Global responses to the COVID-19 pandemic by recreational anglers: considerations for developing more resilient and sustainable fisheries.

The global COVID-19 pandemic resulted in many jurisdictions implementing orders restricting the movements of people to inhibit virus transmission, with recreational angling often either not permitted or access to fisheries and/or related infrastructure being prevented. Following the lifting of restrictions, initial angler surveys and licence sales suggested increased participation and effort, and altered angler demographics, but with evidence remaining limited. Here, we overcome this evidence gap by identifying temporal changes in angling interest, licence sales, and angling effort in world regions by comparing data in the 'pre-pandemic' (up to and including 2019); 'acute pandemic' (2020) and 'COVID-acclimated' (2021) periods. We then identified how changes can inform the development of more resilient and sustainable recreational fisheries. Interest in angling (measured here as angling-related internet search term volumes) increased substantially in all regions during 2020. Patterns in licence sales revealed marked increases in some countries during 2020 but not in others. Where licence sales increased, this was rarely sustained in 2021; where there were declines, these related to fewer tourist anglers due to movement restrictions. Data from most countries indicated a younger demographic of people who participated in angling in 2020, including in urban areas, but this was not sustained in 2021. These short-lived changes in recreational angling indicate efforts to retain younger anglers could increase overall participation levels, where efforts can target education in appropriate angling practices and create more urban angling opportunities. These efforts would then provide recreational fisheries with greater resilience to cope with future global crises, including facilitating the ability of people to access angling opportunities during periods of high societal stress. Supplementary Information: The online version contains supplementary material available at 10.1007/s11160-023-09784-5.

Increasing Access to a Diverse Mental Health Workforce through Emergency Reciprocity Licensure

New Jersey's COVID-19 Temporary Emergency Reciprocity Licensure Program provided temporary licenses to more than 31000 out-of-state healthcare practitioners, over a quarter of whom were mental health providers. As the need for mental health care accelerated during the pandemic, especially among health disparity populations, expanding mental health provider pools may be a critical tool to increase access to care. In January 2021, we surveyed New Jersey's temporary licensees. We analyzed over 4500 mental health provider responses to examine the impact of the temporary licensure program on access to mental health care overall and on enhancing a diverse mental health workforce. Over 3700 respondents used their temporary license to provide mental health care to New Jersey patients. About 7% of respondents self-identified as Hispanic, 12% Black, 6% Asian, 1% American Indian or Alaska Native, and 0% (more than 5) Native Hawaiian or other Pacific Islander. They treated about 30100 New Jersey patients, 40% of whom were new to the provider, and 81% delivered care exclusively using telehealth. Respondents conversed with patients in at least 13 languages. About 53% served at least one patient from an underserved racial/ethnic minority group. Our findings suggest that temporary out-of-state mental health providers helped enhance mental health care continuity and access. Copyright 2023 Federation of State Medical Boards. All Rights Reserved.

The battle over state lines: Leveraging an interstate compact to ensure continuity of care

Background: As a result of COVID-19-related precautions, states temporarily relaxed certain restrictions on telehealth services during the pandemic, including waiving licensing requirements so physicians could serve patients across state lines, but many states ended this flexibility in 2021. According to two online surveys fielded by the Cystic Fibrosis Foundation (CFF) to accredited centers in 2020 and 2021, 65% of programs reported providing care to patients living in another state. Of these, 18.5% reported that some of their out-of-state (OOS) patients were not able to access telehealth services because of licensure-related issues [1]. CFF Compass fielded 20 calls from people with cystic fibrosis (CF) in 15 states requesting assistance in accessing their OOS care center, accounting for more than 25% of all network adequacy inquiries received during that time. CFF recognized the need for policy change to improve access to OOS care for people with CF. Method(s): In 2021, we interviewed five CF care centers about their experiences with telehealth and OOS licensing. The administrative burden of applying for multiple state medical licenses was a key barrier to providing remote OOS care, and CFF identified the Interstate Medical Licensure Compact (IMLC) as one solution. The IMLC streamlines the licensing application process for physicians who want to practice in multiple states. From January 2021 to March 2022, CFF supported legislation in 10 states to join the IMLC by sending letters with 31 care center director co-signers. CFF also hosted a webinar in June 2021 to educate CF care centers about the IMLC as away to pursue multiple medical licenses with one application. We shared follow-up information about the IMLC through CFF COVID-19 digest emails. CFF sent a survey in March 2022 to all CF care centers to understand current use of and barriers to telehealth for CF care teams. Data from this survey are forthcoming. Result(s): Before CFF's engagement in January 2021, 30 states and the District of Columbia were members of the IMLC. As of April 8, 2022, five additional states have passed legislation to join the IMLC, reflecting a 17% increase in state participation from January 2021 to March 2022. Within the 35 participating states at present,126 CF care center programs will have the potential to use the IMLC. CFF has supported legislation in all six states with pending legislation to join the IMLC in 2022. Increased physician awareness of IMLCwas evidenced by physician participation from 20 states in thewebinar, aswell as broad distribution of the recording via the COVID- 19 digest to 288 CF programs in 49 states afater the session. Conclusion(s): Although more states taking action to join the IMLC is an important step, challenges persist. Even in IMLC member states, CF providers express concerns about the cost and administrative burden of maintaining licenses in multiple states. Permanent regulations regarding use of and reimbursement for telehealth remain uncertain. To better understand current challenges and opportunities for telehealth and remote OOS care, CFF is supporting additional research and advocacy.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

