Efficacy of home respiratory culture kits in people with cystic fibrosis

Background: Respiratory cultures are an important part of clinical care for people with cystic fibrosis (CF). Telemedicine visits during the COVID-19 pandemic have not allowed for routine collection. To address this, the University of Michigan Adult Cystic Fibrosis Program mailed home culture kits to patients. We hypothesized that results from home sputum samples would be consistent with prior cultures obtained in sputum collected in clinic but that self-collected throat swabs would provide false-negative results. We also sought to determine percentage return rate. Method(s): Adults with CF were sent culture kits containing a specimen cup and a throat swab. Patients had the choice to submit either sample for processing. Medical personnel provided written instructions with the culture kits and, on occasion, instructed patients on proper collection techniques via phone. Samples were then refrigerated for up to 24 hours before a delivery service returned the specimen to a University of Michigan laboratory for analysis. Data collected from December 2020 to December 2021 (N = 77) included percentage return rate, result, source, and presence of microorganisms. Pairwise culture data of samples collected in clinic versus home-collected samples within 1 yearwere included in the analysis. Descriptive statistics and Cohen kappa correlation coefficients were computed for all culture data and subgroups (Table 1A-E). Result(s): Of 77 culture kits returned, 46 had corresponding clinic samples collected using the same method, and the remaining 21 were collected using different methods (throat swab vs sputum sample). Overall, approximately 200 kits were mailed to patients, with a return rate of 38.5%. A similar percentage of positive culture results was obtained with same method of collection: sputum and throat samples (Table 1C, D, E), although the discordance rate between cultures collected in clinic and at home ranged from approximately 10% to 30%. Correlation between clinic and home culture data was generally good throughout, except for clinic Table 1 ( 115): Analysis of respiratory culture results for (A) all cultures, (B) different collection, and (C, D, E) same collection method. *p < 0.05. Cohen kappa correlation coefficient between groups: poor agreement <0.20;fair agreement = 0.21-0.40;moderate agreement = 0.41-0.60;good agreement = 0.61-0.80;very good agreement = 0.81-1.00. PsA = Pseudomonas aeruginosa;Staph = Staphylococcus aureus.(Table Presented)versus home throat swabs, probably because of a lowevent rate in the small sample size. Conclusion(s): The data suggest that, overall, clinic and home culture kits provide similar positive results, although discordance in specific culture results was common. This may be due to natural fluctuations from culture to culture in people with CF. A limitation of this study is that the cultures being compared in our study were not completed on the same day. Nevertheless, our data also indicate that collection technique may influence results for certain microorganisms. How these differences might influence antibiotic selection and treatment outcomes in the era of telemedicine requires more investigation. The return rate was found to be relatively low, demonstrating the need for interventions to improve patient outreach and compliance.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

Is post-acute sequelae COVID-19 (Long-COVID) a post-viral postural orthostatic tachycardia syndrome?

Objectives: To compare autonomic function and health-related quality of life (HRQoL) in those with post-acute sequelae of Covid-19 (PASC), postural orthostatic tachycardia syndrome (POTS) and healthy controls. Method(s): A total of 60 participants were recruited (PASC = 20, POTS = 20, controls = 20). There were no significant differences in age or other demographics between groups. PASC was defined as >=3 months of persistent unexplained symptomology post SARS-CoV-2 infection. 10-minute active standing test was undertaken using Finapres NOVA to measure beat-to-beat haemodynamic response. Composite Autonomic Symptom Score (COMPASS-31) was used to assess autonomic symptomology and the Euroquol 5-Dimension (EQ-5D) survey to assess HRQoL (scale of 0-1 with '1' representing full health). The 5-point hypermobility questionnaire (5-PHQ) was used to assess generalized joint hypermobility (defined as score >=2). Result(s): 95% of PASC subjects fulfilled the standing test criteria for POTS (DELTA heart rate, bpm: 42 +/- 10 vs. 48 +/- 14 in POTS and 16 +/- 6 in controls;p < 0.001) and significantly increased autonomic symptoms per COMPASS-31 score as compared to controls (39 +/- 11 vs. 51 +/- 15 in POTS and 12 +/- 14 in controls;p < 0.001). Individuals with PASC and POTS had higher rates of joint hypermobility than controls (45% vs. 75% vs. 25% respectively;p = 0.006) and significantly reduced HRQoL utility scores (0.61 +/- 0.04 vs. 0.64 +/- 0.03 vs. 0.94 +/- 0.09 respectively;p < 0.001). Conclusion(s): Autonomic dysfunction and reduced HRQoL is prevalent in sufferers with PASC and bear high similarity to those with POTS. This is in keeping with the often-observed post-viral illness-mediated POTS. Our data calls for routine involvement of autonomic physicians in the care of subjects with PASC.

