Diagnostic test property of transcription-reverse transcription concerted reaction reagent TRCReady® SARS-CoV-2 i using nasopharyngeal swab samples

TRCReady® SARS-CoV-2 i is a reagent for transcription-reverse transcription concerted reaction (TRC) to detect SARS-CoV-2 N2 gene, used with the automated rapid isothermal nucleic acid amplification test (NAAT) analyzer TRCReady®-80. Sensitivity and specificity of TRCReady® SARS-CoV-2 i was assessed by comparison with the results of real-time reverse transcription-polymerase chain reaction (RT-PCR) using nasopharyngeal swab samples. From November 2020 to March 2021, a total of 441 nasopharyngeal swabs were obtained and analyzed both with TRCReady® SARS-CoV-2 i and RT-PCR. Sensitivity and specificity of TRCReady® SARS-CoV-2 i were 94.6% (53/56) and 99.2% (382/385), respectively. Reaction time to positivity of TRCReady® SARS-CoV-2 i ranged from 1.166 to 9.805 (median: 2.887) min, and minimum detection sensitivity of TRCReady® SARS-CoV-2 i was 9 copies per test, with reaction time as 5.014 min. Detection of SARS-CoV-2 gene from nasopharyngeal swab sample using TRCReady® SARS-CoV-2 i shows comparative diagnostic test accuracy with RT-PCR, and can be used as a useful test to diagnose SARS-CoV-2 infection. © 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases

PSTCNN: Explainable COVID-19 diagnosis using PSO-guided self-tuning CNN

Since 2019, the coronavirus disease-19 (COVID-19) has been spreading rapidly worldwide, posing an unignorable threat to the global economy and human health. It is a disease caused by severe acute respiratory syndrome coronavirus 2, a single-stranded RNA virus of the genus Betacoronavirus. This virus is highly infectious and relies on its angiotensin-converting enzyme 2-receptor to enter cells. With the increase in the number of confirmed COVID-19 diagnoses, the difficulty of diagnosis due to the lack of global healthcare resources becomes increasingly apparent. Deep learning-based computer-aided diagnosis models with high generalisability can effectively alleviate this pressure. Hyperparameter tuning is essential in training such models and significantly impacts their final performance and training speed. However, traditional hyperparameter tuning methods are usually time-consuming and unstable. To solve this issue, we introduce Particle Swarm Optimisation to build a PSO-guided Self-Tuning Convolution Neural Network (PSTCNN), allowing the model to tune hyperparameters automatically. Therefore, the proposed approach can reduce human involvement. Also, the optimisation algorithm can select the combination of hyperparameters in a targeted manner, thus stably achieving a solution closer to the global optimum. Experimentally, the PSTCNN can obtain quite excellent results, with a sensitivity of 93.65% ± 1.86%, a specificity of 94.32% ± 2.07%, a precision of 94.30% ± 2.04%, an accuracy of 93.99% ± 1.78%, an F1-score of 93.97% ± 1.78%, Matthews Correlation Coefficient of 87.99% ± 3.56%, and Fowlkes-Mallows Index of 93.97% ± 1.78%. Our experiments demonstrate that compared to traditional methods, hyperparameter tuning of the model using an optimisation algorithm is faster and more effective. © 2023 Centro Regional de Invest. Cientif. y Tecn.. All rights reserved.

Association between Invitation Method and Response Rate: Results of a Multi-Centered National Survey of Canadian Picu Families

BACKGROUND AND AIM: National surveys soliciting family experiences present challenges and opportunities. We performed a pan-Canadian, multi-centered, online survey of family experiences with restricted family presence in PICU during COVID-19. Sites chose from 6 respondent approach methods. This sub-study explores relationships between invitation methods and response rates. METHOD(S): Information was collected from the 11 participating sites via e-mail-based survey to determine: eligible participant numbers;invitation method;time from PICU admission to survey invitation;contact methods for bereaved and non-bereaved families;participation barriers and facilitators. Responses were quantified using descriptive statistics and Spearman's rank order correlation. Free texts were inductively coded. RESULT(S): Sites invited families of PICU patients admitted during 4-month periods, beginning March 2020 (n=9) and/or November 2020 (n=3). Invitations were sent a mean (SD) of 7.7 (2.8) months post-admission. The overall survey response rate was 270/1005 invited families (27%). The mean institution response rate was 27% (SD=13%, range 4-50%) and was highest for sites using postal invite with telephone follow-up (43%, n=2), followed by telephone approach (26%, n=7), text message paired with social media posts and posters (22%, n=1), and postal invite alone (n=1, 8%). Bereaved families received a personalized telephone call. Time from admission to invitation was inversely correlated with response rate (rs = -0.70, p=0.02). Most common recruitment barriers were lack of funded research personnel (n=4) and REB requiring initial contact by care team rather than researchers (n=3). CONCLUSION(S): Multi-centre surveys with unfunded site participation face challenges. Postal invitation with telephone follow-up may improve response rates.

