A Dynamic-Static Dual Input Deep Neural Network Algorithm for Diagnosing COVID-19 by Cough

The COVID-19 (corona virus disease 2019) has caused serious impacts worldwide. Many scholars have done a lot of research on the prevention and control of the epidemic. The diagnosis of COVID-19 by cough is non-contact, low-cost, and easy-access, however, such research is still relatively scarce in China. Mel frequency cepstral coefficients (MFCC) feature can only represent the static sound feature, while the first-order differential MFCC feature can also reflect the dynamic feature of sound. In order to better prevent and treat COVID-19, the paper proposes a dynamic-static dual input deep neural network algorithm for diagnosing COVID-19 by cough. Based on Coswara dataset, cough audio is clipped, MFCC and first-order differential MFCC features are extracted, and a dynamic and static feature dual-input neural network model is trained. The model adopts a statistic pooling layer so that different length of MFCC features can be input. The experiment results show the proposed algorithm can significantly improve the recognition accuracy, recall rate, specificity, and F1-score compared with the existing models. © 2023 Chinese Institute of Electronics. All rights reserved.

First-in-class small molecule drugs in 2022.

2022 is the third year of the global COVID-19 pandemic, and its troubles on new drug discovery are gradually apparent. 37 new drugs were approved by the FDA's Center for Drug Evaluation and Research (CDER) last year, down from the peak of 50 new drug approvals in 2021. Notably, first-in-class drugs still occupy a dominant position this year, with a total of 21 drugs. Among them, 7 are first-in-class small molecule drugs. Although the total number of new drug approvals in 2022 sharply decreased, some first-in-class small molecule drugs were regarded as significant, including mitapivat, the first oral activator targeting the pyruvate kinase (PK);mavacamten, the first selective allosteric inhibitor targeting the myocardial beta myosin ATPase;deucravacitinib, the first deuterated allosteric inhibitor targeting the tyrosine kinase 2 (TYK2);and lenacapavir, the first long-acting inhibitor targeting the HIV capsid. Generally, the research of first-in-class drugs needs to focus on difficult clinical problems and can treat some specific diseases through novel targets and biological mechanisms. There are tremendous challenges in the research processes of new drugs, including biological mechanism research, target selection, molecular screening, lead compound identification and druggability optimization. Therefore, the success of first-in-class drugs development has prominent guidance significance for new drug discovery. This review briefly describes the discovery background, research and development process and therapeutic application of 3 firstin- class small molecule drugs to provide research ideas and methods for more first-in-class drugs.Copyright © 2023, Chinese Pharmaceutical Association. All rights reserved.

Developing Business Model Competences in the Enterprise

Despite the COVID-19 pandemic, 2021 saw a growing interest in starting own business: as per the Census Bureau's Business Formation Statistics, the number of applications to form new businesses filed in the U.S. was the highest compared to any other year on record, reaching the total of 5.4 million (Economic Innovation Group, 2022), while in the EU, after an initial downward trend recorded in the first and second quarters of 2020, the number of new business registrations grew again in the third quarter of that year, and this upward trend continued throughout 2021 (Eurostat, 2022). Of course, as a result of Russia's invasion on Ukraine and related economic crisis, a downward tendency could be observed, but business registration levels in the EU in the first quarter of 2022 were still higher than during the pre-COVID 19 pandemic period (2015-2019) (Eurostat, 2022) and online searches indicating and intent to open a business spiked by 76% from 2018 to 2022 (Search Engine Journal, 2022). This shows that despite many external impediments, people are still tempted to start their own business, and many influencers, motivational speakers and coaches, as well as various popular TV shows broadcast worldwide (like the Apprentice, Dragons' Den, Shark Tank or Planet of the Apps) encourage them to do so. Becoming an entrepreneur has become a goal many people, especially 20-, 30- and 40-year-olds, strive to achieve. However, many of those people fail to realise that the very entry in the business register does not automatically make them entrepreneurs or their business successful. Neither does a good (or even excellent and innovative) business idea that attracts customers, as it was in Kodak's, Blockbuster's, or Ask Jeeves' case. What is required, is the ability to stay attractive to existing and prospective customers, i.e., the ability to win and retain customers, and to adapt to the changing demands, trends and economic conditions. All this can be achieved thanks to a meticulously designed and regularly reviewed and updated business model. The aim of this paper is to present and analyse the learning process of acquiring and building competences in the area of business models with the use of different innovative tools. The results presented and discussed in this article come from surveys as well as face-to-face and on-line meetings conducted in the ProBM 2 ERASMUS+ project (Understanding and Developing Business Models in the Era of Globalisation), in which the total of 261 respondents from seven (7) European countries, i.e. Poland, Italy, Greece, Romania, Portugal, Malta, and Switzerland, took part between 2019 and 2022. From the meetings and surveys it follows that much more awareness of business models needs to be encouraged and developed, particularly as regards improving competences helping future business owners and their employees assess profitability and efficiency of their operations and ensure that the business will be a going concern. © 2022 Authors. All rights reserved.