Forensic Examination Of Covid Certificates And Passports To Extract Felonious Manipulations With Adobe Photoshop Cs5 Tools

In today's era, digital documents are used in official proceedings and various commercial online platforms. With the advent of Digital locker facilities, a digital document is admissible in various Government and private sectors. Due to this, the misuse of digital documents is increasing and criminal activity has surged during COVID times. Digital documents can be easily manipulated with the help of image-processing software applications. Manipulations include forgeries and duplication in the documents, counterfeiting in currency notes, and alteration and tampering in government documents or personal documents have increased manifolds. In the present study, a preliminary attempt has been made to analysed digitally manipulated documents by using different software which includes JPEG snoop, Adobe Photoshop CS5, and forensically beta software. Apart from that, in this paper new methodology to authenticate manipulations in scanned documents is devised. The authors were able to detect manipulations in altered documents like mark sheets, COVID certificates, Id cards, driving licenses, and passports. The morphological attributes like changes in background colour, variations in pixel size, and specifically appearance of dots and layers were observed. The results obtained were conclusive and were able to detect the manipulations, as well as the date and time of alterations, were detected with help of Forensic beta software.Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Gratitude Journal as an Instrument to Increase the Level of Gratitude among Adolescent in Ambon during COVID-19

COVID-19, which has plagued the world since 2020, has brought changes in the order of human life globally, and ultimately has an impact on the psychological state of individuals, including teenagers. The aim of this study is to find the differences between students' gratitude score before and after the implementation of writing gratitude journal regularly. Participants on this study was 20 adolescents in Ambon City Maluku Indonesia, consists of 6 boys and 14 girls. The participants age was between 15-16 years old. Quantitative Method with experimental design used in this study. From the results, it was found that the significant value in the table paired samples correlations was 0.418, meaning that there are relationship between the results of the pre-test and post-test because the value was > sig. 0.05. Although the increase in the value of gratitude among adolescents in Ambon is not too large and increases their classification to be included in the criteria for groups that have sufficient gratitude scores, the important thing explained in implementing gratitude education actually lies in its aim to inspire students that it is important to be grateful in all circumstances. and it's not just about saying thank you or showing grateful behavior. This is an open access article under the CC BY-SA license.Copyright © 2022, Anka Publishers. All rights reserved.

Forensic Examination Of Covid Certificates And Passports To Extract Felonious Manipulations With Adobe Photoshop Cs5 Tools

In today's era, digital documents are used in official proceedings and various commercial online platforms. With the advent of Digital locker facilities, a digital document is admissible in various Government and private sectors. Due to this, the misuse of digital documents is increasing and criminal activity has surged during COVID times. Digital documents can be easily manipulated with the help of image-processing software applications. Manipulations include forgeries and duplication in the documents, counterfeiting in currency notes, and alteration and tampering in government documents or personal documents have increased manifolds. In the present study, a preliminary attempt has been made to analysed digitally manipulated documents by using different software which includes JPEG snoop, Adobe Photoshop CS5, and forensically beta software. Apart from that, in this paper new methodology to authenticate manipulations in scanned documents is devised. The authors were able to detect manipulations in altered documents like mark sheets, COVID certificates, Id cards, driving licenses, and passports. The morphological attributes like changes in background colour, variations in pixel size, and specifically appearance of dots and layers were observed. The results obtained were conclusive and were able to detect the manipulations, as well as the date and time of alterations, were detected with help of Forensic beta software. Copyright © 2023 Wolters Kluwer Medknow Publications. All rights reserved.

The alloCELL program: Patient monitoring, donor selection and GMP-compliant manufacturing of virus-specific T cells from stem cell, family and third-party T-cell donors

