A New Registry for Genetic Diagnosis of Inborn Errors of Immunity within the Military Health System

Genotypic definition of monogenic inborn errors of immunity (IEIs) continues to accelerate with broader access to next generation sequencing, underscoring this aggregated group of disorders as a major health burden impacting both civilian and military populations. At an estimated prevalence of 1 in 1200 individuals, IEIs affect ~8,000 patients within the Military Health System (MHS). Despite access to targeted gene/exome panels at military treatment facilities, most affected patients never receive a definitive genetic diagnosis that would significantly improve clinical care. To address this gap, we established the first registry of IEI patients within the MHS with the goal of identifying known and novel pathogenic genetic defects to increase diagnosis rates and enhance clinical care. Using the registry, a research protocol was opened in July 2022. Since July we have enrolled 75 IEI patients encompassing a breadth of phenotypes including severe and recurrent infections, bone marrow failure, autoimmunity/autoinflammation, atopic disease, and malignancy. Enrolled patients provide blood and bone marrow samples for whole genome, ultra-deep targeted panel and comprehensive transcriptome sequencing, plus cryopreservation of peripheral blood mononuclear cells for future functional studies. We are also implementing and developing analytical methods for identifying and interrogating non-coding and structural variants. Suspected pathogenic variants are adjudicated by a clinical molecular geneticist using state-of-the-art analysis pipelines. These analyses subsequently inform in vitro experiments to validate causative mutations using cell reporter systems and primary patient cells. Clinical variant validation and return of genetic results are planned with genetic counseling provided. As a proof of principle, this integrated genetic evaluation pipeline revealed a novel, candidate TLR7 nonsense variant in two adolescent brothers who both endured critical COVID-19 pneumonia, requiring mechanical ventilation and extracorporeal membrane oxygenation. Our protocol is therefore poised to greatly enrich clinical genetics resources available in the MHS for IEI patients, contributing to better diagnosis rates, informed family counseling, and targeted treatments that collectively improve the health and readiness of the military community. Moreover, our efforts should yield new mechanistic insights on immune pathogenesis for a broad variety of known and novel IEIs.Copyright © 2023 Elsevier Inc.

Design of a cost-effective diagnosis tool for SARSCov-2 variant detection through a next generation sequencing (NGS) based strategy

Background/Objectives: Current pandemic situation, together with the continuous emergence of new SARS-CoV-2 variants reveal the need to develop a more versatile tool than PCR-based methods that allows both high throughput COVID-19 diagnostic and specific variant detection at reduced cost and fast turnaround times. Thus, with the aim of overcoming current test limitations and providing a strategy with these characteristics arises our novel next generation sequencing based approach. Method(s): The developed strategy works with RNA samples obtained from nasopharyngeal swabs. RNA samples are processed with our custom laboratory protocol and can be sequenced with any Illumina platform to generate results within a 24h timeframe. A tailored bioinformatic pipeline analyzes the data and generates a clinical-level report. Result(s): Clinical validation results have shown that the designed solution, sensitively and specifically identifies negative and positive samples that display a broad range in viral loads and readily identifies the following major SARS-CoV-2 variants of concern (VoC): Alpha, Beta, Gamma, Delta, Lambda and Omicron (BA.1 and BA.2). Conclusion(s): The versatility of our solution allows the capability of identifying the presence of other common respiratory viruses as well as identifying patients at risk through the identification of susceptibility human variants in the host. This, together with the possibility of easily adding new VoC as they emerge, will make VoC monitoring in entire populations feasible, providing a new perspective on the application of NGS methods in the field of clinical microbiology.

