All posts by Ulysses Labilles, DMD, PhD

”Every dream comes from a speck of hope. It is through hope where we gain our strength to make a change."

Evaluation and Treatment of Post-COVID conditions: The Rehab Medicine Perspective

Webinar topic:
Evaluation and Treatment of Post-COVID conditions: The Rehab Medicine Perspective

Date and time:
Wednesday, Oct 12, 2022 12:00 pm | (UTC-05:00) Central Time (US & Canada)

Join link:
https://veteransaffairs.webex.com/veteransaffairs/j.php?MTID=m9c3b21bd1cdc559d06054f6108628f47

Webinar number:
2761 700 3522

Webinar password:
8pmP4EmtC*4 (87674368 from phones)

Join by phone
14043971596 USA Toll Number

Access code: 276 170 03522

“Towards Understanding Post-Acute Sequelae of SARS-CoV-2”

Dr. Andrea Lerner

Dr. Andrea Lerner is an infectious diseases physician and medical officer in the Office of the Director of the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH). Her areas of particular interest within infectious diseases include HIV, antimicrobial resistance, and emerging infectious diseases. One of her recent papers is “Toward Understanding COVID-19 Recovery: National Institutes of Health Workshop on Postacute COVID-19” (https://www.acpjournals.org/doi/10.7326/M21-1043). This paper summarized a 2020 workshop held by NIH to summarize existing knowledge on post-acute COVID-19 and to identify key knowledge gaps.

Webinar topic:
“Towards Understanding Post-Acute Sequelae of SARS-CoV-2”

Date and time:
Wednesday, Sep 7, 2022 12:00 pm | (UTC-05:00) Central Time (US & Canada)

Join link:
https://veteransaffairs.webex.com/veteransaffairs/j.php?MTID=mf96a1ab44d57a5f5b9f4a1bab08df86e

Webinar number:
2764 252 7454

Webinar password:
N2pd2cQhS*2 (62732274 from phones)

Join by phone
14043971596 USA Toll Number

Access code: 276 425 27454

“Autonomic rehabilitation and other approaches to Long COVID care”

In the presentation, he will discuss a pragmatic, logical and patient-centered framework for managing people experiencing persistent symptoms after an acute COVID-19 infection.

Date and time:
Wednesday, Aug 3, 2022 12:00 pm | (UTC-05:00) Central Time (US & Canada)
Join link:
https://veteransaffairs.webex.com/veteransaffairs/j.php?MTID=m244f869b42ff5be4e8dfc8b373ef516b
Webinar number:
2762 806 4409
Webinar password:
eGuwuHF@232 (34898431 from phones)
Join by phone
14043971596 USA Toll Number
Access code: 276 280 64409

VASTLHCS Lecture Series invitation

“Mechanisms of Long COVID and Its Relationship to the Emerging Therapeutic Agenda”

Steven G. Deeks, MD, is a Professor of Medicine in Residence at the University of California, San Francisco (UCSF). He is a recognized expert on the impact of viral infections on inflammation, immune function, and health. Dr. Deeks has published over 600 peer-review articles, editorials, and invited reviews on these and related topics. He is one of the UCSF Principal Investigators for RECOVER, an NIH-funded program aimed at defining the post-acute sequelae of SARS-CoV-2 infection (PASC, or “Long COVID”). Dr. Deeks has contributed to several national and international meetings on the topic and provided expert testimony on “Long COVID” to the U.S. House of Representatives Subcommittee on Health on April 28, 2021. He was elected to the American Society for Clinical Investigation (ASCI) and the Association of America Physicians (AAP). He serves on the scientific advisory board for Science Translational Medicine.

