POST STROKE REHABILITATION DEVICE

Stroke is a medical condition that is the fifth cause of death and a leading cause of disability. The different reasons for stroke are high B.P, obesity, smoking, etc. recovery can only be sped up by regular physiotherapy and willpower of the patient. Regular physiotherapy can be interrupted by other commitments of the patient or by the doctor's unavailability. This may lead to a delay in the recovery process. Therefore, the efforts are needed to tackle the problem. The proposed device can be used to monitor and carry out selected exercises advised by the doctor. Here the upper right limb is our focus because it is the most common area to be affected. Furthermore, android application is also designed which have different consoles for doctor and patient. The patient’s app shows the history and progress of the patient while the doctor sets the time and can also see the progress. Firstly, the unit tracks finger and wrist movements and the signal strength of the muscles being exercised, and then performs assisted flexion / extension manipulation of the limb. The results are shown in the app using the graphs so that the patient and the doctor can both monitor the progress. Thus, this design gives ease to the patient as well as the doctor. With the world shifting towards smart devices and remote monitoring and control, there is a need to apply modern technology in the health dept. using the platform of IOT, certain medical treatments can be made easier for the doctors and effective for the patients. By using different sensors, a microcontroller, Arduino software, mobile application, the patient’s physiotherapy exercises can be monitored, recorded and assisted.

380. Environmental Contamination with SARS-CoV-2 in Nursing Homes

Background The COVID-19 pandemic has disproportionately affected nursing home (NH) patients, accounting for 5% of all cases and 32% of all COVID-19 deaths nationwide. Little is known about the frequency and persistence of SARS-CoV-2 environmental contamination in NHs. We characterize SARS-CoV-2 contamination in the rooms of COVID-19 patients and common areas in and around COVID-19 units. Methods A prospective cohort study was conducted at four NHs in Michigan between October 2020 and January 2021. Clinical research personnel obtained swab specimens from high-touch room surfaces of COVID-19 infected patients, up to three times per patient. Weekly swab specimens from six high-touch surfaces in common areas were also obtained. Demographic and clinical data were collected from patient clinical records. Our primary outcome of interest was the probability of SARS-CoV-2 detection from specific environmental surfaces in COVID-19 patient rooms. Results One hundred four patients with COVID-19 were enrolled and followed for 241 visits. Patient characteristics included: 61.5% over the age of 80; 67.3% female; 89.4% non-Hispanic white; 50.1% short-stay. The study population had significant disabilities in activities of daily living (ADL; 81.7% dependent in four or more ADLs) and comorbidities including dementia (55.8%), diabetes (40.4%) and heart failure (32.7) (Table 1). Over the 3-month study period, 2087 swab specimens were collected (1896 COVID-19 patient room surfaces, 191 common area swabs). Figure 1 shows contamination rates at sites proximate and distant to the patient bed. SARS-CoV-2 positivity was 28.4% (538/1896 swabs) on patient room surfaces and 3.7% (7/191 swabs) on common area surfaces. Over the course of follow-up, 89.4% (93/104) of patients had SARS-CoV-2 contamination in their room at least once (Figure 2). Environmental contamination detected on enrollment correlated with contamination of the same site during follow-up. Functional independence increased the odds of proximate contamination. Table 1. Clinical and Demographic Characteristics of the Study Population Including Short- and Long-stay Patients Figure 1. Contamination of Environmental Surfaces Relative to Distance from Patient Bed Figure 2. SARS-CoV-2 on Swab Specimens Collected – Patient-level, Visit-level, and Swab-level Conclusion We conclude that environmental contamination of surfaces in the rooms of COVID-19 patients is nearly universal and persistent. Patients with greater independence are more likely than fully dependent patients to contaminate their immediate environment. Disclosures All Authors: No reported disclosures

