Platform Behavior under Market Shocks: A Simulation Framework and Reinforcement-Learning Based Study

We study the behavior of an economic platform (e.g., Amazon, Uber Eats, Instacart) under shocks, such as COVID-19 lockdowns, and the effect of different regulation considerations. To this end, we develop a multi-agent simulation environment of a platform economy in a multi-period setting where shocks may occur and disrupt the economy. Buyers and sellers are heterogeneous and modeled as economically-motivated agents, choosing whether or not to pay fees to access the platform. We use deep reinforcement learning to model the fee-setting and matching behavior of the platform, and consider two major types of regulation frameworks: (1) taxation policies and (2) platform fee restrictions. We offer a number of simulated experiments that cover different market settings and shed light on regulatory tradeoffs. Our results show that while many interventions are ineffective with a sophisticated platform actor, we identify a particular kind of regulation - fixing fees to the optimal, no-shock fees while still allowing a platform to choose how to match buyers and sellers - as holding promise for promoting the efficiency and resilience of the economic system. © 2023 ACM.

Advantages of Total Bilirubin for Predicting Malignant Obstructive Jaundice, A Combination of the Pandemic Era and Limited Resources Settings

BACKGROUND: Hepatopancreatobiliary (HPB) cancer incidence and mortality are increasing worldwide. An initial diagnostic predictor is needed for recommending further diagnostic modalities, referral, and curative or palliative decisions. There were no studies conducted in area with limited accessibility setting of the COVID-19 pandemic, coupled with limited human resources and facilities. AIM: We aimed to investigate the advantages of total bilirubin for predicting malignant obstructive jaundice, a combination of the pandemic era and limited resources settings. METHOD(S): Data from all cholestasis jaundice patients at M. Djamil Hospital in Pandemic COVID-19 period from July 2020 to May 2022 were retrospectively collected. The data included demographics, bilirubin fraction results, and final diagnosis. Bivariate analysis for obtain demographic risk factor, and Receiver Operating Characteristics (ROC) analysis for getting bilirubin value. RESULT(S): Of a total 132 patients included, 35.6% were malignant obstructive jaundice, and Pancreatic adeno ca was the most malignant etiology (34.4%). Bivariate analysis showed a significant correlation between age and malignant etiology (p = 0,024). Direct and total Bilirubin reach the same level of Area Under Curve (AUC). Total bilirubin at the cutoff point level of 10.7 mg/dl had the most optimal results on all elements of ROC output, AUC 0.88, sensitivity 76.6%, specificity 90.1%, +LR 8.14, and-LR 0.26. CONCLUSION(S): The bilirubin fraction is a good initial indicator for differentiating benign and malignant etiology (AUC 0.8-0.9) in pandemic era and resource-limited areas to improve diagnostic effectiveness and reduce referral duration.Copyright © 2023 Avit Suchitra, M. Iqbal Rivai, Juni Mitra, Irwan Abdul Rachman, Rini Suswita, Rizqy Tansa.

Television coverage of gender-based violence in Spain during lockdown

This article analyzes the presence of gender-based violence on free-to-air Spanish television (TV) channels La1, Antena 3, Tele 5, La Sexta, and Cuatro throughout their 24-h daily broadcasting, between March 20, 2020 and June 20, 2020, along with the same period for the year 2019. This article studies whether, despite the COVID-19-dominated agenda of media coverage of gender-based violence increased or decreased, driven by government policies to protect potential victims. Also, we analyze whether any TV channels provided tools (such as the 016 helpline) to help women or were rather limited to reporting murder cases. In addition, the most predominant terms used in such coverage are identified, along with any potential difference in the behavior of public versus private TV channels. The data confirm, among other issues, that coverage of gender-based violence on these TV channels decreased during the studied time frame. However, the mention of tools aimed at supporting women at risk increased. The results of this study also reveal that TV coverage of violence against women did not coincide with the dates in which gender-based murders took place and that, of all Spanish media networks, public TV paid the most attention to this issue. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

PRELIMINARY FINDINGS OF QUALITATIVE EXPLORATION OF THE EFFECTIVENESS OF AN ONLINE "FATIGUE AND ACTIVITY MANAGEMENT EDUCATION IN WORK” (FAME-W) INTERVENTION FOR INDIVIDUALS WITH INFLAMMATORY ARTHRITIS