Webinar topic Recording:
“Mechanisms of Long COVID and Its Relationship to the Emerging Therapeutic Agenda”

Webex meeting recording: “Mechanisms of Long COVID and Its Relationship to the Emerging Therapeutic Agenda”-20220706 1701-1
Password: sVpasV@3
Recording link: https://veteransaffairs.webex.com/veteransaffairs/ldr.php?RCID=3a2b2bd05bd73e01d4a6436592c46097

Message of Hope

Before I was given a chance to be part of the CDC Foundation (CDCF), I ask myself, when will I have the opportunity to make a difference? Then came a few recruiting calls from CDCF. In the middle of several interviews with COVID-19 epidemiology positions, I turned on the television, saw the REVERB show, a new documentary series from CBSN Originals, and did a story on the Navajo Nation. Watching the story made me realized what my struggles in life that I thought are so miserable is nothing close to the daily challenges the Navajo Nation faces every given day. During this Holiday Season, my second month with CDCF and the Navajo Nation Public Health and Epidemiology organizational structure. I was given a chance to be part of several working groups and co-lead two teams, the “Unified Command Testing Coordination Team (UCTCT) with a colleague at John Hopkins University, and the “Testing Data and Analytics.” I get to meet many great people virtually, like Dr. Jill Jim, one of the many great women leaders in the Navajo Nation.

“Christmas will always be as long as we stand heart to heart and hand in hand.” I believe this Christmas quote goes along well with CDCF’s “Together Our Impact Is Greater.” NavajoEpi posted a picture on Instagram, and I realized being in a collage of photos wearing a mask, all I could see is our eyes, and I realized these are all my brothers and sisters. Brothers and sisters, tackling the day-to-day challenges of the Navajo Nation. If Santa puts something in my Christmas stocking, all I could ask will be the gift that will help my friends in the Navajo Nation and the Tribal Nation as a whole. That will be the help of my Navajo Team on staffing issues. While the vaccine roll-out is in play, testing will still have a vital role until everyone who wants to be vaccinated gets vaccinated. Enhanced testing needs to continue, given that SARS-CoV-2 yet has much space to infect people and create clusters in the Navajo territory.

I choose to affect the world on every given day, not to be affected by its challenges, but to find the strength to narrow the gap between those who have everything and the many that got nothing but hope. “Every dream comes from a speck of hope. It is through hope where we gain our strength to make a change.” 

A Priori Tumor Grading Scale to Triage and Schedule Post COVID-19 Mohs Surgery Patients

The United States is slowly relaxing stay-at-home orders and reopening businesses to reverse the nation’s ailing economy after the spread of the coronavirus that killed millions of jobs and pummeled the global economy. The virus was initially identified as a cluster of pneumonia cases in Wuhan, Hubei Province of China. Later reclassified as a Novel Coronavirus on December 31, 2019, by the World Health Organization (WHO), and health experts in the US, Canada, Germany, Russia, China, Korea, Japan, and Nigeria declared COVID-19 as a Global Pandemic. During the peak of the COVID pandemic, the Centers for Disease and Prevention, the U.S. Centers for Medicare and Medicaid Services, and professional organizations issued countermeasures to flatten the curve, such as elective surgical procedure cancellation. The coronavirus infections are still on the upswing in Texas, Arizona, Florida, and Utah.

A system to forecast the transmission of the virus based on live and current data is critical (Petropoulos & Makridakis, 2020). Cumulative first wave data aggregated nationally and globally could provide accurate forecasting of probable second wave COVID-19 transmission. While accurate forecasting of the virus’s spread is essential, it is critical to establish guidelines to avoid a Coronavirus rebound and frivolous lawsuits that could stunt economic recovery. In the absence of liability protection that shields medical facilities, and employers, it is critical to developing a scheduling point system that controls the number of patients in the waiting area that could be exposed to the asymptomatic transmission of COVID-19. Even with robust liability protection, negligent facilities could still be punished and be sued for damages. The average wait period is 18 minutes during a medical visit. The patients have enough time to mingle, increasing the probability of transmission of infectious diseases based on the amount and nature of contacts between healthy and infected individuals (Goscé & Johansson, 2018). A priori tumor grading scale in scheduling Mohs patients in the post-COVID period as it relates to the parameters for diffusion is vital for the safety and protection of both the patients and healthcare workers. Depending on the tumor grade, the overall degree of connectivity, comorbidity in association to tumor history using the Labilles “United Paradigm of Cancer Causation” (2017), the patient needs to be seen as the earliest. The grading scale introduced on the “Manual of Frozen Section Processing for Mohs Micrographic Surgery” (2008) is an urgency-scoring system to assist Mohs surgeons, administrators, and staff in triaging surgery patients.

