Mainstreaming disaster risk management technical and vocational education and training (DRM-TVET) program in higher education institutions: flexible ladderized capacity building model amid COVID-19

Disasters are increasingly becoming more destructive in their impacts. Lives have been lost and properties damaged due to the lack of institutional and personnel coping and adaptive capacities. Several policies in the Philippines have noted the importance of capacity development in implementing Disaster Risk Management (DRM). To meet the above necessity, in 2017, Philippine School of Business Administration (PSBA), Manila, one of the higher education institutions pioneered a specialization of DRM in its existing Master in Business Administration program. However, meeting the demand for Disaster Risk Management Technical and Vocational Education and Training (DRM-TVET) through Formal Degree Program (FDP) and keeping FDP sustainable is still facing a number of challenges. The main drivers of these challenges include but are not limited to the following: time constraint on the part of participants to complete 2–4 years' FDP;lack of institutions offering DRM-TVET programs;and unavailability of a Learning Management System. The main objective of this research is to develop an Alpha-Flexible Ladderized Capacity Building Model (A-FLCBM) amid COVID-19. Further, the study should also provide logical flow and recommendations to operationalize the remaining activities of the Conceptual Framework in developing the Beta (B)-FLCBM amidst COVID-19. In this regard, the researchers collected pertinent data through a substantive, thorough, sophisticated literature review and examined the available mandates on existing Flexible ladderized models. Further, a Conceptual Framework (CF) is also developed and partially operationalized. The output allowed researchers to develop A- FLCBM amidst COVID-19 using the PSBA curriculum as a pilot case. However, the framework activities, i.e., dry run, Technical Education and Skills Development Authority (TESDA) registration for National Certification (NC), development of B-FLCBM, and the empirical assessment of DRM-TVET and FDP sustainability will be covered in future studies. The A-FLCBM comprises of interrelated activities including mode of learning and well-designed DRM NC short courses, workshops, and trainings for the trainers. The Model is aligned with the Executive Order 358, promulgated in 2004. Further, the Ladderized Education (LE) system introduced through Commission on Higher Education Memorandum Order No. 43, 2008 Series, was also considered for wider-scale and accelerated implementation of LE nationwide and globally. The implementation of B-FLCBM will provide a unique opportunity to develop the skills required to be a professional in the DRM and business continuity field, improving the quality of life and raising awareness on the importance of preventing and mitigating disasters and reducing the loss incurred by countries in terms of lives, property, and economy. © 2023 Elsevier Inc. All rights reserved.

PPP1R13L-Related Cardiomyopathy Stability Following IL1 Inhibition

Introduction: Variants in PPP1R13L are associated with severe childhood-onset cardiomyopathy resulting in rapid progression to death or cardiac transplantation. PPP1R13L is proposed to encode a protein that limits the transcriptional activity of the NFkappaB pathway leading to elevated IL-1, IL-6, and TNF-alpha production in murine models. Optimal medical management for PPP1R13L-related cardiomyopathy is unknown. Here we report usage of a targeted anti-IL-1 immuno-modulatory therapy resulting in cardiac stabilization in a pediatric patient with congenital cardiomyopathy secondary to PPP1R13L variants. Case Report: A 4-year-old boy presented acutely with fever in the setting of persistent abdominal pain, vomiting, fatigue, and decreased appetite for two months following a mild COVID-19 related illness. Echocardiogram revealed severely depressed biventricular systolic function with an ejection fraction of 30%. Due to acute decompensated heart failure symptoms with hemodynamic instability, he was intubated and placed on continuous inotropic infusions with aggressive diuresis. Cardiac MRI demonstrated extensive subepicardial to near transmural fibrosis by late gadolinium enhancement in right and left ventricles. An implantable cardioverter-defibrillator (ICD) was placed due to frequent runs of polymorphic non-sustained ventricular tachycardia. Testing for viral pathogens was positive for rhino/enterovirus. Initial genetic testing was non-diagnostic (82-gene cardiomyopathy panel) but given the patient's significant presentation whole genome sequencing was pursued that showed two separate PPP1R13L variants in trans (c.2167A>C,p.T723P and c.2179_2183del,p. G727Hfs*25, NM_006663.4). Patient serum cytokine testing revealed elevations in IL-10 (4.7 pg/mL) and IL-1beta (20.9 pg/mL). Given the patient's tenuous circumstances and concern for continued progression of his cardiac disease, a trial of IL-1 inhibition via anakinra dosed at 3 mg/kg or 45 mg daily was initiated following hospital discharge. With approximately 6 months of therapy, the patient's cardiac function is stable with normalization of IL-10 and IL-1beta serum levels. Notably, the ventricular arrhythmia decreased after initiation of anakinra with no ICD shocks given. Therapy overall has been well tolerated without infectious concerns. Conclusion(s): In patients with PPP1R13L-related cardiomyopathy, immuno-modulatory therapies should be considered in an attempt to slow cardiac disease progression.Copyright © 2023 Elsevier Inc.