Liquid biopsy testing in metastatic or advanced breast cancer patients during the COVID-19 pandemic

Objective: During the COVID-19 pandemic, cancer patients had restricted access to standard of care tissue biopsy. Liquid biopsy assays using next generation sequencing technology provides a less invasive method for determining circulating tumour mutations (ctDNA) associated with targeted treatments or prognosis. As part of deploying technology to help cancer patients obtain molecular testing, a clinical program was initiated to offer liquid biopsy testing for Canadian patients with advanced or metastatic breast cancer. Method(s): Blood was drawn in two 10 mL StreckTM DNA BCTs and sent to the CAP/CLIA/DAP accredited Imagia Canexia Health laboratory for testing using the clinically validated Follow ItTM liquid biopsy assay. Plasma was isolated using a double spin protocol and plasma cell-free DNA (cfDNA) extracted using an optimized Promega Maxwell RSC method. Extracted cfDNA was amplified using the multiplex amplicon-based hotspot 30 or 38 gene panel and sequenced. An inhouse developed bioinformatics pipeline and reporting platform were used to identify pathogenic single nucleotide variants (SNVs), indels (insertions and deletions), and gene amplification. Included in the panel are genes associated with metastatic breast cancer: AKT1, BRAF, ERBB2, ESR1, KRAS, PIK3CA, TP53. Result(s): To identify biomarkers, 1214 metastatic or advanced breast cancer patient cfDNA samples were tested. There were 15 cases sent for repeat testing. We reported 48% of samples harboring pathogenic ctDNA mutations in TP53 (22%), PIK3CA (19%), ESR1 (18%), AKT1 (2%), ERBB2 (1.5%). Co-occurring variants were identified in samples with ESR1/PIK3CA as well as TP53/PIK3CA (both p-values <0.001). Interestingly, 29% of samples with mutated ESR1 harbored >= 2 ESR1 ctDNA mutations. In 56% of cases, previous molecular testing indicated the cancer subtype as hormone receptor (ER, PR) positive with/without HER2 negative status. In this specific subgroup, 49% harbored ctDNA mutations with 63% of those being PIK3CA and/or ESR1 mutations. Conclusion(s): A population of Canadian women with metastatic breast cancer were tested using a liquid biopsy gene panel during the COVID-19 pandemic for identification of biomarkers for targeted therapeutic options. Over 50% of the samples were identified as hormone positive, with greater than 60% harboring PIK3CA and ESR1 ctDNA mutations. Studies have shown that metastatic PIK3CA mutated ER-positive/HER2-negative tumors are predictive to respond to alpelisib therapy and have FDA and Health Canada approval. Additionally, ESR1 mutations are associated with acquired resistance to antiestrogen therapies, and interestingly we identified 29% of ESR1 mutated samples with multiple mutations possibly indicating resistance subclones. In future studies, longitudinal monitoring for presence of multiple targetable and resistance mutations could be utilized to predict or improve clinical management.

Challenges in the construction of a tunnel under crossing a channel in Singapore

To increase the conveyance capacity to Western Singapore and to meet long-term water needs in a more cost-effective manner, four new transmission pipelines consisting of 2 numbers of 2200 mm diameter and 2 numbers of 1200mm diameter water pipes will be needed by 2024 to convey water from a Water Reclamation Plant to existing networks in the western region of Singapore. Out of the several possible routes studied, the most cost-effective and technically feasible route was selected by laying the proposed 1.6km-long pipelines that under crosses a channel via a 6m diameter subsea tunnel. This paper outlines the challenges the team faced throughout the project thus far. It also examines the difficulties such as the construction of a 56m-deep launching shaft near a highly sensitive 700mm diameter Gas Transmission Pipeline (GTP) and at a location with high groundwater;and manpower and supply disruptions caused by the COVID-19 pandemic situation. © 2023 The Author(s).

Patch leaks in the pipeline post-pandemic by preparing a resilient and sustainable community: classroom to college

Women faced barriers in academia during the pandemic, and the implications on higher education, their career, and students are meaningful. Research focuses on how the pandemic has affected college students' mental health (Son et al., [12]) and the effects of the pandemic on student success (Lederer et al., [7]). (Re)membering pre-COVID leaks to build resilient community Factors causing the "leaky pipeline" phenomenon, pre-COVID, were not fully understood or addressed;then, we experienced societal upheaval and a pandemic. [Extracted from the article] Copyright of Communication Education is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The Future of COVID-19: What Is Next in the Drug Pipeline

