Enhanced IgG immune response to COVID-19 vaccination in patients with sickle cell disease.

Patients with sickle cell disease (SCD) are considered to be immunocompromised, yet data on the antibody response to SARS-CoV-2 vaccination in SCD is limited. We investigated anti-SARS-CoV-2 IgG titres and overall neutralizing activity in 201 adults with SCD and demographically matched non-SCD controls. Unexpectedly, patients with SCD generate a more robust and durable COVID-19 vaccine IgG response compared to matched controls, though the neutralizing activity remained similar across both cohorts. These findings suggest that patients with SCD achieve a similar antibody response following COVID-19 vaccination compared to the general population, with implications for optimal vaccination strategies for patients with SCD.

Alpha-Gal Syndrome in the Infectious Diseases Clinic: A Series of 5 Cases in Central North Carolina.

Background: Alpha-gal syndrome (AGS) is a recently described allergy to galactose-α-1,3-galactose, an oligosaccharide present in mammalian meat. AGS can present with angioedema, urticaria, and anaphylaxis arising 3-6 hours after ingestion, although symptoms such as gastrointestinal distress, fatigue, and arthralgias are also reported. Because AGS appears to be associated with tick bites, patients may present to infectious diseases (ID) clinics for evaluation. Methods: We documented a series of 5 patients referred to the University of North Carolina ID Clinic between 2020 and 2022 for various tick-borne infections that were found to have symptoms and laboratory testing consistent with AGS. Patients were subsequently referred to the Allergy and Immunology Clinic. Results: Patients were referred to the ID Clinic for persistent symptoms following positive tick-borne disease testing or presumed tick-borne infection. All patients had an elevated alpha-gal immunoglobulin E and clinical presentation consistent with AGS. Common symptoms included episodic gastrointestinal distress (eg, cramping, nausea, diarrhea), fatigue, arthralgias, and subjective cognitive impairment, but a notable absence of severe anaphylaxis. Four patients were seen by at least 1 nonallergy specialist prior to referral to ID. Patients reported substantial improvement in their symptoms following dietary restriction. Conclusions: ID physicians should be aware of AGS as a cause of persistent, nonspecific symptoms following a tick exposure or tick-borne illness. Further research is needed to determine the prevalence of alpha-gal sensitization and AGS following tick-borne bites.

Evidence for Aerosol Transfer of SARS-CoV-2-Specific Humoral Immunity.

Infectious particles can be shared through aerosols and droplets formed as the result of normal respiration. Whether Abs within the nasal/oral fluids can similarly be shared between hosts has not been investigated. The circumstances of the SARS-CoV-2 pandemic facilitated a unique opportunity to fully examine this provocative idea. The data we show from human nasal swabs provides evidence for the aerosol transfer of Abs between immune and nonimmune hosts.

Seroepidemiology and risk factors for SARS-CoV-2 infection among household members of food processing and farm workers in North Carolina.

Background: Racial and ethnic minorities have borne a disproportionate burden from coronavirus disease 2019 (COVID-19). Certain essential occupations, including food processing and farm work, employ large numbers of Hispanic migrant workers and have been shown to carry an especially high risk of infection. Methods: This observational cohort study measured the seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and assessed the risk factors for seropositivity among food processing and farm workers, and members of their households, in North Carolina, USA. Participants completed questionnaires, blood samples were collected, and an enzyme-linked immunosorbent assay was used to assess SARS-CoV-2 seropositivity. Univariate and multi-variate analyses were undertaken to identify risk factors associated with seropositivity, using generalized estimating equations to account for household clustering. Findings: Among the 218 participants, 94.5% were Hispanic, and SARS-CoV-2 seropositivity was 50.0%. Most seropositive individuals did not report a history of illness compatible with COVID-19. Attending church, having a prior history of COVID-19, having a seropositive household member, and speaking Spanish as one's primary language were associated with SARS-CoV-2 seropositivity, while preventive behaviours were not. Interpretation: These findings underscore the substantial burden of COVID-19 among a population of mostly Hispanic essential workers and their households in rural North Carolina. This study contributes to a large body of evidence showing that Hispanic Americans have suffered a disproportionate burden of COVID-19. This study also highlights the epidemiologic importance of viral transmission within the household.

