Simulation Study on Airflow Organization and Environment in Reconstructed Fangcang Shelter Hospital Based on CFD

With frequent outbreaks of COVID-19, the rapid and effective construction of large-space buildings into Fangcang shelter hospitals has gradually become one of the effective means to control the epidemic. Reasonable design of the ventilation system of the Fangcang shelter hospital can optimize the indoor airflow organization, so that the internal environment can meet the comfort of patients and at the same time can effectively discharge pollutants, which is particularly important for the establishment of the Fangcang shelter hospital. In this paper, through the reconstruction of a large-space gymnasium, CFD software is used to simulate the living environment and pollutant emission efficiency of the reconstructed Fangcang shelter hospital in summer under different air supply temperatures, air supply heights and exhaust air volume parameters. The results show that when the air supply parameters are set to an air supply height of 4.5 m, an air supply temperature of 18 °C, and an exhaust air volume of a single bed of 150 m3/h, the thermal comfort can reach level I, and the ventilation efficiency for pollutants can reach 69.6%. In addition, the ventilation efficiency is 70.1% and 70.3% when the exhaust air volume of a single bed is continuously increased to 200 and 250 m3/h, which can no longer effectively improve the pollutant emission and will cause an uncomfortable blowing feeling to patients. © 2023 by the authors.

A Detection System for Comfortable Locations Based on Facial Expression Analysis While Riding Bicycles

In recent years, the use of bicycle as a healthy and economical means of transportation has been promoted worldwide. In addition, with the increase in bicycle commuting due to the COVID-19, the use of bicycles are attracting attention as a last-mile means of transportation in Mobility as a Service(MaaS). To help ensure a safe and comfortable ride using a smartphone mounted on a bicycle, this study focuses on analyzing facial expressions while riding to determine potential comfort along the route with the surrounding environment and to provide a map that users can explicitly feedback(FB) after riding. Combining the emotions of facial expressions while riding and FB, we annotate comfort to different locations. Afterwards, we verify the relationship between locations with high level of comfort based on the acquired data and the surrounding environment of those locations using Google Street View(GSV). © 2023 Owner/Author.

Dynamic Insulation Systems to Control Airborne Transmission of Viruses in Classrooms: A Review of 'Airhouse' Concept

The discovery of the Covid-19 virus in China at the end of 2019 has drastically altered the global landscape. The virus, which has now become a pandemic, has wrought devastation on the world, infecting over 500 million people and killing over 6 million. The virus's mutation into a few variations, however, has enabled the world's alarming situation to continue until now. Airborne particles and viruses including the new Covid-19 variant -Omricon, is not only extremely contagious but also can be transferred by airborne transmission, putting vulnerable people like children at risk, particularly in classrooms. Amongst the strategies to control airborne transmission of viruses and to improve indoor thermal and air quality is using ventilation strategies -such as dynamic insulation. Thus, this paper will review at how dynamic insulation systems in conventional farming and residential buildings, cleanrooms and other controlled environments work to reduce airborne viruses and particles in a room. An innovative "Airhouse" concept that combines with activated carbon has been researched and investigated with regard to the dynamic insulation systems.This system has a high potential to reduce the air temperature, humidity, and airborne viruses including Covid-19 whilst maintaining a steady airflow rate in a normal room. Therefore, it has a great deal of potential to decrease or eliminate concerns about the transmission of airborne viruses and adapt ventilation systems to new pandemic threats.

Celebrating the Sickle Cell Disease World Day on June 19th after Two Years of Pandemic: My Life with Scd, Patients' Perspective