Design to Improve Social Presence among University Students in Asynchronous Online Learning Environment

Since the COVID-19 pandemic, online lectures are becoming more common in higher education. Specifically, asynchronous online classes have become increasingly popular because of their flexibility. Asynchronous online courses, however, may negatively impact students' academic performance and social development due to the diminished sense of social presence. To explore ways to enhance social presence among students in asynchronous online classes, this paper used a co-design methodology that involved 12 undergraduate students as primary stakeholders. As a result, we developed a design framework for designing in-class interaction to promote social presence in asynchronous online lectures. This framework consists of four high-level elements and sub-categories: interaction topic (direct or peripheral topics related to learning), interaction size (small or entire group), interaction mode (anonymity, synchronicity, instructor involvement), and interaction motivator (lightweightness and entertainment). Our design framework may serve as a guide to future technology for improving asynchronous online classes. © 2023 Owner/Author.

Mpox in persons living with HIV: Results from an international dermatologic registry

In 2022, mpox virus spread globally with 99% of cases in non-endemic countries. People living with HIV (PLHIV) are disproportionally affected, often with more severe clinical features and outcomes. The AAD/ILDS Dermatology COVID-19, Monkeypox (mpox), and Emerging Infections registry captured mpox cases from 13 non-endemic countries in a de-identified REDCap registry. We aimed to examine cutaneous symptomatology and outcomes in cases of mpox in PLHIV. Of 119 reported cases, 44 were PLHIV (35%). Cases were 98% male, with a median age of 38 years, located in Europe (57%) and the U.S. (39%). Nearly half of PLHIV reported skin lesions as their initial sign (45%), and 43 (98%) reported skin lesions during illness. The primary initial lesion locations were peri-anal (34%) and genito-inguinal (34%). Co-infection with other sexually transmissible infections (STI) was more common in PLHIV, 57% vs. 38% in all-registry cases (p<0.01). The most common co-infections were gonorrhea, syphilis, and chlamydia. Time to resolution was 17 days, 3 days shorter than all-registry cases, which may be due to higher use of Tecovirimat in PLHIV (36% vs. 25% in all-registry cases;p<0.01). There were no differences in the frequency of hospitalization or scarring. One death was reported. Overall, cutaneous lesion count was similar in PLHIV and all-registry cases. Lesion location was more frequently reported in the peri-anal and genito-inguinal regions. Sample size was insufficient to detect differences in length of infection, hospitalization, or scarring in PLHIV. Co-infections were more common in PLHIV, highlighting a need for co-testing for STIs during mpox evaluation.Copyright © 2023

Mpox first skin lesion location: A reflection of mode of transmission?

The 2022 mpox outbreak affected 84,318 individuals in 110 countries. Mpox is transmitted by multiple modalities, including direct contact, respiratory droplets, and fomites among others. Identifying skin lesions aids prompt diagnosis. Variation in initial skin lesion location is not well understood;it is hypothesized that mode of transmission may determine primary inoculation site and subsequent clinical presentation. This study sourced healthcare provider-reported data from the AAD/ILDS Dermatology COVID-19, Mpox, and Emerging Infections Registry to explore factors related to the location of the first skin lesion in mpox cases. Out 119 mpox cases,115 had primary lesion location data. 97% were male with a median age of 37. Most (83/115, 72%) patients had first skin lesions in the genito-anal area, and 32/115 (27%) had lesions elsewhere or had morbilliform rash. 74% of males had the first lesion in the genito-anal region compared to females (25%, p=0.03). Males in same-sex relationships had ano-genital lesions more often than men in other relationships (77% vs. 44%, p=0.03). The type of mpox exposure was also associated with first lesion location: 83% of patients who contracted mpox from a spouse or other sexual contact had ano-genital lesions as compared to a non-sexual contact (0%, p=<0.01). This analysis characterized factors associated with the first mpox skin lesion location, which can aid healthcare providers in diagnosis and shed light on transmission. This data suggests that type of exposure and mode of transmission may be associated with primary lesion location;patients who contracted mpox from sexual contact were more likely to have ano-genital lesions.Copyright © 2023

Corrigendum to 'Single domain antibodies derived from ancient animals as broadly neutralizing agents for SARS-CoV-2 and other coronaviruses': Biomedical Engineering Advances 4 (2022) 100054.