SARS-CoV-2 seroprevalence and risk factors among meat packing, produce processing, and farm workers

Meat packing, produce processing, and farm workers are known to have an elevated risk of COVID-19, but occupational risk factors in this population are unclear. We performed an observational cohort study of meat packing, produce processing, and farm workers in North Carolina in fall 2020. Blood, saliva, and nasal turbinate samples were collected to assess for SARS-CoV-2 seropositivity. Risk factors for SARS-CoV-2 seropositivity were investigated using chi-square tests, two-sample t-tests, and adjusted risk ratio analyses. Among 118 enrolled workers, the baseline SARS-CoV-2 seroprevalence was 50.0%. Meat packing plant workers had the highest SARS-CoV-2 seroprevalence (64.6%), followed by farm workers (45.0%) and produce processing workers (10.0%), despite similar sociodemographic characteristics. Compared to SARS-CoV-2 seronegative workers, seropositive workers were more likely to work in loud environments that necessitated yelling to communicate (RR: 1.83, 95% CI: 1.25–2.69), work in cold environments (RR: 1.58, 95% CI: 1.12–2.24), or continue working despite developing symptoms at work (RR: 1.63, 95% CI: 1.14–2.32). After adjusting for age and working despite symptoms, high occupational noise levels were associated with a 1.72 times higher risk of SARS-CoV-2 seropositivity (95% CI: 1.16–2.55). Half of food processing workers showed evidence of past SARS-CoV-2 infection, a prevalence five times higher than most of the United States population at the time of the study. Work environments with loud ambient noise may pose elevated risks for SARS-CoV-2 transmission. Our findings also highlight the disproportionate burden of COVID-19 among underserved and economically disadvantaged Latinx communities in the United States.

Seroepidemiology and risk factors for SARS-CoV-2 infection among household members of food processing and farm workers in North Carolina

Background Racial and ethnic minorities have borne a disproportionate burden from COVID-19. Certain essential occupations, including food processing and farm work, employ large numbers of Hispanic migrant workers and have been shown to carry an especially high risk of infection. Methods We conducted an observational cohort study measuring the seroprevalence of SARS-CoV-2 and assessing risk factors for seropositivity among North Carolina food processing and farm workers and members of their households. Participants completed questionnaires and we collected blood samples and used an enzyme-linked immunosorbent assay to assess SARS-CoV-2 seropositivity. Univariate and multivariate analyses were carried out to identify risk factors associated with seropositivity, using generalized estimating equations to account for household clustering. Findings Among the 218 participants, 94.5% were Hispanic, and SARS-CoV-2 seropositivity was 50.0%. Most seropositive individuals did not report a history of illness compatible with COVID-19. Attending church, having a prior history of COVID-19, having a seropositive household member, and speaking Spanish as one's primary language were associated with SARS-CoV-2 seropositivity, while preventive behaviors were not. Interpretation These findings underscore the substantial burden of COVID-19 among a population of mostly Hispanic essential workers and their households in rural North Carolina. Our study contributes to a large body of evidence showing that Hispanic Americans have suffered a disproportionate COVID-19 burden. We also highlight the epidemiologic importance of viral transmission within the household.