Background: After two years of COVID in which activities were reduced due to the pandemic and each one's life was affected by restrictions and limitations, the Sickle Cell Disease (SCD) Association in Padova teamed up with the Sickle Cell Group at the Pediatric Hematology Oncology and Bone Marrow Transplant Unit to celebrate the Sickle Cell Disease world day by organizing an online meeting with children/youths and their families. Theme of the meeting was: "My Life with SCD: poems, pictures and writings express our view on disease and care". Aim(s): One of the goals of this meeting was to create an opportunity for individuals with SCD to meet and have a constructive discussion with each other about the disease and express their feelings after two years of pandemic. Method(s): One month before the meeting children, teenager and parents were asked to sharer with the organizing team any drawing, painting, poem, writing, that they felt could express their feelings or experience of the disease itself or how it affected their life, or their experience in the hospital. The materials received were organized in a power point presentation and At the meeting, families were able to see a PowerPoint presentation with the poems, drawings, writings. Each author had the choice to personally share their production or have it read out loud by a member of the team. Free time to comment or share experiences was given. Result(s): 20 children, teenagers and parents participated. Countries of origin (Nigeria, Ghana, Congo, Albania, Italy), religious background (catholic, muslim, no religion, other) were different as well as disease genotype (HbSS, HbSC, HbSBdegree), severity or treatment received (Hydroxyurea, transfusion, Hematopoietic stem cell transplantation -HSCT, none). Drawings and writings regarded experience with the disease (mechanism of action, admissions), feelings experienced (fear, hope, light at the end of the tunnel), aspirations (sports) and gratitude (to the social and medical team, to parents) (Figure 1). Surprisingly, families who had a child having undergone HSCT, reported on the need and importance to talk about this experience for years after the event and made a request of a support goup. Finally, all families underlined the need to meet again soon to discuss together issues related to personal experience with SCD, even via web. of discussion with each other and with the drepanocytosis group;and that throug the online telematics platform it is still possible to involve all families, listening and trying to comfort them on doubts and perplexities about the disease, In conclusion, it can be said that after two years of pandemic, in our setting, online meeting can help patients and families reconnect with each other and activities can be planned to aid experiences and feelings. Patients' associations and Health Care Teams can collaborate in this area.

A Study on Establishing Thermal Output Conditions of Radiant Ceiling Heating Panels for Improving Thermal Comfort of Perimeter Zone in Buildings

Amid concerns over airflow-induced transmission of the COVID-19 virus in buildings frequented by large numbers of people, such as offices, the necessity for radiant ceiling heating panels has increased. This is due to the concern that the airflows emitted from the convection heating systems installed near the ceiling or windows for winter heating may be a major cause of COVID-19 transmission. In this study, we aim to evaluate thermal comfort under various indoor and outdoor environmental conditions of a building and present the thermal output conditions of the radiant ceiling heating panel that can replace the convection heating system while ensuring comfort in the perimeter zone and handling the heating load. As a result, we were able to present, in a chart format, the thermal output conditions that can secure thermal comfort by analyzing the indoor airflow distribution depending on the surface temperature of the radiant ceiling heating panel, the interior surface temperature of the window, and the influence of internal heat generation. Moreover, through derived empirical formulas, we were able to determine the heating conditions of the panel that can secure the necessary heat dissipation while minimizing discomfort, such as downdrafts, even for indoor and outdoor conditions that were not evaluated in this study.

Lessons Learned from the COVID-19 Pandemic: A Multigroup Structural Equation Modelling of Underground Space Environment and Users' Health

Due to the inherent limitations of underground spaces, such as the lack of natural ventilation and sunlight, underground space users tend to face more health risks compared with their aboveground counterparts. However, little is known about how the underground environment, users' health, and their associations were impacted by the outbreak of the pandemic. In this study, we investigated and compared the impacts of the general underground environment on regular users' physical and psychological health before and after the pandemic. To achieve this aim, the data from 525 surveys were collected from eleven underground sites, followed by an objective field measurement study conducted at five underground sites in Hong Kong pre- and post-outbreak of the pandemic. The multigroup structural equation modelling results indicated that: (i) surprisingly, the users' satisfaction towards almost all underground environment factors, including greenery, connectivity with the aboveground environment, thermal comfort, ventilation, indoor air quality, acoustic comfort, and lighting, excluding wayfinding, were significantly higher in the post-outbreak period;(ii) the users' health, both physical and psychological, was significantly better in the post-outbreak period;(iii) the impacts of visual comfort on the users' physical and psychological health were significantly greater in the post-outbreak period (critical difference ratio (;CDR;) > 1.96);(iv) the impacts of wayfinding, greenery, and acoustic and thermal comfort on the users' physical or psychological health were significant only in the pre-outbreak period (;CDR;> 1.96);(v) the impacts of connectivity on the users' physical and psychological health were significant in both the pre- and post-outbreak periods (;CDR;< 1.96). The findings were further cross-validated using the objective measurement results. With an increasing need to develop healthy underground spaces, the study contributes to the development, design, and management of the underground environment to enhance the users' health in the post-outbreak era.

