Home dialysis therapies are flexible kidney replacement strategies with documented clinical benefits. While the incidence of end-stage kidney disease continues to increase globally, the use of home dialysis remains low in most developed countries. Multiple barriers to providing home dialysis have been noted in the published literature. Amongst known challenges, gaps in clinician knowledge are potentially addressable with a focused education strategy. Recent national surveys in the United States and Australia have highlighted the need for enhanced home dialysis knowledge especially among nephrologists who have recently completed training. Traditional in-person continuing professional educational programs have had modest success in promoting home dialysis and are limited by scale and the present global COVID-19 pandemic. We hypothesize that the use of a "Hub and Spoke" model of virtual home dialysis mentorship for nephrologists based on project ECHO would support home dialysis growth. We review the home dialysis literature, known educational gaps and plausible educational interventions to address current limitations in physician education. This article is protected by copyright. All rights reserved.

The coronavirus disease 2019 (COVID-19) outbreak, caused by SARS-CoV-2, has rapidly expanded to a global pandemic. However, numbers of infected cases, deaths, and mortality rates related to COVID-19 vary from country to country. Although many studies were conducted, the reasons of these differences have not been clarified. In this study, we comprehensively investigated 12,343 SARS-CoV-2 genome sequences isolated from patients/individuals in six geographic areas and identified a total of 1234 mutations by comparing with the reference SARS-CoV-2 sequence. Through a hierarchical clustering based on the mutant frequencies, we classified the 28 countries into three clusters showing different fatality rates of COVID-19. In correlation analyses, we identified that ORF1ab 4715L and S protein 614G variants, which are in a strong linkage disequilibrium, showed significant positive correlations with fatality rates (r = 0.41, P = 0.029 and r = 0.43, P = 0.022, respectively). We found that BCG-vaccination status significantly associated with the fatality rates as well as number of infected cases. In BCG-vaccinated countries, the frequency of the S 614G variant had a trend of association with the higher fatality rate. We also found that the frequency of several HLA alleles, including HLA-A*11:01, were significantly associated with the fatality rates, although these factors were associated with number of infected cases and not an independent factor to affect fatality rate in each country. Our findings suggest that SARS-CoV-2 mutations as well as BCG-vaccination status and a host genetic factor, HLA genotypes might affect the susceptibility to SARS-CoV-2 infection or severity of COVID-19.

It has been demonstrated that salivary gland duct cells have similar receptors as ACE2-positive cells/keratin epithelial cells of the lung which have high potential to be infected by SARS-CoV 2 virus. The aerosols carrying virus have penetration into the healthy human body and lungs via inhalation through nose or mouth.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected from at least 1 buccal specimen in 9 of 11 coronavirus disease 2019 (COVID-19)-infected children (81.8%). Viral loads in buccal specimens were substantially lower than those in nasopharyngeal specimens. Buccal swabs are not good as COVID-19 screening specimens in children.

Lower respiratory tract infections (LRTI) caused by adenovirus can be severe with resultant chronic pulmonary sequelae. More than 50 serotypes have been recognized; however, the exact association of serotype with clinical phenotype is still unclear. There have been no reports on the adenovirus serotype pattern in Hong Kong, and their relationships with disease manifestations and complications are not known. Clinical and epidemiological data on 287 children (<6 years old) admitted with adenovirus respiratory infections from 2001 to 2004 were reviewed. Common presenting symptoms included fever (97.9 %) and cough and rhinitis (74 %). Extra-pulmonary manifestations were present in 37.3 %. The clinical picture mimicked bacterial infection for its prolonged high fever and neutrophilic blood picture. Forty-two patients (14.6 %) had LRTI, either pneumonia or acute bronchiolitis, but none had severe acute respiratory compromise. Children aged 1 to 2 years old were most at risk for adenovirus LRTI (adjusted p = 0.0165). Serotypes 1 to 7 could be identified in 93.7 % of the nasopharyngeal specimens, with serotypes 2 and 3 being the most prevalent. Different serotypes showed predilection for different age groups and with different respiratory illness association. The majority of acute bronchiolitis (71.4 %) were associated with serotype 2 infection, and this association was statistically significant (p < 0.0001). Serotype 3 infection accounted for over half of the pneumonia cases (57C75 %) in those aged 3C5 years old. Only one patient developed mild bronchiectasis after serotype 7 pneumonia. Children aged 1 to 2 years old were the at-risk group for adenovirus LRTI, but respiratory morbidity was relatively mild in our locality. There was an apparent serotypeCrespiratory illness association.

