Multisystem Inflammatory Syndrome in Children: Characteristics and Epidemiology

Shortly after the novel coronavirus (now known as SARSCoV- 2) was recognized, data began to accumulate on the virus's effects on children. Initial data showed that children were more likely to be mildly affected, compared to adults, with lower risks of hospitalization and death. However, in April of 2020, reports appeared of a severe disease in children occurring about two-six weeks after infection with SARS-CoV-2. The features were similar to those seen in a rare vasculitis condition called Kawasaki disease. On May 14, 2020, the Centers for Disease Control and Prevention (CDC) issued a national health advisory regarding this new condition, which was called multisystem inflammatory syndrome in children (MIS-C). The current case definition for MIS-C includes six criteria: (1) serious illness leading to hospitalization or resulting in death;(2) age less than 21 years;(3) measured fever over 38 degrees Celsius or report of subjective fever;(4) laboratory evidence of inflammation;(5) new onset involvement in at least two of the following (cardiac involvement, mucocutaneous involvement, shock, gastrointestinal involvement, and hematologic involvement);and (6) laboratory-confirmed SARS-CoV-2 infection or an epidemiologic link to a person with COVID-19. According to CDC, as of January 3, 2023, there have been 9,333 patients in the United States meeting the case definition of MIS-C, with 76 deaths. The median age of patients was nine years, with half of those affected between the ages of five and 13 years. More than half of the reported patients on whom race-ethnicity information was available were in children who are Hispanic/Latino or Black, non-Hispanic. Over 60% of reported patients were male. Most affected children had previously been healthy. A better understanding of the pathogenesis of this serious illness is needed to provide better treatment options for children with MIS-C. Prevention of MIS-C is focused on the prevention of SARS-CoV-2 infection through staying up to date with COVID-19 vaccination, masking, and other prevention strategies.

Technology, the flipped classroom, and exigent paradigm shifts or being forced into the present

Princeton University, including the various language programs it offers, has intentionally resisted distance learning for decades, primarily out of a desire to concentrate on the residential undergraduate educational experience. In New Jersey, USA, state-level restrictions and institutional decisions resulted in the closure of campus instructional spaces from the halfway point of the 2020 spring semester through the end of the 2020-2021 academic year, with further precautions, mitigations, and flexible responses throughout the following academic year, including but not limited to frequent reversion to remote instruction during periods of high incidence, interior masking requirements, and social distancing when possible in classroom spaces. For the past six years, I have also redesigned, expanded, and aligned our second-year German program with the first year, which is based on a high-frequency core vocabulary and the development of contextual reading strategies, among other approaches (for a detailed description of approach, form, and function, see Oberlin, in press). Of the many tools and approaches considered during this frantic and bewildering week, one stands out: the application of outside-of-class student-to-student communication via Zoom or other video-conferencing technologies with written follow-up to fulfill a number of desiderata: (1) that students speak more in an alternate assignment format given the realities of affective and technological hurdles while using video conferencing software;(2) that they are provided with an unsupervised opportunity to speak in an effort to reduce anxiety;(3) that self-scheduled partner work might offer flexibility necessary during home-based study and the various complications and distractions that entails, particularly during a period of ongoing disruptions;and (4) that a written response to this oral communication would generate classroom discussion, deepen engagement with materials, and present instructors with another avenue for teacher-student feedback and the assessment of sentence- or paragraph-level writing.

Impact of Universal Masking Precautions during COVID-19 Pandemic on Surgical Site Infection in General Surgery Procedures

Introduction: Increasing evidence demonstrates the effectiveness of universal masking precautions in reducing the transmission of COVID-19. Whether these precautions have an impact on surgical site infections (SSI), currently remains unknown. This study assesses whether implementation of universal masking precautions altered the rates of SSI. Method(s): We performed a single-institution, retrospective cohort study using the NSQIP database, evaluating all patients undergoing most performed general surgery procedures from June 2018 to December 2021. SSI rates were compared between patients who underwent operation before and after implementation of universal masking precautions at our institution in March 2020. Statistical analyses were performed using Fisher's exact test. Result(s): A total of 1,539 patients were included;721 patients were in the pre-masking cohort, while 818 in post-masking cohort. During this time period, a total of 143 (9.3%) patients developed SSI, 3.6% incisional and 5.7% deep organ space infections (OSI) (p=0.6601). Incisional and OSI rates did not differ significantly between the two groups (incisional 3.47% vs 3.67%, p=0.891;OSI 5.41% vs 5.99%, p=0.6608). Sub-analysis of top 5 procedures (by volume - laparoscopic cholecystectomy, hepatectomy, thromboendarterectomy, colectomy with anastomosis, and colectomy with ileocolostomy) demonstrated a significant decrease in incisional infections (3.7% vs 1.62%, p=0.0354). Conclusion(s): While the incidence of SSI did not differ significantly in the overall cohort after implementation of universal masking precautions, there was a decrease in incisional infections in commonly performed procedures at our institution. Future research is needed to identify whether continued masking precautions may minimize the risk of SSI in specific patient populations.