Good Architecture Matters: The Architect's Perspective on Design for Ageing and Energy Efficiency

Custom-built solutions for ageing, urban regeneration, energy efficiency, thermal performance, and well-being are contemporary challenges that have prompted considerable research over the past decades. In the construction field, subjects such as energy efficiency and thermal performance are often addressed within the scope of mandatory regulations, the suitability of construction solutions and the incorporation of technical equipment. Considering four residential structures for older adults under construction in Portugal, this paper aims to highlight the importance of a comprehensive approach to these issues, including architectural quality as the main target. In pursuit of this, a cohesive set of intervention principles guided the analysis: the adaptive reuse of raw materials;taking advantage of the site's conditions;vegetation (type and location);construction options and durability;solar exposure and shading;the pedagogy of building use;and the comfort and thermal perception. Several reflections emerge from the analysis: good architectural design must consider dynamic models incorporating each context and the site's conditions;the culture of use and maintenance and the notion of "adaptive comfort" are primary factors to enhance thermal performance and energy efficiency;and each building is a unique result of a complex negotiation process. Bridging research through practice, and multidisciplinary scientific integration enable engagement with reality and raise awareness of the constraints and challenges to innovation in LTC design.

Towards improved thermal comfort predictions and higher energy savings: building energy model of an open-plan office based on indoor CO2 and temperature controls

In recent work, a Hierarchical Bayesian model was developed to predict occupants' thermal comfort as a function of thermal indoor environmental conditions and indoor CO2 concentrations. The model was trained on two large IEQ field datasets consisting of physical and subjective measurements of IEQ collected from over 900 workstations in 14 buildings across Canada and the US. Posterior results revealed that including measurements of CO2 in thermal comfort modelling credibly increases the prediction accuracy of thermal comfort and in a manner that can support future thermal comfort prediction. In this paper, the predictive model of thermal comfort is integrated into a building energy model (BEM) that simulates an open-concept mechanically-ventilated office space located in Vancouver. The model predicts occupants' thermal satisfaction and heating energy consumption as a function of setpoint thermal conditions and indoor CO2 concentrations such that, for the same thermal comfort level, higher air changes per hour can be achieved by pumping a higher amount of less-conditioned fresh air. The results show that it is possible to reduce the energy demand of increasing fresh air ventilation rates in winter by decreasing indoor air temperature setpoints in a way that does not affect perceived thermal satisfaction. This paper presents a solution for building managers that have been under pressure to increase current ventilation rates during the COVID-19 pandemic. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

A Diagnostically Challenging Case of Primary Pancreatic Lymphoma

Introduction: Primary Pancreatic Lymphoma (PPL) is the exceedingly rare instance of extranodal Non-Hodgkin's Lymphoma developing mainly in the pancreas.We report a diagnostically challenging case of a patient presenting with a rapidly growing pancreatic mass, found to have PPL. Case Description/Methods: A 48-year-old female with past history of tobacco use presented with several months of cramping abdominal pain following COVID-19 infection. She denied weight loss, fevers, or night sweats. Her physical exam, CBC, CMP, lipase, LDH, and CA 19-9 were unremarkable. An abdominal ultrasound revealed a 2.8 x 1.9 x 3 cm cystic mass of the pancreatic head, most congruent with a pseudocyst. Worsening abdominal pain prompted repeat ultrasound one month later, which showed a doubling in size. Endoscopic ultrasound (EUS) with fine needle aspiration of the cystic mass and surrounding lymph nodes yielded cystic contents and reactive lymphadenopathy. Two months later, her abdominal pain worsened and repeat imaging showed further doubling in size with encasement of the celiac plexus. A second FNA performed via EUS redemonstrated cystic contents. An ultrasound-guided core needle biopsy of the mass revealed necrotic CD301 diffuse large B cell lymphoma (DLBCL). PET scan was suggestive of stage IV PPL (Figure). Imaging also identified an inguinal lymph node that returned as CD101 BCL61 high grade follicular lymphoma, which was thought to be a distinct lesion. She was started on R-CHOP. Her clinical course was complicated by the formation and subsequent rupture of a splenic artery pseudoaneurysm, gastrointestinal bleeding, anuric kidney injury, and intestinal ischemia. She ultimately transitioned to comfort care. Discussion(s): Primary pancreatic lymphoma comprises 0.6% of extranodal lymphomas and 0.2% of primary pancreatic tumors. The clinical presentation is often vague and includes abdominal pain, B symptoms, jaundice, or bowel obstruction. The diagnostic criteria according to the WHO requires that the (1) majority of tumor burden be localized to the pancreas and (2) existing nearby and distant lymph node involvement should be secondary to pancreatic presentation. A biopsy is required to diagnose PPL, which is histologically most often DLBCL. Our case highlights the challenges associated with diagnosing PPL despite two EUS with FNA. Although rare, one should proceed with a high index of suspicion for PPL in any patient presenting with a rapidly enlarging pancreatic mass.

