multimorbidity and smoking. Result(s): 10,072 adults completed the survey. The prevalence of clinically important breathlessness (mMRC>=2) was 9.54%. mMRC>=2 was associated with worse QoL, and greater healthcare use and productivity loss compared with mMRC=1 (Table). Despite COVID-19 impacts, similar prevalence (8.15%) and associations were seen in a repeat cross-sectional survey in December 2020 (n=10,024). Conclusion(s): Breathlessness carries a significant burden for patients, the healthcare system, and the economy.

A meta-analysis of the associations between insufficient sleep duration and antibody response to vaccination.

Vaccination is a major strategy to control a viral pandemic. Simple behavioral interventions that might boost vaccine responses have yet to be identified. We conducted meta-analyses to summarize the evidence linking the amount of sleep obtained in the days surrounding vaccination to antibody response in healthy adults. Authors of the included studies provided the information needed to accurately estimate the pooled effect size (ES) and 95% confidence intervals (95% CI) and to examine sex differences.1,2,3,4,5,6,7 The association between self-reported short sleep (<6 h/night) and reduced vaccine response did not reach our pre-defined statistical significant criteria (total n = 504, ages 18-85; overall ES [95% CI] = 0.29 [-0.04, 0.63]). Objectively assessed short sleep was associated with a robust decrease in antibody response (total n = 304, ages 18-60; overall ES [95% CI] = 0.79 [0.40, 1.18]). In men, the pooled ES was large (overall ES [95% CI] = 0.93 [0.54, 1.33]), whereas it did not reach significance in women (overall ES [95% CI] = 0.42 [-0.49, 1.32]). These results provide evidence that insufficient sleep duration substantially decreases the response to anti-viral vaccination and suggests that achieving adequate amount of sleep during the days surrounding vaccination may enhance and prolong the humoral response. Large-scale well-controlled studies are urgently needed to define (1) the window of time around inoculation when optimizing sleep duration is most beneficial, (2) the causes of the sex disparity in the impact of sleep on the response, and (3) the amount of sleep needed to protect the response.

The study of the strength and significance of four biological parameters on the body weight of goose.

Alternative products such as those from high-value protien animals have increased the demand for the production of high-quality chicken meat in past few years. This study examines the impact of two distinct feeding types on goose body-weight, as well as the genetic variation of growth hormone (GH) and pituitary-specific transcription factor (Pit-1) genes in ten goose populations using single nucleotide polymorphism (SNP) markers and PCR-RFLP analysis. Both genes were seen as very important for productivity, especially in light of the COVID-19 and its effect on poultry industry at the time. The findings suggest that employing genetic indicators in these two genes in conjunction with a high-fat diet may be a feasible strategy for goose selection programme aiming to increase marketing body weight, as the high-fat diet outperformed the balanced diet. The study investigates the effect of gender, 2 types of diets, breeds and the genetic variation of the two genes, four SNPs were reported to be found: two at the GH gene exons C123T and C158T, and two at the Pit-1 gene exons G161A and T282G. Certain genotypes were found to have a substantial effect on the marketing body-weight of goose, which varied depending on the tested breeds. However, in terms of gender, males report higher and better performance levels than females. Diet, breeds and genotype interaction, and breeds, gender and genotype interaction were found to have a minor effect on goose body weight. However, diet, breeds, gender, SNP locus, diet and breeds interaction, and breeds and gender interaction were found to have a significant effect on goose body weight, as indicated by the effect size results.

META-ANALYSIS: A SOUND BASE FOR STATISTICAL ANALYSIS OF PANDEMIC DISEASE

The paper provides the basic concept of meta-analysis and its literature. We demonstrate how the meta-analysis is used in a practical approach and especially tends to the human dimension research technique. In the present scenario, social scientists have dared to improve how they access summarize and convey a reference to the health indicator used in health policy. Meta-analysis provides a systematic review of existing research using data from different field studies. Dynamic meta-analysis would ensure the policymaker uses the information and perform the best approximate analysis relevant to the context of new policy used for public health research, social science and life science. Especially in this paper, we analyze the definition of meta-analysis and discuss the various steps used in meta-analysis for analysis and use this interpretation to improve the health policy. We discussed the merits of meta-analysis and did the statistical analysis of the five countries of the pandemic Covid-19 from the total data for 2020 and 2021. © 2022 DAV College. All rights reserved.