Post-Lockdown Behaviors and Impacts of Avoiding COVID-19 in Individuals and Caregivers of Individuals at High-Risk of Severe COVID-19: A Qualitative Study

Objectives: Several populations are at greater risk of severe COVID-19 due to inadequate responses to COVID-19 vaccines. Many of these individuals, and their caregivers, continue practicing varying degrees of social isolation to avoid SARS-CoV-2 infection. Following the end of lockdowns, the behaviors and impacts of continued isolation on the quality-of-life of high-risk populations remain poorly understood. This study describes the main avoidance and protective behaviors and ongoing impacts experienced by adults and caregivers of adults at high-risk of severe COVID-19. Method(s): Four virtual focus groups (April-July 2022) were conducted with individuals at high-risk of severe COVID-19, or caregivers, recruited via a convenience sample from patient panels. A discussion guide of open-ended questions was prepared based on COVID-19 guidance documents and a literature review. For qualitative analyses, an inductive approach was used for behaviors, deductive for impacts. A pre-defined codebook was updated throughout as needed. Salient concepts were defined as those mentioned by >=30% of participants or in every focus-group session. Result(s): Fourteen participants were interviewed (12 patients, 2 caregivers). Participants highlighted continued behaviors greatly impacting their quality-of-life. Avoidance behaviors (staying home, avoiding bystanders, avoiding shopping facilities and gatherings, using delivery services, family protection [43%-64%]) and protective behaviors (masking [79%], vaccination [57%]) were reported. Negative impacts included family relationship impacts (71%), collapse of social relationships (57%), difficulties accessing healthcare (43%), anxiety, fear, loneliness and depression (36%-50%), and impacts on employment/finances (36%). Positive impacts included the advent of telehealth (57%) and recognizing family importance (36%). Lack of trust in authority (57%) and hoarding of medications (36%) were negative general impacts of the COVID-19 pandemic highlighted. Concepts reported by patients and caregivers were similar. Conclusion(s): Individuals at high-risk of severe COVID-19 and their caregivers maintained avoidance and protective behaviors similar to those reported during lockdowns. This study highlights the continued burden experienced by high-risk populations.Copyright © 2023

Transcriptomic analysis in patients with SARS-CoV-2 virus infection. Identification of the association of risk/ protective profiles against the disease

Background/Objectives: SARS-CoV2 causes the COVID-19 disease, capable of producing a severe acute respiratory syndrome. Several clinical variables and genetic variants have been related to a worse prognosis. The aim of this study is to measure if difference in the gene expression are associated with COVID-19 severity. Method(s): We performed RNA-seq Transcriptome in RNA extracted from lymphoblastoid cell line in 20 patients who require hospitalization (10 from the intensive care unit) in a GeneStudio S5 Plus Sequencer (Ion Torrent Technology). FASTQ files were obtained and trimmed using BBtools, BBduk for cutting, filtering and masking the data, and Dedupe for the elimination of duplicates. Mapping and counting matrix was done in bash using the Salmon program. Differential expression analysis and subsequent functional enrichment was performed using Rstudio (DESeq2, ClusterProfiler, GO and KEGG). Result(s): We observed that 2042 differentially expressed genes (1996 overexpressed, LFC>0 and 406 underexpressed, LFC<0) were obtained between patients who require hospitalization versus those in the intensive care unit. We found some genes previously SARS-CoV-2 associated (PGLYRP1, HDAC9 and FUT4). Furthermore, genes involved in the activity of the immune system and in inflammatory processes showed significant differences between cohorts (ABCF1 (LFC = -25.14, padj = 1.05e-13), ABHD16A (LFC = 25.00, padj = 1.05e-13) and IER3 (LFC = -24.45, padj = 2.43e-13)). Conclusion(s): We described differential expression in genes of the immune system and inflammatory processes that might be have a role in the risk of develop severe symptoms of COVID-19, including admission in the intensive care unit. This results should be validated by additional functional studies.