BackgroundA Fatigue and Activity Management Education in Work (FAME-W) programme was developed for individuals with inflammatory arthritis to manage fatigue in work (McCormick, 2018). FAME-W was designed as an in-person programme;however, due to COVID-19 pandemic it was modified to be an online group-based self-management intervention.ObjectivesThis study tested the effectiveness of an online format of FAME-W for future use by occupational therapist to help individuals with inflammatory arthritis to stay in work.MethodsParticipants were randomly allocated to intervention or control groups. Participants in the intervention group received the online four-week FAME-W and the control group participants received a FAME-W handbook. Participants in the intervention group attended a focus group immediately after the completion of the online FAME-W programme. A qualitative descriptive design was used with semi-structured focus groups. Data were analysed by thematic analysis (Braun and Clark, 2021).ResultsTwenty-six individuals took part in five separate focus groups. The average number of participants per group was 5 individuals with the largest group having 8 and smallest having 3 participants. The majority of participants were female, working full time and had Rheumatoid Arthritis. The four themes emerging from the focus groups were: "content and delivery of the programme” where participants discussed the relevance of the content to their symptoms and the online delivery format of FAME-W. In the second theme, participants discussed "understanding the effects of symptoms on their own and combined” and how symptoms effect mood, work, cognitive and physical abilities. In the third theme, "implementing the knowledge gained from the programme” through goal setting and practicality of the self-management strategies provided were discussed. Final theme "impact of the FAME-W on symptoms and work” including reassurance of normalising symptoms, change in mindset and approach to their condition were discussed.Table 1.ThemesQuotesContent and delivery of the programme"Each of the four sections were all very relevant” "I am quite happy that it is online because face to face would depend on location if I had the choice”Understanding the effects of symptoms on their own and combined"Now I know that I can sleep better when I manage my pain, and I can manage my pain by managing fatigue” "When you have a long-term illness, you don't look at the symptoms individually, you need to break it and look at it individually to know how to manage it”Implementing the knowledge gained from the programme"I'm in a different place today than I was four weeks ago. I am doing well now. So, for me the goal setting is excellent” "Helps you implement the knowledge into your regular routine and check in with yourself”Impact of the FAME-W on symptoms and work"Just a lightbulb moment to say, great, this is not my fault, because you can blame yourself for all the symptoms”ConclusionPreliminary results show that participants found the online FAME-W to be effective, relevant, reassuring, and helpful. These results suggest that work-related self-management skills are essential in assisting participants with symptom management in the workplace. Furthermore, these preliminary results suggest that the online format of FAME-W may be helpful for individuals with inflammatory arthritis to stay in work and it may become a standard part of clinical care for occupational therapists.References[1] McCormack, RC, O'Shea, F, Doran, M, Connolly, D. Impact of a fatigue management in work programme on meeting work demands of individuals with rheumatic diseases: A pilot study. Musculoskeletal Care. 2018;16: 398– 404.[2] Braun, V., & Clarke, V. (2021). Thematic analysis: A practical guide. SAGE.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

