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This paper reports on the fourth year of a cybersecurity-focused research experience for undergraduates programs site in the summer of 2021. Due to the COVID-19 pandemic, the site operated in a hybrid mode during this summer, after operating entirely virtually during the summer of 2020. The paper compares the results of operating in a hybrid mode with two years of in-person operations and one year of virtual operations. It discusses the lessons learned when operating in the hybrid mode and makes recommendations for future hybrid REU implementations. © American Society for Engineering Education, 2022.
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The COVID-19 pandemic has sparked significant interest in the HyFlex course model. It allows colleges and universities to temporarily close or reduce in-person attendance and apply social distancing policies to classrooms to reduce the risk of disease spread among the student and faculty populations. Thus, it enables students and instructors who prefer instruction in a physical classroom the opportunity to safely do so. This paper covers the adaptation of a course, CSCI 159: Computer Science Problem Solving, to the HyFlex model. This paper presents the strategies used and the lessons learned about how to effectively instruct general education computer sciences courses using the HyFlex course model. © American Society for Engineering Education, 2021
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This paper presents the design and implementation of a class for teaching software entrepreneurship. The class focused on teaching students the basics entrepreneurial venture development and how these processes relate, specifically, to a software venture. This paper presents the overall instructional plan of the course and discusses each of the course's components. The implementation of the project component is discussed, in particular, in detail. The design and implementation challenges that were encountered are discussed. This course was run in Spring of 2020 and started as an in-classroom course, later transitioning to an online course due to the COVID-19 pandemic. The outcomes of the course are discussed. Possible future enhancements are considered. © American Society for Engineering Education, 2021
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A flexible learning defensive security course was developed using the HyFlex delivery model which was initially developed at San Francisco State University. This paper discusses how a limited-flexibility model was transformed due to the COVID-19 pandemic and how the course was changed from having a single path to offering a HyFlex Options Menu where students select between several options for each area of the class. The overall outline and instructional design of the course are presented. The implementation of each of the HyFlex options is presented and the logistics of the overall course are reviewed. The challenges that were faced during course development and while offering the course, and how these were responded to, are discussed. Challenges with the rapid implementation of the HyFlex-based delivery model amidst the pandemic are reviewed. Additionally, differences between the San Francisco State University HyFlex model and the HyFlex-based model used in the course are discussed. Finally, plans for future offerings of this course are reviewed. © American Society for Engineering Education, 2021
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COVID-19 dramatically changed research experience for undergraduates (REU) programs during the summer of 2020. Given the uncertainty about the ability to conduct future REU programs onsite amidst a pandemic of unknown duration, it was decided to undertake the development of a model for online-based REUs and evaluate it using the evaluation tools that have been applied for some time to onsite programs. This paper presents the REU program at North Dakota State University during the summer of 2020 and its assessment. An overview of the program, as it ran in 2020, is provided. This is compared to the way the program operated in prior years as an onsite program. Specific changes that were made and their impact on the equivalency of the program to prior years are discussed. The approach used is presented as a model for potential use by other programs in the future. © American Society for Engineering Education, 2021
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Background: Proteasome inhibitors (PIs) & monoclonal antibodies are backbones of RRMM treatment;Ixa is approved with lenalidomide-dex for pts with ≥1 prior therapy, & Dara is approved in various regimens, including with bortezomib-dex (DVd). In CASTOR (DVd vs Vd), Vd was limited to 8 cycles;however, prolonged PI therapy is associated with improved outcomes. The IDd regimen with oral Ixa may enable longer-term PI therapy than with DVd. We evaluate IDd using a treat-to-progression approach. Methods: Ixa/Dara-naive RRMM pts receive Ixa 4 mg (days 1, 8, 15), Dara 16 mg/kg (days 1, 8, 15, 22, cycles 1–2;days 1, 15, cycles 3–6;day 1, cycles 7+), & dex 20 mg (days 1, 2, 8, 9, 15, 16, 22, 23) in 28-day cycles. The primary endpoint is ≥ very good partial response (VGPR) rate;secondary endpoints include overall response rate (ORR), progression-free survival (PFS), time to progression (TTP), overall survival (OS), & safety. We report data from the 2nd IA, conducted after ~50% of PFS events had occurred (data cutoff: 1/1/2021). Results: 61 pts were enrolled (median age 69 y, 19.7% aged ≥75 y;19.7% International Staging System stage III;26.2% high-risk cytogenetics [del(17p), t(4;14), t(14;16)], 42.6% expanded high-risk cytogenetics [high-risk &/or amp1q21]);59.0/26.2/14.8% of pts had received 1/2/3 prior lines. At data cutoff, pts had received a median of 16 IDd cycles;37.7% were ongoing. Relative dose intensity (RDI) of Ixa, Dara, & dex was 20%) TEAEs were diarrhea (39.3%), anemia (27.9%), thrombocytopenia (26.2%), & fatigue (21.3%);common (>5%) G≥3 TEAEs were pneumonia (11.5%), thrombocytopenia (11.5%), & anemia (8.2%). Infections & Infestations TEAEs were seen in 57.4% of pts (G≥3 24.6%) and were serious in 26.2%, including pneumonia (9.8%) and COVID-19/pneumonia (4.9%). Rate of peripheral neuropathy (PN) was 18.0% (1.6% G≥3). PN was 28.6% & 12.5%in pts with & without history of PN, respectively. Study drug dose modifications, reductions & discontinuations due to TEAEs were required in 57.4% (Ixa 36.1%, Dara 34.4%, dex 41.0%), 32.8%, & 9.8%of pts, respectively. Four pts died on study due to sudden death, COVID-19 pneumonia, septic shock, & COVID-19 (none were considered study drug-related). Conclusion: These IA data suggest IDd has a positive risk-benefit profile in RRMM pts, with a ≥VGPR rate of 30.5%, median PFS of 17.0 m, & a low rate of discontinuation due to TEAEs. The final analysis of this ongoing study is expected in 2022.