Assessment of diffuse ceiling ventilation performance on transmission of airborne infectious diseases

Ventilation systems have been widely used to satisfy the occupants' indoor air quality and thermally comfort conditions. Various air distribution systems have been developed to supply clean air, including mixing, displacement, and diffuse ceiling ventilation systems. Diffuse ceiling systems are recent air distribution systems that supply cold air to the occupant area using perforated diffuse panels. These systems distribute air with a low velocity, minimizing the draft risk and dissatisfaction in highly dense spaces. The transmission risk of airborne infectious diseases like Covid-19 from the infected patient is high in waiting rooms. Thus, there is a demand to assure a secure environment for medical staff and patients in the waiting rooms. This study aims to numerically investigate the impact of the relative distance of the contamination source and exhaust on the transmission of airborne infectious diseases in the waiting room equipped with the diffuse ceiling ventilation system. In this regard, the release of Covid-19 from 4 different patients was investigated separately using the computational fluid dynamics technique. The distribution of the airborne infectious diseases is simulated by releasing SF6 tracer gas. The simulation result revealed that the contaminated patient located adjacent to the room's outlet had no contamination risk for other patients and staff in the waiting room. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Smartwatch-based ecological momentary assessments for occupant wellness and privacy in buildings

This paper describes the adaptation of an open-source ecological momentary assessment smartwatch platform with three sets of micro-survey wellness-related questions focused on i) infectious disease (COVID-19) risk perception, ii) privacy and distraction in an office context, and iii) triggers of various movement-related behaviors in buildings. This platform was previously used to collect data for thermal comfort, and this work extends its use to other domains. Several research participants took part in a proof-of-concept experiment by wearing a smartwatch to collect their micro-survey question preferences and perception responses for two of the question sets. Participants were also asked to install an indoor localization app on their phone to detect where precisely in the building they completed the survey. The experiment identified occupant information such as the tendencies for the research participants to prefer privacy in certain spaces and the difference between infectious disease risk perception in naturally versus mechanically ventilated spaces. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

A Template for Video Telehealth Hand and Wrist Consultations during the Covid-19 Pandemic: A Preliminary Analysis of Patient and Provider Reported Outcomes

Purpose of Study: COVID-19 introduced a rapid shift to video telehealth patient visits. At our institution in Loma Linda, California, less than 13% of hand surgery patients were seen in person at the height of the pandemic, with the majority of patients being triaged to video telehealth appointments. This was challenging for the hand surgeon due to the complexity of a hand patient's physical examination. During this time, it was critical to rapidly develop, test, and implement a tool to assist the surgeon in evaluating and triaging patients effectively over video. The purpose of this project was to develop and implement a tool that would improve the effectiveness and efficiency of video telehealth visits for hand and wrist patients. Methods Used: We developed an informational packet that was sent to patients prior to their video telehealth visit containing a letter of explanation, a new patient questionnaire, and a step-by-step guide with photos for a virtual hand examination. The letter explained the guide's purpose and provided additional instructions to ensure visit effectiveness- remove jewelry and watches, find a space with optimal lighting, wear a short sleeve shirt, etc. In the virtual hand examination guide, we explained common physical examination maneuvers and The Ten Test to assist with virtual sensation assessment. A short "how-to" description in lay terms was given for each of the physical examination maneuvers and included corresponding photographs to maximize patient comprehension. Patients were instructed to read the guide prior to their video visit and to have it available during the visit. Summary of Results: We began to implement this tool in our hand practice for new and established patients in March 2020, and we have since found that our virtual hand examination has become more thorough and efficient. Surgeon satisfaction with this tool has been high, and patients have reported satisfaction and comfort. Patients have felt that it increased their understanding of the virtual physical examination process, decreased frustration, and have stated that they would recommend this guide to other patients scheduled to undergo a video telehealth visit. Conclusion(s): The COVID-19 pandemic necessitated a rapid shift from in-person visits to video telehealth consultations. This subsequently changed the way in which hand surgeons could evaluate their patients. The procedural changes that were adopted during the pandemic can be viewed as a sign of things to come, and we anticipate that video telehealth visits will continue to be commonplace in the future. In the wake of this change, we feel confident that this tool equips the hand surgeon well for an effective and efficient virtual examination and ultimately contributes to patient satisfaction.