American Lessons: The COVID-19 Pandemic and the US Supreme Court

Ever since the outbreak of the COVID-19 Pandemic in America in March 2020, several US states imposed harsh measures to combat the pandemic. Such state measures have at times seriously violated human rights, such as freedom of religion or freedom of movement. This chapter attempts to look at how the US Supreme Court has responded to the pandemic and reviewed several state measures over the past couple of years through selected cases on freedom of religion and compulsory vaccinations. We particularly look at its views on the role of the judiciary during the crisis, the scrutiny applied on human rights violations, as well as whether changes in the Court's composition during the Trump Era have in fact influenced its judicial reasoning. Overall, has the COVID-19 pandemic had an impact on judicial review and the Court's role? If so, how?. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Old Normal, New Normal, or Renewed Normal: How COVID-19 Changed Human Resource Development

This chapter wants to shed light on the consequences that the COVID-19 pandemic had for human resource development (HRD) in organizations and in the labour market. We intend to compare three situations: Old Normal (before February 2020), New Normal (between March 2022 and October 2021), and Renewed Normal (since October 2021). Crucially, in organizations, work was mostly face to face in the Old Normal, remote in the New Normal, and there is a tendency for some hybrid form to be installed in the Renewed Normal. We compare the three phases in terms of four aspects of HRD and within virtual development relations, namely: work environment, competences, training, and skills. The chapter presents results from a literature review in SCOPUS database. We conclude that COVID-19 changed HRD, because technology changed the environment and, therefore, new competences were required. Therefore, a new form of training was also required, which, when in practice, originated new skills. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.

How Frauds in Times of Crisis Target People

While there are no new frauds, internet technology provides new opportunities for fraudsters by facilitating volumes of attacks that law enforcement then struggles to address. Moreover, since context can affect how potential victims respond to frauds, crisis context influences how fraudsters design frauds. This article assesses fraudsters' fraud design strategies during two external crisis events that impacted Australia: The Black Summer Bushfires that occurred from September 2019 to March 2020 and the onset and first year of the COVID-19 pandemic that occurred from January 2020 through January 2021. Targets, during these crises, were more likely to be vulnerable according to Steinmetz's model victim for social engineering framework. This study shows that, in both crises, fraudsters deployed the social engineering techniques of "authority” and "scarcity,” techniques that are more likely to be successful based solely on initial contact. Fraudsters designed their requests to be easily actioned and crafted their scams to reference very recent events as the external crisis events evolved. Thus, they targeted broad audiences with minimal personal involvement. Furthermore, this study shows that fraudsters, when disseminating their scams via social media outlets, attempted to build "social proof” to expand their potential victim pool to include the marks' social circles.

Outcomes of symptomatic gallstone disease in pregnant women: A retrospective study

Gallstone disease with advanced symptoms is one of the common abdominal emergencies during pregnancy and it is considered to be one of the most frequently reported non-obstetric surgical conditions in pregnant women. This study aimed to evaluate the outcomes of surgical cholecystectomy in pregnant women with symptoms of advanced gallstones. This is a retrospective analysis of 2814 pregnant women who attended various wards in government and private hospitals in the governorates of Diyala and Kirkuk in Iraq for more than 2 years, between February 2020 and June 2022. The hospital database was used to confirm the diagnosis of advanced gallstone symptoms in these pregnant women. The incidence of symptomatic gallstones in pregnant women, diagnosis and method of therapeutic management, cholecystectomy according to the pregnancy periods, and perinatal complications of patients according to therapeutic methods were determined. The results confirmed that out of 2814 pregnancies, only 126 (4%) had symptoms of gallstones. It was found that the majority of cases 67 (53%) were within the first trimester of pregnancy and the least 29 (23%) was observed in the second trimester. Acute cholecystitis was the generality 84 (67%) diagnosed in pregnant women with symptomatic gallbladder disease and only 9 (7%) of the patients had undergone prenatal cholecystectomy versus 117 (93%) who were managed conservatively. A total of 20 (16%) cases with undesirable complications were recorded, where 12 cases with low birth weight were noted, where 4 of them underwent surgery and 8 were treated conservatively. It was concluded that a large proportion of women suffer from symptoms of gallstones during pregnancy. Most cases can be managed conservatively, and intervention should be performed as often as needed.Copyright © 2023, Codon Publications. All rights reserved.

