Creating safe classroom learning spaces for students living in urban areas of poverty

The current pilot study introduced trauma-informed professional development for teachers in an urban, K-8, Title I public school prior to the COVID-19 pandemic. Equipping middle school teachers with trauma knowledge and resources enabled them to modify their pedagogical approach to align better with students' emotional and academic needs shaped by living in poverty. Thematic analysis of qualitative data (i.e., 48 teacher journal entries, one focus group transcript) produced three overarching themes related to changes in teaching practices, student engagement, and classroom culture: (a) transforming to teach (i.e., teacher empathy, awareness, understanding of students' living conditions), (b) teaching to transform (i.e., teacher critical thinking about students' needs, reactions, and consequences), and (c) transforming to learn (student engagement, expressiveness, confidence). This study's findings highlight how middle school educators can effectively implement trauma-sensitive techniques in their classrooms to enhance safe learning spaces, student support, and classroom management for stress-affected young people. This study's university-community school partnership may offer a model for the design, structure, and resources necessary to implement classroom-level, trauma-informed professional development for Title I nonclinical middle school personnel. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Anxiety Management among Non-Clinical Society towards COVID-19 Pandemic in the Iranian Context

The COVID-19 pandemic has had a major effect on our lives. Many of us are facing challenges that can be stressful and overwhelming and cause strong emotions in adults and children. The purpose of this study was to measure the level of anxiety of non-clinical individuals in the Iranian community towards COVID-19 in Tehran. The present study is a descriptive correlational method with 308 individuals participating in the study through an online recall. A researcher-made coronary anxiety questionnaire with 18 questions was used to collect data. The data were analyzed by using Cronbach's alpha internal consistency and Guttman's λ2 method. Confirmatory factor analysis (CFA) using Lisrel-8.8 software was used to evaluate the tool construct validity. To standardize the raw scores, they were converted to standard T scores and percentile rank using Jmetrik-4.1.1 software and were prepared as normative tables. The Guttman's λ2 value for the whole questionnaire was obtained as (λ = 0.922), Cronbach's alpha coefficient for psychological symptoms as (α = 0.879), physical symptoms as (α = 0.861), and for the whole questionnaire as (α = 0.919). The range of scores of the questionnaire factors and total score of COVID-related anxiety severity based on standard T scores was divided into three domains: mild, moderate, and severe. The increase in psychological and physical symptom scores of coronavirus anxiety was significantly associated with physical symptoms, anxiety, depression, and social dysfunction. The fact that anxiety acts as a predisposing and health-threatening variable has confirmed that other researchers should examine its psychometric properties in other populations (especially compared to the clinical population to increase the diagnostic value of this questionnaire) as well as in relation to other psychological, social and medical concepts and variables. © 2022 Copyright 2022 by Koninklijke Brill NV, Leiden, The Netherlands.

Toxicological Assessments of a Pandemic COVID-19 Vaccine-Demonstrating the Suitability of a Platform Approach for mRNA Vaccines.

The emergence of SARS-CoV-2 at the end of 2019 required the swift development of a vaccine to address the pandemic. Nonclinical GLP-compliant studies in Wistar Han rats were initiated to assess the local tolerance, systemic toxicity, and immune response to four mRNA vaccine candidates encoding immunogens derived from the spike (S) glycoprotein of SARS-CoV-2, encapsulated in lipid nanoparticles (LNPs). Vaccine candidates were administered intramuscularly once weekly for three doses at 30 and/or 100 µg followed by a 3-week recovery period. Clinical pathology findings included higher white blood cell counts and acute phase reactant concentrations, lower platelet and reticulocyte counts, and lower RBC parameters. Microscopically, there was increased cellularity (lymphocytes) in the lymph nodes and spleen, increased hematopoiesis in the bone marrow and spleen, acute inflammation and edema at the injection site, and minimal hepatocellular vacuolation. These findings were generally attributed to the anticipated immune and inflammatory responses to the vaccines, except for hepatocyte vacuolation, which was interpreted to reflect hepatocyte LNP lipid uptake, was similar between candidates and resolved or partially recovered at the end of the recovery phase. These studies demonstrated safety and tolerability in rats, supporting SARS-CoV-2 mRNA-LNP vaccine clinical development.