Pre-Covid, Covid, and Post-Covid Trends of Rsv and Influenza across Geographic Regions in the USA

INTRODUCTION: Admissions to Pediatric Intensive Care Units (PICUs) for respiratory illnesses, particularly RSV and Influenza (INF), have decreased during the COVID-19 pandemic. The differences in trends for RSV and INF admissions to PICUs across different regions in the U.S. are unknown. Changes in these trends before (2014-19), during (2019-20), and towards the end of the pandemic (2021- 22), and utilization patterns across regions have not been evaluated. This analysis aimed at addressing these questions. METHOD(S): 874,066 USA PICU cases from the Virtual Pediatric Systems database (myvps.org), from Q1-2014 to Q2-2022, were used to study RSV and INF in patients < 18 years. The geographic regions according to U.S. Census definition included Mid-West (MW), Northeast (NE), South (S), and West (W). RSV and INF were defined by ICD-9 and ICD-10 codes. After removing low-risk patients (PRISM III POD < 0.004) the cohort size was 492,642. Segmented regression analysis (Muggeo 2016) was used to fit the trends in yearly rates for RSV and INF. Least-squares linear fits were applied to data segments before and after breakpoints (change in slope) to determine the correlation coefficients of each segment. Fisher's Z-transform was used to investigate significant differences between segments before and after their respective breakpoints. Utilization amongst regions was done by ANCOVA analysis, and Bonferroni corrected p-values for the most prevalent procedures in the cohorts. RESULT(S): All regions showed an increase in RSV and INF between 2014-19, but decreasing during 2020-21. In 2021- 22 all regions showed an increase trend in INF, but RSV increased only in MW and S compared to NE and W. Further analysis using RSV segmented regression revealed: MW, NE, and W breakpoints (positive to negative) in: 2018, 2019, and 2019, respectively. For INF, breakpoints for MW, NE, S, and W were detected in: 2019, 2020, 2019, and 2019, respectively. CPAP use in W was greater than S (p< 0.02). All other procedure comparisons had p-values>0.05. CONCLUSION(S): RSV and INF increased in all regions during pre-COVID. RSV and INF decreased in all regions during COVID. INF increased in all the regions towards the end of pandemic. RSV increased in MW and S near the end of the pandemic. Differences in use of CPAP for RSV were found between W and S.

Versatile gene delivery targeting via Ultrasound and gas Microbubbles

The COVID-19 crisis and the rapid development of highly effective mRNA vaccines opened a new era for gene therapy. While viral vectors were for a long time the only tool for efficient delivery, new non-viral vectors have recently emerged, spawning new opportunities (indications, tissues, etc.). A new one is set to take off thanks to its safety profile, its specificity toward tissues, and its versatility toward both genetic materials and indications. Gas-filled microbubbles (MB), clinically used as ultrasound (US) contrast agents, have proven their benefits in various animal models and clinical applications for targeted delivery of drugs/genes. Herein, we disclose the development of new MB formulations allowing the delivery of various genetic materials at a specific location under the control of an ultrasound probe. We set forth a study to elicit the expression of a foreign enzyme in a liver mouse model. To this aim, MB were systemically co-injected with a Luciferase pDNA (6 to 65 mug) in the tail vein, then Ultrasound were delivered at MB arrival in the liver. The effective pDNA transfection was observed by bioluminescence 24 hours after treatment. Mice were divided into three groups: pDNA alone;pDNA with US;pDNA with US and MBs (n >= 5). The use of our MB allowed increasing the signal up to 5 folds in comparison to the US alone. These results highlight the potential of MB plus US to efficiently deliver locally genetic material without any safety concerns.

