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At the moment, the world lives in a pandemic situation of COVID -19 and related variants, driving urgent needs for expanded assessments. A complementary support of related healthcare can be based on an intelligent system that can diagnose early onset of respiratory disorders. The convolutional neural networks (CNN) were implemented utilizing image data, reflecting bidimensional signals. Specifically, CNN has shown to be powerful tool in the context of cardiopulmonary sounds evaluation. The configurations of CNN contain convolutional layers to extract feature maps and fully connected layers to classify indicators of interest. Even though, learning algorithms use parameters like learning rate which can determine and attain CNN configuration less complex, with excellent results as reflected in the experiments we carried out, and which focused on achieved configuration of CNN with excellent results classifying heart sounds (HS) and lung sounds (LS). © 2022 IEEE. | CNN Networks to Classify Cardiopulmonary Signals |
BACKGROUND: Neoadjuvant endocrine therapy (NET) is effective in downstaging large hormone receptor-positive (HR+) breast cancers and increasing rates of breast-conserving surgery (BCS), but data regarding nodal pathologic complete response (pCR) are sparse. We reported nodal and breast downstaging rates with NET, and compared axillary response rates following NET and neoadjuvant chemotherapy (NAC). METHODS: Consecutive stage I-III breast cancer patients treated with NET and surgery from January 2009 to December 2019 were identified from a prospectively maintained database. Nodal pCR rates were compared between biopsy-proven node-positive patients treated with NET, and HR+/HER2- patients treated with NAC from November 2013 to July 2019. RESULTS: 127 cancers treated with NET and 338 with NAC were included. NET recipients were older, more likely to have lobular and lower-grade tumors, and higher HR expression. With NET, the nodal pCR rate was 11% (4/38) of biopsy-proven cases, and the breast pCR rate was 1.6% (2/126). Nodal-dowstaging rates with NET and NAC were not significantly different (11% vs 18%; P = 0.37). Patients achieving nodal pCR with NET versus NAC were older (median age 70 vs 50, P = 0.004) and had greater progesterone receptor (PR) expression (85% vs 13%, P = 0.031), respectively. Of patients not candidates for BCS due to a large tumor relative to breast size, 36/47 (77%) became BCS-eligible with NET (median PR expression 55% vs 5% in those remaining ineligible, P < 0.05). CONCLUSION: Although nodal pCR is more frequent than breast pCR, NET is more likely to de-escalate breast surgery than axillary surgery. However, with a nodal pCR rate of 11%, NET remains an option for downstaging node-positive patients without clear indications for NAC. | How Effective is Neoadjuvant Endocrine Therapy (NET) in Downstaging the Axilla and Achieving Breast-Conserving Surgery? |
Prochlorococcus and Synechococcus are the most abundant photosynthesizing organisms in the oceans. Gene content variation among picocyanobacterial populations in separate ocean basins often mirrors the selective pressures imposed by the region's distinct biogeochemistry. By pairing genomic datasets with trace metal concentrations from across the global ocean, we show that the genomic capacity for siderophore-mediated iron uptake is widespread in Synechococcus and low-light adapted Prochlorococcus populations from deep chlorophyll maximum layers of iron-depleted regions of the oligotrophic Pacific and S. Atlantic oceans: Prochlorococcus siderophore consumers were absent in the N. Atlantic ocean (higher new iron flux) but constituted up to half of all Prochlorococcus genomes from metagenomes in the N. Pacific (lower new iron flux). Picocyanobacterial siderophore consumers, like many other bacteria with this trait, also lack siderophore biosynthesis genes indicating that they scavenge exogenous siderophores from seawater. Statistical modeling suggests that the capacity for siderophore uptake is endemic to remote ocean regions where atmospheric iron fluxes are the smallest, especially at deep chlorophyll maximum and primary nitrite maximum layers. We argue that abundant siderophore consumers at these two common oceanographic features could be a symptom of wider community iron stress, consistent with prior hypotheses. Our results provide a clear example of iron as a selective force driving the evolution of marine picocyanobacteria. | Siderophores as an iron source for picocyanobacteria in deep chlorophyll maximum layers of the oligotrophic ocean. |
Specialized pro-resolving lipid mediators (SPMs) are natural bioactive agents actively involved in inflammation resolution. SPMs act when uncontrolled inflammatory processes are developed, for instance, in patients of COVID-19 or other diseases. The so-called resolution pharmacology aims at developing new treatments based on the use of SPMs as agonists, which promote inflammation resolution without unwanted side effects. It has been shown that the biosynthesis of SPMs called eicosapentaenoic acid (EPA)-derived E-series resolvins is initiated by aspirin-acetylated COX-2 from EPA, leading to 18-hydroperoxy-eicosapentaenoic acid (18-HpEPE). However, there are many open questions concerning the intriguing role of aspirin in the molecular mechanism of resolvin formation. Our MD simulations, combined with QM/MM calculations, show that the potential energy barriers for the H16-abstraction from EPA, required for forming 18-HpEPE, are higher than for the H13-abstraction, thus explaining why 18-HpEPE is a marginal product of COX-2 catalysis. By contrast, in the aspirin-acetylated COX-2/EPA complex, the H16proS-abstraction energy barriers are somewhat lower than the H13proS energy barriers and much smaller than the H16-transfer barriers in the wild type COX-2/EPA system. Those results agree with the experimental observation that aspirin favours the synthesis of several SPMs known as aspirin-triggered resolvins. In the following step of the catalytic mechanism, the calculated O2 addition to C18 is preferred versus the addition to C14 which also agrees with 18R-HEPE and 18S-HEPE being the main products from EPA in aspirin-acetylated COX-2. | The role of acetylated cyclooxygenase-2 in the biosynthesis of resolvin precursors derived from eicosapentaenoic acid. |
Objective: Coronavirus Disease-2019 (COVID-2019), which originated in Wuhan, China in December 2019 and became a global pandemic in March 2020, is a viral infectious condition. This study was planned due to the novel character of the virus, unexpected clinical course of the disease as well as due to the relative lack of data on determinants of severe disease. Methods: This retrospective study was carried out with the inclusion of 80 patients admitted to the Intensive Care Unit (ICU), Medical Faculty of Erzincan Binali Yildirim University between 1st April 2020 and 1st October 2020 due to the diagnosis of COVID-19 pneumonia. Demographic, clinical, and laboratory data, as well as treatments complications, length of ICU stay and mortality rate were compared between patients who had survive or not. Results: Of the 80 patients, 18 were died, and 62 were discharged. The mean age was 69.7 ± 14.7 years, with a female to male ratio of approximately 1:2. Systolic blood pressure and mean arterial pressure on admission were significantly lower in non-survivors (p=0.002, and p=0.026, respectively). Also, non-survivors had significantly higher levels of CRP, procalcitonin, D-dimer, urea, LDH, INR, lactate, and neutrophil count and significantly lower lymphocyte counts as compared to survivors. The predictors of mortality were determined as the need for mechanical ventilation, presence of complications, higher CRP and urea levels in a multivariate regression analysis . Conclusion: Early estimation of patients with a high likelihood of severe illness, assessment of the intensive care unit admission, and convenient treatment strategies are important. This is a precious study that detects an early need for ICU admission and close follow-up of patients. | Determinants of Mortality in Patients Admitted to Intensive Care Unit Due to COVID-19 Pneumonia: Turkish Journal of Medical and Surgical Intensive Care Medicine |
OBJECTIVE: This study aimed to evaluate the short-term patient satisfaction, compliance, disease control, and infection risk of telemedicine (TM) compared with standard in-person follow-up (FU) for patients with lupus nephritis (LN) during the COVID-19 pandemic. METHOD: This was a single-center open-label randomized controlled study. Consecutive patients followed at the LN clinic were randomized to either TM or standard FU (SF) group in a 1:1 ratio. Patients in the TM group received FU via videoconferencing. SF group patients continued conventional in-person outpatient care. The 6-month data were compared and presented. RESULTS: From June to December 2020, 122 patients were randomized (TM: 60, SF: 62) and had at least 2 FUs. There were no baseline differences, including SLEDAI-2k and proportion of patients in lupus low disease activity state (LLDAS), between the two groups except a higher physician global assessment score (PGA) in the TM group. After a mean FU of 19.8 ± 4.5 weeks, the overall patient satisfaction score was higher in the TM group. More patients in the TM group had hospitalization (15/60, 25.0% vs 7/62, 11.3%; p = .049) with higher baseline PGA (OR = 1.17; 95% CI, 1.08–1.26) being the independent predictor. The proportions of patients remained in LLDAS were similar in the two groups (TM: 75.0% vs SF: 74.2%, p = .919). None of the patients had COVID-19. CONCLUSIONS: TM FU resulted in better patient satisfaction and similar short-term disease control in patients with LN compared to standard care. However, it was associated with more hospitalizations and might need to be complemented by in-person visits especially in patients with higher PGA. | Use of telemedicine for follow-up of lupus nephritis in the COVID-19 outbreak: The 6-month results of a randomized controlled trial |
OBJECTIVE To examine the presence of severe acute respiratory syndrome (SARS) coronavirus-specific antibodies in the sera from non-SARS children. METHODS Indirect immunofluorescent assay and double-antigen sandwich enzyme-linked immunosorbent assay (ELISA) were used to detect the virus-specific antibodies in sera of 1,060 non-SARS children in Guangzhou. RESULTS All the serum samples from the 1,060 non-SARS children were negative for both IgG and IgM antibodies against SARS coronavirus as determined by indirect immunofluorescent assay, with only two serum samples showing weak positivity for SARS coronavirus-specific antibodies identified by double-antigen sandwich ELISA. CONCLUSION No SARS coronavirus-specific antibody are present in the sera of non-SARS children. | [Detection and analysis of SARS coronavirus-specific antibodies in sera from non-SARS children]. |
Transformative learning theory has been recommended as a pedagogy of uncertainty for accommodating new beliefs that enable humans to thrive amid the challenges and complexity of our world. As higher education institutions embrace new roles and responsibilities, few studies have focused on how the disruptions caused by COVID-19 may facilitate formative learning experiences. This study explored how registrars responded to the challenges facing clinical training during the first wave of COVID-19, and how the impact of these disruptions prompted personal and professional development. Registrars completed an online qualitative SWOT (strengths, weaknesses, opportunities, and threats) analysis of their training experiences during the COVID-19 pandemic. Data were thematically analysed. Four hundred and five responses were received from 54 registrars. Themes related to challenges included mental distress, resource constraints, and compromised and inadequate training. Themes related to strengths and opportunities included new learning experiences, resilience, coping strategies, and enhanced graduate competencies related to leadership, collaboration, communication, and health advocacy. The disruptive and disorienting elements of COVID-19, although situated in chaos, aggravating the constraints of training in under-resourced settings, also provided unexpected learning opportunities. These findings highlight the transformative potential of disrupted learning contexts and the need for responsive curricular to enhance graduate competencies, adaptability, and resilience. © 2022 by the authors. Licensee MDPI, Basel, Switzerland. | “Growing as a Stronger Clinician in Adverse Conditions”—A Snapshot of Clinical Training during COVID-19 |
Nutrition and immunity are closely related, and the immune system is composed of the most highly energy-consuming cells in the body. Much of the immune system is located within the GI tract, since it must deal with the huge antigenic load introduced with food. Moreover, the incidence of immune-mediated diseases is elevated in Westernized countries, where “transition nutrition” prevails, owing to the shift from traditional dietary patterns towards Westernized patterns. This ecological correlation has fostered increasing attempts to find evidence to support nutritional interventions aimed at managing and reducing the risk of immune-mediated diseases. Recent studies have described the impacts of single nutrients on markers of immune function, but the knowledge currently available is not sufficient to demonstrate the impact of specific dietary patterns on immune-mediated clinical disease endpoints. If nutritional scientists are to conduct quality research, one of many challenges facing them, in studying the complex interactions between the immune system and diet, is to develop improved tools for investigating eating habits in the context of immunomediated diseases. | How to Tackle the Relationship between Autoimmune Diseases and Diet: Well Begun Is Half-Done |