Establishment of multicenter COVID-19 therapeutics preclinical test system in Republic of Korea.

Throughout the recent COVID-19 pandemic, South Korea led national efforts to develop vaccines and therapeutics for SARS-CoV-2. The project proceeded as follows: 1) evaluation system setup (including Animal Biosafety Level 3 (ABSL3) facility alliance, standardized nonclinical evaluation protocol, and laboratory information management system), 2) application (including committee review and selection), and 3) evaluation (including expert judgment and reporting). After receiving 101 applications, the selection committee reviewed pharmacokinetics, toxicity, and efficacy data and selected 32 final candidates. In the nonclinical efficacy test, we used golden Syrian hamsters and human angiotensin-converting enzyme 2 transgenic mice under a cytokeratin 18 promoter to evaluate mortality, clinical signs, body weight, viral titer, neutralizing antibody presence, and histopathology. These data indicated eight new drugs and one repositioned drug having significant efficacy for COVID-19. Three vaccine and four antiviral drugs exerted significant protective activities against SARS-CoV-2 pathogenesis. Additionally, two anti-inflammatory drugs showed therapeutic effects on lung lesions and weight loss through their mechanism of action but did not affect viral replication. Along with systematic verification of COVID-19 animal models through large-scale studies, our findings suggest that ABSL3 multicenter alliance and nonclinical evaluation protocol standardization can promote reliable efficacy testing against COVID-19, thus expediting medical product development.

FDA and industry collaboration: Identifying opportunities to further reduce reliance on nonhuman primates for nonclinical safety evaluations.

The nonhuman primate (NHP) has always been a limited resource for pharmaceutical research with ongoing efforts to conserve. This is due to their inherent biological properties, the growth in biotherapeutics and other modalities, and their use in small molecule drug development. The SARS-CoV-2 pandemic has significantly impacted the availability of NHPs due to the immediate need for NHPs to develop COVID-19 vaccines and treatments and the China NHP export ban; thus, accelerating the need to further replace, reduce and refine (3Rs) NHP use. The impact of the NHP shortage on drug development led DruSafe, BioSafe, and the United States (U.S.) Food and Drug Administration (FDA) Center for Drug Evaluation and Research (CDER) to discuss this issue at their 2021 annual meeting. This meeting identified areas to further the 3Rs in NHP use within the current nonclinical safety evaluation regulatory framework and highlighted the need to continue advancing alternative methods towards the aspirational goal to replace use of NHPs in the long term. Alignment across global health authorities is necessary for implementation of approaches that fall outside existing guidelines. This article captures the proceedings from this meeting highlighting current best practices and areas for 3Rs in NHP use.

Clinical Application of Detecting COVID-19 Risks: A Natural Language Processing Approach.

The clinical application of detecting COVID-19 factors is a challenging task. The existing named entity recognition models are usually trained on a limited set of named entities. Besides clinical, the non-clinical factors, such as social determinant of health (SDoH), are also important to study the infectious disease. In this paper, we propose a generalizable machine learning approach that improves on previous efforts by recognizing a large number of clinical risk factors and SDoH. The novelty of the proposed method lies in the subtle combination of a number of deep neural networks, including the BiLSTM-CNN-CRF method and a transformer-based embedding layer. Experimental results on a cohort of COVID-19 data prepared from PubMed articles show the superiority of the proposed approach. When compared to other methods, the proposed approach achieves a performance gain of about 1-5% in terms of macro- and micro-average F1 scores. Clinical practitioners and researchers can use this approach to obtain accurate information regarding clinical risks and SDoH factors, and use this pipeline as a tool to end the pandemic or to prepare for future pandemics.

Open science and conflict of interest policies of medical and health sciences journals before and during the COVID-19 pandemic: A repeat cross-sectional study: Open science policies of medical journals.