The existing steady and continual rise of online learning in higher education has been accelerated by COVID-19 and resulted in a move away from solely on-campus teaching. Prior to the pandemic, online education was providing higher education to students who were returning to study to up-skill, are employed full-time, caring for family members, living rurally or remotely and/or for whom otherwise face-to-face campus learning was not a preference or option. To understand how we can better support online students in their unique circumstances and create an optimal learning environment, we must understand the factors associated with academic achievement within an online setting. This systematic review involved a search of relevant databases published between January 2009 and May 2021 examining factors and constructs related to academic performance in online higher education settings. Across 34 papers, 23 (67.6%) explored factors and constructs related to student characteristics including cognitive and psychological, demographic, university enrolment, and prior academic performance. Twenty-one (61.8%) papers explored learning environment factors including engagement, student experience, course design, and instructor. Our overall synthesis of findings indicates that academic performance in online learning is most strongly associated with motivation (including self-efficacy), and self-regulation. We propose three main implications of our review for online learning stakeholders such as educators and designers. Firstly, we argue that the wellbeing of online learners is important to understand, and future research should explore its impact on students experience and success in online higher education. Secondly, we emphasise the importance of developing and designing online courses utilising relevant frameworks and evidence-based principles. Finally, we propose an approach to promoting improved student cognitive and psychosocial experiences (such as self-efficacy, self-regulation, and perceived support) could be achieved by creating and incorporating an online learning orientation module at the commencement of enrolment. Systematic Review Registration: (website), identifier (registration number). Copyright ? 2022 Chung, McKenzie, Schweinsberg and Mundy.

Mendaglio shares a little bit about herself Growing up in Montreal had a profound effect on her outlook in many ways, and that having worked in a field outside of education impacted who she became as a teacher From the moment that she and her husband arrived in London, Ontario from Montreal, Quebec, to attend graduate school, they felt like strangers in a strange land Studying to become a teacher in Ontario required not just that she learned about the Education Act and classroom-management techniques She had to learn a new language, a new culture, and make some serious adjustments to what she perceived to be the natural, right way of doing math and teaching math

The COVID-19 pandemic exposed the dangers of tying health care delivery to brick-and-mortar health care facilities. Both before and, more intensely, during the pandemic, health systems have struggled to support high-need patients, especially those unable to engage with virtual technology or needing urgent care in the home. The pandemic has highlighted an ongoing need to create a distributed health care delivery ecosystem centered in patients' homes and the community. This age-friendly ecosystem would initially focus on high-need patients, expand access, improve equity, and be of high value. It would integrate episodic and longitudinal care and expand to serve broader populations as it matures. We briefly describe the evidence base for home-based care models that constitute this ecosystem, define the guiding principles underlying it, and discuss what will be required to build out and scale it.

Summary We describe an outbreak of carbapenem-resistant Acinetobacter baumannii (CRAB) in a COVID-19 dedicated hospital The suspected mechanism of transfer was an environmental source that persisted despite evacuation and terminal cleaning of the entire hospital, and transmitted through healthcare workers hands or equipment This outbreak demonstrates that practices to prevent the spread of multidrug-resistant organisms must not be neglected during the COVID-19 pandemic