Background: Intensive immunosuppression to prevent graft rejection and GvHD leads to impaired T-cell immunity in HSCT and SOT patients. These are at high risk for infection with and reactivation of opportunistic pathogens such as CMV, EBV, HHV6, ADV and BKV, which are associated with significant morbidity and mortality. The inadequacies of conventional therapies have increased interest in T-cell immunotherapy. Here, timely T-cell donor recruitment and rapid production of antiviral T cells are required. Method(s): To improve T-cell donor recruitment, the alloCELL registry was established (www.alloCELL.org), currently recording >3,500 HLAtyped donors with extensively characterized antiviral T-cell repertoire. The registry has been extended by convalescent COVID-19 donors. The alloCELL lab established protocols to consider clinical requirements of patients at high risk or with failed conventional therapy. The manufacturing license for clinical-grade virus-specific T-cell products using Cytokine Capture System and CliniMACS Prodigy was obtained. T-cell donors are considered eligible if >=0.01% specific Interferon-gamma+ T cells are detectable. A related haploidentical or >=5/10 HLA-matched alloCELL donor is recommended if the stem cell donor is not eligible. Result(s): As of April 2022, >410 multi-/monovirus-specific T-cell products were generated for clinical applications by using overlapping peptide pools that cover the complete sequence of a viral protein. For patients in need of an unrelated third-party donor, suitable donors were found and clinical grade T-cell products were provided within 1.5 weeks after request with an HLA compatibility >=5/10. The applied T cells were monitored to determine frequency, chimerism and TCR repertoire. Patients who received antiviral donor T cells did not show severe adverse effects and in 80% of the cases, antiviral T cells were detected in blood after T-cell transfer. Of note, there is evidence that adoptive T-cell transfer induces endogenous T-cell responses. Conclusion(s): Success of antiviral T-cell transfer benefits from (i) accurate monitoring of viral load and antiviral T-cell frequencies in patients, and (ii) early and fast selection of suitable T-cell donors. Our data support clinical safety and efficacy of third-party antiviral T cells.

S-11-01 Covid19 vaccine toxicology: introduction and CRO experience/perspectives

The pandemic needed the rapid development of a SARsCov2 vaccine, without impacting on safety and despite Covid being a new disease, with limited understanding of the animal models, unknown correlates of protection and challenges of biosafety levels. mRNA vaccines, which were previously in the therapeutic domain, also brought some additional considerations. Despite these challenges, the first person to be vaccinated was just over a year after the first case was identified, on 29th December 2020. This presentation discusses the requirements for a non-clinical program for a SARsCov2 vaccine, linking how vaccines work and addressing potential safety concerns from first in human to license. Woven into the presentation will be a discussion on models and species selection, as well as how we supported speeding development up and kept up with an adapting regulatory environment. We also needed to educate and support new players (both manufacturers and scientists) who were often more familiar with the principles of ICH than the WHO guidelines (the key guidelines for prophylactic vaccine). Finally, we will provide an update on how we are continuing discussions on models and species selection, as well as briefly mentioning the new WHO guidelines for mRNA vaccines. Copyright © 2022 Elsevier B.V.

Compulsory Licensing System in Bosnia and Herzegovina: How Pandemic-Proof Is It?

The article examines the relevant provision of the Patent law of Bosnia and Herzegovina governing the conditions and procedures for granting a compulsory licence in light of the Covid-19 pandemic. In the course of this critical analysis, the insufficiencies of the regulatory framework for the application of this mechanism are detected, and improvements to the system proposed. Furthermore, the article also discusses other legislative (e.g., Law on Medicines and Medical Devices) and regulatory obstacles for the production and marketing of generic medicines on the territory of Bosnia and Herzegovina. Finally, it presents a short overview of the pharmaceutical industry in the country and identifies a potential compulsory licensing event. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

The Learning Contract and its Impact on Scholarship among Moroccan Nursing Students

Background: E-learning refers to the use of new technologies to deliver distance learning programs. This mode of learning is also considered one of the innovative teaching/learning methods best suited to the current conditions, which entail the suspension of face-to-face courses due to the COVID-19 pandemic to ensure continuity of training, overcome learning difficulties and increase student autonomy and motivation. Our study focuses on this teaching model as an example of an apprenticeship contract, often adopted in technical, vocational, work-linked training. The aim of this study is to measure the perception of this learning contract through e-learning and its impact on learning among multi-skilled nursing students in semester four (S4) of the Professional License of the Higher Institute of Nursing and Health Techniques of Casablanca within the framework of the course of nursing care in psychiatry. Methods: A group of 58 students participated in a survey conducted by questionnaire, with a response rate of 86.20%. Results: The results revealed that the students had a positive perception regarding the use of the learning contract;according to them, the learning contract approach increases autonomy, motivation and the application of the theoretical courses in practice. Conclusion: The learning contract offers several advantages as a learning strategy and this has been implemented in different nursing education contexts, which may encourage nursing educators to use this contract more widely in theoretical and also practical teaching. © 2022 Lamiri et al.

Comparison of abiraterone acetate and prednisolone (AAP) or combination enzalutamide (ENZ) + AAP for metastatic hormone sensitive prostate cancer (mHSPC) starting androgen deprivation therapy (ADT): Overall survival (OS) results of 2 randomised phase III trials from the STAMPEDE protocol