Objectives: Development of new and repurposed medicines in response to the COVID-19 pandemic has occurred at an unprecedented rate, resulting in a dynamic pipeline marked by significant challenges and successes. This analysis provides an overview of the vaccines and therapies undergoing clinical evaluation or with recent approval for the treatment and prevention of COVID-19 in global markets. Method(s): For this analysis, COVID-19 pipeline medicines are defined in three categories: vaccines, new treatments and repurposed medicines. GlobalData is the primary data source for this study, in addition to online databases from Health Canada, the US FDA, and the EMA. International markets examined include the US and geographic Europe (excluding Russia and Turkey). Result(s): As of November 2022, the global pipeline contained over 600 therapies and vaccines undergoing Phase I, II, III clinical trials or pre-registration for the prevention and treatment of COVID-19. Preventive and repurposed medicines include antivirals, immunoglobulins, monoclonal antibodies, cellular therapies, and convalescent plasma. In Canada, twelve medicines, including six vaccines, have been approved for COVID-19. The number of global approvals is greater, with approximately 9 vaccines on the market in OECD countries. In addition to pre-exposure preventative therapies, manufacturers are also developing COVID-19 drugs to be used as prophylactic therapy. The analysis identifies new oral antiviral treatments and preventative therapies in the pipeline and under review in various jurisdictions globally. Conclusion(s): This research provides a clearer picture of the characteristics and evolution of the market for new and emerging COVID-19 medicines, which will help policy-makers and other stakeholders understand and anticipate the unique pressures of the COVID-19 pandemic.Copyright © 2023

Identification of genetic determinants of COVID-19 severity by exome sequencing

Background/Objectives: The severity of the symptoms of coronavirus disease 2019 (COVID-19) has been associated to age, comorbidity, and male sex. Besides virus characteristics, host genetic factors influence the infection outcome. Different genome-wide association studies and meta-analyses investigated the contribution of common variants, whereas the role of rare variants just started to be elucidated. Our goal is to determine the contribution of rare variants to the development of severe COVID-19 in the Italian population. Method(s): We compared the genetic background of 215 severe COVID-19 patients with 1764 individuals from the general population. Rare variants (minor allele frequency <1%) from wholeexome sequencing data were retrieved using a bioinformatics variant discovery pipeline. We tested the impact of rare variants (classified according to their predicted effect on the gene product) both using a burden test design, and an iterative machine learning (ML) approach. Result(s): We identified a total of 690,000 rare variants in the entire examined population. Among them, 250 were associated with COVID-19 severity at a nominal P < 0.05. Gene-based burden test revealed a gene with an excess of loss-of-function mutations at P < 0.05. Finally, the ML approach, analysing all the 690,000 rare variants, identified the best combination of variants that is able to predict COVID-19 severity in our cohort. Conclusion(s): Our work provides new insights on the genetic signature of COVID-19 in the Italian population. The most informative rare variants could be exploited to define individuals' risk profiles to COVID-19 severity for the Italian population.

Equitable Access

The COVID-19 epidemic has once again highlighted the challenges to achieve equitable access to critical antimicrobials and vaccines. The problem is particularly acute for antimicrobials. Despite recent investments improving the pipeline for new treatments, most new treatments are not available to populations most in need, especially in low- and middle-income countries. Once a drug is approved a range of factors may hinder access, from lack incentives to register and commercialize products due to unattractive market potential to unfunded national action plans that can help improve the uptake and appropriate use of new tools to combat antibiotic resistance. Previous studies have shown that the majority of the 18 new antibacterials approved and launched between 2010-2020 were accessible in only 3 out of 14 high-income countries (Sweden, UK, and US). In low- and middle-income countries, the problem is even worse, with only 10 of the 25 new antibiotics that entered the market between 1999 and 2014 registered in more than ten countries. While lack of equitable access to life-saving medicines, diagnostics, and vaccines is not a new problem for infectious diseases, emerging opportunities and innovative approaches can help improve access globally. This talk will review promising recent developments in governance and collaborations, policies, economic models and initiatives that may help correct deadly inequities. For example, the objectives of the Access to COVID-19 Tools Accelerator may serve as model that convenes diverse actors to mount a coordinated access response which may be applied to access to other antimicrobials and vaccines. In addition, novel licensing agreements for access and stewardship to cefiderocol, an antimicrobial that is on the WHO Essential Medicines List can help serve as a pathfinder to accelerate equitable access to novel antimicrobials. The talk will also surface critiques of ongoing initiatives and raise questions for further study and discussion.Copyright © 2023