References

Beggs, C. B., Shepherd, S. J., & Kerr, K. G. (2010). Potential for airborne transmission of infection in the waiting areas of healthcare premises: stochastic analysis using a Monte Carlo model. BMC infectious diseases10(1), 247.

Franczyk, B. (2019, July). An Intelligent and Data-Driven Decision Support Solution for the Online Surgery Scheduling Problem. In Enterprise Information Systems: 20th International Conference, ICEIS 2018, Funchal, Madeira, Portugal, March 21-24, 2018, Revised Selected Papers (Vol. 363, p. 82). Springer.

Friedman, E., Friedman, J., Johnson, S., & Landsberg, A. (2020). Transitioning out of the coronavirus lockdown: A framework for zone-based social distancing. arXiv preprint arXiv:2004.08504.

Goscé, L., & Johansson, A. (2018). Analysing the link between public transport use and airborne transmission: mobility and contagion in the London underground. Environmental Health17(1), 84.

Labilles, U. (2017). Pathopoiesis mechanism of smoking and shared genes in pancreatic cancer (Copyright Registration No. TX0008490984) [Ph.D. dissertation, Walden University]. ProQuest Dissertations Publishing.

McCulloch, Hetzer, Geddis, McConnell, Brock, Keating, Labilles, Marino, Beck, Wade & Fisher (2008). Manual of Frozen Section Processing for Mohs Micrographic Surgery. In F. Fish III (Ed.). Labilles, U, Immunohistochemistry (p.1201). American College of Mohs Surgery.

Petropoulos, F., & Makridakis, S. (2020). Forecasting the novel coronavirus COVID-19. PloS one15(3), e0231236.

IN THE CONTEXT OF DATA COLLECTION — IS BIGGER BETTER? Can big data help in our fight against COVID-19?

Color logo with backgroundThe traditional researcher concept that big data equates statistical significance should not eclipse the importance of understanding the interrelationship between the effect size, power, and sample size that could translate to both practical and statistical significance. It is critical to be guided by a working theory that gives birth to a useful solution to any given problem, such as in cancer epidemiology, most importantly, to the current COVID-19 pandemic. In 2017, the ”Unified Paradigm of Cancer Causation (UPCC),” a metatheory on cancer epidemiology, was introduced. The premise of this theory can be used in contact tracing as it relates to correlation with socio-behavioral risk factors, environmental interaction, and demographic determinants (SEDD). Understanding the trajectory of COVID-19 transmission could benefit from lessons learned from past and existing legal measures on efficient delivery of emergency and disaster relief not only by updating research reporting protocols but using a theory that bridge the gap between the federal, state, and local government. Petropoulos and Makridakis (2020) highlighted the integral significance of investigating the unknown variables associated with COVID-19 transmission. It is vital to explore the compounding factors that derail emergency relief. Should there be an improved, coordinated effort from the federal, state, and local governments? Are there other compounding factors in establishing an effective strategy in flattening the curve? In the next series, the questions on the COVID-19 epidemiology and its impact on Public Health will be explored, as well as how vital to streamline the Public Health Emergency Preparedness and Disaster Relief Systems. Months after the first case of the virus in the U.S, should we already have started establishing a seasonality pattern prediction protocol? This protocol does include not only age-specific social dynamics but also other compounding factors that complicate the public health countermeasure on social distancing?

It is crucial to adopt real-time modeling that is not only a computational algorithm but provides timely availability of relevant data, as stated by Birrell et al. (2020). Interdisciplinary collaboration both the U.S. and globally must embrace the promise of real-time modeling that provides a timely, relevant data available that could produce a novel cutting edge support tool and methodology for emergency and disaster management and public health policy.

References

Birrell, P. J., Wernisch, L., Tom, B. D., Held, L., Roberts, G. O., Pebody, R. G., & De Angelis, D. (2020). Efficient real-time monitoring of an emerging influenza pandemic: How feasible?. Annals of Applied Statistics14(1), 74-93.