Comparison of Capillary Blood Self-Collection using the Tasso-SST Device with Venous Phlebotomy for anti-SARS-CoV-2 Antibody Measurement (preprint)

Measuring seroprevalence over time is a valuable epidemiological tool for improving our understanding of COVID-19 immunity. Due to the large number of collections required for population surveillance as well as concerns about potential infection risk to the collectors, self-collection approaches are being increasingly pursued. To advance this methodology, we collected paired venous and capillary blood samples by routine phlebotomy and Tasso-SST device respectively from 26 participants and measured total immunoglobulin (Ig) and IgG antibodies to the SARS-CoV-2 receptor binding domain (RBD) by enzyme-linked immunosorbent assay (ELISA) on both specimens. Qualitatively, no discrepancies were noted in binary results between Tasso and venipuncture-derived plasma. Furthermore, in vaccinated participants, correlation between Tasso and venous Ig total and IgG specific antibody quantitative levels was high (Total Ig: {rho} ; = 0.72, 95% CI (0.39- 0.90); IgG {rho} ; = 0.85, 95% CI (0.54, 0.96)). Our results support the use of Tasso at-home collection devices for antibody testing.

Increased Number and Severity of Open Globe Injuries during COVID-19 Stay-at-home Orders.

PURPOSE: To evaluate the occurrence and outcome of open globe injury during state-mandated COVID-19 stay-at-home orders compared to historical averages at a tertiary medical center in Portland, Oregon. METHODS: Open globe injury between January 1, 2015 and December 31, 2020 was identified using relevant procedure codes. The number of injuries, mechanism of trauma, and short-term outcomes of globes repaired during the study period of March 23, 2020 to July 6, 2020 when stay-at-home orders were in effect were compared to a cohort from the same 15-week time frame in 2015-2019. We also evaluated injuries occurring throughout 2020 as compared to the prior 5 years. RESULTS: 263 consecutive open globe injuries were identified between January 2015 and December 2020. While Oregon's stay-at-home orders were in effect, we observed a significant increase in the number of open globe injuries treated compared to the prior 5 years (p = .004). Twenty-four cases identified during the study period represent a 2-fold increase over the 2015-2019 average of 11.8 globe repairs during the same 15-week time period. Visual acuity < 20/200 at 6 months (p = .008) and secondary enucleation (p < .001) were more frequent during stay-at-home orders, and severity of injury as calculated by the Ocular Trauma Scores (OTS) was higher. Time-to-repair was similar between the two cohorts. CONCLUSION: At our center, there was an increased number and severity of open globe injury during the period of mandatory COVID-19 stay-at-home orders. Visual acuity outcomes and risk for secondary enucleation were poorer compared to the reference cohort.Abbreviations: Ocular Trauma Score (OTS), Open globe injury (OGI), Emergency department (ED), Oregon Health and Science University (OHSU).

Use of virtual meeting and survey technology to assess Covid-19 related mental wellbeing of healthcare workers.

BACKGROUND AND AIMS: - Healthcare workers (HCW) throughout the world have been exposed to economic and existential stress during the Covid-19 pandemic. The American Medical Association (AMA) has documented that increased healthcare burden correlates with increased HCW stress, burnout, and psychological burden. However, limits on personnel, time, and in person interactions make it challenging to assess mental health outcomes during a pandemic. This pilot test case study used virtual technology to efficiently assess these outcomes. SETTING: - Data were collected based on voluntary participation in the Coping with Covid-19 for Caregiver's survey created by AMA. The survey was sent out to approximately 300 participants who included local physicians, medical residents, medical students, and allied health professionals and students who attended a virtual Mental Health Summit. METHODS: - The survey was developed by the AMA, and it included questions about demographics, overall stress, fear of infection and transmission of the virus, perceived anxiety or depression due to Covid, work overload, childcare issues, and sense of meaning and purpose. The AMA allows for up to five additional questions to be added to their survey, therefore five questions regarding support service utilization, perseverance, and resilience during Covid-19, and two items to further understand students' areas of medical interest. The survey was administered using an online platform through the AMA. The data were analyzed using descriptive statistics. RESULTS: - There were 81 survey respondents. Based on the results of the survey, "high stress" was found in 52 (64%) participants. 66 (81%) were afraid (moderately or to a great extent) of exposure or transmission, 61 (75%) described high levels of anxiety or depression, and 67 (84%) noted work overload. Despite this increase in stress, most respondents (77%) said they were not likely to reduce their devoted hours in clinical care or research in the next 12 months, and 81% answered that they would not leave their practice or research within two years. CONCLUSION: - Covid-19 has negatively affected the wellbeing of HCW. This is a similar trend seen during other times of healthcare strain. Mental health support, work modulation, and various provisions should be explored as means to reduce Covid-related negative impacts. The use of online an online summit and online data collection methods were appropriate for collecting data on the impact of Covid on mental health. This pilot study supports the larger scale implementation of this technology for health informatics research.