User Perception of Wysa as a Mental Well-being Support Tool during the COVID-19 Pandemic

The COVID-19 pandemic has disrupted daily lives globally, causing social isolation that impacted the mental health and well-being of the population, particularly the students. With the shortage of accessible healthcare facilities and resources, the community is turning to technology-based mental healthcare interventions such as telemental health systems, online support groups, self-service web and mobile applications, and chatbots. In this study, we assessed the extent in which the daily interaction with the chatbot Wysa can influence the well-being of students during the COVID-19 pandemic. Students evaluated the usability and effectiveness of Wysa's clinical interventions which include the talk therapy, gratitude journal, self-care practices and mindfulness exercise throughout the duration of the week-long experiment. They provided their perception on the quality of the chatbot's response, affect and human-likeness, and shared attributes that would motivate self-disclosure and openness to communicate with the chatbot. Our findings can shed insights on the effectiveness of mental health apps as a coping mechanism in a time of social isolation and provide suggestions on how such technologies can be improved in order to maximize well-being benefits as well as user satisfaction. © 2022 ACM.

SingHealth COVID-19 Disease Registry

Background. One of Singapore's national strategies for the COVID-19 pandemic was containment. Efforts included a fourteen-day quarantine of close contacts, were subjected to an entry and exit SARS-CoV-2 PCR test, the latter being done between 11-14 days post exposure. Additionally, symptomatic contacts were tested for SARS-CoV-2. We aim to determine the trend in COVID-19 incubation periods during three distinct pandemic waves corresponding to different SARS-CoV-2 variants. Incubation Period Incubation period of the prevalent SARS-CoV-2 variant in circulation Methods. This is an ecological study and information collected from the SingHealth COVID-19 Registry, a database of all inpatients admitted to any of the SingHealth hospitals. For patients under quarantine, the start date of the quarantine period was assumed to be the last date of exposure to the index case. Incubation period was determined by the duration between date of exposure and date of the first positive SARS-CoV-2 PCR test. The prevalent strain in circulation was identified from the Singapore database in the GISAID collection. Only variants of concern, as categorized by WHO, Alpha (23rd Jan 2020 - 1st Mar 2021), Delta (5th May 2021 - 31st Oct 2021) and Omicron (1st Jan 2022 - Present) were considered. For the Omicron variant, quarantine was discontinued, hence the last date of arrival from international travel was assumed to be the date of exposure. Results. From January 2020 to March 2022, there were 19,905 patients in the COVID-19 registry, of whom 11,235 were under quarantine and 8,612 had preceding international travel. Of the 11,235 patients under quarantine, 8,189 patients were infected when SARS-CoV-2 Alpha variant and 3,046 patients were infected when SARS-CoV-2 Delta variant were in circulation. Of the 8,612 patients with preceding travel, 6,503 patients were infected when SARS-CoV-2 Omicron variant was in circulation. The median incubation period for the Alpha variant was 11 days (IQR: 7-14 days) versus 3 days (IQR: 2-4 days) for the Delta variant versus 3 days (IQR: 0-5 days) for the Omicron variant. Pairwise comparisons between the variants were (p-value = < .001) Conclusion. The significant differences between incubation periods of the SARS-CoV-2 variants in circulation poses a challenge to containment efforts and has emphasize the importance of dynamic national strategies.

