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Background It is a challenge for pharmacy courses worldwide to combine theoretical knowledge with practical skills to equip students for their future practice. Computer-based simulation offers a way of building a bridge between theory and practice. In recent years, digital simulation has expanded rapidly as a new technique of virtual learning. The digital platform ''Pharmacy Simulator'' proposes computer-based encounters with virtual patients to train clinical and communication skills in a community pharmacy setting. However, during the COVID-19 pandemic, while students were digitally resilient and endured the endless challenges of online lectures, many were dealing with Zoom and screen fatigue. Purpose To investigate pharmacy students' acceptance of Pharmacy Simulator before and during a pandemic situation. This focuses on students' self-assessment and confidence in counselling after playing the scenarios on Pharmacy Simulator. Method Two cohorts of Master of Pharmacy students at The University of Western Australia played two scenarios on Pharmacy Simulator in 2019 (anaphylaxis and salbutamol) and 2021 (anaphylaxis and vaccination). A mixed-method analysis was performed with data from (i) qualitative semi-structured interviews carried out in 2019 pertaining to participants' acceptance of Pharmacy Simulator and in 2021 (ii) a questionnaire with 25 items derived from the interviews. The interviews were transcribed verbatim into electronic format with the data management assistance MAXQDA and analyzed inductively using the Framework Method. Questionnaire responses were analyzed in Microsoft Excel using descriptive statistics. Openended questions were evaluated inductively. Findings Data were collected from 20 interviews and 31 answered questionnaires. In 2019, participants reported that Pharmacy Simulator was a fun, engaging, and straightforward learning tool and, therefore, user-friendly. They reported the feedback at the end of the session to be most valuable. The platform was perceived to fill the gap between the theory from lectures and community pharmacy practice. In 2021, participants ''agreed'' (median: 4, on a 5-point Likert scale) with seven statements about Pharmacy Simulator's usability, such as it being a helpful tool for acquiring new knowledge. Participants' confidence in counselling regarding the scenario topics improved. One participant stated, ''It taught me more through trial and error''. Conclusion Pharmacy students reported similar acceptance levels of Pharmacy Simulator before and during the COVID-19 pandemic. The use of simulation during virtual patient encounters seems to facilitate the transfer from theory to practice, independently of learning conditions that were predominantly screen-based.
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Background: Italy, France and New York City have reported an increase in out-of-hospital cardiac arrest (OHCA) incidence during the COVID-19 pandemic. The purpose of our study was to assess the effect of COVID-19 on OHCA cases in Chicago. Method(s): Cardiac Arrest Registry to Enhance Survival (CARES) database was used. Bivariate analysis was conducted to assess changes in demographic and other characteristics. We excluded the cases that occurred in a healthcare facility or a nursing home. We compared the cases reported in 2020 to 2019 (and prior years). ArcGIS was used to geocode incident addresses and to show the temporal distribution by community areas. Bivariate analysis was done using chi-square tests. Result(s): A total of 3221 OHCA cases were reported in Chicago in 2020, which is 31.5% higher than those reported in 2019 (n=2450 cases). This increase was higher than what has been noticed historically (for instance, the increase from 2018 to 2019 was only 17%). There was an increase in Hispanic OHCA cases (17.3% in 2020 vs. 13.5% in 2019, p<0.01) but a decrease in White cases (20.5% vs. 23.1%). The cases in 2020 were less likely to be reported at public location (22% vs. 26%, p<0.001) or have shockable rhythm (10% vs. 13%, p=0.0002). There was a marked increase in those that were declared dead in the field in 2020 (37% vs. 27%, p<0.001). However, there were no statistically significant differences in age distribution, gender, witnessed arrest (49% vs. 51%, p=0.07) or bystander cardiopulmonary resuscitation (BCPR) (23% vs. 22%, p=0.3). Conclusion(s): A better understanding of the causes of the excess cardiac arrest numbers will be important to help plan and better prepare for future public health interventions. The effect of COVID19 on OHCA survival needs to be examined further in future studies.
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We report the development of a metal-free four-step one-pot synthetic strategy to access high-value functionalized phthalazines using o-methyl benzophenones as starting compounds. Combining a light-mediated enolization of o-methyl benzophenones/Diels-Alder reaction domino process with a subsequent deprotection/aromatization domino reaction in one-pot leads to sustainable and efficient organic synthesis. The tangible advantages, i. e., absence of catalysts or additives, utilization of commercially available and/or easily accessible substrates, mild reaction conditions, simplicity, and single work-up procedure, make this combined process highly appealing for the direct construction of various 1-aryl-phthalazines. Importantly, in vitro bioactivity evaluation of these newly prepared heterocyclic compounds demonstrated a strong antiviral efficacy against major human pathogens like HCMV and SARS-CoV-2. © 2022 The Authors. European Journal of Organic Chemistry published by Wiley-VCH GmbH.