Attitudes amidst the pandemic: Virtual delivery of care in an adult cystic fibrosis population

Background: The COVID-19 pandemic has altered how we deliver care to people with cystic fibrosis (CF) across the spectrum of disease severity. Because of lockdowns and avoiding exposure to COVID-19 by limiting inperson clinic visits, clinical care has pivoted from standard practices to virtual care in combination with in-person traditional visits. This approach has allowed patients to be monitored and treated in a timely manner. Such virtual visits have the advantage of reducing the time commitment for clinic visits because the patient does not have to travel to and from the hospital, but virtual care lacks the ability to conduct a physical examination and to obtain objective and standardized testing of key measurements known to be associated with health outcomes in CF. The objective of this study was to evaluate the attitude of patients to virtual delivery of care and their comfort level with such care. Method(s): This is a prospective, cross-sectional survey of adults with CF who are followed at St. Michael's Adult CF Center in Toronto, Canada. An online survey was created using SurveyMonkey to assess attitudes toward and satisfaction with virtual care. The survey was emailed to participants and included the Canadian CF Registry ID;a reminder email sent a week later. Baseline demographic and clinical data were obtained from the Canadian CF Registry and presented as median (range) or proportions as appropriate. Questions using a 3-point Likert scale will be categorized into agree, neutral, and disagree. Result(s): A total of 210 participants (53.0% female) completed the survey (median age 37.8, range 19.2-78.9). Median age of diagnosis was 2.2, 95.7% were Caucasian, 76.0% had completed post-secondary education, 63.0% were employed and 11.0% were students, 75% were pancreatic insufficient, 39.0% had CF-related diabetes, and 12.4% were post lung-transplant. Median percentage predicted forced expiratory volume in 1 second was 65.8% (range 17.9-126.9%), and median body mass index was 23.6 kg/m2 (range 15.5-45.7 kg/m2). Eighty-one percent of respondents had had a virtual visit before completing the survey. Sixty percent of respondents felt that in-person visits were the preferred way of completing a medical assessment, and 27.0% preferred virtual visits. Seventy-three percent felt it was important for the virtual visit to occur at the booked time, 59.0% had concerns that their lung function was not assessed during virtual visits, 46.0% felt they were losing the benefits of allied health team assessments with virtual visits, and 40.0% worried that their health would decline if primarily seen virtually. Just over half of respondents wanted to continue with virtual visits in some capacity after the pandemic. The optimal proportion of in-person visits was felt to be 50.0%. More than 85% of respondents were comfortable with technology (phone or computer) and had reliable access to the Internet to conduct virtual visits. Seventy percent of people would like to have access to a home spirometer, but cost was a barrier. Conclusion(s): From the patient's perspective, in-person visits were still the preferred way to complete a medical assessment, which seemed to be driven by concerns over lack of methods for assessment, particularly lung function, and access to the multidisciplinary team. Home spirometers, if freely available, might increase comfort with virtual appointments.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

Heat vs. Health: Home Office under a Changing Climate

Stressors are especially widespread in urban agglomerations. Common themes of built environment interventions that support health and well-being are blue and green infrastructure, indoor and outdoor air quality, thermal comfort, access to natural lighting, and acoustics. Given the current megatrends of increasing summer temperatures and the high popularity of home offices, we aimed at modeling thermal comfort changes of people working at home in three Austrian cities (Vienna, Innsbruck, and Graz) during the next decades until 2090. We present findings based on (I) an inter-disciplinary literature search and (II) indoor and outdoor climate simulations for actual and future climate scenarios. Based on the results, we discuss the potential impacts for work and human health and well-being, and we suggest a framework for the home office in "post-COVID-19 Austria” that integrates social, ecological, and economic aspects. The results of our study indicate that, in future climate scenarios, overheating of the interior can no longer be prevented without active cooling measures and nature-based solutions. Recommendations on the adjustment of behavior under climate change, including greening, adequate ventilation, and cooling techniques, are thus urgently needed for employees who are working from home in order to maintain physical and mental health and wellbeing.