With decades of experience implementing STI and HIV programmes globally what do we know and what are we still learning? Implementation science is a relatively new approach to understanding what facilitates rapid implementation and the barriers to implementation. With a rising tide of some STIs and need to eliminate HIV as a public health threat, this presentation will focus on experiences of a national programme manager implementing STI, HIV and other programmes in an upper middle-income country - South Africa. Looking ahead does the COVID-19 pandemic provide us with opportunities to do things differently - and if yes, what can they be. | What's to know and what's to be done-implementing and monitoring STI and HIV programmes |
The coronavirus pandemic and related social distancing measures have brought about dramatic changes in people's lives. In particular, health workers have been forced to change their activities both for the different needs of patients and for preventive measures against the spread of the virus.This study is aimed at comparing the urgent psychiatric consultations (UPC) performed at the outpatient Mental Health Center (MHC) of Modena during the coronavirus outbreak period, from 1 March to 31 August 2020, with the same period in 2019. We retrospectively collected in a database the socio-demographic and clinical characteristics of patients who required UPC in the MHC during the 6-month observation periods in both 2019 and 2020. Data were statistically analyzed.We analyzed 656 urgent psychiatric consultations in 2019 and 811 in 2020, requested by 424 patients in 2019 and 488 in 2020, respectively. In the pandemic period, we observed an increase in the total and daily number of UPC which were more frequently required by patients in care at local outpatient services in comparison with the previous period. During 2020, an increased number of UPC were carried out remotely and the outcome was more frequently represented by discharge at home, avoiding hospitalization as much as possible.In the course of the coronavirus pandemic, MHC had to face an increased demand for clinical activity especially from the most clinically and socially vulnerable patients, who more frequently required UPC in outpatient psychiatric services. | Urgent psychiatric consultations at Mental Health Center during COVID-19 pandemic: a retrospective observational study |
COVID-19 pandemic has an unprecedented impact all over the world since early 2020. During this public health crisis, reliable forecasting of the disease becomes critical for resource allocation and administrative planning. The results from compartmental models such as SIR and SEIR are popularly referred by CDC and news media. With more and more COVID-19 data becoming available, we examine the following question: Can a direct data-driven approach without modeling the disease spreading dynamics outperform the well referred compartmental models and their variants? In this paper, we show the possibility. It is observed that as COVID-19 spreads at different speed and scale in different geographic regions, it is highly likely that similar progression patterns are shared among these regions within different time periods. This intuition lead us to develop a new neural forecasting model, called Attention Crossing Time Series (\textbf{ACTS}), that makes forecasts via comparing patterns across time series obtained from multiple regions. The attention mechanism originally developed for natural language processing can be leveraged and generalized to materialize this idea. Among 13 out of 18 testings including forecasting newly confirmed cases, hospitalizations and deaths, \textbf{ACTS} outperforms all the leading COVID-19 forecasters highlighted by CDC. | Inter-Series Attention Model for COVID-19 Forecasting |
This article traces income and employment changes through various phases of the lockdown based on primary data It analyses the coping strategies of people in response to fall in their income The article reveals that there was a large drop in income and employment with the announcement of lockdown While there is some recovery with easing of the lockdown, the income at the time of survey is still substantially lower than its pre-lockdown level Casual labour households with the largest fall in income and employment are the most affected Income and employment losses are also higher among Scheduled Caste (SC) and Other Backward Caste (OBC) households In the absence of any income, the households either had to live off their savings or had to borrow money for their basic needs With rapidly depleting savings, borrowing approached its limits, and with slow recovery of income, households may need substantial government assistance to save them from deprivation | Income and Employment Changes Under COVID-19 Lockdown: A Study of Urban Punjab |
This article presents the design and the implementation of CAIR: a cloud system for knowledge-based autonomous interaction devised for Social Robots and other conversational agents. The system is particularly convenient for low-cost robots and devices. Developers are provided with a sustainable solution to manage verbal and non-verbal interaction through a network connection, with about 3,000 topics of conversation ready for"chit-chatting"and a library of pre-cooked plans that only needs to be grounded into the robot's physical capabilities. The system is structured as a set of REST API endpoints so that it can be easily expanded by adding new APIs to improve the capabilities of the clients connected to the cloud. Another key feature of the system is that it has been designed to make the development of its clients straightforward: in this way, multiple devices can be easily endowed with the capability of autonomously interacting with the user, understanding when to perform specific actions, and exploiting all the information provided by cloud services. The article outlines and discusses the results of the experiments performed to assess the system's performance in terms of response time, paving the way for its use both for research and market solutions. Links to repositories with clients for ROS and popular robots such as Pepper and NAO are given. | Sustainable Verbal and Non-verbal Human-Robot Interaction Through Cloud Services |
This article is linked to Hadi et al. papers. To view these articles, visit https://publons.com/publon/10.1111/apt.16730 https://doi.org/10.1111/apt.16900 | Letter: association between COVID‐19 and inflammatory bowel disease |
Recent advancements in bidimensional nanoparticles production such as Graphene (G) and Graphene oxide (GO) have the potential to meet the need for highly functional personal protective equipment (PPE) against SARS-CoV-2 infection. The ability of G and GO to interact with microorganisms provides an opportunity to develop engineered textiles for use in PPE and limit the spread of COVID-19. PPE in current use in high-risk settings for COVID transmission provide only a physical barrier that decreases infection likelihood and does not inactivate the virus. Here, we show that virus pre-incubation with soluble GO inhibits SARS-CoV-2 infection of VERO cells. Furthermore, when G/GO functionalized polyurethane or cotton were in contact SARS-CoV-2, the infectivity of the fabric was nearly completely inhibited. The findings presented here constitute an important innovative nanomaterial-based strategy to significantly increase PPE efficacy in protection against the SARS-CoV-2 virus that may implement water filtration, air purification, and diagnostics methods. | Graphene Nanoplatelet and Graphene Oxide Functionalization of Face Mask Materials Inhibits Infectivity of Trapped SARS-CoV-2 |
BACKGROUND: There are limited data on the long-term outcomes of COVID-19 from different parts of the world. AIMS: To determine risk factors of 90-day mortality in critically ill patients in Turkish intensive care units (ICUs), with respiratory failure. STUDY DESIGN: Retrospective, observational cohort. METHODS: Patients with laboratory-confirmed COVID-19 and who had been followed up in the ICUs with respiratory failure for more than 24 hours were included in the study. Their demographics, clinical characteristics, laboratory variables, treatment protocols, and survival data were recorded. RESULTS: A total of 421 patients were included. The median age was 67 (IQR: 57-76) years, and 251 patients (59.6%) were men. The 90-day mortality rate was 55.1%. The factors independently associated with 90-day mortality were invasive mechanical ventilation (IMV) (HR 4.09 [95% CI: [2.20-7.63], P < .001), lactate level >2 mmol/L (2.78 [1.93-4.01], P < .001), age ≥60 years (2.45 [1.48-4.06)], P < .001), cardiac arrhythmia during ICU stay (2.01 [1.27-3.20], P = .003), vasopressor treatment (1.94 [1.32-2.84], P = .001), positive fluid balance of ≥600 mL/day (1.68 [1.21-2.34], P = .002), PaO(2)/FiO(2) ratio of ≤150 mmHg (1.66 [1.18-2.32], P = .003), and ECOG score ≥1 (1.42 [1.00-2.02], P = .050). CONCLUSION: Long-term mortality was high in critically ill patients with COVID-19 hospitalized in intensive care units in Turkey. Invasive mechanical ventilation, lactate level, age, cardiac arrhythmia, vasopressor therapy, positive fluid balance, severe hypoxemia and ECOG score were the independent risk factors for 90-day mortality. | Clinical Outcomes and Independent Risk Factors for 90-Day Mortality in Critically Ill Patients with Respiratory Failure Infected with SARS-CoV-2: A Multicenter Study in Turkish Intensive Care Units |
The mutations in the spike protein of SARS-CoV-2 Omicron variant (B.1.1.529 lineage) gave rise to questions, but the data on the mechanism of action at the molecular level is limited. In this study, we present the Free energy of perturbation (FEP) data about the RBD-hACE2 binding of this new variant. We identified two groups of mutations located close to the most contributing substitutions Q498R and Q493R, which altered significantly the RBD-hACE2 interactions. The Q498R, Y505H and G496S mutations, in addition to N501Y, highly increased the binding to hACE2. They enhanced the binding by 98, 14 and 13 folds, respectively, which transforms the S1-RBD to a picomolar binder. However, in contrast to the case in mice the Q493R/K mutations, in a combination with K417N and T478K, dramatically reduced the S1 RBD binding by over 100 folds. The N440K, G446S and T478K substitutions had lesser contribution. Thus, the total effect of these nine mutations located on the interaction surface of RBD-hACE2 turns out to be similar to that observed in the Alpha variant. In a special circumstances it could be further altered by the E484A and S477N mutations and even lower binding capacity is likely to be detected. Finally, we provide a structural basis of the observed changes in the interactions. These data may explain only partially the observed in South Africa extremely high Omicron spread and is in support to the hypothesis for multiple mechanisms of actions involved in the transmission. Graphical abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=109 SRC="FIGDIR/small/471246v1_ufig1.gif" ALT="Figure 1"> View larger version (64K): org.highwire.dtl.DTLVardef@144d901org.highwire.dtl.DTLVardef@10310e7org.highwire.dtl.DTLVardef@4ac7dborg.highwire.dtl.DTLVardef@1870231_HPS_FORMAT_FIGEXP M_FIG C_FIG | The High Transmission of SARS-CoV-2 Omicron (B.1.1.529) Variant is Not Only Due to Its hACE2 binding: A Free Energy of Perturbation Study |
BACKGROUND/AIM: We aimed to identify clinical settings of renal transplant patients with COVID-19. MATERIALS AND METHODS: In this retrospective study, we included kidney transplant inpatients with laboratory confirmed COVID-19 who had been discharged or had died by October 1st, 2020. Characteristics of the patients, including basal and last outpatient biochemical parameters were recorded. Discontinuation or dosage reduction of immunosuppressives and other treatment information was documented. RESULTS: Twenty patients were included in this study, of whom 18 were discharged and 2 died in hospital. The mean duration of hospitalization and follow-up were 9.7 ± 6.4 days and 4.5 ± 2.0 months, respectively. Fourteen patients (70%) were male and mean age was 48.0 ± 10.3 years. At admission, all had immunosuppression withdrawn and were started on methylprednisolone 16 mg/day (50%) or dexamethasone (50%). Tacrolimus/m-TOR inhibitors were reduced by 50% and all antimetabolites were discontinued. Hemodialysis was needed for 10% of patients. Acute kidney injury was detected in 25% of the patients. With respect to hospitalization time and complications, there was no significant difference between patients who used dexamethasone and those who did not (P > 0.05). The discontinued immunosuppressives were resumed within 2 to 4 weeks after discharge according to the severity of disease. No rehospitalization or acute rejection was detected during the follow-up of the patients. CONCLUSION: Renal transplant patients are considered a high risk group for COVID-19. It can be said that discontinuation or reducing dosages of immunosuppressives may be effective and safe in kidney transplant patients. | Clinical course of COVID-19 disease in immunosuppressed renal transplant patients |
Acanthamoeba polyphaga Mimivirus, a complex virus that infects amoeba, was first reported in 2003. It is now known that its DNA genome encodes for nearly 1000 proteins including enzymes that are required for the biosynthesis of the unusual sugar 4-amino-4,6-dideoxy-d-glucose, also known as d-viosamine. As observed in some bacteria, the pathway for the production of this sugar initiates with a nucleotide-linked sugar which in the Mimivirus is thought to be UDP-d-glucose. The enzyme required for the installment of the amino group at the C-4' position of the pyranosyl moiety is encoded in the Mimivirus by the L136 gene. Here we describe a structural and functional analysis of this PLP-dependent enzyme, referred to as L136. For this analysis, three high-resolution X-ray structures were determined: the wildtype enzyme/PMP/dTDP complex and the site-directed mutant variant K185A in the presence of either UDP-4-amino-4,6-dideoxy-d-glucose or dTDP-4-amino-4,6-dideoxy-d-glucose. Additionally, the kinetic parameters of the enzyme utilizing either UDP-d-glucose or dTDP-d-glucose were measured and demonstrated that L136 is efficient with both substrates. This is in sharp contrast to the structurally related DesI from Streptomyces venezuelae, whose three-dimensional architecture was previously reported by this laboratory. Here we show that DesI shows a profound preference in its catalytic efficiency for the dTDP-linked sugar substrate. This difference can be explained in part by a hydrophobic patch in DesI that is missing in L136. Notably, the structure of L136 reported here represents the first three-dimensional model for a virally encoded PLP-dependent enzyme and thus provides new information on sugar aminotransferases in general. | Characterization of an aminotransferase from Acanthamoeba polyphaga Mimivirus. |