[This corrects the article DOI: 10.1016/j.bea.2022.100054.].

Improving Enrollment and Adherence to the Lung Transplant Home Spirometry Program

In May 2020, we implemented a home spirometry program (HSP) to facilitate remote monitoring of lung function in lung transplant recipients in response to the COVID-19 pandemic. We found enrollment and adherence rates were below the program goal of 75%. We developed a quality improvement project to optimize the HSP enrollment and onboarding in order to improve enrollment and adherence rates. Gap analysis was performed through observation and qualitative interviews of patients, nurses, and physicians. A fishbone analysis found three main opportunities to improve adherence including a variable onboarding process, no foreign language offerings, and suboptimal educational material. We developed and launched a standardized workflow, a new educational video, and educational materials in 5 languages. In-process metrics were tracked through the use of an EMR "smartphrase" and QR code to indicate use of the new workflow and educational video. Enrollment and adherence were measured by the % of patients submitting more than one FEV1 value in the first 30 days after discharge. After implementation in August 2022, we found the new onboarding process, as indicated by the use of our"smartphrase", and the new educational video, as indicated by the use of the QR code, were utilized for 100% of new patients over the first two months. We found an absolute increase of 85% of patients submitting an FEV1 value in the first month following discharge from lung transplantation (Figure 1). We were able to improve the process of onboarding and education through the development of a new standardized workflow and video. This was found to be reliably executed and resulted in an improvement in patient enrollment and adherence. Moving forward we will track the impact of our new onboarding and video educational tool on long-term adherence. [ABSTRACT FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hate-motivated Crime/Incidents Against Asians in the United States of America: A Systematic Review

Although hate-motivated incidents and crimes against Asians are not a new phenomenon, there has been a lack of scholarly attention on the topic. Using a systematic review, we examine, assess, and analyze 23 published peer-reviewed articles that have explored hate-motivated crime/incidents against Asians in the United States of America between 2000 and 2020. We found all studies included in this systematic review examined microaggressions and/or discrimination, and tended to lump all different Asian subgroups into "Asians.” In addition, most studies focused on the consequences of hate-motivated incidents, such as mental and physical health. We suggest a future research agenda and direction that fills the gap in scholarly journal articles on Asian hate-motivated incidents in the United States. © The Author(s) 2022.

Efficacy Of Distance Learning For Cardiopulmonary Resuscitation Training Utilizing Smartphone App And Mannikin Delivery-collection System

Aim of the study: Effective CPR training is important for provision of high-quality bystander cardiopulmonary resuscitation (CPR). However, the COVID-19 pandemic has hindered conventional face-to-face CPR training. To overcome the limitation, we developed a distance learning CPR training course (HEROS-Remote) that utilized a smartphone app and a delivery-collection system for CPR training manikins. The objective of the study was to evaluate the efficacy of the HEROSRemote course by comparing chest compression quality between trainees who participated in the conventional CPR training (C-training) and HEROS-Remote course (R-training). Method(s): The non-inferiority trial included adult nonhealthcare providers who applied for CPR training. Both groups underwent 2-minute post-training chest compression test followed by course survey on trainees' course and delivery system satisfaction. The primary outcome of the study was mean chest compression depth during the 2-minute post-training test. Result(s): A total of 180 trainees were enrolled with 90 trainees for each training group. There was no statistically significant difference in chest compression depth between R-training and C-training groups (67.4 vs. 67.8, p=0.78) as well as proportion of adequate chest compression depth, chest compression rate, proportion of chest compressions with complete chest recoil and chest compression score (90.8 vs. 92.1, p=0.69;110.8 vs. 110.4, p=0.60;89.8 vs. 94.7, p=0.05;92.7 vs. 95.5, p=0.16, respectively). In the R-training group, 90.0% of the trainees were satisfied with the course, 96% responded that the delivery system was satisfactory and convenient. Conclusion(s): The R-training course was noninferior to the C-training course. The distance learning CPR training method utilizing smartphone app and mannikin delivery-collection system had high user satisfaction and was logistically feasible.

COVID-19 Pandemic and Anti-Asian Racism & Violence in the 21st Century

Since the beginning of the 21st century, we have experienced major pandemics and epidemics. However, we believe the COVID-19 pandemic was the first time a certain racial/ethnic group or nationality was blamed for the pandemic/epidemic. Anti-Asian racism and violence worldwide are not new, but they are on the rise during the COVID-19 pandemic. Although the crimes against Asians during the pandemic received substantial media attention, there has been a paucity of empirical research in social science that addresses xenophobic sentiments, racism, and violence against Asians. To bridge the gap, the Korean Society of Criminology in America (KOSCA) invited papers to address the current global issue of anti-Asian racism and violence in mid2021. It was challenging to conduct empirical research because of the lack of data availability, time restrictions, and the narrowed research scope (e.g., Asians). This editorial introduction introduces six articles in this Special Issue of Race and Justice, "Anti-Asian Racism & Violence." We call for further, continuous attention to anti-Asian racism and violence, and we hope this special issue creates more scholarly discussion on this understudied, often-neglected topic.