Development of an international COVID-19 specific healthrelated quality of life questionnaire, phase III pretesting and validation

Aims: This study aimed to develop, pilot-test and psychometrically analyse a patient-reported health-related quality of life questionnaire for patients with current or previous coronavirus disease (COVID-19). A disease-specific instrument was not available before, even though the patients experience a wide range of symptoms and reduced functioning. Method(s): We used an internationally recognized methodology for questionnaire development consisting of four phases. Adults with current or previous COVID-19, in hospital, nursing home or at home were eligible. In phase I, relevant issues were gathered through literature review, interviews with health-care workers and patients, and operationalized into items in phase II. In the current study, participants completed the questionnaire and were interviewed as part of phase IIIA and, in phase IIIB, participants completed a revised questionnaire and a debriefing form. Validity and reliability were assessed by correlation-based methods, Cronbach's alpha and intra-class correlation coefficient. Result(s): We enrolled participants from 11 countries within and outside Europe, 54 in phase IIIA and 371 in Phase IIIB. The mean time needed to complete the 80-item questionnaire in Phase IIIA was 16 min (range 4-45). Predefined criteria for retention were fulfilled for 71 items of which five needed some rewording. In phase IIIB, 80% of participants completed the 71-item questionnaire within 15 min, on paper (n = 175) or digitally (n = 196). The final questionnaire includes 61 items that fulfilled criteria for retention or were important to subgroups of patients. The item-scale correlations were>0.7 for all but nine items;three of these were changed. The internal consistency (alpha range 0.68-0.92) and test-retest (all but one scale>0.7) results were acceptable. The final scale structure of the Oslo COVID-19 quality of life (QLQ) weekly (W) 61 consists of 15 multi-item scales and six single items covering e.g. acute and long-term physical symptoms, psychological distress, and physical, social functioning. Patient representatives expressed satisfaction with the content of the questionnaire. Conclusion(s): COVID-19 is a disease with a pleomorphic symptomatology. In addition to many items assessing symptoms, multiple functional items were included. The Oslo COVID-19 QLQ-W61 is a cross-cultural instrument, now ready for use in research and clinical practice.

Comparison between neutralizing antibody titres and anti-RBD SARS-CoV2 IgG

Objectives: Serological assays for virus-specific antibody response are commonly employed to establish the immunological response to vaccines and correlates of protection. We aimed to establish the usefulness of immunoassays for the quantitation of IgG antibody response to SARS-CoV2 receptor binding domain (anti-RBD) in the prediction of neutralizing antibody response. Method(s): An observational study was performed, included 97 subjects with positive anti-RBD SARS-Cov2 IgG from Mauriziano hospital S.C. Laboratorio Analisi between December 2021 and June 2022 divided into two groups: the first group (A, n=37) with positive nasal swab for SARS-CoV2 or presence of IgG direct to Nucleocapside antigens (anti-N > 0.30 AU/mL with SARSCoV2 IgG method, Abbott Diagnostics) and second group (B, n=60) with no evidence of late infection. All samples was tested for SARS-CoV2 neutralizing antibody titres (NAb, SGM Italia). Anti-RBD SARS-CoV2 IgG were measured with automated chemiluminescent immunoassay, the results were expressed in Binding Antibody Units (BAU/mL);NAb were performed with quantitative latex immunoturbidimetry method and the results were expressed in neutralizing percent (NAb %). Statistical analysis was performed with Analyze-it. The comparison between anti-RBD levels and neutralizing antibodies has been studied using correlation by Spearman method and receiver operating characteristics (ROC) curve analysis. Result(s): A significant correlation between anti-RBD IgG levels and NAb titres was found in both A and B groups (rs=0.90 and 0.91 respectively, p<0.0001). The 99% probability of hight NAb titer (>56%) was reached at 212 BAU/ml (A) and 238 BAU/mL (B) and the area under the receiver operating characteristic (ROC) curve was 0.99 (CI: 0.98-1.0) and 1 in A and B respectively. Conclusion(s): Our study confirm that there is a hight degree of concordance between anti-RBD antibodies and NAb. Based on our data, a threshold of 220 BAU/mL is highly predictive of strong neutralizing antibody response. However these results sure need further confirmation on a higher number of samples.