A New CURE in Molecular Biology: Testing a Novel Pyrrolidine Compound to Determine Mechanism of Action in an Upper-Division Molecular Biology Course

The COVID-19 pandemic shut down forced introductory biology and chemistry laboratory courses online at DePauw University from March 2020-June 2021, leaving multiple classes of students without the opportunity to learn basic laboratory skills that are essential for the molecular biology laboratory. In an effort to provide students with both basic laboratory skills and advanced molecular biology skills, a new course-based undergraduate research experience (CURE) was developed for the 2022-23 academic year. In collaboration with Dr. Jeff Hansen in the Chemistry and Biochemistry department, novel compounds with potential anti-tumor properties were identified. The CURE in Molecular Biology was designed to have students use Saccharomyces cerevisiae as a model system to evaluate possible cellular pathways affected by the compound, including: cytoskeleton and cell migration, nucleotide biosynthesis, glucose metabolism, apoptosis, and cell cycle regulation. Students learned techniques DNA isolation and PCR, transformation, RNA isolation, cDNA synthesis, qPCR, and Western Blotting, while contributing to an active research project. At the conclusion of the project, students were surveyed about their comfort with molecular techniques and data analysis.Copyright © 2023 The American Society for Biochemistry and Molecular Biology, Inc.

The utility of telemedicine in cystic fibrosis clinic visits

Background: Cystic fibrosis (CF) is a progressive, genetic, multisystem disease. Exacerbations lead to long hospital stays and significant morbidity and mortality. At the crux of pulmonary exacerbation prevention is serial monitoring of pulmonary function tests and frequent outpatient follow-up. Patients at the Helen Devos Children's Hospital CF clinic receive quarterly multidisciplinary care from a CF clinic, but this schedule was complicated by the COVID-19 pandemic because of concern of infection precipitating a pulmonary exacerbation. In lieu of in-person visits, telemedicinewas used to continue necessary monitoring. The purpose of this study was to assess the accessibility, efficacy, and comfort of telemedicine visits at the CF clinic from the patient and provider perspective. Method(s): CF clinic parents and providers completed an anonymous survey by mail or email over a 6-month period. Patient surveys used a 5-point Likert scale to assess responses in four categories-accessibility, functionality, safety, and overall satisfaction-and an open-ended question on patient opinions of their telemedicine experience. Descriptive statistics and comparative means were used to interpret the data. Result(s): Average patient agewas 9.7, average years since diagnosis was 9.5, 53% of patients were male, and average one-way distance traveled to the clinic was 70 minutes (range 15-240). Patients reported that they had few difficulties accessing in-person visits at the clinic. They also reported the telemedicine experience to be functional and easy to navigate. In terms of safety (perceived assessment of respiratory status, overall health, and patients concerns), patients reported feeling neutral to moderate. Patients reported being very comfortable with virtual visits and moderately likely to schedule telemedicine visits at the CF clinic in the future. There was no correlation between travel distance to the clinic and likeliness of scheduling virtual visits in the future, although older patients were more likely to schedule virtual visits in the future. A few factors could be in play here;patients reported in-person visits to be very accessible, reporting that they rarely missed scheduled visits. Some patients reported internet connection problems, which may be more prevalent in rural areas farther from the clinic. At the time of this survey, patients did not have in-home spirometry. Provider responses were overwhelmingly positive, with high opinions of effectiveness, safety, and overall satisfaction. Providers also reported a subjective decrease in no-show rates for virtual visits. Conclusion(s): Virtual visits were found to be functional and have no perceived negative effects on safety. Patients reported high levels of comfort with virtual visits, although they were only moderately likely to schedule virtual visits in the future. This data, in conjunction with the open-ended responses, can be used to improve the CF telemedicine experience;patients are currently offered virtual visits every 6 months.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

The Effect of Senate Bill-159 on the Provision of Hiv Pre- and Post-Exposure Prophylaxis in Sacramento, California