The challenges of online sessions. Psychoanalysis in the face of change

Proven effective and widely practiced during the COVID-19 pandemic, online psychotherapy is today a fundamental tool in the toolbox of the psychoanalyst and the psychotherapist: to be studied in depth in its possible indications and counter-indications and to be included in the training programs of our training schools. Our thesis is that it does not represent a risk, but rather the stimulus to progress for our discipline. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (French) La psychotherapie en ligne s'est averee efficace et largement pratiquee pendant la pandemie de COVID-19 est aujourd'hui un outil fondamental dans la boite a outils du psychanalyste et du psychotherapeute: a etudier en profondeur dans ses eventuelles indications et contre-indications et a integrer dans les programmes de formation des nos ecoles de formation. Notre these est qu'elle ne represente pas un risque, mais plutot une incitation a progresser pour notre discipline. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (German) Die Online-Psychotherapie, die sich wahrend der COVID-19-Pandemie als wirksam erwiesen hat und weithin praktiziert wurde, ist heute ein grundlegendes Instrument im Werkzeugkasten des Psychoanalytikers und des Psychotherapeuten: eines, das vertieft in seinen moglichen Indikationen und Kontraindikationen untersucht und in die Ausbildungsprogramme unserer Ausbildungsstatten integriert werden muss. Unsere These ist, dass sie kein Risiko, sondern vielmehr Ansporn zum Fortschritt fur unsere Disziplin darstellt. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Italian) Dimostratasi efficace e largamente praticata durante la pandemia da COVID-19 la psicoterapia online e oggi uno strumento fondamentale nella cassetta degli attrezzi dello psicoanalista e dello psicoterapeuta: da studiare in modo approfondito nelle sue possibili indicazioni e contro-indicazioni e da inserire nei programmi di formazione delle nostre scuole di formazione. La nostra tesi e che non rappresenti un rischio, ma anzi lo stimolo al progresso per la nostra disciplina. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Spanish) La psicoterapia online demostro ser efectiva y ampliamente practicada durante la pandemia de COVID-19 y es hoy una herramienta fundamental en la caja de herramientas del psicoanalista y psicoterapeuta que merece ser profundizada en sus posibles indicaciones y contraindicaciones e incluida en los programas de formacion de nuestras escuelas de formacion. Nuestra tesis es que no representa un riesgo, sino un estimulo de progreso para nuestra disciplina. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The setting put to the test by the telephone

The COVID-19 pandemic and the lockdown of the spring 2020 led psychotherapists and psychoanalysts working with children and adolescents to experiment, whether they liked it or not, with new ways of meeting, by telephone or video-conferencing, and new practices were generated. In this context, new questions about the treatment format lead to a discussion of the precise place and function of telephone sessions with the adolescent as compared to the child. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (French) La pandemie de Covid-19 et le confinement du printemps 2020 ont conduit les psychotherapeutes et psychanalystes d'enfants et d'adolescents a l'experimentation, a marche forcee, de nouveaux modes de rencontres, par telephone ou visio, generateurs de pratiques inedites. Dans ce contexte de nouvelles interrogations concernant ce dispositif conduisent a preciser la place et la fonction des seances au telephone chez l'adolescent comparativement a l'enfant. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Socio-Political Reading of Nigerians' Criticisms and Commendations of Big Brother Nigeria (BBN) Shows

Popular cultures constitute the predominant attitudes, living styles, and aspirations practised consciously and unconsciously by the people in a society. They emanate from the admixture of indigenous practices and foreign media influences that permeate the people's ways of life. Sometimes, popular cultures can be regarded as youth cultures. In Nigeria in recent times, Big Brother Nigeria (BBN), a TV reality show franchise that started in 2006, has continued to draw criticisms and commendations from Nigerian citizens at home and abroad. Concerned citizens have drummed up various arguments and counter-arguments with regard to issues emanating from BBN show. Nevertheless, it continues to be produced such that it was even produced during the COVID-19 lockdown in the country. Therefore, this paper is interested in the arguments that people advanced for the cancellation or continuation of BBN shows in the Nigerian media landscape. It will investigate the socio-political implications considered by the Nigerian government through its regulatory bodies not to cancel the TV show. Its findings will be compared with the agenda-setting and social responsibility theories of the mass media. As an explorative study, it will rely on secondary data. It is hoped that the study will contribute to the literature on popular cultures and related fields. © The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.

Use of Bluetooth contact tracing technology to model COVID-19 quarantine policies in high-risk closed populations.

Containment measures in high-risk closed settings, like migrant worker (MW) dormitories, are critical for mitigating emerging infectious disease outbreaks and protecting potentially vulnerable populations in outbreaks such as coronavirus disease 2019 (COVID-19). The direct impact of social distancing measures can be assessed through wearable contact tracing devices. Here, we developed an individual-based model using data collected through a Bluetooth wearable device that collected 33.6M and 52.8M contact events in two dormitories in Singapore, one apartment style and the other a barrack style, to assess the impact of measures to reduce the social contact of cases and their contacts. The simulation of highly detailed contact networks accounts for different infrastructural levels, including room, floor, block, and dormitory, and intensity in terms of being regular or transient. Via a branching process model, we then simulated outbreaks that matched the prevalence during the COVID-19 outbreak in the two dormitories and explored alternative scenarios for control. We found that strict isolation of all cases and quarantine of all contacts would lead to very low prevalence but that quarantining only regular contacts would lead to only marginally higher prevalence but substantially fewer total man-hours lost in quarantine. Reducing the density of contacts by 30% through the construction of additional dormitories was modelled to reduce the prevalence by 14 and 9% under smaller and larger outbreaks, respectively. Wearable contact tracing devices may be used not just for contact tracing efforts but also to inform alternative containment measures in high-risk closed settings.