Videoconferencing fatigue and online student engagement among Filipino senior high school students: A mixed methods study

Introduction: The ubiquity of online classes during the COVID-19 pandemic induced the widespread use of videoconferencing applications. However, the prolonged use of these applications can lead to videoconferencing fatigue. Drawing from an online survey sample of 215 senior high school students from a selected private university in Manila, Philippines, this mixed methods study examines videoconferencing fatigue and its relationship with online student engagement (OSE) during the COVID-19 pandemic. Materials and methods: This study utilized a convergent triangulation research design. The quantitative strand was cross-sectional in nature. The constructs were measured using the Zoom Exhaustion and Fatigue Scale and Online Student Engagement Scale. Bivariate and multivariate statistical tests were used to determine the significance of the relationships between variables. The qualitative strand utilized a descriptive design. Narrative data were collected through an open-ended survey question and analyzed using content analysis. Results: Quantitative results indicate moderate to high levels of videoconferencing fatigue among student respondents. Moreover, higher levels of OSE were observed among those who endured higher visual fatigue and attended videoconferences more days a week. Qualitative findings demonstrate various manifestations of videoconferencing fatigue among students and relate it with decreased energy to perform academic tasks and learning absorption. However, the qualitative analysis also reveals students' perceived need for videoconferencing to learn online. Discussion: The nuanced insights from both strands highlight that despite their perceived negative impacts of videoconferencing, students had to tolerate visual videoconferencing fatigue in order to engage meaningfully in online classes. Copyright © 2022 Dacillo, Dizon, Ong, Pingol and Cleofas.

Intravitreal injections in the era of COVID-19-The Metro South Health Queensland experience

Background: Intravitreal anti-vascular endothelial growth factor therapy currently represents the treatment standard for vision-threatening macular conditions, while treatment delays cause precipitous vision loss. The COVID-19 pandemic prompted unprecedented delays for patients receiving intravitreal injections (IVI). We aim to provide real-world data on the effects of delayed IVI treatment due to COVID-19 at our center and its associated visual consequences. Method(s): In this retrospective cohort study based at a tertiary hospital in metropolitan Brisbane, medical records were reviewed for consecutive IVI patients within a 6-week interval between March-May 2020. Patients were divided into two groups based on whether they maintained or delayed their follow-up visit. Main outcome measures included best-corrected visual acuity (BCVA), central macular thickness as well as structural findings on OCT suggestive of disease activity. Result(s): A total of 682 patients were scheduled to receive IVI-based care, with treatment delay observed in 123 patients (18.5%) for an average period of 64 days. BCVA worsened in the delayed group by an average of 0.136 letters compared to 0.008 in the control group (p = 0.02), with the most significant change seen in neovascular age-related macular degeneration patients (p = 0.001). Patients on Aflibercept and Ranibizumab were more likely to maintain vision compared to those on Bevacizumab (p = 0.02 and p = 0.07). Retinal vein occlusion patients were most likely to suffer from longterm visual consequences from delayed follow-up. In multivariate linear regression model for risk factor analysis;BCVA, distance from hospital and patient age were all correlated with treatment delays. Conclusion(s): Patients who experienced treatment delays suffered short-term visual decline. However, visual losses were not sustained in majority of patients.

Towards Building Mental Health Resilience through Storytelling with a Chatbot

The prolonged lockdown from the COVID-19 pandemic has caused a dramatic increase in the number of mental health concerns in the community. Students are among those vastly affected. Their socio-economic and financial conditions add challenges to their academic difficulty and work-life balance that can fuel issues related to mental health and well-being. To cope with these challenges, they need to strengthen their resilience to possess the ability to face and recover from adversity. In this paper, we describe how a mental health chatbot can help strengthen the resilience skills of tertiary level students through daily conversations. These conversations are aimed at promoting one's well-being through self-assessment and care. Grounded on the use of narratives to encourage students to express their emotions, Seligman's PERMA model is utilized as a basis for evaluating the student's well-being and suggesting coping mechanisms to maintain one's positive mental health and emotions.