INTRODUCTION: A quarter of all complaints seen in adult primary care and half of all complaints seen in pediatric primary care are otolaryngology related. Even though half of all medical students enter primary care fields, there is no standardized curriculum for otolaryngology during medical school. Due to increasing limitations on specialty teaching during general medical education, computer-assisted instruction has been suggested as a format for increasing exposure to otolaryngology. METHODS: We designed a computer-based learning module for teaching high-yield otolaryngology topics for third- and fourth-year medical students during their primary care clerkship at our institution from 2016–2018. We evaluated students’ prior otolaryngology knowledge with 11 case-based, multiple-choice questions and then evaluated the efficacy of the module by a similar posttest. RESULTS: Three-hundred and sixty-five students completed the module. The average pre- and posttest scores were 44% (SD = 21%) and 70% (SD = 17%), respectively, showing that the module resulted in significantly increased scores (p < .01). DISCUSSION: The improvement of test scores indicates that this module was an effective educational intervention at our institution for increasing exposure and improving otolaryngology knowledge in third- and fourth-year medical students. As medical schools shift toward adult learning principles such as independent and self-directed learning, computer-assisted instruction is an alternative to classroom-based didactics. Creating resources for independent study will allow more time for otolaryngology faculty and residents to teach clinical exam skills and interactive case-based discussions, which are less suitable to teach via computer-assisted instruction. | Using Computer-Assisted Instruction to Increase Otolaryngology Education During Medical School |
The coronavirus disease 2019 (COVID-19) has challenged the way nursing homes deliver person-centered care (PCC) Preferences for Activity and Leisure (PAL) Cards are a tool to communicate residents' important preferences to staff Monthly interviews (N = 32) were conducted with champions who were conducting a PAL Card quality improvement project in Tennessee nursing homes (N = 11) between March and August 2020 Three major themes emerged: Structural Changes (e g , halting admissions, adding an isolation unit), Resident Burden (e g , physical isolation, loneliness), and Provider Burnout (e g , increased workload, mental exhaustion) Further, providers expressed the benefits to using PAL Cards, specifically in regard to blunting the negative impact of each theme Results showed the overall negative impact of COVID-19 on nursing home communities Nursing staff experienced greater burden than other staff, reflecting their prominent role in providing direct care to residents with COVID-19 Staff reported that PAL Cards helped promote PCC | "It's Been a Whole New World": Staff Perceptions of Implementing a Person-Centered Communication Intervention During the COVID-19 Pandemic |
Introduction: This tutorial offers technical and professional communication (TPC) professionals a heuristic designed to support more just data practices. Key concepts: Understanding how data contribute to discussions of public problems matters, especially in times of crisis during which multiply marginalized communities are disproportionately affected. Critical Data Studies clarifies how data practice and priorities emerging from various domains of power exacerbate structural inequalities. If we recognize, reveal, and reject data practices that cast data as if they were neutral or fixed, we can ensure that our data practices as TPC professionals are more just. Key lessons: 1. Recognize that data are socially constructed and often incomplete. 2. Reveal the overarching social, political, cultural, and economic conditions that shape data collection and by extension, data itself. 3. Reject faulty or biased processes for data interpretation and analysis that perpetuate inequality. Implications for practice: By acknowledging the relationship between data and context, we can promote better, more just data practices, preparing TPC professionals to work alongside community stakeholders in intersectional coalitions and challenging the conditions that lead to unjust data that fail to represent, over-represent, or blatantly misrepresent the realities of vulnerable communities. | Building Toward More Just Data Practices |
With interest we read the study by Simonnet A et al. (1) in which important novel evidence is addressed that obesity is highly frequent among critically ill patients with severe acute respiratory syndrome coronavirus-2 (SARS-Cov-2) infection. Although clinically very relevant, it remains difficult to elucidate the mechanisms by which SARS-Cov-2 severity is increased in the context of obesity. As reported by Katz JN et al. (2), 28% of hospitalised patients with coronavirus disease 2019 (COVID-19) presented cardiac complications including myocarditis, arrhythmias, heart failure (HF) and sudden death. Considering that myocardial response in COVID-19 is closely associated with in-hospital mortality, local biological effects on myocardial tissue from epicardial adipose tissue (EAT) is warrant further discussion. | Obesity accompanying COVID-19: the role of epicardial fat |
In this article, an overview of the barriers to accessing mental health services in Canada is provided and the recent federal funding commitments toward increasing the availability of evidence-based and cost-effective solutions to improve access to mental health services are highlighted. Barriers pertain mainly to costs, not knowing where to get help, excessive wait times, and insufficient funding. Through the Common Statement of Principles on Shared Health Priorities agreement, action is being taken by all jurisdictions in Canada to increase community-based mental health promotion programs and early interventions, especially those targeting children and youth. A growing body of evidence is demonstrating how specific community and primary care-based interventions are both effective and cost-effective. These integrated community solutions, shown to be effective for increasing access to appropriate services for patients while saving costs to the healthcare system, would benefit from the recent funding investments put in place by the federal government. | Mental health services in Canada: Barriers and cost-effective solutions to increase access |
Exhaled breath samples had the highest positive rate (26.9%, n=52), followed by surface swabs (5.4%, n=242), and air samples (3.8%, n=26). COVID-19 patients recruited in Beijing exhaled millions of SARS-CoV-2 RNA copies into the air per hour. Exhaled breath emission may play an important role in the COVID-19 transmission. | COVID-19 patients in earlier stages exhaled millions of SARS-CoV-2 per hour |
Ribosome biogenesis in eukaryotes requires the participation of several transactivation factors that are involved in the modification, assembly, transport and quality control of the ribosomal subunits. One of these factors is the Large subunit GTPase 1 (Lsg1), a protein that acts as the release factor for the export adaptor named Nonsense-mediated mRNA decay 3 protein (Nmd3) and facilitates the incorporation of the last structural protein uL16 into the 60S subunit. Here, we characterised the recombinant yeast Lsg1 and studied its catalysis and binding properties for guanine nucleotides. We described the interaction of Lsg1 with guanine nucleotides alone and in the presence of the complex Nmd3â¢60S using fluorescence spectroscopy. Lsg1 has a greater affinity for GTP than for GDP suggesting that in the cell cytoplasm it exists mainly bound to the former. In the presence of 60S subunits loaded with Nmd3, the affinity of Lsg1 for both nucleotides increases but to a larger extent towards GTP. From this observation together with the excess of GTP present in the cytoplasm of exponentially growing cells over that of GDP, we can infer that the pre-ribosomal particle composed by Nmd3â¢60S acts as a GTP Stabilising Factor for Lsg1. Additionally, Lsg1 undergoes different conformational changes depending on its binding partner or the guanine nucleotides it interacts with. Steady-state kinetic analysis of free Lsg1 indicated slow GTP hydrolysis with values of kcat 1â¯min-1 and Km of 34⯵M. | Characterisation of the interaction of guanine nucleotides with ribosomal GTPase Lsg1 |
Chinese medicine (CM) has been used to control infectious diseases for thousands of years. In 2003 outbreaks of severe acute respiratory syndrome (SARS) occurred in China, Hong Kong and Taiwan. In view of the possible beneficial effect of CM on SARS, we conducted this study to examine whether CM is of any benefit as a supplementary treatment of SARS. Four severe laboratory-confirmed SARS patients received routine western-medicine treatment plus different supplementary treatment: CM A, CM B and CM C (placebo control). We reported the course of the cases in terms of changes in chest radiographic scores. Case 1 treated as a placebo control passed away on the 9th day after onset of disease. The other three cases treated with CM A or CM B survived. The initial findings seemed to indicate a favorable effect of CM on management of SARS. The findings need to be verified with a larger sample. Using CM as a supplementary treatment of severe SARS seems to indicate that natural herbal medicine can be used against avian influenza. Hence, such related experience or clinical trials should be taken into consideration when facing the possible outbreak of avian influenza in the future. | The lesson of supplementary treatment with Chinese medicine on severe laboratory-confirmed SARS patients. |
BACKGROUND: Workplace violence is a common issue worldwide that strikes all professions, and healthcare is one of the most susceptible ones. Verbal and nonverbal miscommunications between healthcare workers and patients are major inducers for violent attacks. AIM: To study the potential impact of verbal and nonverbal miscommunications between the patients and healthcare workers upon workplace violence from the patients' perspectives. METHODS: A descriptive cross-sectional study was performed from November to December 2020. Patients and previously hospitalized patients were asked to complete a self-reported questionnaire that involved items of verbal and nonverbal miscommunication. With the use of a suitable available sample composed of 550 participants, 505 had completed the questionnaire and were included in the study. The data were analyzed by using SPSS version 22 software. RESULTS: 7.2% of the study population reported participating in nonverbal violence and 19.6% participated in verbal violence against healthcare workers. The nonverbal and verbal violence was characteristically displayed by the patients who are male, younger than 30 years old, and bachelor's degree holders. The results of the study demonstrated that the verbal and nonverbal miscommunications between the patients and healthcare workers were the major factors in provoking violent responses from patients. Factors, such as age, gender, and level of education, were significant indicators of the type of patients who were more likely to respond with violence. CONCLUSION: Workplace violence, either verbal or nonverbal, in the health sector is a public health concern in Palestine. The verbal and nonverbal communication skills of healthcare workers should be developed well enough to overcome the effect of miscommunication provoking violent acts from patients and their relatives as well. | Breaching the Bridge: An Investigation into Doctor-Patient Miscommunication as a Significant Factor in the Violence against Healthcare Workers in Palestine |
BACKGROUND: Modifiable risky health behaviors, such as tobacco use, excessive alcohol use, being overweight, lack of physical activity, and unhealthy eating habits, are some of the major factors for developing chronic health conditions. Social media platforms have become indispensable means of communication in the digital era. They provide an opportunity for individuals to express themselves, as well as share their health-related concerns with peers and health care providers, with respect to risky behaviors. Such peer interactions can be utilized as valuable data sources to better understand inter-and intrapersonal psychosocial mediators and the mechanisms of social influence that drive behavior change. OBJECTIVE: The objective of this review is to summarize computational and quantitative techniques facilitating the analysis of data generated through peer interactions pertaining to risky health behaviors on social media platforms. METHODS: We performed a systematic review of the literature in September 2020 by searching three databases—PubMed, Web of Science, and Scopus—using relevant keywords, such as “social media,” “online health communities,” “machine learning,” “data mining,” etc. The reporting of the studies was directed by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Two reviewers independently assessed the eligibility of studies based on the inclusion and exclusion criteria. We extracted the required information from the selected studies. RESULTS: The initial search returned a total of 1554 studies, and after careful analysis of titles, abstracts, and full texts, a total of 64 studies were included in this review. We extracted the following key characteristics from all of the studies: social media platform used for conducting the study, risky health behavior studied, the number of posts analyzed, study focus, key methodological functions and tools used for data analysis, evaluation metrics used, and summary of the key findings. The most commonly used social media platform was Twitter, followed by Facebook, QuitNet, and Reddit. The most commonly studied risky health behavior was nicotine use, followed by drug or substance abuse and alcohol use. Various supervised and unsupervised machine learning approaches were used for analyzing textual data generated from online peer interactions. Few studies utilized deep learning methods for analyzing textual data as well as image or video data. Social network analysis was also performed, as reported in some studies. CONCLUSIONS: Our review consolidates the methodological underpinnings for analyzing risky health behaviors and has enhanced our understanding of how social media can be leveraged for nuanced behavioral modeling and representation. The knowledge gained from our review can serve as a foundational component for the development of persuasive health communication and effective behavior modification technologies aimed at the individual and population levels. | Social Media as a Research Tool (SMaaRT) for Risky Behavior Analytics: Methodological Review |