Artificial Intelligence-Based Smart Tele-Assisting Technology for First-Year Engineering Students

Engineering programs emphasize students career advancement by ensuring that engineering students gain technical and professional capabilities during their four-year study. In a traditional engineering laboratory, students "learn by doing", and laboratory equipment facilitates their discipline-specific knowledge acquisition. Unfortunately, there were significant educational uncertainties, such as COVID-19, which halted laboratory activities for an extended period, causing challenges for students to perform and obtain practical experiments on campus. To overcome these challenges, this research proposes and develops an Artificial Intelligence-based smart tele-assisting technology application to digitalize first-year engineering students practical experience by incorporating Augmented Reality (AR) and Machine Learning (ML) algorithms using the HoloLens 2. This application improves virtual procedural demonstrations and assists first-year engineering students in conducting practical activities remotely. This research also applies various machine learning algorithms to identify and classify different images of electronic components and detect the positions of each component on the breadboard (using the HoloLens 2). Based on a comparative analysis of machine learning algorithms, a hybrid CNN-SVM (Convolutional Neural Network - Support Vector Machine) model is developed and is observed that a hybrid model provides the highest average prediction accuracy compared to other machine learning algorithms. With the help of AR (HoloLens 2) and the hybrid CNN-SVM model, this research allows students to reduce component placement errors on a breadboard and increases students competencies, decision-making abilities, and technical skills to conduct simple laboratory practices remotely. © 2023 IEEE.

Perinatal aspects of sars-cov-2 infection during pregnancy: A potential cause for concern

Ever since the beginning of COVID-19 pandemic, uncertainty regarding clinical presentation and differences among various subpopulations exist. With more than 209,870,000 confirmed cases and more than 4,400,000 deaths worldwide, we are facing the new era of health crisis which will undoubtedly impair global health, economic and social circumstances. In the past year, numerous genetic mutations which code SARS-CoV-2 proteins led to the occurrence of new viral strains, with higher transmission rates. Apart from the implementation of vaccination, the effect of SARS-CoV-2 on pregnancy outcome and maternal fetal transmission remains an important concern. Although neonates diagnosed with COVID-19 were mostly asymptomatic or presented with mild disease, the effect on early pregnancy is yet to be evident. While positive finding of SARS-CoV-2 RNA in some samples such as amniotic fluid, placental tissue, cord blood and breast milk exists, additional research should confirm its association with transplacental transmission.Copyright © 2022, Dr. Mladen Stojanovic University Hospital. All rights reserved.

Perception and Attitude of First-Year Medical Students on Studying Human Anatomy Through Cadaver Dissection (Online Streaming)-A Survey Investigation

In medical colleges, cadaveric dissection is an effective anatomy teaching method. Cadaveric dissections put students at the center of learning and show structures in their natural environment. However, most students dislike autopsy dissection since it's tedious and time-consuming. Thus, our study examined first-year medical students' attitudes toward dissection to learn anatomy. After the semester, students received a 3-domain questionnaire on preparedness, attitude, and restrictions. All information was gathered and recorded anonymously using Google forms. Each domain has many questions that add up to a score that shows how well they are prepared and how far online learning can go. One hundred MBBS first-year students participated in online anatomy lessons. After online courses, consenting students completed Google feedback forms regarding their experiences, which were examined and quantified. One hundred students completed the questionnaire and provided comments. Online courses were the most fantastic method to study human anatomy in medical school, according to 97.2%. Only 32.8% of students were uneasy, utilizing visuals to illustrate the softer aspects. Students' emotions and attitudes during corpse dissection varied by gender. Online was more appealing to males than women. Students prefer online courses over image-based ones because of the flexibility of time management and seating configuration. The statistical analysis revealed significant gender-related inequalities in student opinions. Other medical students showed similar variances at various phases of the research. The online anatomy classes for AVMC&H medical students were easy and enjoyable and utilized the "steeplechase" method. Our study shows the pros and cons of online education. Trainers/instructors should examine using online live forms as an instructional tool in anatomy training and generate new anatomy-related films for formal live teaching in the medical curriculum to accomplish this goal. However, additional study is needed to determine how much online education affects student learning and training.