HERODOTUS: Head and neck cancers international COVID-19 collaboration: An international registry on head and neck cancer with COVID-19

Background: Studies on patients with cancer and COVID-19 have indicated a high mortality rate compared with the general population. Patients with head and neck cancer are thought to be prone to complications following COVID-19 infection due to their older age, smoking habits, and pre-existing cardiopulmonary comorbidities, in addition to cancer therapy. Our aim is to study the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on patients with head and neck cancers. Trial design: Head and Neck ancers international COVID-19 Collaboration (HERODOTUS) registry is a multicentre observational study composed of a cross-sectional component and a longitudinal cohort component. Eligibility criteria were the presence of any head and neck cancer and a COVID-19 diagnosis, either laboratory confirmed with RT-PCR, suspected with symptoms and contacts, or radiologically suspected cases with lung imaging features consistent with COVID-19 pneumonia and symptoms. Patients of any age, sex, histology, or stage were considered eligible, including those in active treatment and clinical follow-up. Clinical data will be extracted from medical records of consecutive patients from Jan 1, 2020 and will be collected until the end of the pandemic declared by WHO. Data on demographics, oncological history and comorbidities, COVID-19 diagnosis, and course of illness and clinical outcomes will be collected. Associations between demographic or clinical characteristics and outcomes will be measured with odds ratios (ORs) with 95% CIs using univariable and multivariable logistic regression, with established prognostic factors included in multivariable analysis. The registry continues to accept new sites and patient data. Clinical trial identification: NCT04632173. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

The impact of COVID-19 on church gatherings in the Philippines: A policy analysis

The Philippines is the largest Christian-majority country in Asia. With church gatherings playing a vital role in the nature of Christianity in the Filipino culture, the advent of the coronavirus disease (COVID-19) pandemic in the Philippines posed challenges to public religious practices amid efforts to mitigate COVID-19 community transmission. Various policy pronouncements from both the government-led Inter-Agency Task Force (IATF) on Emerging Diseases and the church-led Catholic Bishops' Conference of the Philippines (CBCP) were issued. These guidelines were implemented in order to address the two-pronged problem on healthcare and religious obligations. While these guidelines were initially contributory to the mitigation of disease transmission, varied compliance by Filipinos was observed through the progression of the pandemic. Considering the value that church gatherings and religion play in the lives of the Filipino people, further studies on COVID-19 transmission in the church should be conducted in order to develop more efficient policies and guidelines on the practice of religion, particularly for religious gatherings. Furthermore, a more synergistic state and church cooperation must be encouraged in order to arrive at solutions that will mutually address the concomitant problems of the COVID-19 pandemic. © 2021 Center for Health in Mission. All rights reserved.

Perceptions, attitude, responses, knowledge and emotional well-being (PARKE) of COVID-19 among students at Newcastle University Medicine Malaysia (NUMed)

Background: Adherence to preventative measures designed to mitigate transmission of COVID-19 depends on individual's understanding and perception of COVID-19. The objective of this study was to assess the knowledge, perceptions, behavioural adaptation and psychological well-being related to COVID-19 among students attending Newcastle University Medicine Malaysia.

CIDO: The community-based coronavirus infectious disease ontology

Current COVID-19 pandemic and previous SARS/MERS outbreaks have caused a series of major crises to global public health. We must integrate the large and exponentially growing amount of heterogeneous coronavirus data to better understand coronaviruses and associated disease mechanisms, in the interest of developing effective and safe vaccines and drugs. Ontologies have emerged to play an important role in standard knowledge and data representation, integration, sharing, and analysis. We have initiated the development of the community-based Coronavirus Infectious Disease Ontology (CIDO). As an Open Biomedical Ontology (OBO) library ontology, CIDO is an open source and interoperable with other existing OBO ontologies. In this article, the general architecture and the design patterns of the CIDO are introduced, CIDO representation of coronaviruses, phenotypes, anti-coronavirus drugs and medical devices (e.g. ventilators) are illustrated, and an application of CIDO implemented to identify repurposable drug candidates for effective and safe COVID-19 treatment is presented. Copyright © 2020 for this paper by its authors.