419. SARS-CoV-2 Environmental Surface Contamination of Healthcare Staff Common Areas

Background There are limited data regarding SARS-CoV-2 (SC2) environmental contamination in staff areas of healthcare settings. We performed environmental sampling of staff areas in wards where coronavirus disease 19 (COVID-19) patients received care and compared findings to surfaces within COVID-19 patient rooms. Methods The study was conducted at the Hospital of the University of Pennsylvania (Philadelphia, PA) from 9/15/20-1/26/21. Sampling of 20cm2 surfaces in staff common areas (breakroom high-touch surfaces comprising tables and microwave/refrigerator handles; bathroom surfaces comprising toilet, sink, and doorknob; and floors), nurse workstations (computer mice and floors), and COVID-19 patient rooms (high-touch surfaces comprising bedrail, computer mice/keyboards, and doorknobs; bathroom surfaces; and floors) was performed using flocked swabs one or more times per week. Specimens underwent RNA extraction and quantitative real-time polymerase chain reaction to detect the SC2 N1 region. Median comparisons were performed using Wilcoxon rank sum test. Trends in odds were evaluated using Score test. Results Proportions of surface specimens with detectable SC2 RNA are summarized in Table 1. Median copy numbers were lower among staff toilets compared to COVID-19 patient toilets (135.6 vs. 503.8 copies/specimen, p=0.02), lower among staff breakroom compared to patient room high-touch surfaces (104.3 vs. 220.3 copies/specimen, p=0.007), and similar between staff and patient room samples from sinks and floors. At nurse workstations, SC2 RNA was detected among 22/177 (12.4%) computer mouse and 147/178 (82.6%) floor samples. Odds of SC2 detection increased by study week among common area (p< 0.001) and nurse workstation samples (p< 0.001) (Figures 1 and 2). Table 1. SARS-CoV-2 (SC2) RNA detection on staff common area and coronavirus disease 19 (COVID-19) patient room surfaces at the Hospital of the University of Pennsylvania, 9/15/20-1/26/21. Figure 1. Proportion of environmental surface specimens with detectable SARS-CoV-2 RNA from a) staff common areas and b) nurse workstations of inpatient wards where coronavirus disease-19 patients received care at the Hospital of the University of Pennsylvania, 9/15/20-1/26/21. Figure 2. Proportion of environmental surface specimens with detectable SARS-CoV-2 RNA in staff common areas of inpatient wards where coronavirus disease-19 patients received care at the Hospital of the University of Pennsylvania, 9/15/20-1/26/21, by surface type: a) staff breakroom surfaces, b) staff bathroom surfaces, c) staff common area floors. Conclusion A low prevalence of detectable SC2 RNA was observed among staff area high-touch surfaces; however, the likelihood of detection increased over time. Environmental SC2 RNA detection may reflect primary contamination from infected healthcare workers or secondary contamination from contact with infected patients, though a direct relationship between surface SC2 RNA viral detection and transmission risk has not been established. Disclosures Michael Z. David, MD PhD, GSK (Board Member) Ebbing Lautenbach, MD, MPH, MSCE, Merck (Other Financial or Material Support, Member of Data and Safety Monitoring Board (DSMB))

O dynamice i opozycjach XIX-wiecznej kultury

Sabina Brzozowska’s monograph consists of a coherent collection of comparative and historical and literary studies of various artistic and ideological aspects found in selected works of Polish and European modernism. The author focuses on the dramas by Stanisław Wyspiański, Stanisław Przybyszewski, Tadeusz Rittner, Tadeusz Miciński and on the prose by Wacław Berent, Miciński and Thomas Mann. The interpretations of the works included in the monograph show a common area of European nineteenth-century culture, especially of the modernist period. Brzozowska’s reading experience focused on uncovering the intertextual and comparative relationships between, for instance, Wyspiański’s Wesele (The Wedding) and Mann’s Buddenbrooks, Berent’s Ozimina (Snow Crop) and Czarodziejska Góra (The Magic Mountain), Rittner and Ibsen. High art literature of the modernist period found its counterpoint in popular culture, including the new media. The author reconstructed this development dynamic of modernist culture in multiple versions.

A Mosaic Method for Side-Scan Sonar Strip Images Based on Curvelet Transform and Resolution Constraints

Due to the complex marine environment, side-scan sonar signals are unstable, resulting in random non-rigid distortion in side-scan sonar strip images. To reduce the influence of resolution difference of common areas on strip image mosaicking, we proposed a mosaic method for side-scan sonar strip images based on curvelet transform and resolution constraints. First, image registration was carried out to eliminate dislocation and distortion of the strip images. Then, the resolution vector of the common area in two strip images were calculated, and a resolution model was created. Curvelet transform was then performed for the images, the resolution fusion rules were used for Coarse layer coefficients, and the maximum coefficient integration was applied to the Detail layer and Fine layer to calculate the fusion coefficients. Last, inverse Curvelet transform was carried out on the fusion coefficients to obtain images in the fusion area. The fusion images in multiple areas were then combined in the registered images to obtain the final image. The experiment results showed that the proposed method had better mosaicking performance than some conventional fusion algorithms.

Communicable Illness Mitigation Strategies for Traveling Elite Sporting Organizations