Regorafenib in patients (pts) with unresectable hepatocellular carcinoma (uHCC) in real-world practice in Asia: Final analysis of the prospective, observational REFINE study

Background: In an interim analysis of Asian pts with uHCC in the observational REFINE study of regorafenib (NCT03289273), treatment-emergent adverse events (TEAEs) were consistent with those reported in the global, phase 3 RESORCE trial. Here, we present the final analysis of Asian pts with uHCC in REFINE. Method(s): REFINE is an international, prospective, multicenter study that enrolled pts with uHCC for whom a decision to treat with regorafenib was made by the treating physician prior to enrollment, according to the local health authority approved label. The primary objective is safety, including the incidences of TEAEs and dose modifications due to TEAEs (NCI-CTCAE v4.03). Secondary endpoints include overall survival, progression-free survival, and treatment duration. Result(s): Of the 1005 evaluable pts, 557 (55%) were from Asia (Korea [31%], Japan [26%], Taiwan [24%], China [18%], Thailand [1%]) and 82% were male. At baseline, median age was 65 years (range 21-94) and the most common HCC etiology in Asian pts was hepatitis B (60%) and in non-Asian pts was alcohol use (36%;Table). More Asian pts (71%) had received prior transarterial chemoembolization vs non-Asian pts (42%). The initial daily regorafenib dose was 160/120/80/40 mg in 51%/12%/35%/3% of Asian pts and 42%/9%/45%/4% of non-Asian pts. The median treatment duration was 3.7 months (range 0-34.4) in Asian pts and 3.6 months (range 0-38.9) in non-Asian pts. The most common TEAEs in Asian pts were hand-foot skin reaction (40%), diarrhea (27%), and decreased appetite (17%). TEAEs led to dose modification in 44% of Asian pts. [Formula presented]. Conclusion(s): These final data from REFINE confirm the safety and effectiveness of regorafenib in Asian pts with uHCC from a broad population in real-world practice. Final analyses from REFINE are ongoing and will be presented at the conference. Clinical trial identification: NCT03289273. Editorial acknowledgement: Editorial assistance in the preparation of this manuscript was provided by Matthew Reynolds of OPEN Health Communications (London, UK), with financial support from Bayer. Legal entity responsible for the study: Bayer. Funding(s): Bayer. Disclosure: Y.J. Kim: Financial Interests, Personal, Advisory Role: Bayer, Bristol Myers Squibb, Samil, PharmaKing, Celltrion, Bukwang;Financial Interests, Personal, Invited Speaker: Roche, AbbVie, Eisai, Ipsen, Boston Scientific, Bristol Myers Squibb, BTG, Bayer, MSD, Gilead Sciences, Novo Nordisk, Green Cross Cell, Boehringer Ingelheim, AstraZeneca;Financial Interests, Personal, Funding: BTG, Bayer, Boston Scientific, AstraZeneca, Gilead Sciences, Samjin, BL&H. M. Kurosaki: Financial Interests, Personal, Speaker's Bureau: Gilead Sciences, AbbVie, Eisai, Chugai, Lilly, Takeda. H.Y. Lim: Financial Interests, Personal, Advisory Role: Bayer, Eisai, Roche, Ipsen. M. Ikeda: Financial Interests, Personal, Advisory Board: AstraZeneca, Chugai, Eli Lilly Japan, Eisai, Nihon Servier, Novartis, Ono, Takeda, GlaxoSmithKline;Financial Interests, Personal, Invited Speaker: AstraZeneca, Bayer, Bristol Myers Squibb, Chugai, Eli Lilly Japan, Eisai, Nihon Servier, Novartis, Taiho, Yakult, Teijin Pharma, AbbVie, Abbott Japan, Fujifilm Toyama Chemical, Incyte Biosciences Japan, ASLAN, Chugai, Nihon Servier, Takeda;Financial Interests, Institutional, Invited Speaker: Bayer, Bristol Myers Squibb, Eisai, AstraZeneca, Eli Lilly Japan, Chugai Pharmaceutical, Merck Serono, MSD, Ono, Yakult, Novartis, Takeda, J-Pharma, Pfizer, Chiome Bioscience, Nihon Servier, Delta-Fly Pharma, Syneos Health, Merus.N.V. M. Kudo: Financial Interests, Personal, Invited Speaker: Eisai, Chugai, Eli Liiy, Bayer, Takeda, MSD;Financial Interests, Institutional, Research Grant: Otsuka, Sumitomo Dainippon Pharma, EA Pharma, Taiho, Eisai, AbbVie, Gilead Sciences, Takeda, GE Healthcare, Chugai. Y. Huang: Financial Interests, Personal, Advisory Role: Eisai, Bayer, BMS, Ono, Gilead, Lilly, AbbVie, Roche;Financial Interests, Personal, Invited Speaker: Eisai, Bayer, BMS, Ono, Gilead, Lilly, AbbVie, Roche;Financial Inte ests, Personal, Speaker's Bureau: Eisai, Bayer, BMS, Ono, Gilead, Lilly, AbbVie, Roche;Financial Interests, Institutional, Funding: Gilead. N. Kato: Financial Interests, Personal, Invited Speaker: Gilead Sciences Inc., AbbVie G.K., Ohtsuka Pharmaceutical Co., Ltd., Bayer Yakuhin Ltd., Chugai Pharmaceutical Co., Ltd., AstraZeneca K.K., Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Co., Ltd., Zeria Pharmaceutical Co., Ltd., Olympus Corporation, Eisai Co., Ltd., Aska Pharmaceutical Co., Ltd., Tsumura & Co., Mochida Pharmaceutical Co., Ltd., Miyarisan Pharmaceutical Co., Ltd., Covidien Japan Inc., Eli Lilly Japan K.K., Nobelpharma Co., Ltd., Kowa Company, Ltd., Incyte Biosciences Japan GK, Yakult Honsha Co.,Ltd., Olympus Marketing, Inc., Taisho Pharmaceutical Co.,Ltd., Janssen Pharmaceutical K.K.;Financial Interests, Institutional, Research Grant: AbbVie G.K., Ohtsuka Pharmaceutical Co., Ltd., Bayer Yakuhin Ltd., Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Sumitomo Dainippon Pharma Co., Ltd., Shionogi & Co., Ltd., Eisai Co., Ltd., Tsumura & Co., Nippon Kayaku Co., Ltd., JIMRO Co., Ltd., Kowa Company, Ltd. C. Hsu: Financial Interests, Personal, Speaker's Bureau: Bristol Myers Squibb, Ono Pharmaceutical, Merck Sharp & Dohme, Roche, Eisai;Financial Interests, Institutional, Funding: Ono Pharmaceutical, AstraZeneca, MSD, Merck Serono, Taiho Pharmaceutical, Bristol Myers Squibb, BeiGene, NuCana BioMed, Johnson & Johnson, Roche/Genentech, BeiGene;Financial Interests, Personal, Advisory Role: Ono Pharmaceutical, MSD, Bristol Myers Squibb, Merck Serono, Roche/Genentech. B. Chewaskulyong: Financial Interests, Personal, Advisory Role: Pfizer, STADA;Financial Interests, Personal, Invited Speaker: AstraZeneca, Pfizer, DKSH, Janssen, BMS, MSD, Roche, TAIHO;Financial Interests, Personal, Speaker's Bureau: AstraZeneca, Pfizer, DKSH, Janssen, BMS, MSD, Roche, TAIHO;Financial Interests, Institutional, Funding: Bayer. J. Khan: Financial Interests, Institutional, Full or part-time Employment: Bayer. K. Ozgurdal: Financial Interests, Institutional, Full or part-time Employment: Bayer;Financial Interests, Personal, Stocks/Shares: Bayer. All other authors have declared no conflicts of interest. Copyright © 2022