Backgrounds: Few studies examine the transmission dynamics and heterogeneity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in rural areas and clarify rural–urban differences. Moreover, the effectiveness of non-pharmaceutical interventions (NPIs) relative to that of vaccination in rural areas is uncertain.MethodsWe addressed this knowledge gap using an improved statistical stochastic method based on the Galton–Watson branching process considering both symptomatic and asymptomatic cases. Data were collected from the epidemiological records of 1136 SARS-2-CoV infections after the rural outbreak in Hebei, China, between 2 January and 20 February 2021.ResultsThe estimated average reproductive number R and dispersion parameter k ( k < 1 indicating strong heterogeneity) in the rural area were 0.55 (95% confidence interval [CI]: 0.45–0.68) and 0.14 (95% CI: 0.10–0.20), respectively. Although age group and contact-type distributions significantly differed between urban and rural areas, the \(R\) and \(k\) did not. Further, simulation results based on pre-control parameters ( R = 0.81, k = 0.27 ) showed that in the vaccination scenario (80% efficacy and 55% coverage), the cumulative secondary infections will be reduced by more than half;however, NPIs are more effective than vaccinating 65% of the population. The presence of asymptomatic infections might affect the estimation of R but showed no significant effect on estimating transmission heterogeneity.ConclusionThe government should pay equal value to SARS-CoV-2 transmission in rural and urban areas and conduct specific prevention and control measures in rural areas. Older adults and children should receive particular attention in such policies, and community contact should be minimized. Moreover, the government must consider a country’s economy and governance when conducting vaccination and NPIs. | Transmission dynamics, heterogeneity, and controllability of SARS-CoV-2 in the rural area |
This paper presents a new deep learning classifier model based on the ensemble of two concurrent Convolutional Neural Networks (CNNs). The CNN modules have identical architectures according to Visual Geometry Group Network (VGG-Net) pattern, but they are intentionally trained with asymmetric volumes of training samples. The system uses a decision fusion to increase the classification accuracy. We have applied the proposed decision fusion classifier to COVID-19 diagnosis using chest X-ray imagery. For experiments, we have chosen a balanced dataset containing 5674 training chest X-ray images (2837 belonging to subjects with COVID-19, and the other 2837 corresponding to subjects non COVID-19). We have obtained a maximum accuracy of 95.43% on the test set using decision fusion. © 2021 IEEE. | Concurrent Convolutional Neural Networks with Decision Fusion to Diagnose COVID-19 using Chest X-ray Imagery |
Background: Patients with chronic obstructive pulmonary disease (COPD) are highly susceptible from respiratory exacerbations from viral respiratory tract infections However, it is unclear whether they are at increased risk of COVID-19 pneumonia or COVID-19-related mortality We aimed to determine whether COPD is a risk factor for adverse COVID-19 outcomes including hospitalization, severe COVID-19, or death Methods: Following the PRISMA guidelines, we performed a systematic review of COVID-19 clinical studies published between November 1st, 2019 and January 28th, 2021 (PROSPERO ID: CRD42020191491) We included studies that quantified the number of COPD patients, and reported at least one of the following outcomes stratified by COPD status: hospitalization;severe COVID-19;ICU admission;mechanical ventilation;acute respiratory distress syndrome;or mortality We meta-analyzed the results of individual studies to determine the odds ratio (OR) of these outcomes in patients with COPD compared to those without COPD Findings: Fifty-nine studies met the inclusion criteria, and underwent data extraction Most studies were retrospective cohort studies/case series of hospitalized patients Only four studies examined the effects of COPD on COVID-19 outcomes as their primary endpoint In aggregate, COPD was associated with increased odds of hospitalization (OR 4 23, 95% confidence interval [CI] 3 65–4 90), ICU admission (OR 1 35, 95% CI 1 02–1 78), and mortality (OR 2 47, 95% CI 2 18–2 79) Interpretation: Having a clinical diagnosis of COPD significantly increases the odds of poor clinical outcomes in patients with COVID-19 COPD patients should thus be considered a high-risk group, and targeted for preventative measures and aggressive treatment for COVID-19 including vaccination © 2021 The Authors | COPD and the risk of poor outcomes in COVID-19: A systematic review and meta-analysis |
INTRODUCTION: Glucose variability is associated with mortality and macrovascular diabetes complications. The mechanisms through which glucose variability mediates tissue damage are not well understood, although cellular oxidative stress is likely involved. As heat shock proteins (HSPs) play a role in the pathogenesis of type 2 diabetes (T2D) complications and are rapidly responsive, we hypothesized that HSP-related proteins (HSPRPs) would differ in diabetes and may respond to glucose normalization. RESEARCH DESIGN AND METHODS: A prospective, parallel study in T2D (n=23) and controls (n=23) was undertaken. T2D subjects underwent insulin-induced blood glucose normalization from baseline 7.6±0.4 mmol/L (136.8±7.2 mg/dL) to 4.5±0.07 mmol/L (81±1.2 mg/dL) for 1 hour. Control subjects were maintained at 4.9±0.1 mmol/L (88.2±1.8 mg/dL). Slow Off-rate Modified Aptamer-scan plasma protein measurement determined a panel of HSPRPs. RESULTS: At baseline, E3-ubiquitin-protein ligase (carboxyl-terminus of Hsc70 interacting protein (CHIP) or HSPABP2) was lower (p=0.03) and ubiquitin-conjugating enzyme E2G2 higher (p=0.003) in T2D versus controls. Following glucose normalization, DnaJ homolog subfamily B member 1 (DNAJB1 or HSP40) was reduced (p=0.02) in T2D, with HSP beta-1 (HSPB1) and HSP-70-1A (HSP70-1A) (p=0.07 and p=0.09, respectively) also approaching significance relative to T2D baseline levels. CONCLUSIONS: Key HSPRPs involved in critical protein interactions, CHIP and UBE2G2, were altered in diabetes at baseline. DNAJB1 fell in response to euglycemia, suggesting that HSPs are reacting to basal stress that could be mitigated by tight glucose control with reduction of glucose variability. | Plasma heat shock protein response to euglycemia in type 2 diabetes |
Since the detection of the first confirmed case of coronavirus disease 2019 (COVID-19) in early March 2020, 248,852 cases have been detected in Indonesia by 21 September 2020. At least 100 doctors have died from COVID-19 nationwide. Full large-scale social restriction was a temporary measure, followed by an early transition to the new normal era during the never-ending first wave in the country. Workers in industrial, retail, transport, and tourism fields suffered a significant decrease in work. Many countries are, however, in dilemma of protecting the health of the citizens and prioritising economy. Health should be prioritised because it is an important aspect of our lives for our economy. Poor health is estimated to reduce global gross domestic product (GDP) by 15% annually through premature deaths and potential loss of productivity of the working-age citizens. Pandemics also depress economy through decrease in both supply and demand. Data from flu pandemic a century ago suggested the importance of aggressiveness and speed of intervention. Taiwan's early action led to beneficial effects on SARS-CoV-2 infection rate and economy recovery. The target of enhancement of containment measures, provision of personal protective equipments, and testing and isolation facilities should be achieved earlier and be more than the projected demand. | Dilemma of Prioritising Health and the Economy During COVID-19 Pandemic in Indonesia. |
OBJECTIVE: The seroprevalence of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) IgG antibody was evaluated among employees of a Veterans Affairs healthcare system to assess potential risk factors for transmission and infection. METHODS: All employees were invited to participate in a questionnaire and serological survey to detect antibodies to SARS-CoV-2 as part of a facility-wide quality improvement and infection prevention initiative regardless of clinical or nonclinical duties. The initiative was conducted from June 8 to July 8, 2020. RESULTS: Of the 2,900 employees, 51% participated in the study, revealing a positive SARS-CoV-2 seroprevalence of 4.9% (72 of 1,476; 95% CI, 3.8%-6.1%). There were no statistically significant differences in the presence of antibody based on gender, age, frontline worker status, job title, performance of aerosol-generating procedures, or exposure to known patients with coronavirus infectious disease 2019 (COVID-19) within the hospital. Employees who reported exposure to a known COVID-19 case outside work had a significantly higher seroprevalence at 14.8% (23 of 155) compared to those who did not 3.7% (48 of 1,296; OR, 4.53; 95% CI, 2.67-7.68; P < .0001). Notably, 29% of seropositive employees reported no history of symptoms for SARS-CoV-2 infection. CONCLUSIONS: The seroprevalence of SARS-CoV-2 among employees was not significantly different among those who provided direct patient care and those who did not, suggesting that facility-wide infection control measures were effective. Employees who reported direct personal contact with COVID-19-positive persons outside work were more likely to have SARS-CoV-2 antibodies. Employee exposure to SARS-CoV-2 outside work may introduce infection into hospitals. | Seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection among Veterans Affairs healthcare system employees suggests higher risk of infection when exposed to SARS-CoV-2 outside the work environment |
MicroRNAs (miRNAs) are single-strand endogenous and non-coding RNA molecules with a length of about 22 nucleotides, which regulate genes expression, through modulating the translation and stability of their target mRNAs. miR-146a is one of the most studied miRNAs, due to its central role in immune system homeostasis and control of the innate and acquired immune responses. Accordingly, abnormal expression or function of miR-146a results in the incidence and progression of immune and non-immune inflammatory diseases. Its deregulated expression pattern and inefficient function have been reported in a wide spectrum of these illnesses. Based on the existing evidence, this miRNA qualifies as an ideal biomarker for diagnosis, prognosis, and activity evaluation of immune and non-immune inflammatory disorders. Moreover, much attention has recently been paid to therapeutic potential of miR-146a and several researchers have assessed the effects of different drugs on expression and function of this miRNA at diverse experimental, animal, besides human levels, reporting motivating results in the treatment of the diseases. Here, in this comprehensive review, we provide an overview of miR-146a role in the pathogenesis and progression of several immune and non-immune inflammatory diseases such as Rheumatoid arthritis, Systemic lupus erythematosus, Inflammatory bowel disease, Multiple sclerosis, Psoriasis, Graves' disease, Atherosclerosis, Hepatitis, Chronic obstructive pulmonary disease, etc., discuss about its eligibility for being a desirable biomarker for these disorders, and also highlight its therapeutic potential. Understanding these mechanisms underlies the selecting and designing the proper therapeutic targets and medications, which eventually facilitate the treatment process. | A comprehensive review on miR-146a molecular mechanisms in a wide spectrum of immune and non-immune inflammatory diseases. |
Social distancing, an essential public health measure to limit the spread of contagious diseases, has gained significant attention since the outbreak of the COVID-19 pandemic. In this work, the problem of visual social distancing compliance assessment in busy public areas, with wide field-of-view cameras, is considered. A dataset of crowd scenes with people annotations under a bird's eye view (BEV) and ground truth for metric distances is introduced, and several measures for the evaluation of social distance detection systems are proposed. A multi-branch network, BEV-Net, is proposed to localize individuals in world coordinates and identify high-risk regions where social distancing is violated. BEV-Net combines detection of head and feet locations, camera pose estimation, a differentiable homography module to map image into BEV coordinates, and geometric reasoning to produce a BEV map of the people locations in the scene. Experiments on complex crowded scenes demonstrate the power of the approach and show superior performance over baselines derived from methods in the literature. Applications of interest for public health decision makers are finally discussed. Datasets, code and pretrained models are publicly available at GitHub. | BEV-Net: Assessing Social Distancing Compliance by Joint People Localization and Geometric Reasoning (preprint)/ en |