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Background: Tracking person-to-person SARS-CoV-2 transmission in the population is important to under-stand the epidemiology of community transmission and may contribute to the containment of SARS-CoV-2. Neither contact tracing nor genomic surveillance alone, however, are typically sufficient to achieve this objective. Aim: We demonstrate the successful appli-cation of the integrated genomic surveillance (IGS) system of the German city of Dusseldorf for tracing SARS-CoV-2 transmission chains in the population as well as detecting and investigating travel-associated SARS-CoV-2 infection clusters. Methods: Genomic sur-veillance, phylogenetic analysis, and structured case interviews were integrated to elucidate two geneti-cally defined clusters of SARS-CoV-2 isolates detected by IGS in Dusseldorf in July 2021. Results: Cluster 1 (n = 67 Dusseldorf cases) and Cluster 2 (n = 36) were detected in a surveillance dataset of 518 high-quality SARS-CoV-2 genomes from Dusseldorf (53% of total cases, sampled mid-June to July 2021). Cluster 1 could be traced back to a complex pattern of transmission in nightlife venues following a putative importation by a SARS-CoV-2-infected return traveller (IP) in late June;28 SARS-CoV-2 cases could be epidemiologically directly linked to IP. Supported by viral genome data from Spain, Cluster 2 was shown to represent multi-ple independent introduction events of a viral strain circulating in Catalonia and other European coun-tries, followed by diffuse community transmission in Dusseldorf.
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Background: Studies on cancer patients during the COVID-19 pandemic have shown a decrease in new diagnoses, delays in care, and a shift to later stage disease presentations. Considering that NY has been an epicenter for COVID-19 in the U.S., we investigated its impact on new cancer diagnoses at the two campuses of NYU's Perlmutter Cancer Center and hypothesized that there would be a decrease in presentations during the peak outbreaks in NY. Methods: We conducted a single center, retrospective analysis of new cancer diagnoses before, during, and after the peak of the pandemic between Dec 1, 2019, and Aug 31, 2020. Following IRB approval, subjects were identified using our cancer center database, which includes both inpatient and outpatient visits. Subjects were included regardless of their treatment plan. New diagnoses before COVID-19 (Dec to Feb), at first peak (March to May), and during the initial recovery phase (June-Aug) were assessed. No COVID-19 vaccines were available during this time. Results: As summarized in Table, during the initial COVID-19 peak, there was a substantial decrease in new patient visits with statistically significant differences seen by age and certain cancer types including breast, skin, and hematologic malignancies. In all cancers, there was a decrease in the proportion of new patient visits among those over age 75 during the peak. When confining analyses to breast, skin, and hematologic cancers, we saw a significant increase in the proportion of younger new patients at the peak period. We also observed an association between age and stage, with an increase in new stage I diagnoses in the younger (age 18-54) population at peak. Telemedicine was most utilized by the younger population during both peak and recovery periods. Conclusions: In this retrospective analysis, we found that during the initial COVID-19 peak, prior to vaccine availability, outpatient visits for hematologic and solid malignancies decreased at our cancer center in NY. The decrease in the proportion of all cancer types in elderly patients during the peak was likely related to hesitancy among this vulnerable population to seek care. The widespread use of telemedicine also likely contributed to the increased incidence in new patient visits in younger patients. Lessons learned from this experience can help guide outreach to vulnerable populations during future outbreaks, particularly by fostering telemedicine use among the elderly.
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The Covid-19 pandemic was, and continues to be, managed by prevention measures based on limited contact in public spaces and general restrictions on freedom of movement. The question arose as to how infection prevention strategies can be adapted to contexts such as that of the judicial system, particularly prisons. To investigate this, the Swiss National Science Foundation funded a project to analyse institutional strategies to implement prevention measures concerning the Covid-19 pandemic. Surveys were conducted in closed and open institutions of the judicial system across Switzerland, as well as in external residential and work settings, to document successful strategies and identify certain problems. © 2020 Kriminologie. All rights reserved.