Objectives: To audit the transparent and open science standards of health and medical sciences journal policies and explore the impact of the COVID-19 pandemic. Design: Repeat cross-sectional study. Setting: 19 journals listed in Google Scholar's Top Publications for health and medical sciences. Participants: Blood, Cell, Circulation, European Heart Journal, Gastroenterology, Journal of Clinical Oncology, Journal of the American College of Cardiology, Nature Genetics, Nature Medicine, Nature Neuroscience, Neuron, PLoS ONE, Proceedings of the National Academy of Sciences, Science Translational Medicine, The British Medical Journal, The Journal of the American Medical Association, The Lancet, The Lancet Oncology, and The New England Journal of Medicine. Main outcome measures: We used the Transparency and Openness Promotion (TOP) guideline and the International Committee of Medical Journal Editors (ICMJE) requirements for disclosing conflicts of interest (COIs) to evaluate journals standards. Results: TOP scores slightly improved during the COVID-19 pandemic, from a median of 5 (IQR: 2-12.5) out of a possible 24 points in February 2020 to 7 (IQR: 4-12) in May 2021, but overall, scores were very low at both time points. Journal policies scored highest for their adherence to data transparency and scored lowest for preregistration of study protocols and analysis plans and the submission of replication studies. Most journals fulfilled all ICMJE provisions for reporting COIs before (84%; n = 16) and during (95%; n = 18) the COVID-19 pandemic. Conclusions: The COVID-19 pandemic has highlighted the importance of practising open science. However, requirements for open science practices in audited policies were overall low, which may impede progress in health and medical research. As key stakeholders in disseminating research, journals should promote a research culture of greater transparency and more robust open science practices.

Hospital-based telework: The pandemic pilot

This narrative inquiry dissertation study explored the experiences of nonclinical hospital staff placed on pandemic-imposed telework status from the spring of 2020, spring 2022 due to COVID-19. The purpose of this study is to address gaps in the existing literature regarding the feasibility of hospital staff to telework and identify ways to strengthen manager trust in the context of remote work. The study provides an in-depth narrative on the impact of telework on nonclinical care hospital departments and to addresses lessons learned in making remote work more feasible.This study utilized qualitative narrative inquiry approach to address the central research question and two sub-questions. A convenience sample of 11 hospital staff who experienced pandemic imposed telework participated in open ended Microsoft Teams interviews and gave in depth feedback on their lived experience with telework. Verbatim transcripts were used to code and analyze emerging themes. ATLAS.ti Cloud software was used to code and develop thematic analysis of the interviews. A total of 72 unique codes and eight themes resulted from the analysis of the interviews. The result is six recommendations that support the roll out of telework within hospitals. These findings support current research regarding strengths and weaknesses of telework and identify ways to support managers and staff moving forward. Additionally, the research fills the gap in literature regarding the feasibility and experience of telework by nonclinical hospital staff. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

In Vitro and In Vivo Characterization of a Broadly Neutralizing Anti-SARS-CoV-2 Antibody Isolated from a Semi-Immune Phage Display Library.

Neutralizing antibodies targeting the receptor-binding domain (RBD) of SARS-CoV-2 are among the most promising strategies to prevent and/or treat COVID-19. However, as SARS-CoV-2 has evolved into new variants, most of the neutralizing antibodies authorized by the US FDA and/or EMA to treat COVID-19 have shown reduced efficacy or have failed to neutralize the variants of concern (VOCs), particularly B.1.1.529 (Omicron). Previously, we reported the discovery and characterization of antibodies with high affinity for SARS-CoV-2 RBD Wuhan (WT), B.1.617.2 (Delta), and B.1.1.529 (Omicron) strains. One of the antibodies, called IgG-A7, also blocked the interaction of human angiotensin-converting enzyme 2 (hACE2) with the RBDs of the three strains, suggesting it may be a broadly SARS-CoV-2 neutralizing antibody. Herein, we show that IgG-A7 efficiently neutralizes all the three SARS-CoV-2 strains in plaque reduction neutralization tests (PRNTs). In addition, we demonstrate that IgG-A7 fully protects K18-hACE2 transgenic mice infected with SARS-CoV-2 WT. Taken together, our findings indicate that IgG-A7 could be a suitable candidate for development of antibody-based drugs to treat and/or prevent SARS-CoV-2 VOCs infection.