SARS-CoV-2 INFECTION AMONG PERSONS WHO INJECT DRUGS AND THEIR PARTNERS IN KENYA

Background: Despite increased social vulnerability and barriers to care, there has been a paucity of data on SARS-CoV-2 incidence among key populations in sub-Saharan Africa. We seek to characterize active infections and define transmission dynamics of SARS-CoV-2 among people who inject drugs (PWID) and their sexual and injecting partners from Nairobi and the coastal region in Kenya. Method(s): This was a nested cross-sectional study of SARS-CoV-2 infection from April to July 2021 within a cohort study of assisted partner services for PWID in Kenya. A total of 1000 PWID and their partners (500 living with and 500 living without HIV) were recruited for SARS-CoV-2 antibody testing, of whom 440 were randomly selected to provide self-collected nasal swabs for real-time PCR testing. Whole genome sequencing (WGS) was completed on a limited subset of samples (N=23) with cycle threshold values 32.0. Phylogenetic tree construction and analysis was performed using the Nextstrain pipeline and compared with publicly available SARS-CoV-2 sequences from GenBank. Result(s): A total of 438 (99.5%) participants provided samples for SARS-CoV-2 PCR testing. Median age was 37 (IQR 32-42);128 (29.2%) were female;and 222 (50.7%) were living with HIV. The overall prevalence of SARS-CoV-2 infection identified by RT-PCR was 86 (19.6%). In univariate analyses, there was no increased relative risk of SARSCoV- 2 infection related to positive HIV status, frequenting an injection den, methadone treatment, unstable housing, report of any high-risk exposure, or having a sexual or injecting partner diagnosed with COVID-19 or who died from COVID-19 or flu-like illness. Eight samples were successfully sequenced via WGS and classified as WHO variants of concern: 3 Delta, 3 Alpha, and 2 Beta. Seven were classified into clades predominantly circulating in Kenya during 2021. Notably, two sequences were identical and matched identically to another Kenyan sequence, which is consistent with, though not indictive of, a transmission linkage. Conclusion(s): Overall, the risk of SARS-CoV-2 infection in this population of PWID and their partners was not significantly associated with risk factors related to injection drug use. At a genomic level, the SARS-CoV-2 strains in this study were consistent with contemporary Kenyan lineages circulating during the time and not unique to PWID. Prevention efforts, therefore, must also focus on marginalized groups for control given the substantial amount of mixing that likely occurs between populations.

Hiv Detection in Wastewater as a New Epidemiological Tool

Background: Wastewater represents a broad, immediate, and unbiased accounting of the pathgens in the population. We aimed to develop methods to track HIV in wastewater utilizing a viral detection pipeline adapted from platforms developed to track SARS-COV-2. Method(s): We used samples from 6 wastewater treatment plants in the Houston area. We focused on regions of higher prevalence and lower prevalence. First, employing wastewater processing and nucleic acid extraction methods described by our group to detect SARS-COV-2, we tested a single high and low prevalence site in triplicate with all 3 primer sets. nucleic acid extracts from HIV and SIV cell culture supernatants were used as controls. Next, in subsequent samples, RT-PCR reactions with detections were subjected to gel electrophoresis to determine the amplified product sizes. To further confirm HIV detection, we sequenced the RT-PCR products and compared the proportion of reads which mapped to the expected amplified product. In a later set of studies, we fractionated samples into supernatant and pellet. We further tested HIV presence by performing whole virome sequencing on the extracts from some samples that produced detections and mapped reads to published genomes. A crAssphage genome was used as a negative control. Result(s): Samples from all sites resulted in signal detection at least once. Only reactions with gag and pol primers appeared to amplify the expected product. Products from the HIV positive control mapped almost exclusively to the HIV genome (97-100% of reads), with a fraction of reads from the SIV negative control doing the same (16-18% of reads). The ltr and pol products did not map the HIV genome while gag products did (34-44% of reads). Among the fractionated sample, in total, 6 supernatant fractions produced no detection compared to 7 of 8 pellet fractions. The whole virome sequencing produced reads that mapped to the HIV genome with at least 8X depth coverage. The sample with the lowest Ct detection (26) yielded HIV coverage several logs greater than those samples with higher Ct detection (37). Reads from all samples mapped to at least 20% of the HIV genome. Conclusion(s): This work provides the first evidence that HIV can be detected in municipal wastewater systems and has the potential to be developed into a new public health tool.