Primary and Secondary Data Collection to Conduct Researches, Write Thesis and Dissertation Amidst COVID-19 Pandemic: A Guidepost

Research has always been regarded by many as tedious because of the difficulties and challenges associated with doing research such as having to forego certain habits like social life. Doing research became even more difficult, especially with regard to limitation on collecting applicable primary and secondary data due to the COVID-19 pandemic lockdowns. It is to be noted that substantive, thorough, sophisticated literature review and intensive pertinent primary data availability are ncessary for doing quality research relevant to the status quo. Various novel approaches have been adopted by scholars through their diverse academic spheres in conducting internationally acceptable research amidst the COVID-19 pandemic. This research aims to come up with a guidepost to facilitate researchers and other stakeholders with fundamental knowledge and skills in conducting substantive, thorough, sophisticated researches that are of international standards. A comparative and diagnostic analysis method is used for analyzing existing literature and policies developed by higher education institutions and schools for doing research in the advent of the COVID-19 pandemic. The output allowed authors to develop a guidepost with rules on using limited primary and extensive secondary data in doing research. The guidepost consists of various sections explaining on how to do research and write theses and dissertations. These sections include among others research title, statement of the problem, research objectives, theoretical and conceptual frameworks, review of related literature, research methodology, analysis and interpretation of data, and conclusion and recommendations. The guidepost is very significant in doing researches and aids researchers in conducting internationally accepted researches with limited primary data and extensive secondary data in the advent of the COVID-19 Pandemic. The guidepost is flexible and can easily be used by local and international institutions’ researchers through little modification in context of their research fields. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