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Background: Neutralizing antibodies are recognized as a principal correlate for protection induced by SARS-CoV-2 vaccines and have been considered for antiviral treatment as an active component in convalescent plasma therapy (CPT) and as monoclonal antibody therapeutics. However, unless used at a very early stage of infection, antibody-based SARS-CoV-2 therapies have not achieved the substantial disease-modulating effect hoped for. Methods: Here, we conducted a proof-of-principle study of CPT based on a phase I trial in thirty hospitalized COVID-19 patients with a median interval between the onset of symptoms and the first transfusion of 9 days (IQR, 7-11.8 days). A comprehensive longitudinal monitoring of the virologic, serologic, and disease status of recipients in conjunction with detailed post-hoc seroprofiling of transfused convalescent plasma allowed deciphering of parameters on which plasma therapy efficacy depends. Results: In this study, CPT was safe as evidenced by the absence of transfusion-related adverse events. We also observed an overall low mortality (3.3%). Treatment with highly neutralizing plasma was significantly associated with faster virus clearance, as demonstrated by Kaplan-Meier analysis (p = 0.034) and confirmed in a parametric survival model including viral load and comorbidity (adjusted hazard ratio (HR) = 3.0 [95% confidence interval (CI) 1.1;8.1], p = 0.026) (Figure 1). Endogenous immunity had strong effects on virus control. Lack of endogenous neutralizing activity at baseline was associated with a higher risk of systemic viremia. The onset of endogenous neutralization had a noticeable effect on viral clearance but, importantly, even after adjusting for their endogenous neutralization status recipients benefitted from plasma therapy with high neutralizing antibodies (HR= 4.0 [95% CI 1.3;13], p = 0.017). Conclusion: In summary, our data demonstrate a clear impact of neutralizing antibody therapeutics on the rapid clearance of viremia and with this provide directions for improved efficacy evaluation of current and future SARS-CoV-2 therapies beyond antibody-based interventions. In particular, incorporating an assessment of the endogenous immune response and its dynamic interplay with viral production is critical for determining therapeutic effect.
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Considering the relevance of actions to strengthen family farming as a strategy to overcome hunger, poverty and food insecurity, this article aims to understand how COVID-19 pandemic is impacting family farm markets at Vale do Rio Pardo region, indicating the challenges experienced in maintaining trade and the consequences for food supply. The research occurred between April and August of 2020, based on an exploratory methodology, with qualitative and quantitative data collection. The results indicate that the majority of local farmers markets remain active thanks to the mobilization of farmers to implement security measures both at personal level and at trading channel. There was also a positive performance by local governmental organizations vis-a-vis farming families, with no records of infection among people involved in the studied cases. The characterization and socio-spatial distribution of farmers markets in the region are an unprecedented and important result in setting an agenda for future research.
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The values people hold tend to be relatively enduring. An important exception appears to be values adaptation in response to major, life-altering situations. Major events can act as triggers for people to adapt their values based on the new context. In particular, collective traumas—such as the COVID-19 pandemic—may incite immediate values change. The aim of the current paper is to compare business school students' value orientations before and after the COVID-19 global pandemic outbreak. We investigated responses from two comparable samples of business students: one surveyed before and one surveyed after the outbreak of the COVID-19 pandemic. The subjects' individual value orientations were aggregated and analyzed by comparing the distribution of the first group's pre-COVID-19 outbreak responses with the second group's post-COVID-19 outbreak responses regarding the importance given to values in the Rokeach Values Survey. We further explored specific demographic differences in personal versus social orientations and competence versus moral orientations for our samples. Results confirm differences in business school students' pre-COVID-19 outbreak versus post-COVID-19 outbreak value orientations, with the post-COVID-19 outbreak sample reporting greater attention to social values, as predicted, and competence values, not as predicted. Implications of our findings are discussed. © 2022 W. Michael Hoffman Center for Business Ethics at Bentley University.
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The course of an epidemic can often be successfully described mathematically using compartment models. These models result in a system of ordinary differential equations. Two well-known examples are the SIR and the SEIR models. The transition rates between the different compartments are defined by certain parameters that are specific for the respective virus. Often, these parameters are known from the literature or can be determined using statistics. However, the contact rate or the related effective reproduction number are in general not constant in time and thus cannot easily be determined. Here, a new machine learning approach based on physics-informed neural networks is presented that can learn the contact rate from given data for the dynamical systems given by the SIR and SEIR models. The new method generalizes an already known approach for the identification of constant parameters to the variable or time-dependent case. After introducing the new method, it is tested for synthetic data generated by the numerical solution of SIR and SEIR models. The case of exact and perturbed data is considered. In all cases, the contact rate can be learned very satisfactorily. Finally, the SEIR model in combination with physics-informed neural networks is used to learn the contact rate for COVID-19 data given by the course of the epidemic in Germany. The simulation of the number of infected individuals over the course of the epidemic, using the learned contact rate, shows a very promising accordance with the data.