Students' sense of belonging at a South African university during COVID-19

The research on students' sense of belonging in higher education has evolved into a prominent theme worldwide. Institutional research focuses on the institution understanding itself and helps leaders to rethink improvement initiatives. Moreover, the COVID-19 pandemic has required of institutions to revise student support programmes and approaches to maintain a strong sense of belonging. The theories of belonging by Strayhorn (2012) and Dumford et al. (2019) were adopted to analyse student responses. The aim of the study was to understand students' sense of belonging and how the university responded to the challenges presented by the COVID-19 pandemic to ensure a strong sense of belonging. Data were generated through in-depth interviews with 45 undergraduate students from all seven faculties. The findings highlight notable prevention measures intended to limit the spread of the virus on campus and student support in the form of study devices and data. The post-lockdown changes included a return to face-to-face mental health support, drafting COVID-19 catchup plans for first year orientation of 2020 and 2021 cohorts, improving the student voice. Finally, notable principles for responding to a future higher education crisis are highlighted. These initiatives contributed towards establishing and maintaining a strong students' sense of belonging.

Amoxicillin: When the essential is missing.

The antibiotic amoxicillin is usually recommended as a first-line treatment for many common infections affecting children. Repeated lockdowns related to the coronavirus disease 2019 pandemic have contributed to supply difficulties for many drugs, including antibiotics. However, the risks associated with amoxicillin supply shortages appear not to have been sufficiently assessed, and the crisis we are facing today is serious and particularly dangerous for children's health. Without rigorous measures to prevent shortages related to drug production and distribution, populations could face a post-antibiotic era in which common infections and minor injuries can result in serious life-threatening situations. The availability of medicines declared by WHO as essential should be guaranteed not only in production but also in fair distribution. And this principle must be ensured by national and international regulatory agencies.Copyright © 2023 Medico e Bambino. All rights reserved.

The relationship between first year seminar course modality and community college student success

The purpose of this study was to examine the impact of first-year seminar (FYS) course modality on first-semester GPA and second-semester retention of community college students' system-wide. For many student's community colleges serve as an affordable option for higher education. The first-year seminar course connects students to the college to create better academic outcomes. With the increase in technology the FYS course is available in three different course modalities;face-to-face, hybrid, and online. Understanding which course modality has the largest academic outcomes of FYS course will present administrators of the benefits of one modality over others. The study investigated academic outcomes of the FYS course by examining course modality at Lone Star Community College (LSC). Findings revealed no statistical differences between full-time enrolled students in any of the course modalities. Part-time students in the face-to-face FYS had higher first-semester GPA's than those enrolled in the other modalities. Results revealed students in the online FYS course modality were less likely to be retained the second semester. When predicting second-semester retention, enrollment status was a stronger predictor than course modality. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Association of state-level COVID-19 mortality rates with real-world progression and real-world overall survival among patients with advanced non-small cell lung cancer, 2020-2022

