The nosocomial transmission of respiratory pathogens is an ongoing healthcare challenge, with consequences for the health of vulnerable individuals. Outbreaks in hospitals can require the closure of bays or entire wards, reducing hospital capacity and having a financial impact upon healthcare providers. Here we evaluate a novel strategy of pre-exposure prophylaxis as a means to reduce the nosocomial transmission of SARS-CoV-2. We model the effect of ursodeoxycholic acid (UDCA) upon levels of angiotensin-converting enzyme 2 (ACE2) expression, SARS-CoV-2 viral entry, and ultimately the probability of an infection. We then implement this model within simulations describing the spread of SARS-CoV-2 infections within a hospital context, simulating an intervention in which UDCA is given to patients on a ward for 10 days following the detection of a case of SARS-CoV-2 on that ward. Under default model parameters we infer a potential 17% reduction in the nosocomial transmission of SARS-CoV-2 to patients, with increased importation of cases into the hospital increasing the effectiveness of the intervention, and of the order 1000-2000 patient treatment days per nosocomial patient infection prevented. Our study provides preliminary evidence of the value of pre-exposure prophylaxis with UDCA as a strategy to reduce nosocomial SARS-CoV-2 transmission.

Digital approaches to physical rehabilitation are becoming increasingly common and embedding these new technologies within a musical framework may be particularly motivating. The current feasibility study aimed to test if digital musical instruments (DMIs) could aid in the self-management of stroke rehabilitation in the home, focusing on seated forward reach movements of the upper limb. Participants (n=3), all at least 11 months post stroke, participated in 15 researcher-led music making sessions over a 5 week intervention period. The sessions involved them 'drumming' to the beat of self-chosen tunes using bespoke digital drum pads that were synced wirelessly to an iPad App and triggered percussion sounds as feedback. They were encouraged to continue these exercises when the researcher was not present. The results showed significant levels of self-management and significant increases in functional measures with some evidence for transfer into tasks of daily living.