Hospitalized patients with irreversible lung injury from COVID-19 have higher morbidity but similar 1-year survival after lung transplant compared to hospitalized patients transplanted for restrictive lung disease.

BACKGROUND: Hospitalized lung transplant (LT) recipients (LTRs) have higher post-LT morbidity and mortality than those who are well enough to wait for transplant at home. Outcomes after LT for COVID-19-associated acute respiratory distress syndrome (CARDS) may be even worse; thus, we compared post-LT outcomes between hospitalized LTRs transplanted for CARDS and those transplanted for restrictive lung disease (RLD). METHODS: Between 2014 and 2021, hospitalized LTRs ≥18 years old with CARDS or RLD were included. Primary and secondary outcomes were 1-year post-LT survival and postoperative morbidity. For each patient in the CARDS group, an analysis of 1-to-1 matched patients from the RLD group was performed using logistic regression modeling. RESULTS: Of 764 LTRs, 163 (21.3%) were hospitalized at the time of LT; 132 met the inclusion criteria: 11 (8.3%) were transplanted for CARDS and 121 (91.7%) for RLD. LTRs with CARDS were younger with longer pre-LT hospitalization stays and higher rates of pretransplant mechanical ventilation, dialysis, and ECMO as a bridge to transplant. A propensity-matched analysis demonstrated comparable rates of intrathoracic adhesions, posttransplant duration of mechanical ventilation, PGD3 at 72 hours, and delayed chest closure. Compared to LTRs with RLD, those with CARDS had significantly longer posttransplant hospital stays and a higher prevalence of ACR ≥A2 and DSA >2000 MFI, but comparable 1-year survival rates. CONCLUSION: Even with careful selection, LT for patients with CARDS was associated with significant morbidity; however, 1-year survival of recipients with CARDS was comparable to that of matched hospitalized recipients with RLD.

The effectiveness of social media for inclusion of women in computing

Despite the projection of an increase in the number of jobs in the computer science (CS) field by 13% from 2020 to 2030 in the United States (as reported by the Bureau of Labor Statistics), the representation of women, especially women of color, in the field remains low. Lack of representation for women in computer science negatively impacts the growth of this demographic as it becomes harder for prospective individuals to envision themselves in the field when they do not see others like them already succeeding in CS. Studies have found that the retention of women in the field is stronger when the representation of women is evident in their environment, however, it is hard to come by considering the low population of women computer scientists. While new prospects may find fewer women in their CS departments in their college experience, or at their workplaces, there is a plethora of social media personalities and communities for them to engage in and find like-minded individuals.This full research paper investigates the experiences of women, or lack thereof, in CS communities centered around social media and how it contributes to their sense of belonging in the CS field at large. It is evident that there is limited scope in the existing literature that studies the impact social media participation has on CS women. This literature review distinguishes the narrow scope of literature focused on women's experiences with open-source software communities in CS from women's experiences with more generic widespread platforms such as Twitter, or Instagram. It argues for the expansion of knowledge for the effects of CS women's participation on such platforms and provides insight into approaches, such as photovoice, that may be utilized to study this space. The outcomes of this review reveal the potential of utilizing online platforms in retaining women in the CS workforce effectively. Considering the current status of many organizations that have switched from in-person to remote engagement due to COVID, this review contributes to the analysis of the effective use of technology and its impact at a critical time. © 2022 IEEE.