Comparison between ELISA and automated ECLIA for Interleukin-6 determination during COVID-19 pandemic

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) is a highly contagious illness associated with a hyperactivated and dysregulated host immune humoral response. In detail, there is a cytokine storm which may take to the release of interleukin IL-6 as a critical mediator for respiratory failure, shock and multiorgan dysfunction. Such dysregulation may act as a target for therapeutics and, in this view, a blockade of IL-6 function by an anti-IL-6 receptor antibody (tocilizumab) has been described to be effective for the treatment of the inflammatory process COVID-19-related. Timing of administration of therapy was reported in literature to have a critical role in benefit for patients;thus, the aim of the present study is to compare two different methods for the IL-6 assessment: the Human IL-6 ELISA Kit (Invitrogen) and the Elecsys IL-6 (Roche). Method(s): IL-6 levels of 128 COVID-19 patients, who were consequently admitted to the Emergency and Medicine Department of AOU Careggi (Hospital in Florence -Italy ) between April and May 2020, were assessed by using the two above mentioned methods and were analysed through Passing-Bablok regression fit and Bland-Altman plot. Result(s): The analyses showed that the two methods correlate, but do not agree in terms of numeric results. In particular, further investigation were performed on the Bland-Altman results, showing that the maximum number of samples for which the differences between the two methods is close to "0" (p > 0.05) (which means a good overlap between the two methods) is 49 (p=0.07), and among them, 40 samples showed a complete agreement of results (p=0.95). These results can be attributed to the different methods' linearities: 3.1-200 pg/mL for ELISA and 1.5#5000 pg/mL for ECLIA, which could be extended to 50 000 pg/mL. Conclusion(s): Although a small percentage of data overlapping in a certain range, still a high correlation among the two methods can be found;given the overall analytical performance of the ECLIA, it can be considered more adequate for different reasons: i) it is available on a fully automated platform h24, ii) it uses of a small sample volume, iii) it is low cost and no-time consuming and iiii) the different timing for measuring IL-6 is much attractive.

Evaluation of three chemiluminescence immunoassay for the detection of SARS-CoV-2 antibody after BNT162b2 mRNA COVID-19 vaccine

Background: Vaccination programs have been highly effective for curbing the spread of SARS-CoV-2 . In this context, serology surveillance of SARS-CoV-2 antibodies represents a useful tool for monitoring of potential protective immunity in the population but the long-term antibody response over time remains an open question. Method(s): We compared the performance of three SARS-CoV-2 antibody serological immunoassays in 600 vaccinated individuals after two and third BNT162b2 mRNA COVID-19 (Comirnaty) vaccine dose. Result(s): All three methods were able to detect a post-vaccine humoral immune response with good analytical performance obtained from a comparison with serum samples obtained in the pre-Covid-19 era. Median (IQR) anti-RBD IgG, Access SARS-CoV-2 IgG (1st IS) and Access SARS-CoV-2 IgG II levels of the subjects investigated were, respectively, 687 BAU/mL (131-2325), 419 IU/ mL (58-1091) and 104 AU/mL (14-274). The analysis of the comparison of the methods showed a correlation between the levels of antibodies of the three methods analized. We also considered the kinetics of subjects with multiple doses and observed that the differences between the absolute decreasing gradients were statistically significant (overall Friedman test p <0.001). Conclusion(s): All immunoassays considered in the study proved useful in evaluating the antibody response to the vaccine. Our results suggest that postvaccination testing of antibody response is an important and feasible tool for following people after vaccination and selecting individuals who might require a third / fourth dose of vaccine at an earlier time point or subjects who may not need to another dose of vaccine due to previous SARS-CoV-2 infection. Reference: Lo Sasso B. et al. Longitudinal analysis of anti-SARS-CoV-2 S-RBD IgG antibodies before and after the third dose of the BNT162b2 vaccine. Sci Rep. 2022;12: 8679. Published online 2022 May 23.

Detection of SARS-CoV-2 neutralizing antibodies: reliability of serological tests