Accuracy of telephone screening tools to identify dementia patients remotely: systematic review.

The COVID19 pandemic highlighted the need for remote diagnosis of cognitive impairment and dementia. Telephone screening for dementia may facilitate prompt diagnosis and optimisation of care. However, it is not clear how accurate telephone screening tools are compared with face-to-face screening. We searched Cochrane, MEDLINE, Embase, Web of Science, PubMed and Scopus for all English language papers published between January 1975 and February 2021 which compared telephone screening for dementia/ mild cognitive impairment and an in-person reference standard, performed within six-weeks. We subsequently searched paper reference lists and contacted authors if data were missing. Three reviewers independently screened studies for inclusion, extracted data, and assessed study quality using an adapted version of the Joanna Briggs Institute's critical appraisal tool. Twenty-one studies including 944 participants were found. No one test appears more accurate, with similar validities as in-person testing. Cut-offs for screening differed between studies based on demographics and acceptability thresholds and meta-analysis was not appropriate. Overall the results suggest telephone screening is acceptably sensitive and specific however, given the limited data, this finding must be treated with some caution. It may not be suitable for those with hearing impairments and anxiety around technology. Few studies were carried out in general practice where most screening occurs and further research is recommended in such lower prevalence environments.

Exploring the Status of Life Expectancy at Birth in Indian States and the Evolving Health Perspectives for well-being

The present study aims to assess the life expectancy at birth (LEB) of the fifteen major states in India and verify for the regional disparity in LEB over the study period. An analysis of secondary data on LEB is performed. The coefficient of variation (CV) of LEB across states is estimated to examine sigma-convergence and absolute convergence is assessed by means of ordinary least square (OLS) technique. Gini Coefficient is also used to measure the change in regional inequality in LEB over the time period. A technique of estimating divergence reduction is employed to assess the accomplishment of states on the LEB indicator. The sigma and absolute convergence estimation reveals that India is experiencing continuous gains in life expectancy and regional divide in LEB has reduced over the years. But a regional gap still remains. A variation in life expectancy is mostly caused by differences in the social determinants of health viz. potable water, medical care, sanitation, hygiene. The states which are aiming at improving LEB should focus on non-clinical measures as well to enhance the life span of individuals and also to reduce the burden on health infrastructure. The health policy design and implementation should also be designed in creating health rather than purely focused on curing illness. A pandemic like the coronavirus disease (COVID -19) has urged a new way of looking at health;beyond pharmaceutical measures. Social, meditative and technology based intervention can help in improving the life expectancy and other health indicators.

rVSV-ΔG-SARS-CoV-2-S vaccine: repeated intramuscular (IM) toxicity, local tolerance, immunogenicity and biodistribution study in NZW rabbits.

BriLife®, a vector-based vaccine that utilizes the recombinant vesicular stomatitis virus (VSV) platform to express and present the spike antigen of SARS-CoV-2, is undergoing testing in a phase 2 clinical trial in Israel. A nonclinical repeated-dose (GLP) toxicity study in New Zealand white rabbits was performed to evaluate the potential toxicity, local tolerance, immunogenicity and biodistribution of the vaccine. rVSV-ΔG-SARS-CoV-2-S (or vehicle) was administered intramuscularly to two groups of animals (106, 107 PFU/animal, n = 10/sex/group) on three occasions, at 2-week intervals, followed by a 3-week recovery period. Systemic clinical signs, local reactions, body weight, body temperature, food consumption, ophthalmology, urinalysis, clinical pathology, C-reactive protein, viremia and antibody levels were monitored. Gross pathology was performed, followed by organs/tissues collection for biodistribution and histopathological evaluation. Treatment-related changes were restricted to multifocal minimal myofiber necrosis at the injection sites, and increased lymphocytic cellularity in the iliac and mesenteric lymph nodes and in the spleen. These changes were considered related to the inflammatory reaction elicited, and correlated with a trend for recovery. Detection of rVSV-ΔG-SARS-CoV-2-S vaccine RNA was noted in the regional iliac lymph node in animals assigned to the high-dose group, at both termination time points. A significant increase in binding and neutralizing antibody titers was observed following vaccination at both vaccine doses. In view of the findings, it was concluded that the rVSV-ΔG-SARS-CoV-2-S vaccine is safe. These results supported the initiation of clinical trials.