This study evaluated a special form of lockdown that was applied in Jordan: one day of lockdown every week, which was applied on consecutive weekend days (i.e., Friday in Jordan, for 24 hours). We tried to assess the impact of this form of lockdown on the daily number of positive coronavirus disease 2019 (COVID-19) cases, using interrupted time series analysis. We included the period of March 5 to April 17, 2021, as the period affected by the Friday lockdown, which was applied to seven consecutive Fridays with a total of 168 hours. We used R version 4.0.5 (R Foundation for Statistical Computing, Vienna, Austria) for our analysis. We used Poisson model regression analysis, where the number of positive cases was used as the outcome variable, while the total number of tests, time, and lockdown were used as the predictor variables. We further performed quasi-Poisson regression analysis to confirm the first model. On Poisson model regression analysis, it was found that there was an evidence of an increase in the number of positive COVID-19 cases following the intervention of Friday lockdown, with a p value of <0.001 (relative risk, 1.569; 95% confidence interval, 1.549-1.590). On using quasi-Poisson regression, similar results were found with a wider confidence interval. We concluded that a single weekend day lockdown led to an increase in the number of daily cases of COVID-19. Therefore, we recommend authorities to adhere to evidence-based measures or to the WHO recommendations in the dealing with this pandemic. | Impact of a Single-Day Lockdown on COVID-19: An Interrupted Time Series Analysis |
COVID-19 adalah penyakit yang ditetapkan sebagai pandemi global sejak Maret 2020. Salah satu tantangan dalam menghadapi pandemi COVID-19 saat ini adalah maraknya keraguan penggunaan vaksin, padahal vaksinasi adalah salah satu cara tersukses untuk mengatasi wabah penyakit menular. Vaccine hesitancy ini diantaranya dapat diamati dari sentimen atau persepsi publik di media sosial, salah satunya adalah Twitter. Keberadaan media sosial dapat mempengaruhi serapan informasi yang diterima seseorang, dalam kasus ini media sosial juga menjadi media propaganda anti vaksin yang dapat berakibat pada menurunnya kepercayaan masyarakat terhadap vaksin COVID-19. Penelitian ini bertujuan mengembangkan model klasifikasi dengan menggunakan metode Support Vector Machine (SVM) untuk analisis sentimen pada Tweet terkait vaksin COVID-19. Beberapa penelitian sebelumnya telah melakukan analisis sentimen terkait COVID-19, namun penelitian ini secara spesifik melakukan analisis sentimen pada topik vaksin COVID-19 sehingga persiapan data dan konfigurasi model akan berbeda. Penelitian ini juga menggunakan metodologi Design Science Research Methodology (DSRM) untuk penelitian secara keseluruhan sebelum fokus pada penggunaan metode SVM. Hasil penelitian terdiri dari algoritma pembuatan data set dan model klasifikasi untuk analisis sentimen yang dapat digunakan untuk mengetahui persepsi publik terhadap isu vaksinasi COVID-19. Penelitian ini juga membandingkan penggunaan tokenisasi unigram dan bigram. Berdasarkan hasil yang diperoleh, nilai rata-rata setiap aspek pengukuran evaluasi lebih tinggi diperoleh saat tokenisasi bigram ikut digunakan. Meskipun lebih tinggi, nilai yang diperoleh memiliki selisih yang tidak signifikan yaitu pada kisaran 0,6% -0,7%. Pada hasil evaluasi dengan penggunaan tokenisasi unigram dan bigram, nilai tertinggi seluruh aspek pengukuran yaitu accuracy, recall, f-measure, dan precision adalah 84%. Kata Kunci: Analisis sentimen, SVM, Vaksin COVID-19 COVID-19 is a disease that has been declared a global pandemic since March 2020. One of the challenges in dealing with the current COVID-19 pandemic is the widespread doubts about the use of vaccines even though vaccination is one of the most successful ways to deal with infectious disease outbreaks. Vaccine hesitancy can be observed among others from public sentiment or perception on social media one of them is Twitter. The existence of social media can affect the absorption of information received by a person in this case social media is also a medium for anti-vaccine propaganda which can result in a decrease in public confidence in the COVID-19 vaccine. This study aims to develop a classification model using the Support Vector Machine (SVM) method for sentiment analysis of Tweet related to the COVID-19 vaccine. Several previous studies have conducted sentiment analysis related to COVID-19 but this research specifically conducts sentiment analysis on the topic of the COVID-19 vaccine so that data preparation and model configuration will be different. This study also uses the Design Science Research Methodology (DSRM) for research as a whole before focusing on the use of the SVM method. The results of the study consist of an algorithm for creating data sets and a classification model for sentiment analysis that can be used to determine public perceptions of the issue of COVID-19 vaccination. This study also compares the use of unigram and bigram tokenization. Based on the results obtained the average value of each aspect of the evaluation measurement is higher when the bigram tokenization is used. Although higher the value obtained has an insignificant difference in the range of 0.6% - 0.7%. In the evaluation results using unigram and bigram tokenization the highest scores for all aspects of measurement namely accuracy recall, f-measure and precision were 84%. Keywords: Sentiment analysis, SVM, COVID-19 vaccine | Analisis sentimen pada tweet terkait vaksin COVID-19 menggunakan metode support vector machine |
Traditional funding models must change as governments decrease funding and often freeze tuition at a domestic level. As a result, universities face an increasing need to diversify their business models, including revenue streams. Therefore, interest in raising significant funds from other sources is stronger than ever, leading to the need for a fundraising approach that is more sophisticated. Medical educators and health professionals are some of the most trusted members of society, and with this paper, the authors aim to raise awareness of the critical role they play in helping universities with their global impact and fundraising efforts. | Fundraising in Education: Road Map to Involving Medical Educators in Fundraising |
The effects of SARS-CoV-2 infection in the first trimester on the pregnant woman and the fetus remain unclear. We describe the complete follow-up of a pregnant woman with asymptomatic SARS-CoV-2 infection in the first trimester. The woman tested positive for SARS-CoV-2 viral RNA in nasopharyngeal swabs in her seventh week of gestation and was admitted to a local hospital for treatment. Although the woman had a BMI above 28 and a total gestational weight gain of 21 kg, no pregnancy complications or severe complications related to SARS-CoV-2 were reported. An ultrasound scan identified no fetal abnormalities at 22 weeks. The pregnancy ended at term (37 weeks), and the newborn's birth weight was 3100 g. Placental insufficiency was revealed by placental histology examination but this appeared not to be related to the SARS-CoV-2 infection. In-situ hybridisation and immunohistochemical tests for SARS-CoV-2 RNA, spike protein 1, and nucleocapsid proteins were negative. However, ACE-2 was positive in samples of the placenta, umbilical cord and fetal membrane. The baby was followed up through to 10 days after birth and grew normally. Our results suggest that asymptomatic SARS-CoV-2 infection in the first trimester of pregnancy might not have significant harmful effects on the mother and the developing fetus. This finding may be of interest to the general public, midwives and general practitioners. However, large population studies are needed to confirm our findings. | Maternal, placental and neonatal outcomes after asymptomatic SARS-CoV-2 infection in the first trimester of pregnancy: A case report |
The objective of the review is to present recent updates on anaphylaxis in paediatric population worldwide. The article summarizes the results of epidemiological studies, diagnostic methods and treatments. We present a new WAO definition of anaphylaxis (2019), which broader criteria excluding dermal symptoms should facilitate faster life-saving adrenaline use. Adrenaline remains the best treatment to manage severe symptoms and to prevent biphasic reactions. There is ongoing effort to increase adrenaline use, such as modified autoinjectors, individual training, and diversified dosing. There are five independent risk factors of lethal anaphylaxis in children, including history of asthma, almost immediate onset of symptoms, unwell appearance, tachycardia and hypotension. We also report improvements in diagnostics, like component-resolved diagnostics, and novel therapies stimulating immunotolerance. We signal the development of ICD-11 with updated coding of anaphylaxis, which corresponds better to clinical observations. | The 2020 update on anaphylaxis in paediatric population |
The recent epidemic of the new SARS-CoV-2 in the northern regions of Italy is putting the organization of the Italian health system under serious attack. The current emergency requires all possible efforts to stem the spread of the virus. In this context, it is clear that we have the urgent need to rely upon etiopathogenetic data, in order to do all possible efforts to block the epidemic. However, observing the trend of the infections in China and the geographic areas of the main outbreaks, it could be hypothesized that air pollution plays a role. In particular, it has been previously demonstrated, in specific populations, a role of particulate matter in worsening clinical presentation of virus infection in airways. Without prejudice to the ascertained virus spread by air droplets or contaminated surfaces, the factors that could have favored its spread remain to be investigated. Moreover, if these observations were to be confirmed, when the health emergency is resolved, it will be mandatory to redesign an economic-productive model in balance with the environment. | SARS-CoV-2 spread in Northern Italy: what about the pollution role? |
The influence of different types of information sources on individual preventive behaviors remains unclear. We aimed to investigate the associations between individual information usage to obtain information about COVID-19 and compliance with preventive behaviors. This longitudinal study was based on an Internet survey conducted in August–September 2020 and February 2021. We used compliance with four preventive behaviors for COVID-19, “wearing a mask”, “ventilation”, “social distancing”, and “avoiding crowds” as outcome variables, and 20 types of information sources based on people or institutions (Medical worker, Government, etc.) and media (TV news, Twitter, etc.) as predictors. Absolute differences and 95% confidence intervals were estimated using generalized estimating equations adjusted for possible confounders. Among the 18,151 participants aged 20–79, the mean age was 51.7 (SD = 15.9) in 2020, and 51.3% were male. In total, compliance with “wearing a mask”, “ventilation”, “social distancing”, and “avoiding crowds” was seen in 86.2%, 46.9%, 45.4%, and 62.6% of individuals in 2020, and 89.3%, 38.2%, 47.2%, and 61.6% of individuals in 2021, respectively. In the multivariate analysis, “medical workers”, “professionals”, “the government”, “Twitter”, “news websites”, and “TV news” were positively associated with compliance with two or more preventive behaviors (p < 0.05). The type of information source may play an important role in providing information for COVID-19 prevention. | Information Usage and Compliance with Preventive Behaviors for COVID-19: A Longitudinal Study with Data from the JACSIS 2020/JASTIS 2021 |
BACKGROUND: Population-level mathematical models of outbreaks typically assume that disease transmission is not impacted by population density (‘frequency-dependent’) or that it increases linearly with density (‘density-dependent’). AIM: We sought evidence for the role of population density in SARS-CoV-2 transmission. METHODS: Using COVID-19-associated mortality data from England, we fitted multiple functional forms linking density with transmission. We projected forwards beyond lockdown to ascertain the consequences of different functional forms on infection resurgence. RESULTS: COVID-19-associated mortality data from England show evidence of increasing with population density until a saturating level, after adjusting for local age distribution, deprivation, proportion of ethnic minority population and proportion of key workers among the working population. Projections from a mathematical model that accounts for this observation deviate markedly from the current status quo for SARS-CoV-2 models which either assume linearity between density and transmission (30% of models) or no relationship at all (70%). Respectively, these classical model structures over- and underestimate the delay in infection resurgence following the release of lockdown. CONCLUSION: Identifying saturation points for given populations and including transmission terms that account for this feature will improve model accuracy and utility for the current and future pandemics. | The importance of saturating density dependence for population-level predictions of SARS-CoV-2 resurgence compared with density-independent or linearly density-dependent models, England, 23 March to 31 July 2020 |
The converging crises of COVID-19 and racist state violence in 2020 shifted public discourse about marginalization, public health, and racism in unprecedented ways. Nursing responded to the pandemic with heroic commitment and new politicization. But public engagement with systemic racism is forcing a reckoning in nursing. The profession has its own history of racism and of alliance with systems of state control with which to contend. In this article, we argue nursing must adopt an ethics of abolitionism to realize its goals for health and justice. Abolitionism theorizes that policing and prison systems, originating from systems of enslavement and colonial rule, continue to function as originally intended, causing racial oppression and violence. The harms of these systems will not be resolved through their reform but through creation of entirely new approaches to community support. Nursing as a collective can contribute to abolitionist projects through advocacy, practice, and research. | Feminist Abolitionist Nursing |