Future Directions in Outpatient Therapy for Mild to Moderate Covid-19

Robust efforts to rapidly develop outpatient therapies for acute COVID-19 leveraged existing platforms and small molecule antivirals originally developed for other viral infections to rapidly identify multiple effective therapies that reduce risk for hospitalization and death in persons at increased risk for severe COVID-19 and have been authorized for this use. These have included single and combination anti-SARS-CoV-2 monoclonal antibodies (mAbs), remdesivir, nirmatrelvir/ritonavir, molnupiravir, and convalescent plasma in select populations. However, the limitations of mAbs became evident early, and none are currently authorized for use in the U.S. The remaining available therapies each have limitations, such as drug-drug interactions, challenges with administration, or uncertain and potentially lower efficacy. In this presentation, we will discuss the evidence for antiviral therapy for mild-to-moderate COVID-19 - who should be treated - in today's context of vaccinations, prior infections, and lower hospitalization and death rates. We will also discuss selection of therapy for immunocompromised persons and touch on the COVID-19 therapeutics pipeline and current challenges in outpatient COVID-19 clinical trial design.

Predicting COVID-19 Severity Integrating RNA-Seq Data Using Machine Learning Techniques

A fundamental challenge in the fight against COVID-19 is the development of reliable and accurate tools to predict disease progression in a patient. This information can be extremely useful in distinguishing hospitalized patients at higher risk for needing UCI from patients with low severity. How SARS-CoV-2 infection will evolve is still unclear. Method(s): A novel pipeline was developed that can integrate RNA-Seq data from different databases to obtain a genetic biomarker COVID-19 severity index using an artificial intelligence algorithm. Our pipeline ensures robustness through multiple cross-validation processes in different steps. Result(s): CD93, RPS24, PSCA, and CD300E were identified as COVID-19 severity gene signatures. Furthermore, using the obtained gene signature, an effective multi-class classifier capable of discrimi-nating between control, outpatient, inpatient, and ICU COVID-19 patients was optimized, achieving an accuracy of 97.5%. Conclusion(s): In summary, during this research, a new intelligent pipeline was implemented to develop a specific gene signature that can detect the severity of patients suffering COVID-19. Our approach to clinical decision support systems achieved excellent results, even when processing unseen samples. Our system can be of great clinical utility for the strategy of planning, organizing and managing human and material resources, as well as for automatically classifying the severity of patients affected by COVID-19.Copyright © 2023 Bentham Science Publishers.

Drum Up SUPPORT: Systematic Analysis of Image-Schematic Conceptual Metaphors

Conceptual metaphors represent a cognitive mechanism to transfer knowledge structures from one onto another domain. Image-schematic conceptual metaphors (ISCMs) specialize on transferring sensorimotor experiences to domains. Natural language is believed to provide evidence of such metaphors. However, approaches to verify this hypothesis largely rely on top-down methods, gathering examples by way of introspection, or on manual corpus analyses. In order to contribute towards a method that is systematic and can be replicated, we propose to bring together existing processing steps in a pipeline to detect ISCMs, exemplified for the image schema SUPPORT in the COVID-19 domain. This pipeline consists of neural metaphor detection, dependency parsing to uncover construction patterns, clustering, and BERT-based frame annotation of dependent constructions to analyze ISCMs. © 2022 Association for Computational Linguistics.

Characteristics of the Health Service Psychologist Workforce

This article describes major employment and demographic trends in the health service psychologist workforce with information provided about clinical psychology where available. Workforce projections suggest the workforce is insufficiently sized and inadequately trained to respond to future health needs, such as those from Hispanic and older adult populations. Still, there are encouraging shifts toward greater racial/ethnic diversity in the workforce and increasing ratings of knowledge about working with diverse populations. Future directions consider implications for education and practice, such as the possible role of telehealth and the impact of the COVID-19 pandemic. © 2022 Elsevier Ltd. All rights reserved