Mild COVID-19 outcomes in adults with inborn errors of immunity: a single-center experience

Currently, 640 million cases of coronavirus disease 2019 (COVID-19) and 6.6 million deaths have been reported world-wide. Risk factors for severe COVID-19 are known, including those with compromised immunity. Among patients with inborn errors of immunity (IEI), early reports of severe outcomes lead to strict masking and social distancing measures. While this resulted in relatively low infection rates among those with IEI, real-world data describing the clinical course of COVID-19 in this patient population have remained limited. We performed a retrospective study of adult IEI patients followed by our center in which a positive test (rapid antigen or PCR) for COVID-19 was determined between November 2021-November 2022. Medical charts were reviewed, and patient interviews conducted. All patients provided informed consent. Twenty-nine patients were enrolled (22 females, 7 males), aged between 18-69 years (median: 20-29 years). The cohort included those with antibody deficiencies (41.37%), combined immunodeficiencies (34.48%;HIES, CARD11, STAT1-GOF), immune dysregulation disorders (20.69%;LRBA deficiency, AIRE deficiency) and phagocyte defect (3.45%;CGD). The duration of symptoms ranged between 3 days-4 weeks (median: < 1 week). Upper respiratory symptoms (including sore throat, congestion) were reported in 97% while fever was present in 41% of patients. Prior to infection, 14 (48%) patients had underlying asthma or bronchiectasis - 2 subsequently experienced shortness of breath and were treated with inhalers or Sotrovimab, respectively. No treatment was required in 65.5% of cases. The remaining received Paxlovid (10.3%), Sotrovimab (13.79%), or antibiotics (10.3%). Of the 2 patients with STAT1-GOF, one tested positive during a repeat episode of febrile neutropenia which required hospitalization. No other patients were hospitalized or needed ICU admission. No deaths were recorded. In light of these favourable outcomes, patients with IEI can gradually and safely return to normal activities.Copyright © 2023 Elsevier Inc.

Covering the Distance: A Study of Parent and Teen Attitudes on COVID-19 Mitigation Measures During the COVID-19 Pandemic.

Background The Unity® Consortium surveyed teens and parents and guardians of teens across the country at three distinct time points or waves during the COVID-19 pandemic to assess participant attitudes and beliefs regarding COVID-19 mitigation guidelines, such as mask-wearing and physical distancing. Methodology A third-party market research company conducted 15-minute, online surveys from nationally representative panels. Surveys were conducted at three distinct time points or waves (August 2020, February 2021, and June 2021) with 300 teens aged 13-18 years in each wave and 593/531/500 parents and guardians of teens aged 13-18 years in each wave, respectively. Participants responded using a five-point Likert scale (strongly agree to strongly disagree) on their COVID-19 experiences, including the perceived importance of strictly following mask-wearing and/or social distancing guidelines and the perceived effectiveness of mask-wearing and social distancing in preventing the spread of COVID-19. Data were analyzed for differences across waves and demographic variables. Statistical analyses included frequencies, analysis of variance (ANOVA), and t-tests/z-tests. Results While significantly more parents and teens in Waves 2 and 3 knew someone who was hospitalized or died due to COVID-19 compared to Wave 1, significantly fewer in Wave 3 reported experiencing a lot or some stress and worry regarding the pandemic. By Wave 3, 58% of teens and 56% of parents had received at least one dose of a COVID-19 vaccine. Despite changes in experiences over time, a significant majority of parents and teens consistently agreed on the importance and effectiveness of social distancing and masking guidelines against the spread of COVID-19. In Wave 3, the demographic variables significantly associated with agreement on importance included race (Black (92%) > White (80%)), community type (urban (91%) > suburban (79%) and rural (73%)), and positive vaccination status of parents and teens (92%/89%) > not vaccinated (73%/73%), respectively). The demographic variables significantly associated with agreement on effectiveness included race (Black (91%) > White (81%)), community type (urban (89%) > suburban (83%) and rural (71%)), and positive vaccination status of parents and teens (94%/90% > not vaccinated (72%/70%), respectively). Conclusions This study into the perceived importance and perceived effectiveness of mitigation strategies during the COVID-19 pandemic revealed differences in attitudes among sociodemographic groups. Understanding these differences can help shape how adherence to public health guidelines in a pandemic is promoted.