Tidal lung hysteresis to interpret PEEP-induced changes in compliance in ARDS patients.

BACKGROUND: In ARDS, the PEEP level associated with the best respiratory system compliance is often selected; however, intra-tidal recruitment can increase compliance, falsely suggesting improvement in baseline mechanics. Tidal lung hysteresis increases with intra-tidal recruitment and can help interpreting changes in compliance. This study aims to assess tidal recruitment in ARDS patients and to test a combined approach, based on tidal hysteresis and compliance, to interpret decremental PEEP trials. METHODS: A decremental PEEP trial was performed in 38 COVID-19 moderate to severe ARDS patients. At each step, we performed a low-flow inflation-deflation manoeuvre between PEEP and a constant plateau pressure, to measure tidal hysteresis and compliance. RESULTS: According to changes of tidal hysteresis, three typical patterns were observed: 10 (26%) patients showed consistently high tidal-recruitment, 12 (32%) consistently low tidal-recruitment and 16 (42%) displayed a biphasic pattern moving from low to high tidal-recruitment below a certain PEEP. Compliance increased after 82% of PEEP step decreases and this was associated to a large increase of tidal hysteresis in 44% of cases. Agreement between best compliance and combined approaches was accordingly poor (K = 0.024). The combined approach suggested to increase PEEP in high tidal-recruiters, mainly to keep PEEP constant in biphasic pattern and to decrease PEEP in low tidal-recruiters. PEEP based on the combined approach was associated with lower tidal hysteresis (92.7 ± 20.9 vs. 204.7 ± 110.0 mL; p < 0.001) and lower dissipated energy per breath (0.1 ± 0.1 vs. 0.4 ± 0.2 J; p < 0.001) compared to the best compliance approach. Tidal hysteresis ≥ 100 mL was highly predictive of tidal recruitment at next PEEP step reduction (AUC 0.97; p < 0.001). CONCLUSIONS: Assessment of tidal hysteresis improves the interpretation of decremental PEEP trials and may help limiting tidal recruitment and energy dissipated into the respiratory system during mechanical ventilation of ARDS patients.

Prevalence of Antibiotic-Resistant Pathogenic Bacteria and Level of Antibiotic Residues in Hospital Effluents in Selangor, Malaysia: Protocol for a Cross-sectional Study.

BACKGROUND: Antimicrobial resistance (AMR) has emerged as a major global public health challenge due to the overuse and misuse of antibiotics for humans and animals. Hospitals are among the major users of antibiotics, thereby having a large contribution to AMR. OBJECTIVE: The aim of this study is to determine the prevalence of antibiotic-resistant pathogenic bacteria and the level of antibiotic residues in the hospital effluents in Selangor, Malaysia. METHODS: A cross-sectional study will be performed in the state of Selangor, Malaysia. Tertiary hospitals will be identified based on the inclusion and exclusion criteria. The methods are divided into three phases: sample collection, microbiological analysis, and chemical analysis. Microbiological analyses will include the isolation of bacteria from hospital effluents by culturing on selective media. Antibiotic sensitivity testing will be performed on the isolated bacteria against ceftriaxone, ciprofloxacin, meropenem, vancomycin, colistin, and piperacillin/tazobactam. The identification of bacteria will be confirmed using 16S RNA polymerase chain reaction (PCR) and multiplex PCR will be performed to detect resistance genes (ermB, mecA, blaNDM-L, blaCTX-M, blaOXA-48, blaSHV, VanA, VanB, VanC1, mcr-1, mcr-2, mcr-3, Intl1, Intl2, and qnrA). Finally, the level of antibiotic residues will be measured using ultrahigh-performance liquid chromatography. RESULTS: The expected outcomes will be the prevalence of antibiotic-resistant Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter (ESKAPE) bacterial species from the hospital effluents, the occurrence of antibiotic resistance genes (ARGs) from the isolated ESKAPE bacteria, and the level of antibiotic residues that may be detected from the effluent. Sampling has been conducted in three hospitals. Data analysis from one hospital showed that as of July 2022, 80% (8/10) of E. faecium isolates were resistant to vancomycin and 10% (1/10) were resistant to ciprofloxacin. Further analysis will be conducted to determine if the isolates harbor any ARGs and effluent samples are being analyzed to detect antibiotic residues. Sampling activities will be resumed after being suspended due to the COVID-19 pandemic and are scheduled to end by December 2022. CONCLUSIONS: This study will provide the first baseline information to elucidate the current status of AMR of highly pathogenic bacteria present in hospital effluents in Malaysia. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/39022.