Anxiety Management among Non-Clinical Society towards C OVI D-19 Pandemic in the Iranian Context

The COVID-19 pandemic has had a major effect on our lives. Many of us are facing challenges that can be stressful and overwhelming and cause strong emotions in adults and children. The purpose of this study was to measure the level of anxiety of nonclinical individuals in the Iranian community towards COVID-19 in Tehran. The present study is a descriptive correlational method with 308 individuals participating in the study through an online recall. A researcher-made coronary anxiety questionnaire with 18 questions was used to collect data. The data were analyzed by using Cronbach's alpha internal consistency and Guttman's lambda 2 method. Confirmatory factor analysis (CFA) using Lisrel-8.8 software was used to evaluate the tool construct validity. To standardize the raw scores, they were converted to standard T scores and percentile rank using Jmetrik-4.1.1 software and were prepared as normative tables. The Guttman's lambda 2 value for the whole questionnaire was obtained as (lambda = 0.922), Cronbach's alpha coefficient for psychological symptoms as (alpha = 0.879), physical symptoms as (alpha = 0.861), and for the whole questionnaire as (alpha = 0.919). The range of scores of the questionnaire factors and total score of COVID-related anxiety severity based on standard T scores was divided into three domains: mild, moderate, and severe. The increase in psychological and physical symptom scores of coronavirus anxiety was significantly associated with physical symptoms, anxiety, depression, and social dysfunction. The fact that anxiety acts as a predisposing and health-threatening variable has confirmed that other researchers should examine its psychometric properties in other populations (especially compared to the clinical population to increase the diagnostic value of this questionnaire) as well as in relation to other psychological, social and medical concepts and variables.

Laboratory information management system for COVID-19 non-clinical efficacy trial data.

BACKGROUND: As the number of large-scale studies involving multiple organizations producing data has steadily increased, an integrated system for a common interoperable format is needed. In response to the coronavirus disease 2019 (COVID-19) pandemic, a number of global efforts are underway to develop vaccines and therapeutics. We are therefore observing an explosion in the proliferation of COVID-19 data, and interoperability is highly requested in multiple institutions participating simultaneously in COVID-19 pandemic research. RESULTS: In this study, a laboratory information management system (LIMS) approach has been adopted to systemically manage various COVID-19 non-clinical trial data, including mortality, clinical signs, body weight, body temperature, organ weights, viral titer (viral replication and viral RNA), and multiorgan histopathology, from multiple institutions based on a web interface. The main aim of the implemented system is to integrate, standardize, and organize data collected from laboratories in multiple institutes for COVID-19 non-clinical efficacy testings. Six animal biosafety level 3 institutions proved the feasibility of our system. Substantial benefits were shown by maximizing collaborative high-quality non-clinical research. CONCLUSIONS: This LIMS platform can be used for future outbreaks, leading to accelerated medical product development through the systematic management of extensive data from non-clinical animal studies.

Perspective: Chicken Models for Studying the Ontogenetic Origin of Neuropsychiatric Disorders.