Collapsing Glomerulopathy in a Patient With Recent COVID-19 and APOL-1 High-Risk Genotype

Introduction: Collapsing glomerulopathy (CG) is an aggressive subtype of focal segmental glomerulosclerosis, associated with poor renal outcomes. Risk factors for CG include HIV infection, APOL1 high-risk genotypes, and CG has also recently been reported in patients with COVID-19. We report a case of CG with acute kidney injury (AKI) in a patient with a high risk APOL1 genotype, who had renal recovery after prednisone treatment. Case Description: A 43-year-old male with no past medical history presented with fever, myalgia, hemoptysis, vomiting, and diarrhea of 2 weeks duration. Initial exam was remarkable for temperature 103 degrees Fahrenheit, SpO2 95% on room air, and inspiratory crepitations without peripheral edema. Labs were notable for serum creatinine 2.6 mg/dL (unknown baseline), peak creatine kinase 4037 U/L, and urine protein creatinine ratio 19 g/g without RBCs. Chest CT was consistent with multilobar pneumonia. SARS-CoV2 PCR was repeatedly negative but COVID-19 spike and nucleocapsid IgG were positive. Extensive serologic workup for causes of glomerulonephritis and nephrotic syndrome was negative. He was empirically treated with antibiotics for pneumonia but cultures remained negative. Bronchoscopy revealed no evidence of alveolar hemorrhage. His renal function worsened, requiring hemodialysis. Kidney biopsy revealed collapsing glomerulopathy associated with thrombotic microangiopathy, few myoglobin casts suggestive of rhabdomyolysis, and acute tubular injury. Prednisone was initiated at 1mg/kg daily and tapered over 2 months. Lisinopril was initiated for proteinuria. After 5 months, serum creatinine was 1.3 mg/dL and urine protein creatinine ratio improved to 0.6g/g. Genetic testing revealed APOL1 G1/G1 genotype. Discussion(s): In this patient, SARS-CoV2 PCR was likely negative because he presented weeks after symptom onset but the clinical course and serologic evidence of prior SARS-CoV-2 infection supports the diagnosis of COVID-19 associated CG in the setting of APOL1 high-risk G1/G1. Proposed mechanisms of COVID-19-related CG include increased cytokines, that upregulate podocyte expression of toxic APOL1 variants and AKI with tubular injury is often found. Our patient improved with steroid treatment but the treatment of COVID-19 associated CG requires further study.

Well-being of Cardiothoracic Surgeons in the Time of COVID-19: A Survey by the Wellness Committee of the American Association for Thoracic Surgery.

The prevalence of burnout among physicians has been increasing over the last decade, but data on burnout in the specialty of cardiothoracic surgery are lacking. We aimed to study this topic through a well-being survey. A 54-question well-being survey was developed by the Wellness Committee of the American Association for Thoracic Surgery (AATS) and sent by email from January through March of 2021 to AATS members and participants of the 2021 annual meeting. The 5-item Likert-scale survey questions were dichotomized, and associations were determined by Chi-square tests or independent samples t-tests, as appropriate. The results from 871 respondents (17% women) were analyzed. Many respondents reported at least moderately experiencing: 1) a sense of dread coming to work (50%), 2) physical exhaustion at work (58%), 3) a lack of enthusiasm at work (46%), and 4) emotional exhaustion at work (50%). Most respondents (70%) felt that burnout affected their personal relationships at least "some of the time," and many (43%) experienced a great deal of work-related stress. Importantly, most respondents (62%) reported little to no access to workplace resources for emotional support, but those who reported access reported less burnout. Most respondents (57%) felt that the COVID-19 pandemic has negatively affected their well-being. On a positive note, 80% felt their career was fulfilling and enjoyed their day-to-day job at least "most of the time." Cardiothoracic surgeons experience high levels of burnout, similar to that of other medical professionals. Interventions aimed at mitigating burnout in this profession are discussed.