Background: The COVID-19 pandemic impacted the delivery of cancer care and outcomes in the United States (US). We examined the association between time-varying state-level weekly COVID19 mortality and progression-free survival (rwPFS), time to progression (rwTTP), and survival (rwOS) among pts with advanced non-small cell lung cancer (advNSCLC). Method(s): This retrospective study used the nationwide Flatiron Health electronic health recordderived de-identified database. The cohort included community oncology pts diagnosed with advNSCLC between March 1, 2020 and December 31, 2021 (follow-up through March 30, 2022). We extracted US data on COVID-19 deaths from the COVID-19 Data Repository by the Center for Systems Science and Engineering at Johns Hopkins University. We calculated state-level weekly COVID-19 death rates as weekly COVID-19 deaths per state population size from the 2019 American Community Survey. We categorized rates into quintiles based on all weekly rates during the observation period. Analyses were restricted to treated pts and indexed to start of first-line therapy. For rwPFS analyses, first occurrence of progression or death was considered an event, and pts were censored at last clinic note date. For rwTTP, only progression (not death) was considered an event, and pts with no event were censored at last clinic note date. For rwOS analyses, pts who did not die were censored at last structured activity. We used Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for associations between weekly time-varying state-level COVID-19 mortality rates and outcomes of rwPFS, rwTTP, and rwOS, adjusted for age at diagnosis, race/ethnicity, and state. Result(s): Among 7,813 advNSCLC pts, the median age at diagnosis was 70 years, the majority of the cohort was non-Hispanic White (59%), had non-squamous cell histology (68%) and a history of smoking (87%). Compared to pts living in states with the lowest quintile of COVID-19 mortality rates (Q1), pts living in states with the highest COVID-19 mortality (Q5) had worse rwOS (Q5 vs. Q1: HR 1.46, 95% CI 1.26-1.69) and rwPFS (Q5 vs. Q1: HR 1.18, 95% CI 1.05-1.33). No association was observed with rwTTP (Q5 vs. Q1: HR 1.05, 95% CI 0.90-1.22). Conclusion(s): In this study of real-world oncology data, we demonstrated the use of publicly-available COVID-19 mortality data to measure the time-varying impact of COVID-19 severity on outcomes in pts with advNSCLC. Higher state-level COVID-19 mortality rates were associated with worse rwOS and rwPFS among advNSCLC pts. The association with increased mortality among pts with advNSCLC may be related to COVID-19-related mortality or other factors such as pre-existing comorbidities which were not explored in this study.

COVID-19 in Early Pregnancy. Clinical Implications and Methodological Considerations

There is limited information on the effects of COVID-19 early in pregnancy on the risk of major congenital malformations (MCMs). Initial research has been limited by small samples, lack of attention to the timing of infection during pregnancy, lack of an appropriate control group, and biased selection of participants. The International Registry of Coronavirus Exposure in Pregnancy (IRCEP) was designed to estimate the relative risk of adverse perinatal outcomes among women with COVID-19 at specific times during gestation. Adult women were eligible to enroll if they had a SARS-CoV-2 test, regardless of the results, or clinically confirmed COVID-19 during pregnancy. Self-administered questionnaires collected data on the infection, pregnancy outcomes, and potential confounders. The analysis of MCMs included women with either a positive SARS-CoV-2 PCR test or a clinical diagnosis of COVID-19 during the first trimester (exposed group) or a negative SARS-CoV-2 test (reference) that enrolled while pregnant. Of 17,163 participants enrolled between June 2020 and July 2021, 1,727 had a SARS-CoV-2 infection during the first trimester and 10,235 had a negative test during pregnancy. Restriction to participants with complete follow-up reduced the sample size to 92 exposed and 292 unexposed reference pregnancies. MCMs were reported in three (3.3%) exposed and eight (2.7%) unexposed (RR 1.2;95% CI 0.32-4.2) newborns. No specific pattern of malformations was observed. The accumulated evidence is most compatible with no major teratogenic effects associated with maternal SARS-CoV-2 infection. Multiple biases need to be considered and addressed when estimating and interpreting the effects of COVID-19 early in pregnancy. The biggest methodological challenges for IRCEP were retention of participants enrolled in early pregnancy, and the potential bias introduced when participants enroll after pregnancy outcomes are known. Studies that allow enrollment after the outcome is known may select pregnancies with the outcome;those that exclude them would select survivors.