Nutrients and xenobiotics cross the blood-placenta barrier, potentially depositing in the fetal brain. The prenatal exposure affects the neuroendocrine and microbial development. The mechanism underlying maternal risk factors reprograming the microbiota-gut-brain axis with long-term effects on psychosocial behaviors in offspring is not clear. In humans, it is not possible to assess the nutrient or xenobiotic deposition in the fetal brain and gastrointestinal system for ethical reasons. Moreover, the maternal-fetal microbe transfer during gestation, natural labor, and breast-feeding constitutes the initial gut microbiome in the progeny, which is inevitable in the most widely utilized rodent models. The social predisposition in precocial birds, including chickens, provides the possibility to test behavioral responses shortly after being hatched. Hence, chickens are advantageous in investigating the ontogenetic origin of behaviors. Chicken embryos are suitable for deposition assessment and mechanistic study due to the accessibility, self-contained development, uniform genetic background, robust microbiota, and easy in vivo experimental manipulation compared to humans and rodents. Therefore, chicken embryos can be used as an alternative to the rodent models in assessing the fetal exposure effect on neurogenesis and investigating the mechanism underlying the ontogenetic origin of neuropsychiatric disorders.

Development of COVID-19 therapies: Nonclinical testing considerations.

Therapies have been developed in the last couple of years to allow vaccination against, or treatment of patients with, COVID-19 using pathways such as Emergency Use Authorization (EUA) in the USA and Conditional Marketing Authorization (CMA) in the EU and UK. However, nonclinical studies were performed to allow such authorization and these were reviewed for 6 vaccines, 7 biological (monoclonal antibodies [mAbs]) and 4 small molecule therapies to examine whether the number and types of studies normally needed for regulatory agency authorization have been reduced. Results showed that the short answer is generally no. Thus, a battery of immunogenicity/efficacy or related pharmacology/biological activity studies showing utility against SARS-CoV-2 were performed as well as general toxicity studies across all 3 compound classes along with pharmacokinetic studies for mAbs and small molecules and, reproduction toxicity testing for vaccines and small molecules; additionally, genotoxicity testing occurred for small molecules. What was different from conventional, lengthy drug development, was that for vaccines and small molecules, leverage to existing platform technology or data available for other development programs, respectively, occurred. Recognition that mAbs can target the spike protein leading to neutralization allowed rapid development into clinical candidates.

Proposal for the revision of the guidelines for Non-clinical studies of vaccines for the prevention of infectious diseases in Japan.

The efficacy and safety of vaccines for the prevention of infectious diseases are mostly evaluated based on the induction of an immune response against antigens, and do not necessarily depend on the dose administered. Therefore, there are some specific aspects that need to be considered in the development of vaccines and have been described in "The Guidelines for the non-clinical studies of vaccines for the prevention of infectious disease" in Japan. Recent changes in the vaccine development field, such as the introduction of vaccines developed overseas in Japan and vaccine development on a global scale have increased the need for revision of these guidelines. In this study, we identified the current challenges in the development of vaccines through comparison of Japanese and international guidelines. We conducted a questionnaire-based survey of pharmaceutical industries in Japan, and found issues related to non-clinical studies, such as the necessity of safety pharmacology studies and repeated-dose toxicity studies for each route of administration. We examined international guidelines on these issues as well as review reports by regulatory authorities, and determined that the results of repeated-dose toxicity studies can be used to decide whether safety pharmacology studies are required, and that studies to evaluate toxicity due to systemic effects may not be necessary for both intramuscular and subcutaneous administration. We propose revision of the guidelines for the non-clinical studies of vaccines in Japan taking international harmonizaion into account. We expected that the revised guidelines will promote smooth and rational vaccine development.

The Effectiveness of a Nonguided Mindfulness App on Perceived Stress in a Nonclinical Dutch Population: Randomized Controlled Trial.