Serological assays allow to explore the synthesis of antibodies against SARS-CoV-2 proteins. The gained knowledge finds applications in sero-epidemiology studies, to develop accurate forecasts of protective immunity spreading within a population. Indeed, last February, the European Centre for Disease prevention and Control (ECDC) recommended the use of serological tests for population surveys, in the context of epidemiological studies. The up-to-date reference method to determine the amount of protective antibodies is the in vitro neutralization test, which is expensive, timeconsuming and requires biosafety level 3 laboratories. The current study aims at highlighting the correlation between the results of the reference method and four different serological assays. Three immunoassays (Elecsys Anti SARS-CoV-2 S, MAGLUMI SARSCoV- 2 S-RBD IgG and MAGLUMI 2019-nCoV IgG test) and an ELISA surrogate viral neutralization test (EUROIMMUN SARS-CoV-2 NeutraLISA assay) have been studied on 83 patients, previously infected by SARS-CoV-2. The correlation between each serological test and the reference method is reported, as well as the predictive performances to distinguish serum samples with neutralizing antibody titers higher than 160. All the assays achieved good performances in terms of correlation with the reference method, as well as concerning the predictive ability over NAb titers > 160. The best correlation (Spearman coefficient = 0.784) and predictive features (area under curve = 0.921) have been observed for EUROIMMUN SARS-CoV-2 NeutraLISA assay, as displayed by ROC curve analyses.

II International Conference on Vascular Access, CIAV 2022

The proceedings contain 13 papers. The topics discussed include: are citizens involved in vascular access research? a scoping review protocol;nursing care to prevent peripherally inserted central catheter (PICC) related complications: a systematic review;clothing constraints in maintaining vascular access;supporting Portuguese nurses' evidence-based practice related to peripheral intravenous catheterization: a Delphi consensus study;aseptic techniques for peripherally inserted central catheters: a scoping review protocol;unusual placement of a fully implantable catheter into the internal thoracic vein;relationship between nutritional status and catheter-related infection in COVID-19 patients;comparison of two methods for evaluation of the tip position in totally implantable venous access device (TIVAD);and best practice in the insertion and maintenance of removal of peripheral intravenous catheters (PIVC): contributions to nursing care.

A Novel Technology for Extraction and Enrichment of Hcv Antigen Using Temperature-Sensitive Smart Polymer: A Comparison with Pcr, a Pilot Study

Background: Achievement of WHO goals for HCV elimination needs scaling up of diagnosis and treatment capacities in low-income and middle-income countries, where HCV is highly endemic. However, in these regions, access to HCV diagnostic tools is severely limited. The current diagnostic algorithm is based on using two steps;rapid diagnostic test (RDTs) and viral load confirmation. So there is a need for simple point of care (POC) test that can be done in the field. Recently, we developed a novel technology for extraction and enrichment of HCV antigen using temperature-sensitive Smart Polymer, which used previously For enabling affinity enrichment of current coronavirus (SARS-CoV- 2) to improve its diagnostic sensitivity Our aim is to design a novel method for extraction and enrichment of HCV antigen using temperature-responsive smart polymer 'NIPAAm-co- HIPAAm- co- SAKIPAAm' (Patent: 2019/2002) for enabling affinity enrichment of HCV antigen to be used as a part of POC test to improve the cascade of care Methods: We used temperature-responsive smart polymer 'NIPAAm-co- HIPAAm- co- SAKIPAAm' (Patent: 2019/2002) for extraction and enrichment HCV antigen for 15 positive HCV serum samples and 5 negative HCV serum samples confirmed by PCR technique. After extraction and enrichment of HCV antigen by temperature-responsive smart polymer 'NIPAAm-co- HIPAAm- co- SAKIPAAm' samples undergo amplification and detection by thermal cycler as amplification and detection of Rt-PCR technique (SLAN-96P Real-Time PCR System ). Result(s): . The time needed for extraction and enrichment of HCV Antigen using temperature-sensitive smart polymer (10mins) which is shorter than extraction time in RT-PCR ( One hour). The results showed that HCV antigen extracted and enriched by temperature-responsive smart polymer gave the same results with positive and negative HCV samples detected by PCR, Sensitivity 100%, Specificity 100% Conclusion(s): The novel temperature-responsive smart polymer 'NIPAAm-co- HIPAAm- co- SAKIPAAm' (Patent: 2019/2002) is able to extract and enrich HCV antigen in the same sensitivity and specificity like the current PCR. The time needed for this simple technique may make it be suitable to be a part of POC test for rapid, affordable, easy-to- use test in comparison to PCR technique which needs dedicated facilities and highly qualified personnel.

CNN-ACO Technique for Diagnostics of Covid-19 Using Wireless LAN Radiography

WLAN-based direct digital radiography is useful for Picture Archiving & Common System (PACS). This is used for Covid-19 diagnostics forX-ray image classification using the CNN model. ACO is further helpful in improving the efficiency of the system. In comparison with standard methods, these techniques provide highly efficient mechanism diagnostics of Covid-19. Copyright © 2022, Anka Publishers. All rights reserved.