Detection of SARS-CoV-2 Antibodies in Matched Pregnant Women and Newborn Blood

Objective: The factors affecting the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies from mother to newborn and the duration of seropositivity rates in these infants have not yet been clearly demonstrated. The objectives of this study were (1) to assess the levels of SARS-CoV-2 spike-specific immunoglobulin G (IgG) in women infected in the pregnancy period and newborns born to these women and (2) to search the transplacental transfer ratio of spike-specific IgG. Method(s): Seventy pregnant women with symptomatic SARS-CoV-2 infection and their newborns were prospectively followed. Anti-SARS-CoV-2 immunoassay was used for the detection of the in vitro quantitative determination of total antibodies to the SARS-CoV-2 spike protein. Discussion(s): Spike-specific IgG was demonstrated in 89.1% (44 of 46) of pregnant women infected more than 14 days before delivery and in 92.6% (43 of 44) of their newborns. Median transfer ratio of spike-specific Ig was 0.87 (interquartile range [IQR], 0.34-0.90), 1.0 (IQR, 0.9-0.29), and 0.81 (IQR, 0.02-1.0) in first trimester (n = 4), second trimester (n = 14), and third trimester (n = 28) pregnant women, respectively. Antibody transfer ratio was correlated with time elapsed from infection (p < 0.001). Peak antibody transfer ratio above 1 was observed at a median 60 to 120 days after the infection from delivery. Antibody transfer ratio was high in pregnant women infected more than 60 days before delivery (p < 0.001). Transfer ratio was significantly higher in the severe-critically symptomatic women (n = 15) than the mild-moderately symptomatic women (n = 55) (p = 0.001). At 3 months, 18 of 25 infants (72%) had spike-specific IgG. Conclusion(s): Timing from infection to delivery and severity of maternal infection are critical in assessing the antibody generation and transport. Higher antibody transfer ratio can be detected in neonates when SARS-CoV-2 infection is present for more than 60 days before birth. Maternally derived antibody can persist for 3 months after birth.Copyright © 2023. The Author(s).

Transformational contribution of technology to studio culture: experience of an online first-year architecture design studio during the COVID-19 pandemic

PurposeDesign studios experienced an unprecedented contribution of technology when it came to organizing studios online, as imposed by COVID-19, which requires exploration of its impacts on the main metaphors of education, learning dimensions, and undoubtedly studio culture.Design/methodology/approachIn order to explore the impacts on the key dimensions of learning, a careful investigation was carried out from organizational, instructional, and learner points of view. The investigation utilized thematic analysis of records of pedagogical actions, as well as online communications, performance, and questionnaire responses of students to infer the conclusions. The freshmen architecture students were found to be an important group for study since they had no previous experiences in on-site design studios and will continue their education based on their first-year experiences.FindingsExploration of indicators—including reflective dialogue, retention, transfer of learned information to decisions, processing feedback as an investment in future performance, and self-regulation—as major contributors to design learning revealed that first-year students exhibited strong presence and interaction during online studio, and students' individuality influenced the teaching environment in terms of content and process. Hence, sense of belonging, which is a revamped feature of authentic context and studio culture, expands toward fortification of bottom-up educational frontiers.Originality/valueDeveloping pedagogies with no concern for the unprecedented impacts of the transformative role of technology on fundamental layers of design education will adversely influence students' chances of personal and professional success. The findings in this paper, regarding the transformational impacts of technology on design studio culture, follow investigation of the direction it has led current and can lead future design education. The study provides unique support for crystalizing new teaching and learning opportunities and pedagogical developments.

Coming out of the shadows: investing in English private tutoring at a transition point in Kazakhstan's education system during the global pandemic

Unequal access to language learning resources has been exacerbated by the global expansion of English private tutoring (EPT). Despite its popularity, no study has examined the implications of EPT during the COVID-19 pandemic. Therefore, this mixed-methods study explored the nature and effectiveness of EPT that first-year Kazakhstani undergraduate students had experienced over the previous 12 months during the COVID-19 pandemic. It was informed by Benson's (2011) model of language learning beyond the classroom. Data were collected through a close-ended questionnaire and semi-structured online interviews. The study found that 318 out of 750 (42.4%) had experienced EPT, and 64% of respondents had received face-to-face EPT although it was considered a health risk during the pandemic. All the interviewees perceived EPT sessions as an encouraging environment for coaching towards the university entrance examination and expanding their knowledge. They attributed this mainly to the individual attention they obtained from their tutors, which was lacking in online classes with their English teachers due to teachers' indifferent attitude to students' questions and the limited duration of video conferencing sessions. The participants acted agentively by evaluating the advantages and drawbacks of online EPT. Pedagogical implications and areas for further research are suggested.