The rising environmentalists: Fostering environmental goal attainment through volunteer tourism

This study attends to Generation Zers' volunteer tourism. It draws on self-determination and goal-setting theories to synthesize a model delineating how the interplay of internal and external environmental motivational factors reshapes green volunteering involvement amid the pandemic, leading to environmental goal attainment and persistent endeavors. The inquiry adopted an online survey-based design with data collected from 340 rising environmentalists. Results first suggest that environmental self-efficacy and social climate are positively related to green volunteering involvement, with environmental self-efficacy exhibiting a more profound effect. These relationships are also moderated by eudaimonic environmental pursuits in that the relationships remain stronger when volunteers pursue eudaimonia to a high degree. Furthermore, involvement is evident in fostering environmental goal attainment, leading to pro-environmental behaviors and advocacy. With the above findings taken together, this investigation sheds light on environmental goal attainment through volunteer tourism amid the COVID-19 turbulence. It brings to light a motivation–goal attainment–behavior model that deserves investigating.

Assessing the effectiveness of portable HEPA air cleaners for reducing particulate matter exposure in King County, Washington homeless shelters: Implications for community congregate settings.

Over four thousand portable air cleaners (PACs) with high-efficiency particulate air (HEPA) filters were distributed by Public Health - Seattle & King County to homeless shelters during the COVID-19 pandemic. This study aimed to evaluate the real-world effectiveness of these HEPA PACs in reducing indoor particles and understand the factors that affect their use in homeless shelters. Four rooms across three homeless shelters with varying geographic locations and operating conditions were enrolled in this study. At each shelter, multiple PACs were deployed based on the room volume and PAC's clean air delivery rate rating. The energy consumption of these PACs was measured using energy data loggers at 1-min intervals to allow tracking of their use and fan speed for three two-week sampling rounds, separated by single-week gaps, between February and April 2022. Total optical particle number concentration (OPNC) was measured at 2-min intervals at multiple indoor locations and an outdoor ambient location. The empirical indoor and outdoor total OPNC were compared for each site. Additionally, linear mixed-effects regression models (LMERs) were used to assess the relationship between PAC use time and indoor/outdoor total OPNC ratios (I/OOPNC). Based on the LMER models, a 10 % increase in the hourly, daily, and total time PACs were used significantly reduced I/OOPNC by 0.034 [95 % CI: 0.028, 0.040; p < 0.001], 0.051 [95 % CI: 0.020, 0.078; p < 0.001], and 0.252 [95 % CI: 0.150, 0.328; p < 0.001], respectively, indicating that keeping PACs on resulted in significantly lower I/OOPNC. The survey suggested that keeping PACs on and running was the main challenge when operating them in shelters. These findings suggested that HEPA PACs were an effective short-term strategy to reduce indoor particle levels in community congregate living settings during non-wildfire seasons and the need for formulating practical guidance for using them in such an environment.