Background: AAP or ENZ added to ADT improves outcomes for mHSPC. Any benefit of combining ENZ & AAP in this disease setting is uncertain. Methods: STAMPEDE is a multi-arm, multi-stage (MAMS), platform protocol conducted at 117 sites in the UK & Switzerland. 2 trials with no overlapping controls randomised mHSPC patients (pts) 1:1 to ADT +/- AAP (1000mg od AA + 5mg od P) or AAP + ENZ (160mg od). Treatment was continued to progression. From Jan 2016 docetaxel 75mg/m2 3-weekly with P 10mg od was permitted + ADT. Using meta-analysis methods, we tested for evidence of a difference in OS and secondary outcomes (as described previously: failure-free, metastatic progression-free, progression-free & prostate cancer specific survival) across the 2 trials using data frozen 3 Jul 2022. All confidence intervals (CI) 95%. Restricted mean survival times (RMST) restricted to 84 months (m). Results: Between Nov 2011 & Jan 2014, 1003 pts were randomised ADT +/- AAP & between Jul 2014 & Mar 2016, 916 pts were randomised ADT +/- AAP + ENZ. Randomised groups were well balanced across both trials. Pt cohort: age, median 68 years (yr), IQR 63, 72;PSA prior to ADT, median 95.7 ng/ml, IQR 26.5, 346;de novo 94%, relapsed after radical treatment, 6%. In AAP + ENZ trial, 9% had docetaxel + ADT. OS benefit in AAP + ENZ trial, HR 0.65 (CI 0.55‒0.77) p = 1.4×10-6;in AAP trial, HR 0.62 (0.53, 0.73) p = 1.6×10-9. No evidence of a difference in treatment effect (interaction HR 1.05 CI 0.83‒1.32, p = 0.71) or between-trial heterogeneity (I2 p = 0.70). Same for secondary end-points. % (CI) of pts reporting grade 3-5 toxicity in 1st 5 yr: AAP trial, ADT: 38.5 (34.2-42.8), + AAP: 54.4 (50.0-58.8);AAP + ENZ trial, ADT: 45.2 (40.6 – 49.8), + AAP + ENZ: 67.9 (63.5 – 72.2);most frequently increased with AAP or AAP + ENZ = liver derangement, hypertension. At 7 yr in AAP trial (median follow-up: 95.8m), % (CI) pts alive with ADT: 30 (26, 34) versus with ADT + AAP: 48 (43, 52);RMST: ADT: 50.4m, ADT + AAP: 60.6m, p = 6.6 x 10-9. Conclusions: ENZ + AAP need not be combined for mHSPC. Clinically important improvements in OS when adding AAP to ADT are maintained at 7 yr. Clinical trial identification: NCT00268476. Legal entity responsible for the study: Medical Research Council Clinical Trials Unit at University College London. Funding: Cancer Research UK, Medical Research Council, Janssen, Astellas. Disclosure: G. Attard: Financial Interests, Personal, Invited Speaker: Janssen, Astellas, AstraZeneca;Financial Interests, Personal, Advisory Board: Janssen, Astellas, Novartis, Bayer, AstraZeneca, Pfizer, Sanofi, Sapience, Orion;Financial Interests, Personal, Royalties, Included in list of rewards to discoverers of abiraterone: Institute of Cancer Research;Financial Interests, Institutional, Research Grant: Janssen, Astellas;Non-Financial Interests, Principal Investigator: Janssen, Astellas;Non-Financial Interests, Advisory Role: Janssen, AstraZeneca. W.R. Cross: Financial Interests, Personal, Invited Speaker, Speaker fee: Myriad Genetics, Janssen, Astellas;Financial Interests, Personal, Advisory Board, Advisory Board fee: Bayer;Financial Interests, Institutional, Research Grant, Research grant: Myriad Genetics. S. Gillessen: Financial Interests, Personal, Advisory Board, 2018: Sanofi, Roche;Financial Interests, Personal, Advisory Board, 2018, 2019: Orion;Financial Interests, Personal, Invited Speaker, 2019 Speaker's Bureau: Janssen Cilag;Financial Interests, Personal, Advisory Board, 2020: Amgen;Financial Interests, Personal, Invited Speaker, 2020: ESMO;Financial Interests, Personal, Other, Travel Grant 2020: ProteoMEdiX;Financial Interests, Institutional, Advisory Board, 2018, 2019, 2022: Bayer;Financial Interests, Institutional, Advisory Board, 2020: Janssen Cilag, Roche, MSD Merck Sharp & Dohme, Pfizer;Financial Interests, Institutional, Advisory Board, 2018: AAA International, Menarini Silicon Biosystems;Financial Interests, Institutional, Advisory Board, 2019, 2020: Astellas Pharma;Financial Interests, Institutional, Advisory B ard, 2019: Tolero Pharmaceuticals;Financial Interests, Personal, Invited Speaker, 2021, 2022: SAKK, DESO;Financial Interests, Institutional, Advisory Board, 2021: Telixpharma, BMS, AAA International, Novartis, Modra Pharmaceuticas Holding B.V.;Financial Interests, Institutional, Other, Steering Committee 2021: Amgen;Financial Interests, Institutional, Advisory Board, 2021, 2022: Orion, Bayer;Financial Interests, Personal, Invited Speaker, 2021: SAKK, SAKK, SAMO - IBCSG (Swiss Academy of Multidisciplinary oncology);Financial Interests, Personal, Advisory Board, 2021: MSD Merck Sharp & Dhome;Financial Interests, Personal, 2021: RSI (Televisione Svizzera Italiana);Financial Interests, Institutional, Invited Speaker, 2021: Silvio Grasso Consulting;Financial Interests, Institutional, Other, Faculty activity 2022: WebMD-Medscape;Financial Interests, Institutional, Advisory Board, 2022: Myriad genetics, AstraZeneca;Financial Interests, Institutional, Invited Speaker, 2022: TOLREMO;Financial Interests, Personal, Other, Travel support 2022: AstraZeneca;Financial Interests, Institutional, Funding, 2021, Unrestricted grant for a Covid related study as co-investigator: Astellas;Non-Financial Interests, Advisory Role, 2019: Menarini Silicon Biosystems, Aranda;Non-Financial Interests, Advisory Role, Continuing: ProteoMediX. C. Pezaro: Financial Interests, Personal, Advisory Board, Ad board Dec 2020: Advanced Accelerator Applications;Financial Interests, Personal, Advisory Board, Aug 2021: Astellas;Financial Interests, Personal, Advisory Board, Oct 2021: Bayer;Financial Interests, Personal, Invited Speaker, Sept-Oct 2020: AstraZeneca;Financial Interests, Personal, Invited Speaker, Oct 2020: Janssen;Financial Interests, Personal, Advisory Board, July-Sept 2022: Pfizer. Z. Malik: Financial Interests, Personal, Advisory Board, advisry board for new hormonal therapy for breast cancer: sanofi;Financial Interests, Institutional, Invited Speaker, research grant for CHROME study: sanofi;Other, Other, support to attend meetings or advisory boards in the past: Astellas,Jaansen,Bayer;Other, Other, Sponsorship to attend ASCO meeting 2022: Bayer. M.R. Sydes: Financial Interests, Personal, Invited Speaker, Speaker fees at clinical trial statistics training sessions for clinicians (no discussion of particular drugs): Janssen;Financial Interests, Personal, Invited Speaker, Speaker fees at clinical trial statistics training session for clinicians (no discussion of particular drugs): Eli Lilly;Financial Interests, Institutional, Research Grant, Educational grant and drug for STAMPEDE trial: Astellas, Janssen, Novartis, Pfizer, Sanofi;Financial Interests, Institutional, Research Grant, Educational grant and biomarker costs for STAMPEDE trial: Clovis Oncology. L.C. brown: Financial Interests, Institutional, Research Grant, £170k educational grant for the FOCUS4-C Trial from June 2017 to Dec 2021: AstraZeneca;Financial Interests, Institutional, Funding, Various grants awarded to my institution for work undertaken as part of the STAMPEDE Trial: janssen pharmaceuticals;Non-Financial Interests, Other, I am a member of the CRUK CERP funding advisory panel and my Institution also receive grant funding from CRUK for the STAMPEDE and FOCUS4 trials: Cancer Research UK. M.K. Parmar: Financial Interests, Institutional, Full or part-time Employment, Director at MRC Clinical Trials Unit at UCL: Medical Research Council Clinical Trials Unit at UCL;Financial Interests, Institutional, Research Grant: AstraZeneca, Astellas, Janssen, Clovis;Non-Financial Interests, Advisory Role, Euro Ewing Consortium: University College London;Non-Financial Interests, Advisory Role, rEECur: University of Birmingham;Non-Financial Interests, Advisory Role, CompARE Trial: University of Birmingham. N.D. James: Financial Interests, Personal, Advisory Board, Advice around PARP inhibitors: AstraZeneca;Financial Interests, Personal, Advisory Board, Prostate cancer therapies: Janssen, Clovis, Novartis;Financial Interests, Institutional, Expert Testimony, Assisted with submissions regarding licencing for abiraterone: Janssen;Financial Interests, Personal, Advisory Board, Docetaxel: Sanofi;Financial Interests, Institutional, Expert Testimony, Providing STAMPEDE trial data to facilitate licence extensions internationally for docetaxel: Sanofi;Financial Interests, Personal, Advisory Board, Bladder cancer therapy: Merck;Financial Interests, Personal, Advisory Board, Advice around novel hormone therapies for prostate cancer: Bayer;Financial Interests, Personal, Invited Speaker, Lecture tour in Brazil August 2022 - speaking on therapy for advanced prostate cancer: Merck Sharp & Dohme (UK) Limited;Financial Interests, Institutional, Invited Speaker, Funding for STAMPEDE trial: Janssen, Astellas;Financial Interests, Institutional, Invited Speaker, Funding for RADIO trial bladder cancer: AstraZeneca. All other authors have declared no conflicts of interest.