The current COVID-19 pandemic caused by the novel coronavirus (SARS-CoV2) poses a threat to global health owing to its high rate of spread and severe forms of respiratory infection. The lack of vaccines and antivirals prevents clinical strategies against the disease, creating an emerging need for the development of safe and effective treatments. Strategies for vaccine development include complete vaccines against viruses, subunits, and nucleic acids, but are still in their early stages. Studies carried out to date on possible SARS-CoV2 drug targets highlight glycoprotein S, Mpro (main protease or protease type 3C), and a member of the transmembrane serine protease II families (TMPRSS2). However, due to the pandemic state, priority is given to marketed drugs. These include chloroquine (CQ), hydroxychloroquine (HCQ), nitazoxanide, remdesivir, Lopinavir/ritonavir (LPV / r), in addition to treatment with convalescent plasma. But, therapeutic specific effects against SARS-CoV2 have not yet been verified. Most of the information obtained about treatment is based on preliminary and limited studies. We conclude that, at this time of emergency, the search for new therapies is more urgent due to the need to save lives. Thus, we point out as interesting targets for future more specific research: glycoprotein S, Mpro, and TMPRSS2.

With the global outbreak of COVID-19 in March 2020, there was an immediate shutdown of face-to-face classes and a sudden shift to on-line learning Confinement required finding innovative approaches to teaching and student assessment This paper aims to share the experience of adapting the course in Biochemical Engineering, part of the Biotechnology program at Francisco de Vitoria University (Madrid, Spain), to remote learning A sequence of collaborative learning activities, with active student participation, was designed to replace the traditional mid-term exam Activities were carefully implemented, considering the range of learning styles Engineering skills, transversal competences and higher-order thinking skills were fostered through these activities The analysis of the teaching/learning experience was based on teacher observations, academic performance and student surveys All indicators showed that the adopted methodology had a positive impact of student performance Student participation, especially among those repeating the course, also improved Furthermore, students gained a more accurate and positive perception of the link between Chemical Engineering and Biotechnology, which may have a favourable impact on the teaching of Bioreactors in the coming academic year

Reinfections with SARS-CoV-2 have already been documented in humans, although its real incidence is currently unknown. Besides having a great impact on public health, this phenomenon raises the question of immunity generated by a single infection is sufficient to provide sterilizing/protective immunity to a subsequent SARS-CoV-2 re-exposure. The Golden Syrian hamster is a manageable animal model to explore immunological mechanisms able to counteract COVID-19, as it recapitulates pathological aspects of mild to moderately affected patients. Here, we report that SARS-CoV-2-inoculated hamsters resolve infection in the upper and lower respiratory tracts within seven days upon inoculation with the Cat01 (G614) SARS-CoV-2 isolate. Three weeks after the primary challenge, and despite high titres of neutralizing antibodies, half of the animals were susceptible to reinfection by both identical (Cat01, G614) and variant (WA/1, D614) SARS-CoV-2 isolates. However, upon re-inoculation, only nasal tissues were transiently infected with much lower viral replication than those observed after the first inoculation. These data indicate that a primary SARS-CoV-2 infection is not sufficient to elicit a sterilizing immunity in hamster models but protects against lung disease.

The stormy clouds of the coronavirus disease 2019 outbreak caused a rapidly spreading epidemic still hanging over the sphere Any steps to transition toward a new normal should be guided by health authorities, together with economic and societal considerations There are various items mainly falling into three classifications, including patient worry, clinical demand, and economic recession Social distancing, lay-offs, and decreased number of patients with health insurance may lead to a prolonged period to retrieve normalcy To return to a new normal, an individualized management model should be developed for each laboratory based on staff, instruments, services, crowding, physical space, hospital base unit, or outpatient clinic Continuous training of different occupational staffs is among the key parameters in maintaining this readiness The proposed response model should have internal and systemic integrity as well as coherence among the included items in two intra- and inter-unit management categories, namely thinking globally and acting locally