Integrating Artificial Intelligence into Cybersecurity Curriculum: New Perspectives

As societies rely increasingly on computers for critical functions, the importance of cybersecurity becomes ever more paramount. Even in recent months there have been attacks that halted oil production, disrupted online learning at the height of COVID, and put medical records at risk at prominent hospitals. This constant threat of privacy leaks and infrastructure disruption has led to an increase in the adoption of artificial intelligence (AI) techniques, mainly machine learning (ML), in state-of-the-art cybersecurity approaches. Oftentimes, these techniques are borrowed from other disciplines without context and devoid of the depth of understanding as to why such techniques are best suited to solve the problem at hand. This is largely due to the fact that in many ways cybersecurity curricula have failed to keep up with advances in cybersecurity research and integrating AI and ML into cybersecurity curricula is extremely difficult. To address this gap, we propose a new methodology to integrate AI and ML techniques into cybersecurity education curricula. Our methodology consists of four components: i) Analysis of Literature which aims to understand the prevalence of AI and ML in cybersecurity research, ii) Analysis of Cybersecurity Curriculum that intends to determine the materials already present in the curriculum and the possible intersection points in the curricula for the new AI material, iii) Design of Adaptable Modules that aims to design highly adaptable modules that can be directly used by cybersecurity educators where new AI material can naturally supplement/substitute for concepts or material already present in the cybersecurity curriculum, and iv) Curriculum Level Evaluation that aims to evaluate the effectiveness of the proposed methodology from both student and instructor perspectives. In this paper, we focus on the first component of our methodology - Analysis of Literature and systematically analyze over 5000 papers that were published in the top cybersecurity conferences during the last five years. Our results clearly indicate that more than 78% of the cybersecurity papers mention AI terminology. To determine the prevalence of the use of AI, we randomly selected 300 papers and performed a thorough analysis. Our results show that more than 19% of the papers implement ML techniques. These findings suggest that AI and ML techniques should be considered for future integration into cybersecurity curriculum to better align with advancements in the field. © American Society for Engineering Education, 2022

The effect of taste on swallowing: A scoping and systematic review.

Consuming foods and liquids for nutrition requires the coordination of several muscles. Swallowing is triggered and modified by sensory inputs from the aerodigestive tract. Taste has recently received attention as a potential modulator of swallowing physiology, function, and neural activation; additionally, taste impairment is a sequela of COVID-19. This review presents factors impacting taste and swallowing, systematically summarizes the existing literature, and assesses the quality of included studies. A search was conducted for original research including taste stimulation, deglutition-related measure(s), and human participants. Study design, independent and dependent variables, and participant characteristics were coded; included studies were assessed for quality and risk of bias. Forty-eight articles were included after abstract and full-text review. Synthesis was complicated by variable sensory components of stimuli (taste category and intensity, pure taste vs. flavor, chemesthesis, volume/amount, consistency, temperature), participant characteristics, confounding variables such as genetic taster status, and methods of measurement. Most studies had a high risk of at least one type of bias and were of fair or poor quality. Interpretation is limited by wide variability in methods, taste stimulation, confounding factors, and lower-quality evidence. Existing studies suggest that taste can modulate swallowing, but more rigorous and standardized research is needed.