Comparison of 2 functional assays (HIMEA and HIPA) for the diagnosis of vaccine-induced immune thrombocytopenia and thrombosis (VITT): A franco-greek collaborative study

Background: Vaccine-induced immune thrombosis and thrombocytopenia (VITT) has been recognized as a rare thrombotic complication of adenovirus-based vaccines against COVID-19. While VITT presents some common features with heparin-induced thrombocytopenia (HIT), VITT antibodies differ from typical HIT antibodies by their ability to induce spontaneous platelet aggregation in the absence of heparin. In this context, reliable functional tests are of crucial importance to confirm VITT diagnosis. Aim(s): To compare the performances of Heparin-Induced Multiple Aggregometry (HIMEA) and Heparin-Induced Platelet Activation assay (HIPA) for VITT diagnosis. Method(s): From April to October 2021, 7 patients meeting the 5 following criteriae of definite VITT were included: Onset of symptoms 5-42 days after vaccination, thrombosis, thrombocytopenia, D-dimers >4000 ng/mL and positive anti-PF4 IgG (Zymutest HIA IgG and/or Lifecodes PF4 IgG). HIMEA was performed on whole blood from healthy donors in the hematology laboratory of Alexandra General Hospital. HIPA was performed on washed platelets from healthy donors in the hematology laboratory of Bichat Hospital. Result(s): 4 patients showed a characteristic pattern that was concordant between the two methods. HIMEA showed a sigmoid curve with elevated area under the curve (mean AUC 189+/-78 AU) in saline, that was lower (mean 148+/-51 AU) in the presence of heparin 1 IU/mL and further decreased (mean 34+/-28 AU) in the presence of heparin 100 IU/mL. HIPA showed positive aggregation in the presence of saline and heparin 0,2 IU/mL but no aggregation with heparin 50 IU/mL. 2 patients who showed lower AUC in HIMEA saline (109 and 60 AU) had weakly positive or negative results with HIPA. In these 2 cases, blood was drawn after intravenous immunogloblulin (IVIG) initiation. 1 patient showed discrepant results with typical positive HIMEA but negative HIPA patterns. Conclusion(s): VITT antibodies show heterogenous reactivity patterns that can be highlighted only by using different functional assays such as HIMEA and HIPA. IVIG treatment can be reponsible for lower antibody reactivity.

Evaluation of D-dimer concentrations measured with three methods in patients with COVID-19

Background: COVID-19 is associated with an increased risk of venous thrombosis, even when patients are on standard-dose antithrombotic prophylaxis. Hence, the identification of biomarkers of thrombosis helps tailoring dosage of antithrombotic prophylaxis. D-dimer has been extensively employed as a biomarker and cut-off values at hospital admission have been proposed to stratify the risk of thrombosis and make decision on prophylaxis. However, D-dimer measurement is not standardized, and it is unknown if the cut-off values used for decision making can be used interchangeably between methods. Aim(s): To assess for concordance of results obtained with different commercially available laboratory methods measuring D-dimer. Method(s): Plasma samples collected from COVID-19 patients at the Hospital of Cremona were evaluated for D-dimer with three widely used immunoturbidimetric methods (Liatest D-di, Stago, Asnieres, France;D-dimer HS 500, Werfen, Orangeburg, NY;Innovance D-dimer, Siemens, Marburg, Germany). Result(s): A total of 87 COVID-19 patients [54 male and 33 female, median age of 73 years (range 28-98)] were enrolled in the study. No significant differences were found between mean D-dimer concentrations obtained with the three methods even when stratifying D-dimer levels in 4 groups (<1000, 1000-2000, 2000-5000, >5000 ng/mL) (Figure 1). The three methods showed substantial result agreement [Stago-vs- Werfen and Siemens-vs- Stago (Cohen's kappa coefficient of 0.760 and 0.699, respectively)] to an almost perfect agreement [Siemens-vs- Werfen (Cohen's kappa coefficient of 0.811)], with a p-value < 0.001. Results from the three methods showed a good linear correlation (Rho = 0.94) (Figure 2). Conclusion(s): The relatively good concordance of D-dimer results among the three investigated methods indicates that D-dimer cut-off values could be used interchangeably regardless of the method used for testing. The results pave the way to clinical trials aimed to assess the value of D-dimer as a biomarker to make decision on the intensity of antithrombotic prophylaxis in COVID-19 patients. (Figure Presented).