Countering Vaccine and Health Mis and Disinformation: An Evidence-Based Approach

COVID-19 was the first pandemic that unfolded in an information environment transformed by the ubiquitous mass and social media. Sensational misinformation and deliberate disinformation proliferated capturing hearts and minds. Traditional medical and public health organization's voices were well-intentioned and informed to communicate about the threat of SARSCoV- 2 infection and appropriate countermeasures (for example, masking and vaccines) but were overwhelmed. This new reality on communicating health and science was called out by the World Health Organization in 2020 as an Infodemic. In 2021, the U.S. Surgeon General issued his first report entitled 'Confronting Health Misinformation: The U.S. Surgeon General's Advisory on Building a Healthy Information Environment' urging at scale investment to tackle misinformation. Yet, while warnings were issued, mis- and disinformation proliferated with a palpable casualty emerging with waning vaccine confidence and uptake globally. This fundamental tenet of public health-vaccination-is at risk as a credible defense against disease and illness. This is not due to the microbial vectors but instead the societal response gathering momentum during the COVID 'infodemic'. This endemic challenge on how we communicate health and science will be described with an evidence-based perspective vetted in the field of communication with conceptual, scientific and theoretical grounding. This presentation will offer approaches to help build scientific, health and vaccine literacy, counter mis- and dis-information and foster strategic health communication capabilities at all levels of society.

Thinking Resistance, "Emergency,” and Kismet: A Response to Dylan Rodríguez's Presidential Address

The battles over masking only amplified preexisting culture and race wars in which entrenched libertarianism and neoliberal individualism evaded the economic and existential precarity caused by degraded social welfare and state health care. Counterterrorism projects such as Countering Violent Extremism (CVE) introduced by Barack Obama have relied on recruitment of community members, social service providers, and educators for self-surveillance and self-regulation of political expression and community organizing: a liberal counterterrorism approach for "reformist reform.” 5 Nabeel Abraham and Will Youmans provide important analyses of the "Containment System” in response to the War on Terror, based on "entrepreneurial opportunism” (Rodríguez) by Arab and Muslim American educators, professionals, and community leaders (including in the nonprofit industrial complex), some of whom collaborated with federal and state agencies.6 Academic Containment Reckoning with these critiques from critical Arab American or Southwest Asian and North African (SWANA) studies requires grappling with the long history of anti-Arab/Muslim state policies of surveillance, policing, and mass incarceration that preceded 2001. The Zionist lobby and anti-Palestinian organizations such as the Anti-Defamation League have increasingly deployed the language of tolerance and civility to tar critics of Israel with charges of anti-Semitism.7 These liberal strategies, illustrating Rodríguez's argument, can be more damaging than frontal attacks on the Palestine justice movement because the language of racism is harder to challenge

ASSOCIATION BETWEEN OBSERVED MASKING AND SARS-CoV-2 PRESENCE IN SCHOOL WASTEWATER

Background: The SARS-CoV-2 virus is airborne and highly transmissible. Masking is an important strategy for source control and personal protection. The American Academy of Pediatrics recommends masking as part of a comprehensive strategy to reduce the spread of COVID-19 and respiratory diseases in school settings, however the effectiveness of school masking policies has been heavily debated. Previous studies of masking effectiveness have been limited by the use of self-reported masking behavior, policies as a proxy for masking behaviors, and/or case surveillance data that are biased by access to testing Methods: The Safer at School Early Alert (SASEA) project provided daily wastewater SARS-CoV-2 surveillance for elementary schools serving historically marginalized communities in San Diego County. We previously found that daily wastewater surveillance can identify 95% of PCR-detectable COVID-19 cases on campus. Between March 2 and May 27, 2022, we randomly selected 10 schools from the SASEA project for bi-weekly systematic observations of masking behaviors of students, staff, and parents. Each school was observed by 4 trained observers from the time school let out until all individuals had left. Observers counted the total number of adults and children and whether they were fully masked (nose and mouth covered), partially masked, or unmasked. We built a logistic regression model to measure the association between positive wastewater signals in the 5 days following an observation event (outcome) and the percentage of individuals who were observed fully masked vs partially or unmasked (primary predictor). Result(s): We conducted 60 observation events over 6 weeks, during which positive wastewater signals- suggesting the presence of at least one COVID-19 case on campus-occurred on 9 days. On average, 38.6% of individuals were observed fully masked. After adjusting for intra-site correlation, observation week, current case rate per 100,000 in the school ZIP code and vaccination rate in the school ZIP code, we found that the odds of a positive wastewater signal in the 5 days after observation decreased by 47% (aOR 0.53, 95% CI: 0.28 - 0.99) for each 10% increase in the proportion of fully masked individuals. Conclusion(s): Masking is an effective strategy to prevent the spread of COVID-19 in school settings. Even a relatively small increase in the proportion of individuals masking can potentially lead to a significant difference in epidemic spread.