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Introduction: We aim to better understand the clinical experiences and quality of life of patients with idiopathic subglottic stenosis (iSGS) during the COVID-19 pandemic. We also seek to investigate how the COVID-19 crisis has affected iSGS patient interactions with their health care providers and access to care. Method: This is a survey study through an online questionnaire. An anonymous survey was used to collect responses to a series of questions administered to the largest support group for those with airway stenosis, “Living with idiopathic subglottic stenosis.” Results: The study is currently ongoing, with 474 complete individual responses to date (99.8% female, majority ages 41-55 years, 97.59% White, 77.6% from North America). A total of 44.65% of respondents had asked their doctor about COVID-19. Questions included risk of contracting COVID- 19 (67.13%), plan for procedures (52.78%), and how the virus could affect breathing (47.69%). Clinic visits were affected by change in format to virtual (41.84%) and postponement (33.33%). Of the patients, 61.28% were concerned that COVID-19 may cause a life-threatening delay in therapy (50.68%) or intubation airway damage (45.27%). Respondents said that the pandemic has not affected their ability to attend the clinic (70.87%) or procedures (50.94%). Conclusion: The COVID-19 pandemic has affected iSGS patient perspectives on their condition and interactions with the health care system. Despite increased unease surrounding disease management during the pandemic, most iSGS patients have been able to continue appointments and necessary procedures. The findings highlight the need for enhanced communication between providers and iSGS patients to address the unique challenges of iSGS management during the pandemic.
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Purpose: Ophthalmic diagnostic devices require patient and operator to be physically close during the exam. Goal of this study is to develop and release protective measures to increase patient and operator protection during COVID-19. Methods: We applied recommendations by the World Health Organization (WHO), the Center of Disease Control (CDC) and the Environmental Protection Agency (EPA) to the situation in the ophthalmic exam room, and developed, released, distributed, and communicated the resulting protective measures. We report the number of website visits, document downloads, and parts distributed from March 2020 through February 2021. Results: Detailed instructions on remote control of ophthalmic devices using remote desktop software or extension on monitors were published, viewed 4,450 and downloaded 1,014 times. Custom breath shields separating operator and patient were developed and a total of 82,827 have been shipped, free of charge or at-cost. Third party order information for single-use plastic bags and dental barrier film that fit ophthalmic devices and can cover high touch surfaces has been published on a dedicated web page. All cleaning instructions have been published in one place (viewed 25,819 times, downloaded 11,781 times). Highly accelerated lifetime tests were performed to confirm that frequent cleaning and disinfection of the HFA bowl with a spray of atomized isopropyl alcohol will not damage or alter the performance of the bowl. Updated disinfection instructions have been published and downloaded 8,318 times. An additional highly accelerated lifetime test has shown that the bowl inside the HFA can be disinfected using UV-C radiation without damaging the functionality of the perimeter. Conclusions: In response to the COVID-19 pandemic, we have provided improved cleaning instructions for the HFA family of bowl perimeters, have developed and distributed over 80,000 breath shields, have identified protective coverings for high-touch areas, and have developed and communicated different ways to operate existing devices remotely. While we have not been able to quantify the effectiveness of the individual measures, it is our assumption that implementing these measures which are based on recommendations by the WHO, the CDC, and the EPA, have increased patient and operator protection.