BACKGROUND: Mindfulness has become increasingly popular, and positive outcomes have been reported for mindfulness-based interventions (MBIs) in reducing stress. These findings make room for innovative perspectives on how MBIs could be applied, for instance through mobile health (mHealth). OBJECTIVE: The aim of this study is to investigate whether a nonguided mindfulness mobile app can decrease perceived stress in a nonclinical Dutch population over the course of 8 weeks, with follow-up at 6 months. METHODS: A randomized controlled trial was performed to compare an experimental group that made use of a structured 8-week mHealth mindfulness program and a control group after 8 weeks, with follow-up after 6 months. Participants were recruited via a national television program. The primary outcome measure was perceived stress as measured by the Perceived Stress Scale, secondary outcomes were symptoms of burnout (measured using the visual analog scale [VAS]) and psychological symptoms (measured using the Four-Dimensional Symptom Questionnaire [4DSQ] at follow-up). Outcomes were analyzed using a multilevel regression model. RESULTS: At baseline, 587 respondents were included. Results showed no postintervention differences between groups for the level of perceived stress. With regard to the secondary outcome measures, the VAS for emotional exhaustion and physical exhaustion showed significantly lower scores for the experimental group after 8 weeks (P=.04 and P=.01, respectively), but not at follow-up. There were no differences between groups for psychological symptoms measured using the 4DSQ. CONCLUSIONS: These findings do not support our hypothesis that using the mindfulness app would reduce stress levels. However, our findings related to diminished exhaustion at 8 weeks are encouraging and require further investigation. TRIAL REGISTRATION: ClinicalTrials.gov NCT05246800; https://clinicaltrials.gov/show/NCT05246800.

The perceptions of anatomy teachers for different majors during the COVID-19 pandemic: a national Chinese survey.

During the spring semester of 2020, medical school anatomists in China were forced by the COVID-19 pandemic to transition from face-to-face educators or part-time online educators to full-time online educators. This nationwide survey was conducted to assess online anatomy education during the pandemic for medical students from nonclinical medicine and clinical medicine majors at medical schools in China via WeChat. The total of 356 responders included 293 responders from clinical medicine and 63 respondents from nonclinical medicine majors (i.e., 21 from preventive medicine, 13 from stomatology, and 29 from traditional Chinese medicine). The survey results showed that several aspects of online anatomy education were quite similar in clinical and nonclinical majors' classes, including theoretical and practical sessions, active learning, assessments and evaluations. However, there were statistically significant differences in class size, implementation of active learning activities prior to the pandemic, and the evaluation of the effectiveness of online learning during the pandemic, between clinical and nonclinical medicine majors. These results indicated that, compared with teachers of anatomy courses in clinical medicine, teachers of nonclinical medicine majors using online learning in medical schools in China had relatively poor preparation for online learning in response to the unforeseen pandemic.

Vaccinating adolescents against SARS-CoV-2 in England: a risk-benefit analysis.

OBJECTIVE: To offer a quantitative risk-benefit analysis of two doses of SARS-CoV-2 vaccination among adolescents in England. SETTING: England. DESIGN: Following the risk-benefit analysis methodology carried out by the US Centers for Disease Control, we calculated historical rates of hospital admission, Intensive Care Unit admission and death for ascertained SARS-CoV-2 cases in children aged 12-17 in England. We then used these rates alongside a range of estimates for incidence of long COVID, vaccine efficacy and vaccine-induced myocarditis, to estimate hospital and Intensive Care Unit admissions, deaths and cases of long COVID over a period of 16 weeks under assumptions of high and low case incidence. PARTICIPANTS: All 12-17 year olds with a record of confirmed SARS-CoV-2 infection in England between 1 July 2020 and 31 March 2021 using national linked electronic health records, accessed through the British Heart Foundation Data Science Centre. MAIN OUTCOME MEASURES: Hospitalisations, Intensive Care Unit admissions, deaths and cases of long COVID averted by vaccinating all 12-17 year olds in England over a 16-week period under different estimates of future case incidence. RESULTS: At high future case incidence of 1000/100,000 population/week over 16 weeks, vaccination could avert 4430 hospital admissions and 36 deaths over 16 weeks. At the low incidence of 50/100,000/week, vaccination could avert 70 hospital admissions and two deaths over 16 weeks. The benefit of vaccination in terms of hospitalisations in adolescents outweighs risks unless case rates are sustainably very low (below 30/100,000 teenagers/week). Benefit of vaccination exists at any case rate for the outcomes of death and long COVID, since neither have been associated with vaccination to date. CONCLUSIONS: Given the current (as at 15 September 2021) high case rates (680/100,000 population/week in 10-19 year olds) in England, our findings support vaccination of adolescents against SARS-CoV2.