While going through difficult times, we may learn new strategies for success, new problem-solving skills, and that we are stronger and more durable than we may have thought. Since the onset of the COVID-19 pandemic, we have been living with massive disruptions to our lives: personal, professional, and educational. In reality, comparison can serve as a form of reflection: a self-evaluation of what is going well and what is not, or where we are vs where we need to be. Eskreis-Winkler and Fishbach review a body of research that demonstrates that negative experiences and information command our attention, are processed more deeply than positive information, and persist in our memories.7 Loscalzo argues that failure is imperative within medical education in order to develop students' and residents' tenacity and selfcontrol.8 Sharing examples of our failures is one way we can demonstrate vulnerability and persistence to our students, fostering a learning environment where they can take intellectual risks.9 Yet teachers are less likely to share their professional failures than their professional successes with other teachers. Years ago, one of the authors attended a teaching and learning conference where participants took turns sharing an "oops moment," describing a time when things had not gone as planned in the classroom. | Comparison Can Be a Basis for Resilience Rather Than the Thief of Joy |
OBJECTIVES: Oxidative stress appears to initiate organ failure in sepsis, justifying treatment with antioxidants such as vitamin C at megadoses. We have therefore investigated the safety and efficacy of megadose sodium ascorbate in sepsis. DESIGN: Interventional study. SETTING: Research Institute. SUBJECTS: Adult Merino ewes. INTERVENTIONS: Sheep were instrumented with pulmonary and renal artery flow-probes, and laser-Doppler and oxygen-sensing probes in the kidney. Conscious sheep received an infusion of live Escherichia coli for 31 hours. At 23.5 hours of sepsis, sheep received fluid resuscitation (30 mL/kg, Hartmann solution) and were randomized to IV sodium ascorbate (0.5 g/kg over 0.5 hr + 0.5 g/kg/hr for 6.5 hr; n = 5) or vehicle (n = 5). Norepinephrine was titrated to restore mean arterial pressure to baseline values (~80 mm Hg). MEASUREMENTS AND MAIN RESULTS: Sepsis-induced fever (41.4 ± 0.2°C; mean ± SE), tachycardia (141 ± 2 beats/min), and a marked deterioration in clinical condition in all cases. Mean arterial pressure (86 ± 1 to 67 ± 2 mm Hg), arterial PO2 (102.1 ± 3.3 to 80.5 ± 3.4 mm Hg), and renal medullary tissue PO2 (41 ± 5 to 24 ± 2 mm Hg) decreased, and plasma creatinine doubled (71 ± 2 to 144 ± 15 µmol/L) (all p < 0.01). Direct observation indicated that in all animals, sodium ascorbate dramatically improved the clinical state, from malaise and lethargy to a responsive, alert state within 3 hours. Body temperature (39.3 ± 0.3°C), heart rate (99.7 ± 3 beats/min), and plasma creatinine (32.6 ± 5.8 µmol/L) all decreased. Arterial (96.5 ± 2.5 mm Hg) and renal medullary PO2 (48 ± 5 mm Hg) increased. The norepinephrine dose was decreased, to zero in four of five sheep, whereas mean arterial pressure increased (to 83 ± 2 mm Hg). We confirmed these physiologic findings in a coronavirus disease 2019 patient with shock by compassionate use of 60 g of sodium ascorbate over 7 hours. CONCLUSIONS: IV megadose sodium ascorbate reversed the pathophysiological and behavioral responses to Gram-negative sepsis without adverse side effects. Clinical studies are required to determine if such a dose has similar benefits in septic patients. | Reversal of the Pathophysiological Responses to Gram-Negative Sepsis by Megadose Vitamin C |
Close contact is unavoidable in the care of patients with neuromuscular diseases (NMD). In addition, respiratory physiotherapy and noninvasive ventilation generate massive amounts of aerosols. Caring for a patient suffering from coronavirus disease‐19 raises concerns about the risk of infection not only to the caregiver and/or medical staff but also to other individuals in contact with these personnel. We reviewed the points to be noted in infection control when a patient with neuromuscular diseases receiving respiratory care is infected with COVID‐19 and summarizes the recommendation. Infected patients must be isolated in a negative‐pressure or actively ventilated room. Clear zoning separating clean and infected areas should be performed for pathogen containment. Caregivers should wear appropriate personal protective equipment and thoroughly clean their hands. Leak‐prevention measures and the use of proper respiratory circuits and filters with virus‐removal performance are crucial to reducing aerosols in noninvasive ventilation. Although respiratory physiotherapy is essential, treatment should be minimized in consideration of the infection state and sputum status, and alternative therapies such as postural drainage should be carefully considered. Infection control is distinctly obligate; however, it impairs the quality of life and activity of daily living significantly. We should implement it with enough ethical consideration, adequate explanation, and patient consent. We hope that this paper will contribute to appropriate COVID‐19 infection control in patients with neuromuscular diseases requiring respiratory care. | Infection control in the respiratory care of coronavirus disease‐19 patients with neuromuscular diseases |
Face masks continue to be a necessity until a large proportion of the population, including children, receive immunizations for COVID-19. The aim of this study was to investigate the relationship between parental attitudes and beliefs about masks and parent-for-child mask behavior using the Theory of Planned Behavior. We administered a survey in August 2020 to parents of school-aged children residing in the United States and Canada. Measures included sociodemographic variables for the parent and child, attitudes, norms, perceived control over children’s mask use, intentions and enforcement of mask wearing among children (also titled “parent-for-child mask behavior”). Data were analyzed using structural equation modelling. We collected data from 866 parents and 43.5% had children with pre-existing conditions (e.g., allergies, anxiety, impulsivity, skin sensitivity, asthma) that made extended mask wearing difficult, as per parent’s report. Among the full sample, negative attitudes (β = -0.20, p = .006), norms (β = 0.41, p = .002), and perceived control (β = 0.33, p = .006) predicted intentions. Norms (β = 0.50, p = .004) and intentions (β = 0.28, p = .003) also predicted parent-for-child mask use, while attitudes and perceived control did not. Intentions mediated the associations between attitudes, norms, perceived control, respectively, and mask behavior. Subgroup analyses revealed intentions as the key predictor of parent-for-child mask use among children with pre-conditions and norms as the key predictor among children without pre-conditions (i.e. healthy). Future public health messaging should target parental intentions, attitudes, norms, and perceived control about children’s masks wearing. | Parent-for-child mask behavior during the COVID-19 pandemic in Canada and the United States: An investigation of attitudes, norms, and perceived control using the theory of planned behavior |
OBJECTIVE: Development of severe disease and death from COVID-19 is more frequent in patients with comorbidities. Some studies report an increased frequency of severe COVID-19 in cancer patients. This review aims to describe the risk of infection and developing severe COVID-19 in cancer patients. MATERIALS AND METHODS: A systematic review was carried out through an exhaustive search of literature in PubMed and Scopus until May 2020. A secondary search was performed to include more studies. RESULTS: The initial search identified 2,192 records, which included 17 publications with at least 10 infected cancer patients. Also, 5 articles were added from the additional search of the references cited by those 17 publications. Ten publications were from Chinese authors. Data analysis showed that COVID-19 infection is more frequent in cancer patients, and frequent therapeutic visits to the healthcare facility may be the cause. The presence of neoplasia predisposed patients to develop severe disease. Advanced age, associated comorbidities, advanced malignancy, and the presence of serum inflammatory markers increased the risk of developing severe disease. Initial studies indicate that the use of systemic treatment may also be a predisposing factor. CONCLUSIONS: The risk of becoming infected by COVID-19 and developing severe disease is higher in the oncological population. | COVID-19 in cancer patients: a systematic review./ COVID-19 en pacientes con cáncer: revisión sistemática |
Recent surveillance has revealed the emergence of the SARS-CoV-2 Omicron variant (BA.1/B.1.1.529) harboring up to 36 mutations in spike protein, the target of vaccine-induced neutralizing antibodies. Given its potential to escape vaccine-induced humoral immunity, we measured neutralization potency of sera from 88 mRNA-1273, 111 BNT162b, and 40 Ad26.COV2.S vaccine recipients against wild type, Delta, and Omicron SARS-CoV-2 pseudoviruses. We included individuals that were vaccinated recently (<3 months), distantly (6-12 months), or recently boosted, and accounted for prior SARS-CoV-2 infection. Remarkably, neutralization of Omicron was undetectable in most vaccinated individuals. However, individuals boosted with mRNA vaccines exhibited potent neutralization of Omicron only 4-6-fold lower than wild type, suggesting that boosters enhance the cross-reactivity of neutralizing antibody responses. In addition, we find Omicron pseudovirus is more infectious than any other variant tested. Overall, this study highlights the importance of boosters to broaden neutralizing antibody responses against highly divergent SARS-CoV-2 variants. | mRNA-based COVID-19 vaccine boosters induce neutralizing immunity against SARS-CoV-2 Omicron variant |
OBJECTIVES: This paper looks at how contraceptive prescribing by General Practices in England was affected by the COVID-19pandemic and lockdown. It compares English prescribing data in April – June 2019, the year before COVID19, and April–June 2020, the first three months of ‘lockdown’. DESIGN & SETTING: This paper is based on retrospective analysis of the English Prescribing Dataset which reports monthly on prescribed items from English General Practices. Data on all forms of prescribed contraceptive methods were extracted using BNF codes, and total quantities tabulated by method. To reach the total number of months of contraception provided, total quantities were divided or multiplied according the frequency with which the method is taken per month or the numbers of months of contraception provided. RESULTS: Prescription of the combined oral contraceptive pill reduced by 22% during the period of lockdown compared to the same three months in 2019. Prescriptions of Progestogen-Only pills remained stable. Prescription of long-acting methods reduced, with the greatest reductions in implants (76% reduction from pre-lockdown levels), intra-uterine systems (79% reduction from pre-lockdown levels) and intrauterine devices (76% reduction from pre-lockdown levels). CONCLUSIONS: The disruption of face-to-face contraceptive consultations in General Practice during a COVID-19 ‘lockdown’ has resulted in a reduction in oestrogen –containing methods compared to progestogen-only methods, which require less face-to-face monitoring. Implant and intrauterine contraceptive device prescription reduced by three quarters over the first three months of lockdown, which has the potential to result in a rise in unintended pregnancies. | Effect of the COVID-19 pandemic on contraceptive prescribing in general practice: a retrospective analysis of English prescribing data between 2019 and 2020 |
Abstract Aims Coronavirus disease (Covid-19) could lead persons with pre-existing medical conditions to severe respiratory infections. The Italian Government introduced quarantine to limit viral transmission. This measure could lead people with type 1 diabetes (PWT1D) to disrupt daily care routine including PA practice with difficulties in glycemia management. This study aims to explore PA level in PWT1D before and during quarantine and to describe variation in glycemia values. Methods An online survey investigating medical factors and the perceived and PA level in pre-established period before and after the introduction of quarantine was developed. Comparison between pre and post quarantine was assessed by Wilcoxon Signed Ranks test for continuous variables. Results A total of 154 subjects satisfied the eligibility criteria (54.5% males, 44.8±12.5 years). We found a decrease of PA level (Godin Scale Score 25±1.7vs38.6±1.7 points), steps number and minutes of exercise (respectively 12.606±5026vs4.760±3.145 and 66±4vs38±3) and an increase of glycemia values (142.1± 25.4 mg/dLvs150.8±29.4 mg/dL) Conclusions PWT1D reported a decrease in exercise and worst glycemia. Although PWT1D tried to remain active, their PA level was inadequate to prevent glycemia rising. The difficult to maintain a glycemic control could expose patients to diabetes complications and to an higher risk to counteract infections. | Coronavirus disease (Covid-19): how does the exercise practice in active people with Type 1 Diabetes change? A preliminary survey |
Sikh healthcare professionals make up a small but significant proportion of the workforce in the United Kingdom. The COVID-19 pandemic has presented healthcare staff across the country with challenges relating to safe clinical practice whilst wearing personal protective equipment (PPE). Practising Sikhs are mandated to keep their hair unshorn and have been negatively impacted by some standard PPE requirements. This article aims to raise awareness of this issue and provide suggestions on how this conflict can be resolved. | Your Hair or Your Service: An Issue of Faith for Sikh Healthcare Professionals During the COVID-19 Pandemic |