Patient Navigator Pilot to Improve Completion of FIT Testing in Primary Care

Introduction: Colorectal cancer (CRC) screening is a critical preventative service and part of routine patient care. CRC is the second leading cause of cancer death in the US, and yet a third of the eligible population does not undergo routine screening. Endoscopy centers have been stretched thin by both COVID-19 and the recent drop in screening initiation age to 45. Fecal immunochemical testing (FIT), a sensitive and specific CRC screening modality, may be used to reach and risk-stratify more patients to increase the yield for detecting advanced neoplasia and cancer, reducing pressure on colonoscopy centers. Unfortunately, FIT is often suboptimal as patients inconsistently complete and return the test for analysis. Method(s): We performed a retrospective analysis of 5211 individuals at a single internal medicine clinic who had FIT ordered as part of USPSTF recommended care from 01/2017 through 12/2021. Starting in 01/2021 we instituted a dedicated patient navigator to support patients in completing FIT. Chi-square, Fisher exact test, and Student's t-tests were performed for descriptive analyses. Multivariable logistic regression was used to compare FIT kit drop off rates pre- and post-intervention, with the model adjusted by age, gender, race, ethnicity, language, and insurance status. Analysis was performed in SAS version 9.4. (Table) Results: The post-intervention period included 1181 (22.7%) patients. The predominant reasons cited for failure to complete testing were forgot (25%), too busy (13%), and lost kit (11%). Our intervention improved drop off rates from 46.4% to 51.3% at 2 weeks (OR 1.19, 95%CI 1.01-1.41), 56.7% to 73.7% at 1 month (2.14 [1.78-2.58]), 64.7% to 89.7% at 3 months (4.73 [3.66-6.12]), and 78.9% to 98.2% at 1 year (14.39 [8.25-25.12]). Overall, our intervention improved FIT kit drop off rates by 53.4% (1.53 [1.30-1.81]). FIT was positive in 4.9% (p=0.0529). (Figure) Conclusion(s): FIT can increase CRC screening rates, particularly in resource-limited settings, and may decrease the burden on endoscopy centers nationwide by improving the efficiency of colonoscopy in the average risk screening population. The addition of a dedicated patient navigator is a simple intervention that, by providing culturally competent care and personalized attention, improves completion rates and return time, allowing FIT to be a reliable method of screening. The ability to increase screening rates and prioritize patients for diagnostic colonoscopies will ultimately lead to earlier detection and treatment of CRC.

Metavirome in Sewage and Fecally-Tainted River Waters in the Philippines: Highlighting the Role of Environmental Surveillance in the Covid-19 Pandemic

Intro: The COVID-19 pandemic has triggered global collaborative efforts on response and research to detect SARS-CoV-2 particles not just in the human population but also in wastewater. While the examination of clinical samples from COVID-19 patients links SARS-CoV-2 to specific individuals, the analysis of an amalgam of human feces through environmental surveillance (ES) links SARSCoV-2 to populations and communities served by the wastewater system. Studies on SARS-CoV-2 in the environment were already done in high-resource countries. However, its epidemiology in wastewater bodies in the Philippines is limited. In this study, we used the National ES for Polio and Other Pathogens Network to investigate the molecular epidemiology and transmission dynamics of SARS-CoV-2 at the outset of the pandemic. Method(s): This is a retrospective study of 250 wastewater samples collected from May 2020 to July 2021. Samples were processed using the two-phase concentration technique. Pepper mild mottle virus RNAs were quantified as the internal control. Real-time PCR was used to detect the N-gene of the SARS-CoV-2. Whole genomes were sequenced using the COVID-19 ARTIC v4.0. Phylogenetic and mutation analysis were done and lineage assignments were established using the PANGOLIN software. Finding(s): Forty-two percent (107/250) of the environmental samples detected SARS-CoV-2 particles. Fifty-nine samples with Ct values <=38 were sequenced and the whole genome analysis revealed B.1.1 and B.6. lineages of SARS-CoV-2. When viral load were plotted with the weekly cases in the respective site, we observed that SARS-CoV2 can be detected in wastewater weeks before the spike of cases in the community. Conclusion(s): This is the first report on the detection of B.1.1 and B.6 SARS-CoV-2 particles in waste/surface waters in the Philippines. With the declining incidence of COVID-19 cases, this study provided data regarding the feasibility of establishing environmental surveillance for SARS-CoV-2 as a supplemental tool for human or case monitoring especially in resource-limited settings.Copyright © 2023

Development of an Online Learning Module on Gastroenterology Issues in Global Health