A retrospective observational study of the effects of Kaftrio® on the current cohort of patients at Nottingham University Hospitals NUH trust

Background: Due to disease progression, people with cystic fibrosis (PwCF) were expected to lose 1–2% of the FEV1% predicted per year along with decreased exercise tolerance, malabsorption and weight loss. Research into the development of CFTR modulators has dominated PwCF research, and in 2020, NHSE agreed to a deal which made approximately 80% of PwCF eligible for Triple Modulator Therapy (Kaftrio®). The combination of the elexacaftor/tezacaftor/ivacaftor has shown improvements in the structure and function of the NaCl channels. PwCF reported improvements in: energy, strength, breathing, sputum production, diabetes control, BMI and lung function (Edgeworth 2017).Wewere therefore interested to observe the effects of Kaftrio® on our patient group at Nottingham University Hospitals Trust (NUH) Objectives: To observe the physiological effects of Kaftrio® in regard to weight, FEV1, grip strength and 6MWT in adult PwCF at NUH Methods: A retrospective observation of 99 eligible patients who attended the NUH (Sept 20-March 21) was undertaken on initiation of on-license Kaftrio®. Patients were seen on initiation and after 3 months. Data was collected as part of their routine MDTAnnual Assessment process (Weight, FEV1, grip strength and 6MWT). Results: Of the 99 patients (aged 18–50) we observed, weight +4.14% (n = 55), FEV1 +22.5% (n = 42), grip strength − 0.48% (n = 41) and 6MWT +1.14% (n = 36). Limitations: Patient dissent to assessments, interrater reliability, variability in spirometry device, COVID-19 pandemic restrictions and side effects resulting in termination of Kaftrio®. Conclusions: Overall improvement occurred in all areas except for grip strength. It is encouraging to see a general improvement within our cohort of patients which reflects changes aligned with international research. However, the reduction in chest symptom burden does pose the question of the nature of thephysiotherapy involvement in cystic fibrosis for thefuture.

Trends in intravenous antibiotic prescriptions pre- and postintroduction of Kaftrio® in a large UK adult cystic fibrosis centre

Background: Since the introduction of Kaftrio® in 2020, people with CF (pwCF) have reported significant health improvements. Real-world experiences over the last 2 years suggest that pwCF are using fewer antibiotics. Evidence has confirmed this is the case with nebulised antibiotics, however it is unclear what the impact has been on intravenous antibiotics (IVABx). Objective: To investigate IVABx use in pwCF, in our centre, pre and post Kaftrio® commencement. Method: Retrospective data was collected from our internal pharmacy database on number of IVABx dose units issued pre and post the widespread use of Kaftrio®. Results: Since Jan 2020, 282 pwCF, 81% of our cohort, have commenced on Kaftrio®;initially via clinical trials and compassionate use programmes, then more widely from August 2020 following its UK licence. (Table Presented) Pharmacy data shows overall IVABx prescriptions have reduced consistently since 2019 with a trend towards less inpatient therapy. Conclusion: Data suggests that the use of IVABx has reduced in our centre since the introduction of Kaftrio®. Other factors which may have influenced IVABx usage during this period include the COVID-19 pandemic, which led to pwCF “shielding” for several months during 2020, providing protection from community acquired infections and potentially increasing anxiety levels around seeking in-patient healthcare. CFHealthHub has also been vital during this time, supporting pwCF to increase their adherence to longterm nebulised treatments. Further work is needed to investigate the trends of antibiotic usage (nebulised and IV) beyond the pandemic and the effect on the long-term health outcomes of pwCF.

MAKING AN IMPACT ON THE COVID PANDEMIC

STATEMENT OF PROBLEM/QUESTION: When hospitals and skilled nursing facilities (SNF) were impacted during the COVID surge, what healthcare delivery model can be used to increase hospital bed capacity while maintaining quality care for marginalized patients with no access to a SNF? DESCRIPTION OF PROGRAM/INTERVENTION: Background - Santa Clara Valley Medical Center is the second largest public safety net healthcare system in California. During the COVID surge, our hospitals experienced a significant demand for hospital beds. At this time, SNFs were impacted and did not accept patients with barriers in discharge planning. Problem: How to safely discharge non-acute patients with no accepting SNF to increase hospital bed capacity. Intervention: Develop a post-acute care team (PACT) for marginalized, non-acute patients. These patients were initially hospitalized for severe medical conditions but could not be safely discharged once stabilized. During the COVID surge, Santa Clara County operationalized a 36-bed, lowacuity hospital called DePaul Health Center (DPHC) through an emergency state-issued alternative care license. DPHC implemented a novel healthcare model for post-acute transitions of vulnerable, non-acute patients during a resource-constrained time period. Of the 131 admissions to DPHC, 42% had unstable housing, 29% had active substance use, and 100% had no accepting SNFs. The operationalization involved: - Training volunteer outpatient providers to work in an inpatient setting with COVID-positive patients. - Building a referral model to include all hospitals in our county. - Transition of care services including: direct transition to drug treatment programs, linkage to medical respites, COVID vaccinations, specialty care followup, and medication delivery/teaching at bedside. MEASURES OF SUCCESS: - Number of hospital bed days saved. - Number of additional potential hospital admissions. - Implementation of high-quality inpatient services for non-acute patients. FINDINGS TO DATE: Over six months, DPHC admitted 127 patients across three county hospitals. DPHC allowed for a potential 446 additional hospital admissions (based on 2232 potential bed days saved and an average hospital LOS of 5 days per hospital admission). KEY LESSONS FOR DISSEMINATION: - Establishing a post-acute care team addresses structural inequities prevalent in our healthcare system for marginalized patients. - Incorporating a post-acute care team improves access to SNF for marginalized patients.