Context: Transmission of communicable diseases observed in sporting organizations is often preventable. Early detection, isolation, and treatment can significantly diminish time lost. Until recently, there has been a paucity of standardized guidelines outlining feasible, preventable measures to protect both athletes and staff from contagious illnesses. Therefore, the purpose of this narrative was to highlight optimal prevention practices for transmission mitigation, with a particular focus on hygiene activity and travel considerations in professional sporting organizations. Evidence Acquisition: Current recommendations from the Centers for Disease Control and Prevention and peer-reviewed journals. Study Design: Clinical review. Level of Evidence: Level 5. Results: Communicable illness prevention strategies begin at the level of sufficient personal hygiene practices. Common area surface cleaning recommendations, including shared equipment sanitization between usage as well as designated equipment use to specific athletes, should be considered to minimize cross-contamination, in particular, for liked-position players. Intelligent design for shared areas can include redistributing the layout of communal spaces, most feasibly, spreading locker designation a minimum distance of 6 ft from one another. Travel considerations can include placing most susceptible passengers closest to window seating, boarding last and exiting first. Team physicians should have knowledge of essential personnel medical histories in an effort to risk stratify staff members and players in the setting of communicable disease. Conclusion: Providing a framework for illness management and prevention is important when considering the effects on player health, missed time, performance, and overall cost. Containment of commonly observed communicable illnesses can be optimized with sufficient personal hygiene practices, common area surface cleaning recommendations, intelligent design for shared areas, travel and hotel considerations, as well as appropriate screening tools and isolation techniques. Strength of Recommendation Taxonomy (SORT): B.

SPICE-19: a 3-Month Prospective Cohort Study of 640 Medical Students and Foundation Doctors

Introduction There is paucity of data around the support that medical students have been provided with, need to be provided with, and would like to be provided with during the COVID-19 pandemic. This study sought to explore the effects of the COVID-19 pandemic on medical students and establish the support they require. Methods A prospective, observational, multicentre study was conducted in 2020. All medical students and interim foundation year 1 doctors were eligible to participate. Results Six hundred forty individuals participated from 32 medical schools. Participants reported a drop in their mood following the onset of the pandemic (p < 0.001). This drop in mood was evident in both May and August. Participants did have an improved mood in August compared to May (p < 0.001). There was a significant decrease in pandemic disease-anxiety (13.8/20 to 12.4/20, p < 0.001) and consequence-anxiety (6.3/10 to 6.0/10, p < 0.001) between May and August. Nineteen percent of participants (n = 111/596, 19%) had not received the support they needed from their university by August. The most common area of support that our participants needed and had not received from their medical schools by August was support with course material (n = 58/111, 52%). ‘Clinical knowledge’ was thought to have been affected by the greatest number of participants in both May and August. Conclusion Medical students’ mental well-being has been adversely affected during the COVID-19 pandemic. Our findings have actionable implications that can better protect medical students as they acclimatise to a working environment that has been radically changed by COVID-19.

European Guideline on IgG4-related digestive disease: UEG and SGF evidence-based recommendations

Immunoglobulin subclass 4 related disease (IgG4-RD) is an increasingly recognised autoimmune disease with the potential of affecting various organs. It has a predilection for certain anatomical hotspots and the pancreatobiliary tract is the the most common area involved. Due to the relative novelty of IgG4-RD, the understanding of the disease process continues to involve. Recent European guidelines on IgG4-RD have been published by a working group collaboration between the United European Gastroenterology and Swedish Society of Gastroenterology. In our commentary, we aim to extract the key practical points with an emphasis on diagnosis and management of IgG4-RD with specific focus on the pancreatobiliary tract.

Prevalence of symptoms of body dysmorphic disorder (BDD) and associated features in Swiss military recruits: a self-report survey

Background Body dysmorphic disorder (BDD), defined as the obsessive idea that some aspect of one’s own body or appearance is severely flawed/deformed, is relatively common in the general population and has been shown to have strong associations with mood and anxiety disorders and substance abuse disorders. Furthermore, a previous study on symptoms of BDD among people in the military showed that muscles are an important area of preoccupation. Hence, this study aimed to 1. assess the prevalence of BDD symptoms in Swiss military recruits, 2. specify the areas of preoccupation, and 3. analyze associated features (depression and alcohol/drug abuse). Method A total of 126 Swiss male military recruits (age: M = 20.12, SD = 1.09, range: 18–24) were examined using self-report measurements to assess symptoms of BDD, depression, alcohol/drug abuse. Results The results showed that symptoms of BDD were relatively common (9.5% reached the cutoff value for probable BDD, 84% reported some symptoms), with the muscles as the most common area of preoccupation. A positive correlation (r = .38, p < .001) between depressive symptoms and symptoms of BDD was found, thus no correlation between alcohol/drug abuse and symptoms of BDD. Conclusion The results indicate a need to develop and implement measures for prevention (e.g. raising awareness among the military) and intervention in this specific population.

Navigating the complexity of calf injuries in athletes: a review of MRI findings

The calf muscle group is a common area for injury within the professional athlete population. Anatomical and biomechanical differences between the different component muscles vary their individual predispositions to and patterns of injury. However, there is a common unifying factor: injuries involving tendinous components have greater clinical implications with regards to rehabilitation, potential intervention, length of time to return to play, and re-injury rates. As such, accurate understanding of the underlying anatomy and subsequent interpretation of the injury patterns carry significant clinical ramifications. Ultrasound is a useful tool but has limitations, particularly when assessing soleus. As such, magnetic resonance imaging remains the workhorse in calf injury investigation.