Transplacental transfer of SARS-CoV-2 variant antibodies following COVID-19 vaccination during pregnancy

Problem: Despite being over 3 years into the pandemic, infants remain highly undervaccinated and at a high risk for hospitalization due to COVID-19. Further investigation as to how maternal health decisions for immunization can reduce morbidity from infant COVID-19 by providing passive immunity is necessary. The objective of this study was to describe the rates of SARS-CoV-2 variant antibody transfer from mother to infant cord blood by trimester ofmaternal vaccination. Methods of study: This is an observational cohort study including mother-infant dyads receiving primary or subsequent booster COVID- 19 vaccines during pregnancy.Unvaccinated, but SARS-CoV-2 infected dyads with were included as a comparison group. We quantified median titer and interquartile range (IQR) for SARS-CoV-2 receptor binding domain (RBD) IgG in infant cord blood samples at delivery using the mesoscale discovery platform (electrochemiluminescence). Primary outcome was infant cord IgG titer by trimester of vaccination for the WA1/2022 RBD IgG and current circulating, immune evasive XBB RBD IgG. Secondary outcome is the percent detectable IgG for each variant. Sensitivity analysis was performed based on known SARS-CoV-2 infection. Result(s): Eighty-three mother-infant dyads were included in this analysis. Seven were vaccinated in the first trimester, 37 in the second trimester, 33 in the third trimester, and 6 were unvaccinated and infected. Twenty-three (30%) of the vaccinated group had known SARS-CoV-2 infection. Most received monovalent mRNA COVID-19 vaccines during pregnancy, aside from two who received the viralvectored Ad26.COV2.S, and two received the bivalent mRNA vaccine during pregnancy. The median cord blood WA1/2020 RBD IgG titer was 5370 (412-7296) for first, 1225 (589-3289) for second, 2623 (664-5809) for third trimester in individuals who received aCOVID-19 vaccine dose during pregnancy, and 45 (10-187) in those unvaccinated and infected. After excluding thosewith infection, the cord blood IgG was 514 (106-4182), 1070 (518-2317), and 2477 (664-4470) for first, second, and third trimester, respectively. The rate of detectable WA1/2020 RBD IgG was 100% for all three trimesters, even when excluding infected individuals. For theXBBvariant, cord bloodRBDIgG titer was 284 (43-1296) for first, 66 (32-227) for second, 173 (45-389) for third trimester, and 10 (10-11) in the unvaccinated/infected group. Excluding infections, the cord blood XBB RBD IgG was 54 (10-128), 44 (25-181), and 152 (45-360) for first, second, and third trimester vaccination, respectively. The rate of detectable XBB IgG in those who received a vaccine during pregnancy were 83%, 91%, and 90% for first, second, and third trimester respectively, compared to 17% in the unvaccinated/infected group. Excluding infections, the rate of XBB RBD IgG detection was 66%, 89%, and 95% for first, second, and third trimester vaccination, respectively. Conclusion(s): Vaccination during pregnancy leads to high rates of detectable cord blood IgG specific to SARS-CoV-2 WA1/2020 variant and current circulating variants (XBB), regardless of trimester of vaccination. Infection history leads to higher cord blood IgG in vaccinated;however, infection alone without vaccination leads to lower titer and greater rates of undetectable cord IgG at delivery.

Comparison of Obstetric Outcomes in First and Second COVID-19 Waves: Analysis from a COVID-19-dedicated Tertiary Care Hospital

Introduction: The physiological changes in the respiratory and cardiovascular systems in the immunosuppressed state of pregnancy may exacerbate clinical features and deteriorate outcomes due to COVID-19 infection. We aimed to compare the maternal and neonatal adverse effects in the first and second COVID-19 waves. Methodology: This study was a prospective cohort study conducted in a tertiary care COVID-19-dedicated hospital. In total, 104 (group A) and 96 (group B) COVID-19-positive pregnant women admitted during the first and second waves, respectively, were included in the study. Data on baseline variables, associated comorbidities, clinical presentations, management strategies, and neonatal and maternal outcomes were collected and compared using parametric and nonparametric tests and analyzed. Result(s): Around 2.08% in group A and 6.72% in group B of COVID-19-infected pregnant women, respectively, had moderate-to-severe disease and required intensive care unit stay. Almost 1.04% in group A and 3.84% in group B had maternal mortality, 13.4% and 19.8% babies of groups A and B required admission in neonatal intensive care units, and 8.6% and 7.3% of newborns in groups A and B had COVID-19-positive reports by reverse transcriptase polymerase chain reaction (RT-PCR) at birth, respectively. Of them, 2.1% newborns in group B had RT-PCR positive on day 7 of life and beyond, whereas none had positive RT-PCR reports on 7 days and beyond in group A. Conclusion(s): Dreadful maternal outcomes like requirement of ICU and mechanical ventilator and persistence of neonatal infections were higher during the second wave.Copyright © The Author(s). 2023.