RECOGNIZING THEIR POWER: How Athletes Have Utilized Social Media to Influence Crisis Communication Decisions During COVID-19

In this chapter, we investigated how internal stakeholders (i.e., NFL/NCAA athletes) employed their personal social media accounts to influence organizational decision-making during the COVID-19 pandemic. We analyzed two cases that featured athlete-led social media campaigns: 1) NFL Athletes’ #WeWantToPlay campaign, and 2) NCAA Athletes’ #WeAreUnited and #WeWantToPlay campaigns. In both instances, internal stakeholders (i.e., athletes) formulated a coordinated social media campaign to spur responses from external stakeholders (i.e., fans) that would, jointly, influence organizational decisions pertaining to COVID-19 safety protocols and the playing of the 2020 professional and collegiate football seasons. Implications for internal stakeholders, crisis communication management, crisis communication scholarship were discussed. © 2022 Taylor and Francis.

PLEUROPARENCHYMAL FIBROELASTOSIS UNCOVERED IN A PATIENT WITH COVID-19 PRESENTING WITH PNEUMOTHORAX

SESSION TITLE: Diagnosis of Lung Disease through Pathology Case Posters SESSION TYPE: Case Report Posters PRESENTED ON: 10/19/2022 12:45 pm - 01:45 pm INTRODUCTION: This report describes the case of a patient presenting with pneumothorax and Severe Acute Respiratory Syndrome (SARS) Coronavirus-2 (SARS-cov-2) infection leading to Coronavirus Disease 2019 (COVID-19) pneumonia, with worsening presentation, later found to have underlying Pleuroparenchymal Fibroelastosis (PPFE). CASE PRESENTATION: A 68 year old male with a past medical history of hypertension and type 2 diabetes presented to his primary care clinic with shortness of breath. He underwent a Chest X-Ray as an outpatient which revealed a moderate right-sided pneumothorax (PTX), and he was sent to the Emergency Department by his primary care provider. He was found to be COVID positive on initial workup, also requiring supplemental oxygen. Other routine laboratory tests did not reveal any significant abnormalities. His shortness of breath worsened and on repeat X-rays his pneumothorax increased in size therefore a chest tube was placed by Cardiothoracic Surgery. Computerized Tomography of the chest revealed moderate right pneumothorax, bilateral diffuse ground glass opacities and pulmonary micronodules [Figure 1]. The patient had mild initial improvement and the chest tube was removed but he had recurrence of the PTX and he underwent urgent Video Assisted Thoracoscopic Surgery (VATS), with right upper lobe wedge resection and talc pleurodesis. A biopsy of the resected lung revealed a benign lung with fibroelastotic scarring, diffusely involving subpleural tissue and prominently extending into and entrapping areas of underlying alveolated tissue, with no inflammation, granulomas or pneumonia noted. Workup for tuberculosis, autoimmune disorders, HIV was negative. He eventually was discharged home with close pulmonology and cardiothoracic surgery follow ups, planned for disease surveillance and malignancy workup. DISCUSSION: PPFE is a rare entity, and classified amongst rare causes of idiopathic interstitial pneumonias (IIP) [1]. It is characterized by upper lobe fibrosis, supleural and parenchymal scarring. It can occur at any age, and the usual presentation is of pneumothorax in a thin male, with a shortened anteroposterior diameter of the chest. Radiographic findings typically include subpleural nodular or reticular opacities in the upper lobes, usually sparing the middle and lower lobes. Pathology reveals increased elastic tissue and dense collagen fibers, along with subpleural fibrosis [2]. Pulmonary function testing reveals a restrictive pattern with reduced diffusion capacity and it is usually resistant to steroids [3]. CONCLUSIONS: PPFE is an uncommon cause of insidious, slowly progressive fibrotic lung disease often limited to the upper lobes. It should be suspected in any person presenting with recurrent pneumothorax or blebs without other known inciting causes. Lung biopsy helps establish the diagnosis. Patients with this condition need close pulmonology follow up to assess progression. Reference #1: Travis WD, Costabel U, Hansell DM, King TE Jr, Lynch DA, Nicholson AG, Ryerson CJ, Ryu JH, Selman M, Wells AU, Behr J, Bouros D, Brown KK, Colby TV, Collard HR, Cordeiro CR, Cottin V, Crestani B, Drent M, Dudden RF, Egan J, Flaherty K, Hogaboam C, Inoue Y, Johkoh T, Kim DS, Kitaichi M, Loyd J, Martinez FJ, Myers J, Protzko S, Raghu G, Richeldi L, Sverzellati N, Swigris J, Valeyre D;ATS/ERS Committee on Idiopathic Interstitial Pneumonias. An official American Thoracic Society/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2013 Sep 15;188(6):733-48. doi: 10.1164/rccm.201308-1483ST. PMID: 24032382;PMCID: PMC5803655. Reference #2: Frankel SK, Cool CD, Lynch DA, Brown KK. Idiopathic pleuroparenchymal fibroelastosis: description of a novel clinicopathologic entity. Chest. 2004 Dec;126(6):2007-13. doi: 10.1378/chest.126.6.2007. PMID: 1559 706. Reference #3: Watanabe K. Pleuroparenchymal Fibroelastosis: Its Clinical Characteristics. Curr Respir Med Rev. 2013 Jun;9(4):299-237. doi: 10.2174/1573398X0904140129125307. PMID: 24578677;PMCID: PMC3933942. DISCLOSURES: No relevant relationships by FNU Amisha No relevant relationships by Perminder Gulani No relevant relationships by Hyomin Lim No relevant relationships by paras malik No relevant relationships by Divya Reddy