Introduction: Global health (GH) education is expanding and 23.1% of US medical students acquire international health experience prior to postgraduate training. Digestive diseases carry a high global burden. However, few GH programs and professional societies consider the inclusion of gastroenterology into their standard curriculum. In addition, travel restrictions during the COVID-19 pandemic have brought traditional GH rotations to a halt and spurred new educational approaches. Our goal is to develop a comprehensive online learning module on gastroenterology issues in GH for medical students undertaking GH electives. Method(s): A team of faculty and residents was convened between the Center for Community and Global Health and the Division of Gastroenterology. GH curricula across institutions and core competencies across 2 professional societies were examined via literature review. A survey was conducted among 2nd (MS2) and 3rd year medical students (MS3) interested in GH to assess attitudes toward GI-related issues in GH curriculum. An online learning module was developed consisting of 10, video-based lessons each addressing specific GH competencies (Figure 1). Result(s): In total, 41% (28/69) of MS2 and MS3 interested in GH responded to the survey, with a similar distribution of MS2 (13/28) and MS3 (15/28). Nearly all (92.8%) reported that learning GI conditions in a GH curriculum is moderately or very important (Table 1). A majority (78.5%) also reported feeling at least somewhat anxious or more about managing GI conditions during GH electives. Few medical students reported feeling moderately or extremely prepared to identify risk factors for GI conditions in different settings (21.5%) and to define approaches to therapy in resource-limited settings (14.3%). Interestingly, a majority (71.4%) reported feeling not at all prepared or slightly prepared to deliver cost-effective care to challenging populations. Conclusion(s): Our survey responses demonstrated an unmet need for GI-related training and cost-conscious care in the GH curriculum. Developing an online learning module on GI conditions to supplement GH curriculum may be useful and feasible. A randomized controlled trial is underway to examine the effect of this online learning module on medical student knowledge and preparedness to address GI conditions in GH electives.

Evaluation of airborne infection risk with different window airing strategies in classroom

The coronavirus disease may spread by airborne aerosols, especially in a poorly ventilated enclosure. Natural ventilation can reduce the transmission of infection. The WHO suggested the minimum ventilation rate of 10 L/s/person in non-residential settings. The objective was to evaluate risk of airborne infection with different settings in natural ventilated classroom. The risk was evaluated by using the modified Wells-Riley equation associated with the variation of contaminant concentration simulated by a multi-zone airflow model. The results provide the guidance of natural ventilation strategy in the classroom to reduce the transmission of airborne infection disease. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Screening Strategies in Different Resource Settings

Health care-associated infections/ Hospital-acquired infections (HAIs) have a significant impact on patients' morbidity and mortality. The risk of HAIs in resource-limited settings (RLS) has been reported 2-20 times higher than that in developed countries. Moreover, multi-drug- resistant organisms (MDROs) have emerged and spread throughout the world. In addition, increases in HAIs were observed during the COVID-19 pandemic throughout the world.Thus, screening strategies/surveillance of MDROs were recommended as a core component of infection prevention and control (IPC) measures for the effective HAIs prevention. We review and summarize current critical knowledge on screening strategies in different resource settings, especially on guidelines for the prevention and control of carbapenem- resistant Enterobacteriaceae (CRE), Acinetobacter baumannii (CRAB), and Pseudomonas aeruginosa (CRPsA) in health care facilities. The guidelines (especially WHO) were strongly recommended for surveillance of CRE-CRAB-CRPsA infections and surveillance cultures of asymptomatic CRE colonization. There were conditional recommended on surveillance cultures of the environment for CRE-CRAB-CRPsA colonization/contamination. The surveillance cultures (stool samples or rectal swabs) allowed the early introduction of IPC measures to prevent transmission to other patients and the hospital environment. Given the clinical importance of CRE-CRAB-CRPsA infections, regular ongoing active surveillance of infections were required in all microbiology laboratory settings. In addition, surveillance cultures for asymptomatic CRE colonization should also be performed, guided by local epidemiology and risk assessment. The surveillance cultures of asymptomatic CRE colonization should be considered for patients with previous CRE colonization and patients with a history of recent hospitalization in endemic CRE settings or contacted CRE colonized/ infected patients. In contrast, the evidence available on surveillance cultures for CRAB and CRPsA colonization in asymptomatic patients was not sufficiently relevant for the recommendation. Nowadays, the CRE surveillance strategies have been implemented in various methods from traditional culture- based methods to molecular assays. The limitation of microbiology laboratory capacity for MDROs in RLS was concerning. However, the surveillance data would help with appropriate IPC measure implementation and outbreak investigations. Thus, the proper screening strategies and strengthening microbiology laboratory capacity, especially in RLS are challenge for improving IPC measures and patient outcomes.Copyright © 2023