Prediction of covid-19 virus anxiety based on positive psychological characteristics, personality characteristics and health concerns in nurse

The aim of this research was to predict the anxiety of Corona based on personality traits and positive psychology components in nurses in karaj. The research sample consisted of 100 nurses who were selected from the statistical population using available sampling method. The research tools included Alipour et al.'s Corona Anxiety Questionnaire (2020), Eysenck's Personality Characteristics Questionnaire (EPQ) and Rashid's Positive Psychology Components Questionnaire (2008). The research design was correlational. Pearson's correlation coefficient and regression methods were used for data analysis. The obtained results showed that there is a negative and significant relationship between Corona anxiety and the components of positive psychology (pleasant life, committed life and meaningful life). Also, among the personality traits, there is only a positive and meaningful relationship between Corona anxiety and neuroticism. Also, personality traits and positive psychology components are able to predict 4% of corona anxiety in nurses.

The Use of Ketamine Sedation for the Treatment of Nail Bed Repairs in the Paediatric Emergency Department

Aim: To determine if ketamine sedation is a safe and cost-effective way of treating paediatric patients presenting with nail bed injuries to the emergency department. Method:Aretrospective cohort study was carried out over a nine-month period in children between ages 18 months and 16 years old, presenting to the paediatric emergency department (PED) at Chelsea and Westminster Hospital, London, with nail bed injuries requiring repair by the plastic surgery team. The primary outcome measures are complications at the time of sedation and at outpatient follow up including surgical site infection at seven days. A secondary outcome measure of parental satisfaction was collected at four months. A cost analysis comparison against procedures completed under general anaesthetic was also undertaken. Results: During the 9-month period, 10 nail bed repairs were performed under ketamine sedation in the PED. There were no serious adverse events recorded. No cases required further procedures and there were no cases of surgical site infections at 7 days. Parents reported favourable outcomes, with an average overall satisfaction score of 9.4 (where 10 is complete satisfaction). At follow up, there was one recorded complication which was successfully treated, with all patients being discharged from follow up within 3 months. Conclusion: This small study has shown ketamine procedural sedation in the paediatric population to be a safe and cost-effective method for the treatment of nail bed injuries in children presenting to PED. We believe that this management strategy, brought to the fore during the COVID-19 pandemic, should be considered as standard across all PEDs.

Predicting Quality of Life and Domestic Violence against Women During COVID-19 Quarantine Based on Resilience and Coping Styles

Background: Restrictive measures caused by the COVID-19 have exposed the families’ structure to some critical issues such as reduced quality of life and increased domestic violence. For this reason, the study of psychological factors are essential in this regard. Objectives: The study aimed to predict the quality of life and violence against women during COVID-19 quarantine based on resilience and coping styles. Methods: This descriptive correlation study was conducted on all married women in Karaj from October 1 to November 30, 2020. A total of 241 people were randomly selected as the sample and answered the questionnaires about coping styles, quality of life, violence against women, and resilience scale. The data were analysized by Pearson correlation test and regression analysis. Results: There was a significant positive relationship between resilience, efficient coping style, and quality of life, as well as a significant negative relationship between inefficient coping style and quality of life (P < 0.01). A significant negative relationship was observed between coping style with domestic violence, as well as a significant positive relationship between dysfunctional coping style and domestic violence (P < 0.01). Resilience and effective coping style predicted the quality of life, domestic violence, and ineffective coping style of domestic violence against women (P < 0.01). Conclusions: According to the results, individual and psychological factors of people could play a significant role in the occurrence of violence and thus reduce their quality of life. In educational-therapeutic sessions, counselors and family therapists increased the quality of life and reduced violence by examining coping styles and resilience to use educational strategies in this area.