Purpose of Study: The passing of Senate Bill (SB)-159 in May, 2019 allows California pharmacies to provide HIV pre-exposure (PrEP) & post-exposure prophylaxis (PEP) to patients without a physician's prescription. The goal of this study is to investigate whether Sacramento pharmacies are familiar with SB-159 and carry PrEP/PEP, evaluate SB-159's progress over the past three years, and elucidate possible avenues for further improvement in implementation. Methods Used: This study reports findings from surveys of state-licensed pharmacies in Sacramento conducted in 2020-2021 (Year 1) and 2022-2023 (Year 2) using an IRB-approved script. The script assessed the pharmacy's stock, promotion of PrEP/PEP, and familiarity with SB-159. Surveys for Year 2 are still ongoing. Respondent pharmacies were identified as carriers or non-carriers based on whether they carried prophylaxis. Respondents that scored a familiarity >= 3 for SB-159 were assigned as "familiar." The survey also investigated reasons for not furnishing Prophylaxis, advertising of Prophylaxis without prescription, comfort with dispensing protocol, and future plans for staff training to dispense Prophylaxis. Summary of Results: We first examined if pharmacies in Sacramento, California carried stock of PEP/PrEP. In Year 1 (2020-21), 14% of surveyed pharmacies reported carrying PEP/PrEP (7 out of 50). In Year 3 (2022-2023), this increased to 62% (24 out of 39 surveyed pharmacies). Next, we examined the familiarity of pharmacies and pharmacists with SB-159. In Year 1, 43% of carriers (3/7) and 16% of non-carriers (7/43) were familiar with SB-159. By Year 3, pharmacies were more familiar with the law, with 67% of carriers (16/24) and 54% of non-carriers (7/13) reporting to be familiar with SB-159. Finally, we examined whether the pharmacies advertised the ability to obtain PEP/PrEP prophylaxis without a prescription. In Year 1, 28.6% of carriers and 6.98% of non-carriers stated they advertise the ability to obtain PEP/PrEP prophylaxis without a prescription. In Year 3, the values decreased to 4.2% and 0%, respectively. Conclusion(s): Compared to Year 1, there was an increase in the percent of Year 3 pharmacies surveyed that stock PrEP/PEP. However, data from the past 2 years show that carriers and non-carriers showed similar responses to questions related to familiarity with SB-159 and advertising. Taken together, this would suggest that the passing of SB-159 has increased access to HIV PrEP/PEP, yet has not significantly improved pharmacy advertising and awareness. Possible explanations include the focus that pharmacies have put into vaccination efforts against the COVID 19 pandemic instead of fulfilling SB-159. Future studies should include survey questions that objectively assess a pharmacy's familiarity with SB-159, and follow up with pharmacies that plan to implement training for their staff to dispense PrEP/PEP.

Improving Interdepartmental Communication with Radiation Oncology

Topic significance and study purpose/background/rationale: The current Radiation Oncology electronic health record (EHR) at an Academic Medical Center remains distinct from the EHR in use by other departments. The transplant tracking system used by the Transplant and Cellular Therapy (TCT) division provides additional complexity. The previous system relied on treatment schemas physically signed by the attending, then scanned into the transplant tracking system. Precipitated by the COVID-19 pandemic, entering and verifying chemotherapy admissions moved from paper to the EHR. The transplant coordinator enters and routes the conditioning treatment plans to the physician and clinical pharmacists for verification. The clinical pharmacists integrated dosing into the treatment plans for conditioning regimens. Evaluation within the continuous quality improvement process identified that Radiation Oncology still utilized the transplant tracking system to plan total body irradiation (TBI) dose dates. The limited comfort and ability of Radiation Oncology to view treatment plans was identified as a barrier. To prevent errors, a standardized process to communication within the EHR was developed. Methods, intervention, and analysis: While the conditioning regimen information could be included in the referral order, Radiation Oncology wanted further documentation of physi-cian signatures, particularly to allow for plan alterations. To further document the physician signatures, a standardized note template was developed for the transplant coordinators to utilize in a nursing note. The note summarizes the condi-tioning regimen and radiation dates, then gets automatically routed to the attending physician for co-signature and, if necessary, attestation. Findings and interpretation: The project is ongoing with a goal compliance rate of 100% for adult stem cell recipients undergoing TBI-based conditioning. Discussion and implications: Workarounds open up vulnera-bilities for safety lapses, particularly within a complex health-care system. Utilization of the EHR's full capabilities provides an opportunity to clearly document communicationCopyright © 2023 American Society for Transplantation and Cellular Therapy