INTRODUCTION: Pneumocystis jirovecii pneumonia (PJP) occurs in immunocompromised hosts. It is classified as PJP with human immunodeficiency virus (HIV) infection (HIV-PJP) and PJP without HIV infection (non-HIV PJP). Compared with HIV-PJP, non-HIV PJP is more likely to develop rapidly into respiratory failure, with difficult diagnosis and high mortality. PATIENT CONCERNS: A 46-year-old male with membranous nephropathy was treated with oral corticosteroids and tacrolimus. He was admitted to our hospital for fever and dyspnea which developed 4 days ago. Laboratory data revealed that leukocytes were 10.99 × 10(9)/L, neutrophils 87.7%, lymphocytes 9.6%, C-reactive protein 252.92 mg/L, New coronavirus nucleic acid detection negative. CT scan of chest revealed ground-glass opacity in both lungs. He was admitted to the respiratory department of our hospital, and then transferred to ICU because of his critical condition. DIAGNOSIS: High throughput gene detection of pathogenic microorganisms in alveolar lavage fluid showed that the detection sequence of Pneumocystis yersiniae increased significantly. The serum HIV-antibody was negative. Therefore, the patient was diagnosed as non-HIV PJP. INTERVENTIONS: After admission, the patient was assisted by noninvasive ventilator and treated with compound trimethoprim-sulfamethoxazole (SMX-TMP) and caspofungin. The patient's condition continued to deteriorate, and then underwent endotracheal intubation and veno-venous extracorporeal membrane oxygenation (VV-ECMO) combined with prone position ventilation until the lung lesion improved. OUTCOMES: VV-ECMO was stopped on day 12, tracheal intubation was removed after 2 days. The patient was transferred to the respiratory department on day 15, discharged after 12 days without complications. Two months later, the follow-up showed that the patient was in good condition. CONCLUSION: VV-ECMO combined with prone position ventilation could be a useful choice for respiratory assistance in non-HIV PJP patients. | VV-ECMO combined with prone position ventilation in the treatment of Pneumocystis jirovecii pneumonia: A case report |
Since theoretical models provide data that cannot be otherwise gathered, numerical methods applied to medical devices analysis have emerged as fundamental tool in preclinical development. Large efforts were done to study mechanical and drug-eluting properties in stents but often the coating modelling is neglected. This work presents a finite element framework to calculate mechanical loads and drug distribution in three commercial drug-eluting stents (Palmaz-Schatz, Palmaz Genesis and Multi Link Vision), to check coatings strength and drug distribution maps in biological tissues. The promising copolymer poly(methylmethacrylate-co-n-butylmethacrylate), loaded with paclitaxel, is analyzed. Results demonstrated that the coating undergoes localized plastic phenomena, and calculated stresses are lower than the ultimate stress, ensuring coating integrity. Computed drug concentration depends on stent geometry and its values are in all cases lower than the toxicity level for this drug. | Numerical analysis of paclitaxel-eluting coronary stents: Mechanics and drug release properties. |
Objectives: Notably, as a result of the unique circumstances that the global population is facing (Covid-19), there has been an increase in interest in educational leadership science, particularly in academic environment, with the aim of enhancing an ecosystem that is inclusive, open to change, monitoring, and often unforeseen challenges. Of the various types of educational leadership, transformational leadership is recognized as the most suitable for use in academic environment. It focuses on the division of leadership responsibilities among academics with varying skills in order to handle collectively the spectrum of leadership responsibilities needed in a variety of contexts. Methods/Analysis: This perspective is embodied in this study paper, which examined the degree to which members of the Senate of three Universities of Greece, engaged in three distinct types of leadership (transformational leadership, transactional leadership, and leadership to be avoided) via digital leadership. The findings were interpreted using descriptive, diagnostic, predictive and prescriptive data analysis algorithms. Findings: The findings indicate that participants demonstrate a high level of Transformational and Transactional Leadership. They demonstrated a high level of Digital Leadership while avoiding Passive-To Avoid Leadership. The study demonstrates that Digital Leadership has a relatively favorable association with the leadership outcome, which is translated as a high level of performance and satisfaction coexisting with a high level of digital leadership execution. Novelty /Improvement: The research project indicates that a good leader who practices transformational leadership and is prepared with the necessary digital skills would be more effective in carrying out administrative responsibilities in an academic environment. © 2021 by the authors. Licensee ESJ, Italy. | Associations between traditional and digital leadership in academic environment: During the COVID-19 pandemic |
In the modern era, social media and electronic news play an important role in the dissemination of information across the world. The ease of sharing news articles and information over the electronic media has made it challenging to prevent the outspread of fake news articles. Thus, it has been observed that in the present situation of a pandemic the misleading news specifically about COVID-19 are increasing day by day. Multiple research groups identified this challenge and proposed machine learning-based binary classifiers for categorizing news articles into fake and true classes. But, none of them addressed the challenge of identifying the misleading news. Also, the existing research works do not focus on examining the reliability of the news about COVID-19. Moreover, there is a lack of complete system that provide an integration of front-end and back-end where the users can check the reliability of news article and get recommendation of the sources for validation of news articles. The authors in this manuscript propose the Deep Learning-based tool with multiclass classifier for classifying the news articles into fake, true and misleading. This tool is an integration of front-end and back-end that is equally effective in assessing the reliability of news about COVID-19 and other events. The classifier of the tool has been trained on the integrated dataset comprising general new articles from the globe as well as news articles about COVID-19. The trained classifier reported an accuracy of 88% in classifying the news into Fake, Misleading, and True classes. The higher accuracy than state-of-the-art models validate the acceptance of the tool for real-life applications. © 2021 ACM. | Deep Learning Driven System to Analyze Reliability of COVID Infodemic and News Articles |
This research investigates destination imagery of Switzerland as a travel destination. This research first conducted survey and content analysis to identify 23 unique statements reflecting travel in Switzerland. Through an online survey, this research collected 399 responses from French and Italian respondents. Based on the comparisons of association strength and association valence of every statement to the aggregated association strength and association valence, this research developed the Destination Imagery Diagnosis model. The results show that, overall, French and Italian respondents have strong and positive associations to statements related to Switzerland’s nature and opportunities for outdoor activities. Furthermore, respondents rated “Healthy lifestyle” and “Welcoming and friendly” positively but the associations to Switzerland were weaker. This research also identified marketing opportunities specifically for French and Italian respondents. The Destination Imagery Diagnosis Model serves as a new tool to compare destination imageries between markets or keep track of changes of destination imagery. | Destination Imagery Diagnosis Model: The Case of Switzerland |
Off-center spindle positioning in mammalian oocytes enables asymmetric divisions in size, important for subsequent embryogenesis. The migration of the meiosis I spindle from the oocyte center to its cortex is mediated by F-actin. Specifically, an F-actin-cage surrounds the microtubule spindle and applies forces to it. To better understand how F-actin transmits forces to the spindle, we studied a potential direct link between F-actin and microtubules. For this, we tested the implication of Myosin-X, a known F-actin and microtubule binder involved in spindle morphogenesis and/or positioning in somatic cells, amphibian oocytes and embryos. Using a mouse strain conditionally invalidated for Myosin-X in oocytes and by live cell imaging, we show that Myosin-X is not localized on the spindle and dispensable for spindle and F-actin assembly. It is not required for force transmission since spindle migration and chromosome alignment occur normally. More broadly, Myosin-X is dispensable for oocyte developmental potential and female fertility. We therefore exclude a role for Myosin-X in transmitting F-actin-mediated forces to the spindle, opening new perspectives regarding this mechanism in mouse oocytes, which differs from most mitotic cells. | Myosin-X is dispensable for spindle morphogenesis and positioning in the mouse oocyte. |
Angiotensin-converting enzyme 2 (ACE2) plays a pivotal role in the renin-angiotensin system and is closely related to coronavirus disease of 2019 However, the role of ACE2 in cancers remains unclear We explored the pan-cancer expression patterns and prognostic value of ACE2 across multiple databases, including Oncomine, PrognoScan, Gene Expression Profiling Interactive Analysis, and Kaplan-Meier Plotter Then, we investigated the correlations between ACE2 expression and immune infiltration in cancers We found that tumor tissues had higher expression levels of ACE2 compared with normal tissue in the kidney and the liver and lower expression levels in the lung High expression levels of ACE2 were beneficial to survival in ovarian serous cystadenocarcinoma, liver hepatocellular carcinoma, kidney renal papillary cell carcinoma, and kidney renal clear cell carcinoma, although this was not the case in lung squamous cell carcinoma For those with a better prognosis, there were significant positive correlations between ACE2 expression and immune infiltrates, including B cells, CD8 + T cells, CD4 + T cells, neutrophils, macrophages, and dendritic cells In conclusion, ACE2 could serve as a pan-cancer prognostic biomarker and is correlated with immune infiltrates | Prognostic and Immunological Value of Angiotensin-Converting Enzyme 2 in Pan-Cancer |
[Image: see text] With the COVID-19 pandemic, the evolutionary fate of SARS-CoV-2 becomes a matter of utmost concern. Mutation D614G in the spike (S) protein has become dominant, and recent evidence suggests it yields a more stable phenotype with higher transmission efficacy. We carry out a structural analysis that provides mechanistic clues on the enhanced infectivity. The D614G substitution creates a sticky packing defect in subunit S1, promoting its association with subunit S2 as a means to stabilize the structure of S1 within the S1/S2 complex. The results raise the therapeutic possibility of immunologically targeting the epitope involved in stabilizing the G614 phenotype as a means of reducing the infection efficacy of SARS-CoV-2. This therapeutic modality would not a-priori interfere directly with current efforts toward the immunological targeting of the RBD epitope; hence, it could be exploited as a complementary treatment. | Structural Impact of Mutation D614G in SARS-CoV-2 Spike Protein: Enhanced Infectivity and Therapeutic Opportunity |
BACKGROUND AND PURPOSE The relative merits of treating ruptured aneurysms with clipping versus coiling continue to be a topic of debate. We evaluated a national, multihospital patient data base to examine recent trends in ruptured aneurysm therapies and to compare peri-procedural outcomes between clipping and coiling treatments. MATERIALS AND METHODS The Premier Perspective data base was used to identify patients hospitalized between 2006-2011 for ruptured aneurysm who underwent clipping or coiling therapy. A propensity score model, representing the probability of receiving clipping, was generated for each patient by use of relevant patient and hospital variables. After Greedy-type matching of the propensity score, the risk of in-hospital mortality and morbidity was compared between clipping and coiling cohorts. RESULTS A total of 5229 patients with ruptured aneurysm (1228 clipping, 4001 coiling) treated at 125 hospitals were identified. Clipping therapy frequency decreased from 27% in 2006 to 21% in 2011. After propensity score adjustment, in-hospital mortality risk was similar between groups (OR = 0.94 [95% CI, 0.73-1.21]; P = .62). However, unfavorable outcomes were more common after clipping compared with coiling, including discharge to long-term care (OR = 1.32 [95% CI, 1.12-1.56]; P = .0006), ischemic complications (OR = 1.51 [95% CI, 1.24-1.83]; P = .0009), neurologic complications (OR = 1.64 [95% CI, 1.18-2.27]; P = .0018), and other surgical complications (OR = 1.55 [95% CI, 1.05-2.33]; P = .0240). CONCLUSIONS This study of a data base of multiple hospitals in the United States demonstrates that clipping of ruptured cerebral aneurysms resulted in greater adjusted morbidity compared with coiling. | Comparative effectiveness of ruptured cerebral aneurysm therapies: propensity score analysis of clipping versus coiling. |