ANALYSIS OF PATIENT REPORTED OUTCOME MEASURES (PROMS) IN THE COVID ERA - THE FIRST 6 MONTHS

Background This project analysed the Integrated Palliative Outcome Scale (IPOS) in a 20-bedded in-patient unit during the COVID-19 Pandemic. The scores were taken at admission, at change in Phase of Illness and at point of discharge or death. These scores were used to monitor symptom progression and effectiveness of management during the COVID-19 pandemic. Methods The Electronic patient record (EPR) identified 110 hospice inpatients, from a total 141 admissions between 1st October 2020 - 31st March 2021) who had at least one IPOS recorded. Initial and subsequent IPOS scores were inputted and analysed in Microsoft Excel and baseline symptom prevalence and outcome measures reported (bar charts and radar plots). Results Over the 6-month period analysed 93% of patients admitted had a primary cancer diagnosis and 7% non-cancer related conditions. The worst rated physical symptoms on admission included;weakness (2.67), poor mobility (2.59) and poor appetite (2.27). Family worry was the top score of all the domains with an average initial admission score of 3.13, this is not unsurprising, and likely that the visiting restrictions in place will be contributing to this domain All physical symptoms were successfully reduced from start to end of admission except for impact of drowsiness. The greatest reductions in average scores of the physical domains were seen for constipation (28.6%), Nausea (23.9%) and Weakness (17.2%). However, average scores for anxiety, depression and sharing feelings rose by 2.3%, 10.5% and 5.7% during the admission. Conclusions This work confirms that an in-patient unit can collect and analyse patient outcomes data, even during a pandemic. The results demonstrate the positive impact that admission to a hospice can have on the symptoms of terminally ill patients, especially physical symptoms. For us it has highlighted areas of improvement especially psychological and spiritual care.

Student Engagement and Learning Approaches During COVID-19: The Role of Study Resources, Burnout Risk, and Student Leader–Member Exchange as Psychological Conditions

Objectives: The primary objective of this study was to explore the interplay of psychological conditions that influenced personal engagement among university students. As a theoretical lens through which to investigate this, the study used the job demands-resources model, the study demands-resources model, and the leader–member exchange theory. This study further aimed to explore outcomes that supported students in becoming lifelong learners (i.e., deep-learning approach). Method: Participants were undergraduate students registered at a South African university. We used a purposive, non-probability sampling strategy and employed a cross-sectional survey research design. This study used Mplus version 8.6 for the statistical analyses. Results: Results showed that the psychological conditions of meaningfulness (study resources), availability (burnout risk), and safety (student–leader–member exchange) influenced student engagement. In addition, the results showed that study demands were positively associated with student engagement, although this association can be regarded as small. Furthermore, study resources and student engagement were associated with a deep approach to learning. Conclusions: Findings from the present study demonstrated that Kahn’s theory carried implications beyond the workplace and held true in a student learning environment. Further, an exploration of the psychological conditions that led to engagement showed that the job demands-resources model and the study demands-resources model could be used to operationalise study resources as psychological meaningfulness and burnout risk as availability. Similarly, in the context of exploring the student-lecturer relationship, student leader–member exchange could be operationalised as psychological safety. Implication for Practice: Leaders in higher education are encouraged to focus not only on ensuring that students receive adequate support in terms of structures and physical resources during periods of uncertainty, such as the global COVID-19 pandemic, but to adopt a holistic approach that includes considering all the psychological conditions that encourage and promote students’ engagement. © The Author(s)

B cells promote CD8 T cell primary and memory responses to subunit vaccines.

The relationship between B cells and CD4 T cells has been carefully studied, revealing a collaborative effort in which B cells promote the activation, differentiation, and expansion of CD4 T cells while the so-called "helper" cells provide signals to B cells, influencing their class switching and fate. Interactions between B cells and CD8 T cells are not as well studied, although CD8 T cells exhibit an accelerated contraction after certain infections in B-cell-deficient mice. Here, we find that B cells significantly enhance primary CD8 T cell responses after vaccination. Moreover, memory CD8 numbers and function are impaired in B-cell-deficient animals, leading to increased susceptibility to bacterial challenge. We also show that interleukin-27 production by B cells contributes to their impact on primary, but not memory, CD8 responses. Better understanding of the interactions between CD8 T cells and B cells may aid in the design of more effective future vaccine strategies.