Limited effect of reducing pulmonary tuberculosis incidence amid mandatory facial masking for COVID-19

Tuberculosis (TB) remains a significant health and public issue in many countries. Its incidence and mortality have been decreasing in many countries. The recent COVID-19 could have significant impacts on the transmission and health care for this chronic disease by obligatory facial masking and by affecting healthcare capacities. WHO global tuberculosis in 2021 reported that the TB incidence would rebound at the end of 2020 during COVID-19 pandemic. We wondered if this phenomenon could have existed in Taiwan. We asked whether the trend of TB incidence and mortality would be affected by the COVID-19 epidemic due to their common air transmission route. We also asked whether the incidence of TB in regions with different COVID-19 incidences would be similar. We obtained the yearly new cases of TB and multidrug-resistant TB through Taiwan CDC and estimated the incidence and mortality by the population numbers in 7 administrative regions in Taiwan from 2010 to 2021. The result showed that incidences of TB in recent 10 years show a continuously decreasing trend, even amid the COVID-19 pandemic in 2020-21. Surprisingly, in the low COVID-19 incidence regions of Taiwan, the incidence of TB remained high during the COVID-19 pandemic. We concluded that the decreasing trend of incidence and mortality of TB does not change during the COVID-19 epidemic in Taiwan. The mask-wearing and social distancing could prevent the transmission of COVID-19, however, their effect on the limiting spread of TB may be limited. The health policy decision should take the consideration of the TB rebound, even in the post-COVID-19 era.Copyright © 2023

Brothers or Fools

Justin A. Joyce introduces the eighth volume of James Baldwin Review with a discussion of the US Supreme Court, the misdirected uproar over Critical Race Theory, a survey of canonical dystopian novels, and the symbolism of masking during COVID-19.

Glycan masking in vaccine design: Targets, immunogens and applications.

Glycan masking is a novel technique in reverse vaccinology in which sugar chains (glycans) are added on the surface of immunogen candidates to hide regions of low interest and thus focus the immune system on highly therapeutic epitopes. This shielding strategy is inspired by viruses such as influenza and HIV, which are able to escape the immune system by incorporating additional glycosylation and preventing the binding of therapeutic antibodies. Interestingly, the glycan masking technique is mainly used in vaccine design to fight the same viruses that naturally use glycans to evade the immune system. In this review we report the major successes obtained with the glycan masking technique in epitope-focused vaccine design. We focus on the choice of the target antigen, the strategy for immunogen design and the relevance of the carrier vector to induce a strong immune response. Moreover, we will elucidate the different applications that can be accomplished with glycan masking, such as shifting the immune response from hyper-variable epitopes to more conserved ones, focusing the response on known therapeutic epitopes, broadening the response to different viral strains/sub-types and altering the antigen immunogenicity to elicit higher or lower immune response, as desired.

Effect of non-pharmaceutical interventions on the incidence of respiratory viruses at a tertiary cancer care center.