POSITIVE END-EXPIRATORY PRESSURE (PEEP) INDEX: A NOVEL, BETTER DISCRIMINATION MARKER THAN PAO2/FIO2 FOR RESCUE MEASURES IN COVID-RELATED ARDS

SESSION TITLE: ECMO and ARDS in COVID-19 Infections SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/17/2022 12:15 pm - 1:15 pm PURPOSE: COVID-related acute respiratory distress syndrome (ARDS) is associated with significant morbidity and mortality. PaO2/Fio2 (PFR) is a prognostic and severity marker for ARDS. Other markers have been posited for ARDS. PEEP Index (PIx) [PEEP/PFR] or [(PEEP*Fio2)/PaO2] could serve as a new discriminatory marker to assess rescue therapies such as proning or ECMO referral. METHODS: Retrospective cohort study of all intubated COVID-19 patients with ARDS hospitalized at our institution between February 5th – May 11th, 2020. ARDS were calculated within first 24 hours of worst PaO2/FIO2 and their associated PEEP with bilateral infiltrates on Chest X-ray manually confirmed within 24hours of intubation fulfilling 2012 Berlin criteria. Outcomes of interest were all-cause in-hospital mortality, need for pronation and paralysis use. Binomial logistic regression with ROC curve were performed for univariate association for outcomes of interest. Cox proportional hazard regression modeling was performed and adjusted for potential confounders. PFR was transformed into a denominator of itself to reflect a direct proportional relationship. RESULTS: Data was analyzed from 113 hospitalized COVID-19 patients with identified ARDS. Mean age was 56.4 (STD 14.4);24% (27/113) were female. Median BMI was 30.3 [IQR 48.5,65.5]. Mean Tidal Volume (Vt) was 430 (STD 54). 64% (72/113) were compliant with low Vt (=<6mL/kg based on IBW). Median PFR 125 [IQR 99,192]. Mortality was 66% (74/113). 44% (50/113) were proned. 62% (70/113) required paralysis. PEEP Index outperformed PFR for discrimination for proning use: AUC 0.73 [95%CI 0.63,0.82], p< 0.005;vs AUC 0.674 [95%CI 0.58,0.77], p= 0.02. PEEP Index performed mildy better than PFR for discrimination of requiring paralytic use in ARDS with AUC 0.68 [95% 0.57,0.78], p< 0.05;vs AUC 0.62 [95%CI 0.51,0.73], p<0.05. APACHE2 score showed poor discrimination for both proning and paralytic use (AUC= 0.46 [95%CI 0.35,0.56];p=0.43 and respectively, AUC=0.45 [95%CI 0.34,0.56];p=0.36). After adjusting for confounders, PEEP Index nor PFR didn’t for predict for mortality (p>0.05);however, our sample was not powered. CONCLUSIONS: PEEP Index (PIx) is a novel tool that can serve as a better discriminatory function to evaluate patients with ARDS in the ICU who will require proning in comparison to traditional used PFR. CLINICAL IMPLICATIONS: PEEP Index (PIx) can serve as an easy alternative calculation to Oxygenation Index (OI) [(FiO2 x PAW) / PaO2] to identify patients that would benefit from early proning and other rescue therapies. Further studies are required to compare and validate PIx and OI prospectively as well as benefit cut-off points between proning and ECMO. DISCLOSURES: No relevant relationships by Perminder Gulani No relevant relationships by Manuel Hache Marliere no disclosure on file for Adarsh Katamreddy;No relevant relationships by Hyomin Lim No relevant relationships by Marzio Napolitano No relevant relationships by Leonidas Palaiodimos No relevant relationships by Anika Sasidharan Nair No relevant relationships by Jee Young You

Single domain antibodies derived from ancient animals as broadly neutralizing agents for SARS-CoV-2 and other coronaviruses.

With severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as an emergent human virus since December 2019, the world population is susceptible to coronavirus disease 2019 (COVID-19). SARS-CoV-2 has higher transmissibility than the previous coronaviruses, associated by the ribonucleic acid (RNA) virus nature with high mutation rate, caused SARS-CoV-2 variants to arise while circulating worldwide. Neutralizing antibodies are identified as immediate and direct-acting therapeutic against COVID-19. Single-domain antibodies (sdAbs), as small biomolecules with non-complex structure and intrinsic stability, can acquire antigen-binding capabilities comparable to conventional antibodies, which serve as an attractive neutralizing solution. SARS-CoV-2 spike protein attaches to human angiotensin-converting enzyme 2 (ACE2) receptor on lung epithelial cells to initiate viral infection, serves as potential therapeutic target. sdAbs have shown broad neutralization towards SARS-CoV-2 with various mutations, effectively stop and prevent infection while efficiently block mutational escape. In addition, sdAbs can be developed into multivalent antibodies or inhaled biotherapeutics against COVID-19.

Changes in clinical features and outcomes in three major critical diseases after COVID-19 pandemic: acute myocardial infarction, stroke, and cardiac arrest

A few months after the onset of the coronavirus Disease 2019 (COVID-19) pandemic, the worse prognoses of acute myocardial infarction, ischemic and hemorrhagic stroke, and cardiac arrest were reported. This study aimed to investigate the changes in the characteristics and prognoses of these diseases in the emergency department (ED) over a year after pandemic’s onset. This was a retrospective observational study. The year 2019 was defined as the pre-period, while the year from February 2020 to January 2021 was defined as the post-period. Adult patients diagnosed with acute myocardial infarction, ischemic stroke, hemorrhagic stroke, or cardiac arrest during the study period were included. The primary outcome was in-hospital mortality. Time series analyses using autoregressive integrated moving average (ARIMA)(p,d,q) model were performed to evaluate the changes between periods. A multivariable logistic regression analysis of factors affecting in-hospital mortality was performed. The proportions of patients with acute myocardial infarction (0.8% vs. 1.1%, p < 0.001), hemorrhagic stroke (1.0% vs. 1.2%, p = 0.011), and cardiac arrest (0.9% vs. 1.1%, p = 0.012) increased in the post-period. The post-period was independently associated with in-hospital mortality in acute myocardial infarction (adjusted odds ratio (aOR) 2.54, 95% confidence interval (95% CI) 1.06–6.08, p = 0.037) and hemorrhagic stroke (aOR 1.74, 95% CI 1.11–2.73, p = 0.016), but not for ischemic stroke or cardiac arrest. Over a year after onset of the COVID-19 pandemic in Korea, the number of patients with acute myocardial infarction, hemorrhagic stroke, and cardiac arrest in the ED increased. An independent association between the post-period and mortality was observed for acute myocardial infarction, and hemorrhagic stroke. This study provides important information for future studies and policies. ©2022 The Author(s). Published by MRE Press.

Self-powered triboelectric sensor for cooling fan monitoring

Since the COVID-19 pandemic began, the use of computers, Internet of things devices, and artificial intelligence applications has dramatically increased. For the operation of these devices, it is important to effectively control the thermal management systems. Cooling fans play an important role in air circulation and thermal management for many types of industrial machines. In the past, a disassembly process has been inevitable for monitoring the operational status of cooling fans, making it necessary to develop devices or methods to monitor the operational status of cooling fans more conveniently. In this study, we propose a fan-shaped triboelectric sensor (F-TES) that can detect the operational status of a cooling fan via output signals of a triboelectric nanogenerator. We investigated the effects of rotational speed, as well as the working areas of the tribo-materials. Furthermore, we demonstrated those behaviors by using a light-emitting diode and capacitor charging. We designed an F-TES based on a commercial cooling fan without any structural changes, so that it could be directly utilized for various cooling fans. We anticipate that the results of this study can serve as a cornerstone for the maintenance and management of various commercial cooling fans.