An automated machine learning model for diagnosing COVID-19 infection

The coronavirus disease 2019 (COVID-19) epidemic still impacts every facet of life and necessitates a fast and accurate diagnosis. The need for an effective, rapid, and precise way to reduce radiologists' workload in diagnosing suspected cases has emerged. This study used the tree-based pipeline optimization tool (TPOT) and many machine learning (ML) algorithms. TPOT is an open-source genetic programming-based AutoML system that optimizes a set of feature preprocessors and ML models to maximize classification accuracy on a supervised classification problem. A series of trials and comparisons with the results of ML and earlier studies discovered that most of the AutoML beat traditional ML in terms of accuracy. A blood test dataset that has 111 variables and 5644 cases were used. In TPOT, 450 pipelines were used, and the best pipeline selected consisted of radial basis function (RBF) Sampler preprocessing and Gradient boosting classifier as the best algorithm with a 99% accuracy rate. © 2023, Institute of Advanced Engineering and Science. All rights reserved.

A framework for real-time monitoring, analysis and adaptive sampling of viral amplicon nanopore sequencing.

The ongoing SARS-CoV-2 pandemic demonstrates the utility of real-time sequence analysis in monitoring and surveillance of pathogens. However, cost-effective sequencing requires that samples be PCR amplified and multiplexed via barcoding onto a single flow cell, resulting in challenges with maximising and balancing coverage for each sample. To address this, we developed a real-time analysis pipeline to maximise flow cell performance and optimise sequencing time and costs for any amplicon based sequencing. We extended our nanopore analysis platform MinoTour to incorporate ARTIC network bioinformatics analysis pipelines. MinoTour predicts which samples will reach sufficient coverage for downstream analysis and runs the ARTIC networks Medaka pipeline once sufficient coverage has been reached. We show that stopping a viral sequencing run earlier, at the point that sufficient data has become available, has no negative effect on subsequent down-stream analysis. A separate tool, SwordFish, is used to automate adaptive sampling on Nanopore sequencers during the sequencing run. This enables normalisation of coverage both within (amplicons) and between samples (barcodes) on barcoded sequencing runs. We show that this process enriches under-represented samples and amplicons in a library as well as reducing the time taken to obtain complete genomes without affecting the consensus sequence.

Safety and efficacy of flow diverter stents in the treatment of middle cerebral artery aneurysms: a single-center experience and follow-up data

PURPOSE: This study aims to evaluate the safety and efficacy of flow diverters (FDs) in the treatment of middle cerebral artery (MCA) aneurysms and share the follow-up (F/U) results. METHODS: The treatment and F/U results of 76 MCA aneurysms treated with the flow re-direction endoluminal device (FRED), FRED Jr., and pipeline embolization device (PED) FD stents were evaluated retrospectively. The aneurysm occlusion rates were compared between FDs, and the integrated and jailed branches were evaluated through follow-ups. The oversizing of the stent was compared between occluded/non-occluded aneurysms and integrated branches. RESULTS: The mean F/U duration was 32 ± 6.3 months, and the mean aneurysm diameter was 4.45 mm. A total of 61 (80.3%) aneurysms were wide-necked; 73 (96.1%) were saccular; 52 (68.4%) were located at the M1 segment; and 36 (45.6%) FREDs, 23 (29.1%) FRED Jr.s, and 19 (24.1%) PEDs were used for treatment. The overall occlusion rates for the 6-, 12-, 24-, 36-, and 60-month digital subtraction angiographies were 43.8%, 63.5%, 73.3%, 85.7%, and 87.5% respectively. The last F/U occlusion rates were 67.6% for FRED, 66.7% for PED, and 60.6% for FRED Jr. (P = 0.863). An integrated branch was covered with an FD during the treatment of 63 (82.8%) aneurysms. A total of six (10%) of the integrated branches were occluded without any symptoms at the last F/U appointment. The median oversizing was 0.45 (0-1.30) for occluded aneurysms, and 0.50 (0-1.40) for non-occluded aneurysms (P = 0.323). The median oversizing was 0.70 (0.45-1.10) in occluded integrated branches and 0.50 (0-1.40) in non-occluded branches (P = 0.131). In-stent stenosis was seen in 22 (30.1%) of the stents at the 6-month F/U and in only 2 (4.7%) at the 24-month F/U. Thus, none of the patients had any neurological deficits because of the in-stent stenosis. Severe in-stent stenosis was seen in two stents. CONCLUSION: MCA aneurysms tend to be complex, with integrated branches and potentially wide necks. FD stents are safe and effective in the treatment of MCA aneurysms, and the patency of the side and jailed branches is preserved in most cases. Higher occlusion and lower in-stent stenosis rates are seen with longer F/U durations.