BACKGROUND: Understanding the impact of food insecurity on HIV outcomes is critical for the development and implementation of effective, evidence-based interventions to address food insecurity and improve the HIV care cascade. We conducted a prospective, longitudinal study to determine the impact of food insecurity on HIV outcomes in Senegal, West Africa. METHODS: HIV-infected individuals presenting for care and initiation of ART through the Senegalese National AIDS program in Dakar and Ziguinchor were eligible for enrollment. Data were collected using interviews, clinical evaluations, laboratory analyses, and chart review at enrollment, month 6, and month 12. Logistic regression was used to determine the association between food insecurity and HIV outcomes. RESULTS: Among the 207 participants in this study, 70% were female and the median age was 37 years. The majority (69%) were food insecure at enrollment, 29% were severely food insecure, and 38% were undernourished. Nearly a third (32%) had no formal education, 23% practiced agriculture, and 40% owned livestock. The median daily food expenditure per person was $0.58. The median round trip transportation time to clinic was 90 min (IQR 30C240). The median cost of transportation to clinic was $1.74. At month 12, 69% were food insecure, 23% were severely food insecure, and 14% were undernourished. At month 12, 43% had not disclosed their HIV status; food insecurity was associated with non-disclosure of HIV-status due to fear of stigmatization and feelings of shame. Severe food insecurity was a strong predictor of loss to follow-up (OR 3.13 [1.08C9.06]) and persistent severe food insecurity was associated with virologic failure (OR 5.14 [1.01C26.29]) and poor adherence to ART 8.00 [1.11C57.57]. Poor nutritional status was associated with poor immunologic recovery (OR 4.24 [1.56C11.47]), virologic failure (OR 3.39 [1.13C10.21]), and death (OR 3.35 [1.40C8.03]). CONCLUSION: Severity and duration of food insecurity are important factors in understanding the relationship between food insecurity and HIV outcomes. Our findings highlight the importance of nutritional status, socioeconomic opportunity, and self-stigmatization in the complex pathway between food insecurity and HIV outcomes. Interdisciplinary, multisectoral efforts are needed to develop and implement effective interventions to address food insecurity among people living with HIV. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-10444-1.

PURPOSE: Recently, more than 10 models have been developed to predict remission of type 2 diabetes mellitus (T2DM) after metabolic surgery. The ABCD score was compared to the individualized metabolic surgery (IMS) score in terms of prediction of T2DM remission, but which of the two scoring systems is better remains controversial. METHODS: Patient data from 463 obese East Asian patients who underwent laparoscopic Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), or SG with duodenojejunal bypass (SG-DJB) as a primary operation and were followed for at least 3 years were retrospectively collected from 24 institutions. The correlation between the ABCD and IMS scoring systems and the discrimination power of the models was evaluated. The cut-off point for the IMS stage of T2DM severity was also revised to adjust the scoring system to obese East Asian patients. RESULTS: The two scoring systems were significantly well correlated. The IMS scoring system showed significant differences in T2DM remission rates between the procedures in the moderate stage, but the ABCD score showed no significant differences in each category. The discrimination power of the IMS score was comparable to that of the ABCD score at both 3 and 5 years. The revised IMS scoring system showed that SG-DJB had significantly higher T2DM remission rates in the moderate stage at 5 years than RYGB or SG. CONCLUSION: IMS score may be comparable to ABCD score to predict T2DM remission in obese East Asian patients. The revised IMS scoring system may also select candidates for SG or SG-DJB.

A simple Monte-Carlo method will be put forward herein, to enable the extraction of an estimate for the quarantine duration, applicable to visitors to high-risk regions. Results will be obtained on the basis of an analysis of the upper tail of the cumulative distribution function of the time span between the departure of the travellers from the place where the infection occurs and the time instant when COVID-19 infections may currently be detected. As expected, the quarantine duration is a decreasing function of the fraction of the infected travellers, which one is prepared to identify as `acceptable risk'. The analysis suggests that a maximal $5~\%$ risk (of new infections originating from subjects who become infective after their quarantine is lifted) may be associated with a minimal quarantine duration of about eight days, $1~\%$ with about twelve, and $0.1~\%$ with about sixteen. Unless the distribution of the duration of short (typically, up to three weeks) travels departs significantly from the shape assumed in this study, the results of the present analysis do not provide support for the plans to shorten the quarantine duration of about ten days to two weeks, which currently applies to travellers entering most European countries from regions with a high risk of infection.