PHARMACIST INTERVENTION IN SMOKING CESSATION: REALITY OR JUST “BLOWING SMOKING”

BACKGROUND: To extend the reach of primary care physicians, Collaborative Practice Agreements (CPA) and Pharmacist Clinician Licenses (PCL) have emerged as possible solutions to allow clinical pharmacists acting under a protocol to perform specific patient care functions, such as smoking cessation counseling. While studies have supported the efficacy of this approach, few data are available on the frequency of their use. METHODS: A list of pharmacies in the state of New Jersey (NJ) and New Mexico (NM) was obtained through the GoodRx Gold membership program list, which included 1,396 pharmacies in New Jersey and 151 in New Mexico. We randomly selected 113 pharmacies in New Jersey, which we contacted between December 2020 to March 2021. From New Mexico, we randomly selected 104 pharmacies, which we contacted between February 2021 and December 2021. Our interviewer-administered survey, which was designed to assess practice in 2019 (pre-pandemic), included questions on the presence of a CPA or PCL and the counseling provided (duration, frequency and type of counseling). RESULTS: In NJ, 83/113 (73%) pharmacies completed the survey, 17 declined to participate and awaiting reply from 13. Only 8/83 pharmacies reported having a CPA in place. One pharmacy had a CPA plan for diabetes medication management pre-pandemic but plans were postponed due to COVID-19. Another pharmacy stated that they had a CPA but declined any further participation in the survey. Of the remaining pharmacies participating in CPAs, 5 had agreements with physicians and 1 with nurse practitioner along with physician assistant. Three pharmacies provided smoking cessation counseling, two provided other counseling services and 1 solely provided naloxone treatment. Among the pharmacies participating in CPAs, they estimated completing 15-30 counseling interventions during 2019, with interventions ranging 5 minutes to 15 minutes. The pharmacies that provided smoking cessation counseling estimated less than 15 interventions in 2019, ranging from 5 minutes to 30 minutes. In NM, 61/104 (59%) pharmacies contacted, 24 declined to participate and awaiting reply from 19. Of the 61 pharmacies that participated, 7 had a PCL while the other 54 pharmacies did not. Of the pharmacies with PCLs, 4 declined further participation in the survey and of the remaining 3 pharmacies, 1 included smoking cessation counseling. Among the pharmacies recorded in the survey as participating in PCLs, they estimated 15 to 30 interventions during 2019 with interventions ranging 5 minutes to 15 minutes. The pharmacy that provided smoking cessation counseling estimated less than 15 interventions per year ranging from 15 minutes to 20 minutes. CONCLUSIONS: Pharmacists are effective at providing lifestyle counseling and legal agreements exist to support their doing so. We found that this potential remains vastly underutilized. Future studies should further examine barriers to having pharmacists deliver lifestyle counseling and test interventions to increase it.

Levels of some serum cytokines and chemokines in children with coronavirus infection

Objective. To measure serum levels of some cytokines and chemokines in children depending on the severity of coronavirus infection. Patients and methods. We examined 33 children aged 4 to 17 years with coronavirus infection, including 25 patients with mild disease (Group 1;mean age 11 [6.5;14] years) and 8 children with moderate disease (Group 2;mean age 11 [8;13] years). The control group comprised 30 healthy children matched for age (mean age 10 [6;12] years). The following cytokines and chemokines were measured in all study participants using the LEGENDplexTM Human Essential Immune Response Panel (BioLegend, USA): interleukins (IL)-1β,-2,-4,-6,-8,-10,-12p70,-17A, interferon-induced protein (IP-10), monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ). Data analysis was performed using the IBM SPSS Statistics Version 25.0 (International Business Machines Corporation, license No Z125-3301-14, USA). Results. We found that children with coronavirus infection had elevated serum levels of IL-1β, IL-2, IL-4, IL-12p70, IL-17A, IP-10, and MCP-1 regardless of their disease severity compared to controls. Patients with moderate disease demonstrated higher serum levels of IL-12p70 and MCP-1 compared to those with mild disease. The ROC-analysis showed that IL-12p70 and MCP-1 can predict moderate course of coronavirus infection in children. Conclusion. Serum levels of IL-12p70 and MCP-1 can be used as an additional diagnostic marker to estimate the inflammation severity in children with coronavirus infection.