Recent Developments and Opportunities in Fighting COVID-19

Background: COVID-19, a Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov-2), was first diagnosed in the patients from Wuhan, China, in December 2019. Within a cou-ple of months of infection, it was declared as pandemic by the World health organization. COVID-19 has become the most contagious infection with a serious threat to global health. In this review, we aimed to discuss the pathogenesis, diagnostics, current treatments and potential vaccines for COVID-19. Method(s): An extensive literature search was conducted using keywords "COVID-19";"Coron-avirus";"SARS-Cov-2";"SARS" in public domains of Google, Google scholar, PubMed, and Sci-enceDirect. Selected articles were used to construct this review. Result(s): SARS-Cov-2 uses the Spike (S) protein on its surface to recognize the receptor on an-giotensin-converting enzyme 2 (ACE2) and bind with 10-folds greater affinity than SARS-Cov-1. Molecular assays and immunoassays are the most frequently used tests, whereas computed tomog-raphy (CT) scans and artificial intelligence enabled diagnostic tools were also used in patients. In therapeutic treatment, few drugs were repurposed and about 23 therapeutic molecules, including the repurposed drugs are at different stages of the clinical trial. Similarly, the development of vaccines is also in the pipeline. Few countries have managed well to contain the spread by rapid testing and identifying the clusters. Conclusion(s): Till now, the acute complications and mortality of COVID-19 have been linked to pre-existing comorbid conditions or age. Besides the development of therapeutic strategies that include drugs and vaccine, the long term implication of COVID-19 infection in terms of the disor-der/disability in the cured/discharged patients is a new area to investigate.Copyright © 2021 Bentham Science Publishers.

The story of a model restorative school: Creative response to conflict at MS 217 in Queens, NY

Purpose: Restorative practice programs in the USA and Western elementary and secondary schools have been the focus of intensive, large scale field research that reports positive impacts on school climate, pro-social student behavior and aggressive behavior. This paper aims to contribute to a gap in the research by reporting a case study of transformation of an urban middle school in a multi-year implementation of restorative practices. Design/methodology/approach: This paper reports how Creative Response to Conflict (CRC) supported the transformation of Middle School 217, in Queens, NY, from a school with one of the highest suspension rates in New York City to a model restorative school. CRC's model, which incorporates the themes of cooperation, communication, affirmation, conflict resolution, mediation, problem-solving, bias awareness, bullying prevention and intervention, social-emotional learning and restorative practices, helped shift the perspective and practice of the entire school community from punitive to restorative. Findings: Implementation of a full school advisory program using restorative circles for all meetings and classes and development of a 100% respect program committing all school community members to dignified and respectful treatment aided the transformation. Key to MS 217's success was the collaboration of multiple non-profit organizations for provision of peer mediation training, after-school follow-up work, staff coaching and preventative cyberbullying training through the Social Media-tors! Program. Research limitations/implications: Challenges to the restorative practices implementation are reviewed with attention to the implementation online during COVID-19. Originality/value: Next steps in the program post-COVID are articulated as a best practice model for other schools interested in adopting MS 217's commitment, creativity and community-building to become a model restorative school. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

CampusX: An IoT-Powered Real-Time Monitoring System for University Campuses

There is an ever-urgent need for accessing real-time crowdedness and airflow information for indoor study spaces in universities, for example, to control COVID-19 transmission risk. Even before the pandemic, many students spent valuable time finding suitable study areas with proper lighting, low noise, and ample seating. This paper presents a pilot system, CampusX, which aims to provide students with useful real-time information about study spaces on campus. Our system collects and analyzes environmental data before presenting them to students as useful information. This helps them to select the most suitable study spaces. The main components of this system include a sensor platform, data collection and processing pipelines, networking, and an interactive web-application. © 2023 IEEE.