BACKGROUND: In March 2020, nonpharmaceutical interventions (NPIs) including face coverings and social distancing were adopted to curb the spread of SARS-CoV-2. Over the course of the pandemic, adherence to these NPIs has varied and eventually became optional in most non healthcare settings. We investigated the impact of relaxation of NPI on the incidence of respiratory viruses other than SARS-CoV-2 at a tertiary cancer care hospital. METHODS: This was a retrospective cohort study of respiratory viral panel results performed at between 08/01/2014-07/31/2022. Only one viral target result per patient per year was included. Poisson regression models were used to compare 2019-2020, 2020-2021, and 2021-2022 incidence of respiratory viruses to those of 2014-2019. Interrupted time series analysis was performed using autoregressive integrated moving average models in order to compare expected and observed positivity rates. RESULTS: A large reduction in the odds of testing positive for a respiratory virus was observed for most respiratory viruses when comparing results from 2019 to 2020 group to the corresponding period in 2014-2019. Subsequent seasons showed ongoing reductions in the odds of testing positive while slowly increasing over time back toward pre-pandemic levels. A time interrupted series analysis showed that the monthly positivity rate for all respiratory pathogens were reduced after 03/01/2020, when compared to the expected values forecast, except for adenovirus. CONCLUSIONS: This study provides valuable data that could be used to guide public health practices and support the efficacy of NPIs in curtailing the spread of novel and endemic respiratory viruses.

The effect of face masks on the stereotype effect in emotion perception

The accurate and swift decoding of emotional expressions from faces is fundamental for social communication. Yet, emotion perception is prone to error. For example, the ease with which emotions are perceived is affected by stereotypes (Bijlstra, Holland, & Wigboldus, 2010). Moreover, the introduction of face masks mandates in response to the Covid-19 pandemic additionally impedes accurate emotion perception by introducing ambiguity to the emotion perception process. Predictive coding frameworks of visual perception predict that in such situations of increased ambiguity of the sensory input (i.e., faces with masks), people increasingly rely on their prior beliefs (i.e., their stereotypes). Using specification curve analysis, we tested this prediction across two experiments, featuring different social categories (Study 1: Gender;Study 2: Ethnicity) and corresponding emotion stereotypes. We found no evidence that face masks increase reliance on prior stereotypes. In contrast, in Study 1 (but not in Study 2), we found preliminary evidence that face masks decrease reliance on prior stereotypes. We discuss these findings in relation to predictive coding frameworks and dual process models and emphasize the need for up-to-date analytic methods in social cognition research. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Masking morality in the making: how China's anti-epidemic promotional videos present facemask as a techno-moral mediator

The spread of Covid-19 has made facemask a critical artifact for people all over the world. Mediating between (non-)wearers and their environment, facemask makes people aware of a set of morally relevant distinctions and sometimes forces decisions on them. In fact, the semiotics of "facemask in use” largely shapes the parameters for human practice and experience in the epidemic. Drawing on the techno-moral mediation concept [Verbeek, 2008. "Obstetric Ultrasound and the Technological Mediation of Morality: A Postphenomenological Analysis.” Human Studies 31 (1): 11–26], we explore how anti-epidemic promotional videos released by Chinese authorities build facemask-related narratives in the Covid-19 epidemic. Findings reveal that "facemask in use” links people's "smaller love” for family to a "bigger love” for Chinese people in general;transforms an individual to member of a large group of commoner-turned-protectors;or marks the military's loyalty and obedience to the Party-State, which makes possible the "Chinese speed” in saving lives. We add to extant literature by unraveling an entanglement between the moralization of facemask-wearing and China's traditional values, social institutions and media newsroom culture about disaster coverage. This scrutiny into the "face-masking morality in the making” implies that the power to frame the cultural significance of facemask induces an alternative mode of techno-moral change, which may outlast the epidemic itself.

The effects of face masks on emotional appraisal ability of students with autism spectrum disorder

The impact of the COVID-19 pandemic has drastically altered the ways in which people are able to communicate effectively. The addition of the face mask as a distracting stimulus interrupts the holistic process that people use to interpret facial expressions. The present study seeks to investigate the impact of face masking and gaze direction on emotion recognition in students with autism. We predicted that students with autism (n = 14), who characteristically experience difficulties when appraising emotions, would struggle to assess the emotions of people wearing face masks. We did not find a significant three-way interaction of emotion, mask, and gaze on classification accuracy. We did, however, find that face masks reduced participants' ability to emotionally appraise sad faces. Further, participants showed better accuracy appraising faces with a direct gaze. Exploring how face masks impact autistic individuals' emotion recognition will benefit special educators as they adapt to teaching during the pandemic, as well as the general population that seeks to improve communication with neurodiverse persons. Future studies should examine emotional appraisal ability and additional emotions as well as different kinds of emotional stimuli.Copyright © The British Society of Developmental Disabilities 2023.