Common Statistical Errors in Scientific Investigations: A Simple Guide to Avoid Unfounded Decisions.

During my experience as an author, peer reviewer, and editor during COVID-19, I have encountered - and committed - various errors related to the interpretation and use of statistical measures and tests. Primarily concerning health sciences such as epidemiology, infodemiology, and public health, the evidence used to inform a conclusion carries an extremely high weight as it translates into decisions made to preserve the population's well-being. Therefore, the aforementioned evidence must be reliable. This short guide discusses the most common and dangerous mistakes I have experienced during my scientific journey. Real and invented examples have been proposed and analyzed in detail, showing possible interpretations, both correct and incorrect, and their consequences. Such a framework makes it clear that a statistical test alone cannot answer any scientific questions. Indeed, the interpretation of results and the verification of assumptions and test eligibility - subject to the author's evaluation - are crucial components of the integrity of the scientific investigation. Before using a test or adopting a measure, we must ask ourselves the following fundamental questions: Are there valid reasons to explore my research question? Am I sure my approach can fully and adequately answer my research question? Am I sure that my model's assumptions - basic and hidden - are sufficiently satisfied? How could violating those assumptions affect the validity of the results and stakeholders? Is the effect size relevant regardless of statistical significance?

The Effects of a Physical Therapy Program and the Covid-19 Pandemic on Student's Health Outcomes

PURPOSE/HYPOTHESIS: In 2020, COVID-19 became a global pandemic affecting multiple aspects of everyday life.1-4 Since COVID-19 was a highly transmissible disease, in-person classes weremoved online,5,6 gyms were closed,1-3 and social interactions were limited.4 While some data exist on the impact COVID-19 has had on students,5,6 there is a need for further research to examine the compounding effects of the graduate level workload and the COVID-19 pandemic on physical therapy students. The purpose of this study is to understand how COVID-19 affects the cardiovascular (CV) and mental health of Doctor of Physical Therapy (DPT) students as they progress through the program. We hypothesize that students would have better health outcomes in their second year, when the COVID-19 restrictions lessen, compared to their first year, when COVID restrictions were at their peak. NUMBER OF SUBJECTS: 16 students from the University of Texas at El Paso's DPT Class of 2023 were recruited via in-class presentation and email. MATERIALS AND METHODS: Data collection occurred over the time period of a year and a half with a total of 3 visits (Oct 2020, June 2021, and April 2022). Primary outcome measures included cardiovascular fitness level via VO2max, arterial stiffness via Pulse Wave Velocity (PWV), and endothelial function via Venous Occlusion Plethysmography (VOP). Secondary outcome measures included Perceived Stress Survey (PSS), International Physical Activity Questionnaire (IPAQ), and Dietary Screening Questionnaire (DSQ). A repeated-measures analysis of variance (RM-ANOVA) and Cohen's d for standardized effect size were utilized. Significance was set prior at an alpha level of 0.05. RESULT(S): VO2max increased from visit 1 to visit 2 (P5.02, d50.63) and then decreased fromvisit 2 to visit 3 (P< 01, d = 0.85), with no change between visits 1 and 3 (P>.05). Endothelial function increased from visit 1 to visit 3 (P< 01, d=0.89) and from visit 2 to visit 3 (P = .02, d = 0.65), with no differences between visits 1 and 2. Overall, there were no significant differences observed for PWV, PSS, METs, sitting time, sweetened beverages, and added sugar (P>05) between visits. CONCLUSION(S): The DPT Class of 2023 started their graduate education in the beginning of the COVID pandemic, with an already limited physical freedom. COVID restrictions were lessen in early 2021~4 months before visit 2. It appears that those 4 months were enough time to improve VO2max but not endothelial function. Interestingly, VO2max decreased back to baseline after the second year, with an increase in endothelial function. These changes could be attributed to an increase in time spent at school during the second year and increased travel time due to classes moving from virtual to in person, which could impact cardiopulmonary fitness but not endothelial function. CLINICAL RELEVANCE: Results from this study can help DPT programs throughout the nation understand the importance of developing strategies to support their students during times of crisis to reduce the risk of CV and mental health diseases in the future.