Self-Measured Doppler Blood Pressure Readings in Continuous-Flow LVAD Patients are Reliable

Background: Blood pressure (BP) management is imperative in reducing risk of adverse events in continuous flow (CF) left ventricular assist device (LVAD) patients. The gold standard for non-invasive blood pressure (BP) measurement in these patients is Doppler ultrasound, which requires training and dexterity and is not routinely used in the outpatient setting. In the current COVID-19 pandemic era, telehealth assessment has become mandatory to assess and monitor patients. At our institution, we have issued all CF-LVAD patients with a Doppler ultrasound device and an oscillometric BP monitor, and provided training to correctly use these devices. Accuracy of BP measurements in this setting has not been confirmed. Aim: We examined whether Doppler BP obtained by CF-LVAD patients (pts) correlates to Doppler BP obtained by health care workers (HCWs). Methods: CF-LVAD pts were recruited between November 2020 and January 2022. During these routine outpatient follow-up visits, Doppler BP measurements were obtained simultaneously and independently by pts and HCW. BP was taken in a comfortable seating position following 5 minutes rest. Results: A total 223 pairs of simultaneous patient Doppler BP readings and HCW Doppler BP readings were obtained from 38 CF-LVAD patients (87% male, mean age at implant 52 + 14 years, 15 HeartMate3 and 23 HeartWare HVAD, with support duration range 28 - 3492 days). Patient Doppler BP (average 85.9 + 9.8 mmHg) correlated closely with HCW Doppler BP (average 86.1 + 9.6 mmHg), r2=0.90, p<0.0001. There was no significant difference between BP taken by the patient and HCW (p=0.4). The mean difference between the two methods was -0.17 mmHg and the standard deviation was 0.22 mmHg (figure) using Bland-Altman analysis. Conclusions: These results demonstrate that in our patient-population, Doppler-derived blood pressure measurements in CF-LVAD patients were accurate and reliable. This supports the routine use of home Doppler BP measurement and monitoring by CF-LVAD patients, especially in the telehealth era. (Figure Presented).

Lung Cancer Screening Patients Experiences and Satisfaction: Quantitative and Qualitative Findings From a Survey Study

Introduction: In 2015, H. Lee Moffitt Cancer Center & Research Institute (MCC) launched a lung cancer screening program for high-risk individuals based on National Comprehensive Cancer Network guidelines. To identify successes and barriers of this program from the patient perspective, we conducted a survey study to measure patient experiences and satisfaction with lung cancer screening. Methods: In August 2020, a survey and cover letter were mailed to 576 patients who completed one or more lung cancer screenings at MCC. In addition to demographics, smoking history, and impact of the COVID-19 pandemic to get screened, the survey included 34 quantitative questions using a 5-point Likert scale and six open-ended questions. The quantitative questions measured patient satisfaction and experiences across 6 domains: appointment process, clinical staff interactions, communication, visit with the provider, screening results, cost, and clinic facility/overall satisfaction. Results were quantified using descriptive statistics. The six open-ended items elicited barriers and facilitators related to returning for screening, experiences with other cancer screenings, positive and negative experiences with the low-dose computed tomography (LDCT) visit, and suggestions for improving the process of LDCT screening visits. Content analysis using the constant comparison method was applied to the text and coded based on the a priori codes of the open-ended questions. Results: Among the 212 patients (37% completion rate) who completed the survey, 97.6% were white, 48.6% were female, and the mean age was 69 years. In the communication domain, 81.1% “strongly agreed/agreed” that the lung cancer screening process was clearly explained, 92.5% “strongly agreed/agreed” that the potential harms and limitations were clearly explained and 76.9% “strongly agreed/agreed” that the process for follow-up screening was clearly explained. For the provider questions, 71.7% “strongly agreed/agreed” that the provider was willing to listen carefully and 68.4% “strongly agreed/agreed” that the instructions were easy to understand. For results and costs, 78.3% “strongly agreed/agreed” the screening results were clearly explained and 70.8% “strongly agreed/agreed” that the cost of the screening was justified. Regarding overall satisfaction, 88.2% “strongly agreed/agreed” they would recommend lung cancer screening at MCC. Patients who had Medicare insurance or paid out-of-pocket had higher agreement about helpfulness of the staff who assisted them with billing or insurance compared to patients who had private insurance coverage (79.4% Medicare coverage, 60.0% private, and 75.0% self-pay: P-value=0.025). In the qualitative findings, respondents provided generally positive comments about their lung cancer screening experience. Negative comments were related to desire for more information about results, long wait times for results, and billing issues. Conclusions: This study provided insights about patient experiences and satisfaction with lung cancer screening which are important, given the low uptake of this life-saving modality. Ongoing patient-centered feedback may improve the lung cancer screening experience and increase follow-up screening rates. Keywords: survey, screening, patient satisfaction