Bibliometric Analysis on Scopus with the Keyword “Music Streaming” Using Vosviewer Software

The trend of music streaming research has been carried out by many researchers. This has increased the popularity and success of music streaming in recent years. with more and more record labels and musicians acknowledging its usefulness in selling and promoting music. This research uses descriptive quantitative. As for the analysis using bibliometric analysis by collecting the results of scientific article literature obtained from Scopus with the keyword "Music Streaming". The search results of scientific papers are then exported in RIS format and processed using VOSviewer. The map of the development of articles with topics about music streaming, digital music, online music, online music purchases with the categories of article title, , keywords in the period 2002 – 2020 formed into six clusters. The first cluster is red (digital music subscription, mobile shopping, continuance, confirmation, digital distribution), the second cluster is green (consumer, utaut2, applicability, music streaming), the third cluster is blue (flow experience, critical mass, continuance intention, music consumption), the fourth cluster is yellow (piracy, license, music, consumer behavior), the fifth cluster is purple (social presence, interactivity, streaming, Spotify, copyright, digitalization, publishing industry, media distribution) and the sixth cluster is orange (technology acceptance model, TAM, covid-19, freemium, online streaming, generation Y).

Brands, sustainability and citizenship: Navigating a world demanding change

For company brands the lines between business function silos are not clearly drawn, and the formerly compliance-oriented domain of environmental, social and governance (ESG) has become part of the brand in many sectors, whether we like it or not.Whenever an organisation seeks to stand apart on the basis of its citizenship or reputation in any of its competitive realms — for customers, talent, influence or capital — its brand strategy must connect all communications functions to the business strategy in a simple, coherent way.While always desirable, enabling clarity across the organisation is especially critical in these turbulent times. As COVID-19 has accelerated the pace of change and shifted risk appetites, big decisions are being made about corporate futures.This is an opportunity for brand people to tackle some of the barriers to collaboration and influence across functions.This paper outlines the challenge of aligning business functions to define and deliver coherent company positioning and makes a case for taking on that challenge as a matter of urgency to support businesses adapting to rapid changes in social expectations. Engaging executive leadership teams and boards of directors in this exercise is critical, and this paper outlines two practical ways to do so. First, framework thinking, which can accommodate different functions and communications disciplines into a single narrative. Second, and arguably more importantly, board-friendly ways to achieve a project mandate and frame the need to collaborate effectively at the most senior level to align brand and business strategy. © HENRY STEWART PUBLICATIONS 2045-855X.

Reinfection of SARS-CoV-2 in kidney transplant recipient

Coronavirus disease-2019 (COVID-19) which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported from Wuhan, China, and later became a pandemic. While infection is very common, reinfection with SARS-CoV-2 is rare because immune responses from past infection reduce the risk of reinfection. In this report, we describe the case of a kidney transplant recipient who was reinfected with SARS-CoV-2 after successfully recovering from moderate COVID-19, 6 months ago. The first infection occurred in September 2020 while the reinfection occurred in April 2021. Our case highlights that kidney transplant recipients can be reinfected with COVID-19, and therefore, recovery from a primary infection should not be taken as license to shun COVID-related precautions. The disease severity, clinical course, and outcome of reinfection may be different from the first infection.

Opinions on Scare Resource Allocation Policy Exemptions and Adjustments Among Laypeople and Healthcare Workers by License Type

Introduction: COVID-19 magnified the importance of health systems' readiness for scarce resource allocation during times of potential crisis-related shortages. Understanding how ethical values of laypeople differ from that of healthcare workers (HCW) is crucial to ensure a widely accepted policy. We intended to better understand how the values of laypeople, licensed independent practitioners (LIP), and non-LIP HCW align and differ regarding scarce resource allocation, particularly on exemptions and adjustments to ICU triage decisions, which could otherwise undermine public trust if not appropriately understood. Methods: Data were collected from a web-based national survey aimed at understanding the effects of the COVID-19 pandemic. We analyzed 1934 adult respondents, including 1353 lay-people, 200 LIPs and 381 non-LIP HCW. Respondents' values were assessed by 9- point Likert scale, (1= should be less likely to receive, 5 = should not influence, 9 = should be much more likely to receive ICU care), comparing responses using Kruskal-Wallis tests. Results: All groups equally prioritized ICU care for pregnant persons in first trimester. Agreement on prioritization was stronger for 3rd trimester pregnancy, where LIP rated agreement higher than other HCW (P=0.020). Laypeople favored a principle of reciprocity, prioritizing front-line health workers more than either LIP or other HCW (8 vs 7 vs 6, respectively, P<0.001). Laypersons rated their trust that health systems would apply SRA policy in a fair and consistent way slightly lower compared to either LIP or other HCW, but this was not significant (6 vs 7 vs 7, P=0.5). All groups felt similarly anxious and worried when thinking about policies like this (median score 7 where 9 = “I feel very anxious when thinking about this”, P=0.9). Discussion/Conclusions: In creating policies for scarce resource allocation, it is important to consider the nuanced values of all groups affected by these policies. In particular, while concern may exist that systems using non-healthrelated factors in treatment decisions may be less agreeable, we found similar levels of agreement when prioritizing on two key groups: pregnancy and at-risk health worker status. While our survey showed all groups lean towards trusting the healthcare system to fairly allocate resources, the range of responses and the consistent anxiety surrounding these policies emphasizes the importance of trying to understand and accommodate the priorities of affected groups as able. (Table Presented).