COVID-19 Restrictions and Its Influence on Students' Mathematics Achievement in Spain

COVID-19 restrictions in schools worldwide constitute an important limitation for peer support among students. The masks, the distance between tables or the established sitting order are new challenges that both students and teachers must face in Spain. The conventional strategies that took place among students prior to the COVID-19 pandemic have been altered. In this study, the mathematics achievement of high-school students prior to the COVID-19 pandemic and during the COVID-19 pandemic is examined. Quantitative and qualitative methods were used. A total of 368 students from 9th grade (ages 14 to 15) participated in this research. Statistically significant differences were reported when comparing the mathematics achievement of pre-COVID-19 and post-COVID-19 students (t = 22.21, p < 0.01). An overall negative effect size of -2.32 was reported for those students with COVID-19 restrictions. Mathematics achievement scores were 9.90% lower for the group with restrictions. No statistically significant differences were reported when analyzing results by gender or repeating condition. The qualitative information supported the quantitative findings. Alterations in peer support was identified as one of the main factors that could explain this decrease. The main conclusion of this study is that current restrictions due to COVID-19 could be producing an important decrease in students' mathematics achievements.

Virtual Cardiac Point-of-Care Ultrasound Curriculum Among Residents: A Medical Education Project

INTRODUCTION: Point-of-care ultrasound (POCUS) is becoming increasingly important for rapid assessment and diagnosis in a variety of clinical situations. With the ongoing COVID-19 pandemic, the aim of this study is to determine whether a virtual POCUS session can improve learner competency in assessing left ventricular (LV) systolic function. METHOD(S): An hour long session, involving a short lecture and fourteen practice questions was created. The questions consisted of cardiac ultrasound clips from real patients, evaluated by three POCUS experts. For each clip, LV systolic function was classified as hyperdynamic, normal, reduced, or severely reduced. The session was given separately to a group of interns (n1=30) and a group of senior residents (n2=39) virtually via Zoom. Series of clips were shown as the lecture progressed and participants recorded their answers as either hyperdynamic, normal, reduced, or severely reduced using the polling feature within the Zoom platform. Effect size as the percent of correct responses was calculated. Data was analyzed using SPSS software with independent t-test and paired t-test analysis with a level of statistical significance as p <=0.05. Result(s): The intern group had a mean score of 69.9% [SD 21.8%] and the resident group had a mean score of 74.2% [SD 21.5%]. All participants achieved a mean score of 66.6% [SD 26.0%] during the first half of the lecture, which then improved to 77.6% [SD 14.2%] in the second half [p value 0.547]. Both groups showed similar overall trends, although these were not statistically significant. When combined, extremes of LV function (hyperdynamic and severely reduced) were better recognized than more subtle differences (reduced and normal) [81.4%+/-18.1 vs 55.2+/-15.9;p = 0.001] overall. Conclusion(s): Compared to the conventional in-person approach, this study highlights the potential for virtual didactic sessions in POCUS training with impressive results when recognizing extreme cardiac findings.

Effects of a psychomotor program developed in the COVID pandemic on risk factors for falls in nursing home older adults

Objective: This study aimed to determine the effects of a psychomotor program performed during the COVID pandemic on risk factors for falls in nursing home older adults. Method(s): The study involved 10 nursing home older adults (aged 67-91 years old) who integrated two periods without intervention (control: pre-lockdown;and lockdown) and an experimental period (attending the program). Cognitive, emotional and physical functioning risk factors for falling were measured before and after each period. Result(s): Friedman's Test followed by Pairwise Comparison post-test showed that the program induced significant improvements with an effect size (EF) ranging from large to small in the follow risk factors: fear of falling (EF=3.22), depressive states (EF=1.49), static balance (EF=0.83), lower strength (EF=0.76), upper strength (EF=0.73), cognitive status (EF=0.58), upper flexibility (0.52), perception of affordances - real (EF=0.51) and estimated (EF=0.45), agility and balance (EF=0.37), balance and mobility (EF=0.36), lower flexibility (EF=0.24) and aerobic resistance (EF=0.21), (p<0.05). On the other hand, in the no-intervention periods, lower and upper strength, upper flexibility and perception of affordances - estimated significantly decreased (p<0.05). Conclusion(s): Results from the study showed that the psychomotor program was effective in falls prevention by improving cognitive, emotional and physical functioning risk factors for falling. These findings suggest that for older adults' good quality of life, psychomotor programs should be implemented in nursing homes.