Resident Perceptions and Confidence Regarding Pediatric Preventive Care

Purpose of Study: Residents have experienced changes in educational structure, format, content, and patient experience due to the COVID-19 pandemic. Resident physicians across the country have reported changes in workload including a decrease in well child checks and immunizations resulting in limited clinical exposure. This study aimed to assess the confidence of first year pediatric residents (interns) in conducting routine preventive screening for children and to identify potential gaps in knowledge among this cohort. Methods Used: We conducted a cross-sectional observation study that included 13 categorical first year pediatric residents. A voluntary, anonymous online survey was administered in September 2022. The survey assessed confidence levels, and perceived comfort regarding common preventive pediatric encounters and screening tools. The survey included 7-questions based on the 4th Edition Bright Future's Guidelines and respondents rated their answers on a 5-point Likert scale. The surveys were distributed anonymously via e-mail using Survey Monkey, a web-based software platform that provided an intuitive interface for validated data capture. Participants were given 2 weeks to complete the survey and reminders were sent via email. Summary of Results: Eight of 13 interns participated for a response rate of 62%. Sixty-three percent of the residents had completed a subinternship in pediatrics. Of our respondents, 75% reported feeling "not at all confident" in executing well child check-ups for children <12months old and 63% reported feeling "very confident" in examining children> 13months old. Regarding the ability to perform a genitourinary examination in children >12years of age, 63% of respondents stated that they were "slightly" or "not at all confident". We asked interns to rate their confidence in providing anticipatory guidance to their patients. Interns perceived being somewhat confident regarding guidance about safe sex, tobacco use, and healthy lifestyles but less confident regarding newborn care, breast feeding and infant nutrition. Nearly 40% reported comfort in recommending and advising parents about the risks and benefits of age appropriate immunizations. We asked residents to report their ability in administering and interpreting screening tools (ASQ, MCAT, EPDS). Interns reported that were able to interpret results but lacked confidence in providing guidance. Conclusion(s): Our study identifies opportunities to bridge experiential knowledge gaps and confidence among pediatric interns who may have had limited clinical exposure to pediatrics following the COVID-19 pandemic. Graduate medical education programs should consider developing tailored educational interventions specifically geared for identified learning gaps to mitigate the challenges posed by the pandemic.

Basic needs of the first batch of medical staff in the fever clinic of Peking union medical college hospital during Coronavirus disease 2019 outbreak: A qualitative study.

Objective The objective of this study was to investigate the basic needs of medical staff during the coronavirus disease 2019 pandemic in a fever clinic, so as to provide a reference for the global epidemic medical teams. Methods A semi-structured qualitative interview outline was designed, including: (1) work level: Working hours, working intensity, and safety guarantee in a fever clinic;(2)life level: Diet, sleep, and physical comfort;(3)psychological level: Emotion, pressure, coping style, and interpersonal resources. The basic needs of the first batch of the fever clinic in Peking Union Medical College Hospital was studied by open telephone interviews. Results A total of 37 medical staff were interviewed, including 8 males (21.6%) and 29 females (78.4%). Among them, there were 16 doctors (43.2%), 19 nurses (51.4%), and 2 medical technicians (5.4%). In terms of work settings, the ideal continuous working time was 4-6 hours per shift. There should be pro re nata positions during extremely high workload, and sufficient personal protective equipment was the key to safety. In terms of living conditions, providing meals according to different shifts was important for dietary needs, and sleeping pills were temporarily needed for sleep. In terms of psychological reactions, nervousness and worrying were relatively common. Family and colleagues were important resources of support. Sport could help relieve physical and psychological stress, and psychological support from psychologists was helpful in reducing their negative emotions. Conclusions The basic needs of medical staff should be respected so as to keep the efficacy of their work. We suggest that medical staff can rest after each 4-6 h working shift. Personal protective equipment should be sufficient. Psychological support should be noted in all of them and provided when necessary.Copyright © 2021, Peking Union Medical College Hospital. All rights reserved.