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Background: In Germany as well as in other countries, resident oncologists are challenged by the current pandemic as they seek to ensure continuity of treatment and care for cancer patients in severe or terminal conditions with and without SARS-CoV2-infection. Aim: The study aims to analyze challenges, experiences and emerging solutions of resident oncologists in Germany with regard to health care for patients with palliative oncological diseases and their relatives during the pandemic. The findings will contribute to a national strategy on palliative care in pandemic times. Methods: 13 guideline-based telephone interviews with oncologist from Sep-Oct 2020 were analysed using a content-analytical approach. This study is part of the nationwide collaboration project 'National Strategy for Palliative Care in Pandemic Times' (PallPan). Results: At the onset of Covid-19 pandemic some patients have cancelled or postponed follow-up appointments due to fear of infection. Although it seems challenging to make up with those appointments, oncologists report having had no considerable loss of quality of care. In individual cases, patients were referred late from GP care to oncology and therapies started with avoidable delays. Due to a lack of user competency and uncertainties about data protection, digital solutions such as video consultations were used rarely. Practice teams had to re-structure practice facilities, working schedules and appointment management to stick to infection protection measures. The network including other caregivers such as GPs and palliative care teams was assessed mainly stable and stress-resistant which contributed to good patient palliative care. Discussion: The reported re-arrangements on facility level helped securing care and therapy provision and could be re-used in future pandemic times. Public health authorities at local, state and federal level must improve pandemic planning.
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Background: The SARS-CoV-2 pandemic poses major challenges for the health care system. While the infection protection and medical care provision for those infected is the primary intention, it is equally important to maintain and ensure the continuation of palliative care. Aim: The study examines general practitioners' (GPs) experiences, challenges and perspectives on the provision of care for seriously ill and dying patients (with/without COVID-19) and their relatives in pandemic times in Germany. Methods: In 2020, a standardized questionnaire was developed based on findings from an online focus group and two telephone interviews with GPs. The link to the online survey was spread via different email distribution lists (e.g. university institutes for general practice, medical associations;snowball system) to GPs nationwide. The survey was open for four weeks. The questionnaire mainly uses verbal rating scales which were analysed using descriptive SPSS tools. Free-text comments were analyzed based on Kuckartz content analytical methodology using MAXQDA. Results: 410 GPs participated in the survey. GPs noticed a major challenge with contact restrictions which caused deterioration in physical and mental health of patients at their homes (43%;77%) and in nursing facilities (53%;89%). Telephone contacts with patients and relatives had increased compared to before the pandemic (63%). One third of GPs offered video consultations. GPs rated the cooperation with other healthcare providers from good to adequate during pandemic times. Among other stresses, GPs observed an increased fear of loneliness in patients. They also showed an increased personal stress. The integration of GPs in pandemic task forces (92%) was recommended. Discussion: The present work provides insights into pandemic crise management of GPs and supports the development of a national strategy for palliative care in pandemic times.
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OBJECTIVES: Federal open-data initiatives that promote increased sharing of federally collected data are important for transparency, data quality, trust, and relationships with the public and state, tribal, local, and territorial partners. These initiatives advance understanding of health conditions and diseases by providing data to researchers, scientists, and policymakers for analysis, collaboration, and use outside the Centers for Disease Control and Prevention (CDC), particularly for emerging conditions such as COVID-19, for which data needs are constantly evolving. Since the beginning of the pandemic, CDC has collected person-level, de-identified data from jurisdictions and currently has more than 8 million records. We describe how CDC designed and produces 2 de-identified public datasets from these collected data. METHODS: We included data elements based on usefulness, public request, and privacy implications; we suppressed some field values to reduce the risk of re-identification and exposure of confidential information. We created datasets and verified them for privacy and confidentiality by using data management platform analytic tools and R scripts. RESULTS: Unrestricted data are available to the public through Data.CDC.gov, and restricted data, with additional fields, are available with a data-use agreement through a private repository on GitHub.com. PRACTICE IMPLICATIONS: Enriched understanding of the available public data, the methods used to create these data, and the algorithms used to protect the privacy of de-identified people allow for improved data use. Automating data-generation procedures improves the volume and timeliness of sharing data.