Canada's fight against COVID-19: Constitutionalism, laws, and the global pandemic

Canada consists of a federal system, with a unique separation of powers. For example, the federal government's role in health has been traditionally to fund and support the provincial and territorial health services, among other things. However, there is also centralization of particular policies, such as during public health crises, consisting of collaboration with provincial governments, whereas the federal government maintains control over things such as travel, entry and exit, and border control. From the perspective of the separation of powers, there is a clear tendency for provincial governments to be enumerated authority in many areas in health and social policy, together with local authority, although for the most part, it is greatly restricted. For example, Toronto Public Health often follows the mandates of the province of Ontario. Decisions of local restrictions, such as the closure of retail spaces, cinemas/movie theaters, malls, and other facilities, as well as the push against mass gatherings in local parks during the coronavirus (COVID-19) pandemic were, at times, advocated by the local governments and municipalities to the provincial government, in which the former claimed some power and authority. At another point in time, the province of Ontario had expressed that the police would have powers to ask motorists questions about where they were going;however, the Toronto Police Services refused to follow this mandate as it could lead to bias and adverse racial tensions or experiences. It led to the provincial government to formally issue an apology. Meanwhile, many different approaches to public health that were implemented by the federal government also affected local governments, which had resulted in restrictions, such as in travel, yet they resulted in positive changes in terms of epidemic containment. While Canada's case count was low compared to the United States and other countries, Canada was slow in its approach to immunizations during the first half of 2021. As of writing this chapter, the number of cases of COVID-19 was 1,460,175, with total deaths of 26,761 (Government of Canada). © 2023 John Wiley & Sons, Inc.

NOISE MASKING FOR SOLEMNITY AT THE HIROSHIMA PEACE MEMORIAL CEREMONY

On August 6 every year, the Hiroshima Peace Memorial Ceremony is com-memorated in Hiroshima, Japan, to comfort the spirits of the atomic bomb victims and pray for the realization of permanent world peace. However, because various political marches are conducted in and around the venue, demonstrators' voices disturb the cer-emony. Hiroshima City has repeatedly requested that demonstrators lower their volume and change the demonstration route. However, there has been no improvement in this regard. Since 2015, there has been a considerable decrease in demonstrators' disruptions owing to crowds and tents set up as sound barriers. Since 2020, the number of attendees has declined by 90% owing to the COVID-19 pandemic;thus, demonstrators' voices are easily heard in the venue. Previous studies applied active noise control, including high frequencies, to solving this problem. Implementing ANC is difficult because controlling high-frequency sounds in wide-open spaces is complex. In this study, we attempted to reduce demonstrators' noise by masking it with noise acceptable to the ceremony atten-dees in order to keep solemnity. Brown noise was found to be effective in the selection of masking noise. The experimental results confirmed the effective masking of male demon-strators. Therefore, we introduced adaptive masker control to mask all demonstrators and confirmed its effectiveness. © 2023, ICIC International. All rights reserved.

Temperature screening and detection of Covid-19 in school-aged children: A retrospective cohort study assessing the efficacy of temperature screening in schools

In July 2020, Corinth School District was the first in Mississippi to return to the classroom setting. Coronavirus disease 2019 (Covid-19) protocols were developed to maintain the safety of students. These included mandatory masking, seating charts, desk spacing, sanitizing protocols, lunch within classrooms, alteration of extracurriculars, cancellation of assemblies, and quarantine policies. Temperature screenings were also performed. Students registering as febrile would undergo Covid-19 testing. To evaluate the efficacy of temperature scanning as a surveillance method for Covid-19 in the school setting, deidentified data was obtained from the Corinth School District. Overall incidence and grade level incidence of Covid-19 were calculated in children attending school from July 27, 2020 to September 25, 2020. Data were examined for a correlation between documented fevers and Covid-19 positivity. Reports provided by the school district were investigated for positive test groupings signifying a school-related outbreak. Of 28 children with fevers at school, zero tested positive for Covid-19. Twenty-six children tested positive for Covid-19;none were febrile at school. The incidence of Covid-19 in our population during the study period was 1.03%. Incidence in elementary students was 0.34%, 0.93% in middle school, and 2.51% in high school students. There were no school outbreaks during the study period. Both relative risk and odds ratio were calculated as equal to zero (0.00). Temperature scanning is not a sensitive screening method for Covid-19 in school children.Copyright © 2023 Policy Studies Organization.