High-throughput molecular profiling and computational biology are changing the face of virology, providing a new appreciation of the importance of the host in viral pathogenesis and offering unprecedented opportunities for better diagnostics, therapeutics and vaccines. Here, we provide a snapshot of the evolution of systems virology, from global gene expression profiling and signatures of disease outcome, to geometry-based computational methods that promise to yield novel therapeutic targets, personalized medicine and adeeper understanding of how viruses cause disease. To realize these goals, pipets and petri dishes need to join forces with the powers of mathematics and computational biology.

OBJECTIVE: To describe the maternal clinical characteristics, maternal and perinatal outcomes in COVID-19-positive pregnant women. METHODS: Articles in all languages on the SARS-CoV-2 infection in pregnant women were sought from MEDLINE, EMBASE, Cochrane Library and LILACS; China National Knowledge Infrastructure Database (CNKI), Chinese Science and Technology Periodical Database (VIP) and Wan Fang Data between December 1, 2019 and April 27, 2020. Bulletins and national reports were also searched. RESULTS: From 12,168 retrieved articles, 143 were selected for full-text assessment; 33 for descriptive analyses, and 4 case-controls for meta-analysis. In 322 infected pregnant women, aged 20-45 years, the most frequent maternal comorbidity was obesity (24.2%). Forty-two (28.4%) were asymptomatic at admission. Cough (n = 148,59.7%) and fever (n = 147,59.3%) were the most prevalent symptoms. In the meta-analysis, fever (OR: 0.13,95% CI 0.05 to 0.36) and cough (0.26,95% CI 0.11 to 0.59) were lower in pregnant women with COVID-19 than non-pregnant women with COVID-19.195 (60.6%) delivered, and 125 (38.8%) remained pregnant during the study. Cesarean was reported in 99 (50.8%) women and vaginal delivery in 64 (32.8%). The main adverse obstetric outcome was premature birth (n = 37,18.9%). Thirty patients (10.3%) with COVID-19-related complications required intensive care, one (0.3%) died. SARS-CoV-2 was absent in breast milk, amniotic fluid, placenta or umbilical cord blood. CONCLUSIONS: The maternal clinical characteristics of COVID-19-positive pregnant include frequently fever and cough; however significantly less frequently than non-pregnant women with COVID-19. Iatrogenic preterm birth is the main adverse obstetric outcome. Current data does not support vertical transmission in the third trimester.

Traumatic brain injury patients may be dependent on the decision-making of their families. Restrictive visitation policies implemented during the COVID-19 pandemic disproportionately affect these patients and their families. This narrative aims to illustrate this phenomenon and catalyze discussions regarding the need for careful evaluation of restrictive family visitation policies and exceptions that may be required for brain injured patients.

The Coronavirus Disease (Covid-19) triggered substantial shifts in the education systems worldwide as teaching and learning have had to shift from face-to-face to an entirely virtual model due to the closure of educational institutes. The present paper is a descriptive-analytical investigation of the challenges of the current pandemic-imposed E-teaching of English for Specific Purposes (ESP) courses to female preparatory (PY) year students at King Khalid University (KKU). It identifies teachers' and students' responses about the ongoing issues with E-teaching of ESP with to put practical solutions to them. The study is conducted at The University Center for Girls' Studies-Al-Samir Campus-Abha during the academic year 2020-2021. Twenty English Language instructors at the English Language Center (ELC) and eighty students of the preparatory year at the College of Medicine enrolled in Intensive English Course (Njl-019) participated in the study. It adopts mixed qualitative methodology with the teachers' semi-structured interview and students' questionnaire as tools to collect data, and descriptive analysis as a method to interpret data. The study finds out reciprocity of teachers' and students' responses in pinpointing the factors posing serious challenges in teaching and learning ESP courses as majorly related to technology, pedagogy, and Assessment. Considering these challenges, the study puts forth practical suggestions to promote virtual teaching and learning of ESP courses. The suggested solutions are hoped to help providing successful standards for virtual ESP teaching and learning as per the constraints of quality modern education.