Labilles, U. (2016). The New Public Health: Beyond Genetics and Social Inequalities. Unpublished manuscript, College of Health Sciences, Public Health, Epidemiology, Walden University, Minneapolis.

Labilles, U. (2017). Pathopoiesis Mechanism of Smoking and Shared Genes in Pancreatic Cancer.

Olson, D. R., Lopman, B. A., Konty, K. J., Mathes, R. W., Papadouka, V., Ternier, A., … & Pitzer, V. E. (2020). Surveillance data confirm multiyear predictions of rotavirus dynamics in New York City. Science advances6(9), eaax0586.

Petropoulos, F., & Makridakis, S. (2020). Forecasting the novel coronavirus COVID-19. PloS one15(3), e0231236.

Educational Gamification Design Principles and Formative Feedbacks: Overcoming Inappropriate Postings in Discussion Thread

What is Gamification? Gamification is the craft of deriving all the fun and addicting elements found in games (Konopelko & O’Broin,2017) and applied in real-world activities such as learning. Dealing with a learner who posted something inappropriate in a discussion, immediate short feedback using alternative means of communication such as the “message tool” or a private feedback discussion area for a private message is essential to guide the student to the right track following the prescribed rubric of the assigned topic. Incorporating education gamification design principles in combination with formative feedbacks make the learning experience more fun, more “real” and engaging, leading to the perceived enhanced value of the educational exercise.

The education gamification design principle “Freedom to fail” as stated by Haaranen et al., (2014), Berkling and Thomas, (2013), De Byl and Hooper, (2013), Hentenryck and Coffrin, (2014)) presumes no penalties on poor choice or task performance allowed students to revise and re-submit assignments, or go back to the discussion thread and post a relevant argument. Then the student will have the chance to reclaim the conversation, and apply the principle “Freedom of choice” where he/she could weave together the contributions of other students in the class. In this way, as educators, we show empathy; at the same time, help our learners develop empathy. We have the chance in this scenario, to remove the notion of a “tribe of one,” loyal to one party, but rather induce collaboration for the better good. It will add up to a flight of discussion and rebuttal, nurturing a conversation of ideas, a forum where creative partnership thrive. Hybrid formative feedbacks could promote interest and the drive to deeply engage in a discussion forum, transforming the gaming concept to positive addictive behavior that encourages collective intelligence (CI). CI or group intelligence in a class will then eclipse any inappropriate discussion post and reverse the probable implication of negativity to positivity. Feedback to students that is informed by insights derived from both personal and professional experience make the feedback process “more real” to support one’s development as a reflective, resilient, and humanistic professional in their field of choice. Formative feedbacks can illuminate students’ personal and professional growth.

References

Berkling, K., & Thomas, C. (2013). Gamification of a Software Engineering course and a detailed analysis of the factors that lead to it’s failure. Int. Conference on Interactive Collaborative Learning, (pp. 525–530). Kazan, Russia. doi:10.1109/ICL.2013.6644642

De Byl, P., & Hooper, J. (2013). Key Attributes of Engagement in a Gamified Learning Environment. 30th ASCILITE Conference, (pp. 221–229).

Haaranen, L., Ihantola, P., Hakulinen, L., & Korhonen, A. (2014). How (not) to introduce badges to online exercises. In J. Dougherty, & K. Nagel (Ed.), SIGCSE ’14 (pp. 33–38). Atlanta, GA: ACM.

Hentenryck, P. V., & Coffrin, C. (2014). Teaching Creative Problem Solving in a MOOC. In J. Dougherty, & K. Nagel (Ed.), SIGCSE’14 (pp. 677–682). Atlanta, GA: ACM

Konopelko, M., & O’Broin, D., (2017). Helping Students to Internalise Standards Through Gamification. European Conference on Games Based Learning, 890.

Turkle, S., (2016). Reclaiming conversation: The power of talk in a digital age. Penguin.

Wald, H. S., & Weiss, B. (2018). Making it “More Real”: Using Personal Narrative in Faculty Feedback to a Medical Student’s Reflective Writing–An Illustrative Exemplar. MedEdPublish, 7.