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Purpose : Physical separation is the most effective means of protecting patients and clinical staff from the spread of the coronavirus. In order to be able to continue clinical studies in a safe environment, we have developed an imaging workflow that uses fully remote-controlled diagnostic OCT devices in clinical studies. Methods : Retinal OCT imaging was performed using commercially available OCT devices, remote desktop access software and consumer video conferencing technology on mobile phones and tablets. This method completely separates the patient from the operator and creates the safest condition during the COVID-19 pandemic. We have used CIRRUS HDOCT 5000 (ZEISS, Dublin, CA), CIRRUS 6000 (ZEISS, Dublin, CA), and PLEX® Elite 9000 (ZEISS, Dublin, CA). We have used Facetime, Zoom, and Microsoft Teams video conferencing software and TeamViewer remote desktop software. Results : From March to November 2020, we have conducted 12 remote clinical studies. Imaging was performed by 4 different operators. We have imaged 158 eyes of 79 healthy volunteers aged from 30-65 years old. During each imaging session we captured between 4 and 10 OCT scans per eye. Every imaging session was performed entirely remotely with the volunteer in the office and the operator controlling the device from their home. Figure 1 shows the setup of a remote-controlled imaging setup illustrating the remote desktop software shown on a laptop computer as well as the Facetime video conferencing setup. Conclusions : We have demonstrated that during pandemics like COVID-19, OCT retinal imaging studies can be performed in a safe environment by completely separating patient and operator and using video conferencing and remote desktop software. We were able to complete all OCT scan acquisitions requested in the clinical studies. The exam time did not appear to be longer than during in-person exams.
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Purpose : Acquiring high quality ophthalmic images typically requires a trained operator in close proximity to a patient. Motorized alignment can enable remote operation, e.g. for physical distancing during a pandemic, and automated alignment can enable quality imaging when a trained operator is not readily available, e.g. in low-resource environments. We evaluated and compared manual and automated operation of an ophthalmic device on a motorized stage. Methods : We acquired data on 5 normal subjects (10 eyes) by both manual (via a trained operator) and automated operation using a prototype with three off-axis iris cameras (one below and on each side of the device) and a 3-axis motorized stage (Fig. 1). The motorized stage allowed all data to be acquired with a plexiglass shield between the subject and operator for remote operation during the COVID-19 pandemic. Auto-alignment was achieved using custom software to align the device to the patient pupil, with real-time pupil detection via a deep-learning algorithm. Auto-capture was triggered once the pupil was detected at the target location. We evaluated alignment success rate (alignments that triggered a capture), mean ± SD time to align, and accuracy of alignment (mean ± SD distance between detected pupil center and target). Results : Of 24 auto-alignments (1-3 per eye), 23 successfully triggered a capture;1 failed due to a software bug. All 14 manual alignments (1-3 per eye) proceeded to capture. Time to align for auto-alignment (29 ± 15 s) was significantly faster than for manual alignment (72 ± 37 s). The accuracy of alignment was 0.94 ± 0.59 mm for auto and 0.97 ± 0.41 mm for manual operation. A two-sample t-test assuming independent alignments for auto and manual results did not demonstrate a statistically significant difference in accuracy (p > 0.05). Conclusions : This comparison of manual and auto-alignment and capture for a motorized device indicated that this auto-alignment method is 2.5x faster than motorized manual alignment, saving an average of 40 s per alignment. Auto-operation was comparable in accuracy, and reliable on normal eyes. While further investigations are needed for a clinical population, this method shows promise for utility in a clinical setting.
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In emergency situations, such as the current COVID-19 pandemic, less immediate concerns such as cybersecurity and long-term economic impact can fall by the wayside. This paper presents a discussion of the impact of cybersecurity issues that occur during and are attributable to pandemics and other emergency situations. This discussion is facilitated by a simulation tool, the Disaster Vulnerability Threat and Impact Simulator System (DVTISS). DVTISS simulates the network structure, security measures, user characteristics and demographics, data, and devices of an organization or region's computing infrastructure. The system is provided input parameters and performs analysis to identify the combined results of numerous different decisions, which are made in concert, to identify the types of vulnerabilities that may be present and the impact of their exploitation. The impacts of system unavailability are considered. This can aid businesses, governments and others in determining the level of prioritization that should be given to cybersecurity considerations. The simulator can also be used for disaster preparedness and planning, evaluating particular response strategies and the evaluation of laws and policies that impact IT decision making during emergencies. This paper uses the DVTISS tool to consider organizational responses to several example emergency situations. It demonstrates the utility of the tool as well as its efficacy for decision making support. Based on the example emergencies, the paper also discusses key areas of vulnerability during emergency situations and their financial, data and system outage impacts.