Health Service Quality and its Relationship to Team Collaboration and Communication during the COVID-19 Pandemic

BACKGROUND: In the search for innovative methods to improve the quality and efficiency of health services, integrated clinical pathways (ICPs) have been introduced. AIM: As there is a gap in research on ICP efficiency, the aim of the study was to investigate the role and impact of collaboration and communication among three interprofessional ICP teams on the self-assessment of efficiency of ICPs. METHOD(S): A cross-sectional study was conducted using a descriptive quantitative with a survey (n = 152) and qualitative methods with a focus group (n = 27) and in-depth interviews (n = 22) in a typical general hospital in Slovenia. RESULT(S): The results showed that health-care professionals found patient health care and the work of healthcare professionals' better quality with ICP than without ICP. The ICPs team members assessed communication, cooperation, and effectiveness in the ICP team as relatively good but identified the lack of staff as the main reason for their limitations. The impact of ICP team collaboration and communication on ICP safety exists but it does not explain a sufficient proportion of the variance and the corelation is medium strong. The result also revealed that the COVID-19 pandemic did not primarily affect ICP team members' fear of possible infection, as studies have shown in the first wave of the COVID-19 pandemic, but rather staff shortages leading to increased fear of errors and possible complaints and lawsuits from patients and relatives. CONCLUSION(S): Measures are needed for the additional employment of team members and the retention of current staff through financial compensation and the promotion of supportive workplace characteristics.Copyright © 2023 Mateja Simec, Sabina Krsnik, Karmen Erjavec.

Accuration of Classification of Covid with Convolutional Neural Network-Based Image Chest X-ray with Variations in Image Size and Batch Size

The use of convolutional neural networks in Covid classification has a positive impact on the speed of justification and can provide high accuracy. But on the one hand, the many parameters on CNN will also have an impact on the resulting accuracy. CNN requires time and a heavy level of computation. Setting the right parameters will provide high accuracy. This study examines the performance of CNN with variations in image size and minibatch. Parameter settings used are max epoch values of 100, minibatch variations of 32, 64, and 128, and learning rate of 0.1 with image size inputs of 50,100, and 150 variations on the level of accuracy. The dataset consists of training data and test data, 200 images, which are divided into two categories of normal and abnormal images (Covid). The results showed an accuracy with the use of minibatch 128 with the highest level of accuracy at image size 150 × 150 on test data of 99,08%. The size of the input matrix does not always have an impact on increasing the level of accuracy, especially on the minibatch 32. The parameter setting on CNN was dependent on the CNN architecture, the dataset used, and the size of the dataset. One can imply that optimization parameter in CNN can approve good accuration. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Civil society priorities for global health: concepts and measurement.

The global health agenda-a high stakes process in which problems are defined and compete for the kind of serious attention that promises to help alleviate inequities in the burden of disease-is comprised of priorities set within and among a host of interacting stakeholder arenas. This study informs crucial and unanswered conceptual and measurement questions with respect to civil society priorities in global health. The exploratory two-stage inquiry probes insights from experts based in four world regions and pilots a new measurement approach, analysing nearly 20 000 Tweets straddling the COVID-19 pandemic onset from a set of civil society organizations (CSOs) engaged in global health. Expert informants discerned civil society priorities principally on the basis of observed trends in CSO and social movement action, including advocacy, programme, and monitoring and accountability activities-all of which are widely documented by CSOs active on Twitter. Systematic analysis of a subset of CSO Tweets shows how their attention to COVID-19 soared amidst mostly small shifts in attention to a wide range of other issues between 2019 and 2020, reflecting the impacts of a focusing event and other dynamics. The approach holds promise for advancing measurement of emergent, sustained and evolving civil society priorities in global health.