The pandemic outbreak of coronavirus disease 2019 (COVID-19) affects health care systems globally and leads to other challenges besides infection and its direct medical consequences. The aim of this study was to investigate the impact of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic on the university dermatology outpatient clinic (UDOC) of the Technical University of Munich, Germany. We analyzed datasets from 2015 until 2020 extracted from the hospital information system database and our documented outpatient files regarding patient numbers, gender, age, and diagnoses. In 2020, case numbers of outpatient care declined significantly (p = 0.021) compared to previous years and was related to the timing of political announcements answering SARS-CoV-2 pandemic. Additionally, during calendar week 10 to 15-the peak time of the spread of COVID-19 in Germany-the proportion of patients missing their consultation was significantly higher in 2020 than in 2019 (22.4% vs. 12.4%; p < 0.001). Gender-associated differences regarding absences were not detected, but patients aged 85 years or older were significantly more likely to miss their consultation compared to all other age groups (p = 0.002). Regarding different disease clusters, patients with chronic inflammatory skin diseases and infectious and malignant diseases were more likely to miss their consultation (p = 0.006). Noticeably, less patients with malignant diseases, and particularly malignant melanoma, were registered during this pandemic. Our data support the hypothesis that medically constructive prioritization might not be implemented properly by patients themselves. Identifying missed patients and catching up on their medical care apart from COVID-19 will pose an enormous challenge for health care systems globally. | The Impact and Consequences of SARS-CoV-2 Pandemic on a Single University Dermatology Outpatient Clinic in Germany |
COVID19 is a viral disease caused by the SARS-CoV-2 of the coronavirus family. It is highly contagious and highly transmissible through cough and sneeze drops, contaminated surfaces and aerosols. While airborne transmission is questionable, the Centers for Disease Control and the World Health Organization recommend wearing face masks in all countries, in addition to physical distancing, to reduce the spread of the SARS-CoV-2 coronavirus. Cancer patients are known to be more susceptible and vulnerable to infections, including viruses. Compared to the general population, the risk of death is 10 times higher and the risk of hospitalisation is 4 times higher in cancer patients. These are mainly patients with malignant hemopathy, or who receive a lot of chemotherapy, or patients with neutropenia and lymphopenia. | The Lebanese Society of Medical Oncology (LSMO) recommendations and perspectives on oncology care during COVID-19 pandemic. (Special Issue: COVID-19 pandemic.) |
There are differences in the temporal and spatial characteristics of the spread of severe respiratory syndrome (SARS) and new coronavirus pneumonia (COVID-19). In order to explore the difference, this study selected Guangzhou as the research object. Based on the information of confirmed cases of new coronavirus pneumonia (COVID-19) given by the Guangzhou Municipal Health Commission, GIS software was used to analyze the differences in temporal and spatial characteristics of transmission. The study found that: Compared with SARS, COVID-19 spreads more widely and is more contagious. The spread of COVID-19 is characterized by a wide range and dispersion. Compared with SARS, the infection situation of medical staff in the prevention and control of the epidemic has been greatly improved. This study is helpful to grasp the characteristics of the time and space transmission of infectious diseases in metroetpolitan areas and provide effective early warning for emergency decision-making and prevention and control of the epidemic. © 2021 IEEE. | GIS-based characteristics of Infectious disease transmission: A comparison of COVID-19 and SARS in Guangzhou, China |
The outbreak of coronavirus disease 2019 (COVID-19) has presented an unprecedented public health crisis across the globe. Governments have developed different approaches to tackle the complex and intractable challenge, showing variations in their effectiveness and results. South Korea has achieved exceptional performance thus far: It has flattened the curve of new infections and brought the outbreak under control without imposing forceful measures such as lockdowns and travel ban. This commentary addresses the South Korean government’s response to COVID-19 and highlights distributed cognition and crisis management capabilities as critical factors. The authors discuss how the South Korean government has cultivated distributed cognition and three core capabilities—reflective-improvement, collaborative, and data-analytical capabilities—after its painful experience with 2015 Middle East respiratory syndrome-coronavirus (MERS-CoV). South Korea’s adaptive approaches and its learning path examined in this commentary provide practical implications for managing potential additional waves of COVID-19 and a future public health crisis. | Learning From the Past: Distributed Cognition and Crisis Management Capabilities for Tackling COVID-19 |
SOURCE CITATION: Chan KK, Joo DA, McRae AD, et al. Chest ultrasonography versus supine chest radiography for diagnosis of pneumothorax in trauma patients in the emergency department. Cochrane Database Syst Rev. 2020;7:CD013031. 32702777. | Chest ultrasonography by frontline physicians is more sensitive than CXR for diagnosing pneumothorax in trauma patients |
Deployment of the BNT162b2 mRNA Covid-19 Vaccine in Israel began in December 2020. This is a retrospective analysis of serological data, showing SARS-CoV-2 anti-S IgG kinetics in 116 Israeli health care workers receiving BNT162b2. Sero-conversion occurred in 14 days in all study participants, with IgG levels peaking approximately 30 days after initiation of the vaccination series. A statistically significant difference was observed in IgG levels between subjects younger than 50 years and older participants, although in all cases, IgG levels were well above the level considered reactive by the test's manufacturer. The importance of this difference needs to be studied further, but a potential difference in vaccine efficacy and vaccine effect length could possibly be present between these two groups. | Kinetics of SARS-CoV-2 anti-S IgG after BNT162b2 vaccination |
The acidic and basic functional groups in a molecule strongly influence its physicochemical properties, affinity for a macromolecule, pharmacokinetics, and toxicity. For instance, basicity has been correlated with molecular promiscuity, hERG blockade, and phospholipidosis. Nonetheless, a systematic characterization of the acid/base profile of epigenomic databases has not been reported. The present study describes an analysis of the acidic ionization constants distribution of a library of 7820 compounds with reported activity against epigenetic targets. Furthermore, the epigenomics database's acid/base profile is compared to the reference libraries of food chemicals, natural products, and approved drugs. It was found that the acid/base profile of histone lysine demethylase ligands is more similar to previously approved drugs, and histone acetyltransferase ligands have acidic and basic functional groups largely found in food chemicals and natural products, which support the potential of these libraries for finding new epigenetic inhibitors. | The Acid/Base Characterization of Molecules with Epigenetic Activity |
Clinical characteristics of 33 asymptomatic COVID-19 infections were analyzed in this study. The data showed most of asymptomatic patients had small body mass index, good prognosis and low infectivity. This study suggests that screening from high-risk populations to find and isolate asymptomatic patients is an important disease prevention and control strategy for COVID-19. | Clinical Characteristics of 33 Asymptomatic COVID-19 Infections in Wuhan, China. |
Along with the COVID-19 pandemic, an "infodemic" of false and misleading information has emerged and has complicated the COVID-19 response efforts. Social networking sites such as Facebook and Twitter have contributed largely to the spread of rumors, conspiracy theories, hate, xenophobia, racism, and prejudice. To combat the spread of fake news, researchers around the world have and are still making considerable efforts to build and share COVID-19 related research articles, models, and datasets. This paper releases "AraCOVID19-MFH"1a manually annotated multi-label Arabic COVID-19 fake news and hate speech detection dataset. Our dataset contains 10,828 Arabic tweets annotated with 10 different labels. The labels have been designed to consider some aspects relevant to the fact-checking task, such as the tweet's check worthiness, positivity/negativity, and factuality. To confirm our annotated dataset's practical utility, we used it to train and evaluate several classification models and reported the obtained results. Though the dataset is mainly designed for fake news detection, it can also be used for hate speech detection, opinion/news classification, dialect identification, and many other tasks. © 2021 Elsevier B.V.. All rights reserved. | AraCOVID19-MFH: Arabic COVID-19 Multi-label Fake News & Hate Speech Detection Dataset |
OBJECTIVES We estimate the point seroprevalence of SARS-CoV-2 antibodies in the frontline firefighter/paramedic workforce of a South Florida fire department located in the epicentre of a State outbreak. METHODS A cross-sectional study design was used to estimate the point seroprevalence of SARS-CoV-2 antibodies using a rapid immunoglobulin (Ig)M-IgG combined point-of-care lateral flow immunoassay among frontline firefighters/paramedics collected over a 2-day period, 16-17 April 2020. Fire department personnel were emailed a survey link assessing COVID-19 symptoms and work exposures the day prior to the scheduled drive-through antibody testing at a designated fire station. Off-duty and on-duty firefighter/paramedic personnel drove through the fire station/training facility in their personal vehicles or on-duty engine/rescue trucks for SARS-CoV-2 antibody testing. RESULTS Among the 203 firefighters/paramedics that make up the fire department workforce, 18 firefighters/paramedics (8.9%) tested positive for SARS-CoV-2 antibodies, of which 8 firefighters/paramedics (3.9%) were IgG positive only, 8 (3.9%) were IgM positive only and 2 (0.1%) were IgG/IgM positive. The positive predictive value (PPV) of the serological test is estimated to be 33.2% and the negative predictive value is 99.3%. The average number of COVID-19 case contacts (ie, within 6 feet of an infected person (laboratory-confirmed or probable COVID-19 patient) for ≥15 min) experienced by firefighters/paramedics was higher for those with positive serology compared with those with negative (13.3 cases vs 7.31 cases; p=0.022). None of the antibody positive firefighters/paramedics reported receipt of the annual influenza vaccine compared with firefighters/paramedics who tested negative for SARS-CoV-2 antibodies (0.0% vs 21.0%; p=0.027). CONCLUSION Rapid SARS-CoV-2 IgM-IgG antibody testing documented early-stage and late-stage infection in a firefighter workforce providing insight to a broader medical surveillance project on return to work for firefighters/paramedics. Given the relatively low PPV of the serological test used in this study back in April 2020, caution should be used in interpreting test results. | Epidemiology of SARS-CoV-2 antibodies among firefighters/paramedics of a US fire department: a cross-sectional study. |
Climate change and tourism’s interaction and vulnerability have been among the most hotly debated topics recently. In this context, the study focuses on how CO(2) emissions, the primary cause of global warming and climate change, respond to changes in tourism development. In order to do so, the impact of tourism development on CO(2) emissions in the most visited countries is investigated. A panel data from 2000 to 2017 for top 70 tourist countries are analysed using a spatial econometric method to investigate the spatial effect of tourism on environmental pollution. The direct, indirect, and overall impact of tourism on CO(2) emissions are estimated using the most appropriate generalized nested spatial econometric (GNS) method. The findings reveal that tourism has a positive direct effect and a negative indirect effect; both are significant at the 1% level. The negative indirect effect of tourism is greater than its direct positive effect, implying an overall significantly negative impact. Further, the outcome of financial development and CO(2) emissions have an inverted U-shaped and U-shaped relationship in direct and indirect impacts. Population density, trade openness, and economic growth significantly influence environmental pollution. In addition, education expenditure and infrastructure play a significant moderating role among tourism and environmental pollution. The results have important policy implications as they establish an inverted-U-shaped relationship among tourism and CO(2) emissions and indicate that while a country’s emissions initially rise with the tourism industry’s growth, it begins declining after a limit. | The spillover of tourism development on CO(2) emissions: a spatial econometric analysis |
Advances in sequencing technologies have tremendously reduced the time and costs associated with sequence generation, making genomic data an important asset for routine public health practices. Within this context, phylogenetic and phylogeographic inference has become a popular method to study disease transmission. In a Bayesian context, these approaches have the benefit of accommodating phylogenetic uncertainty, and popular implementations provide the possibility to parameterize the transition rates between locations as a function of epidemiological and ecological data to reconstruct spatial spread while simultaneously identifying the main factors impacting the spatial spread dynamics. Recent developments enable researchers to make use of travel history data of infected individuals in the reconstruction of pathogen spread, offering increased inference accuracy and mitigating sampling bias. Here, we describe a detailed workflow to reconstruct the spatial spread of a pathogen through Bayesian phylogeographic analysis in discrete space using these novel approaches, implemented in BEAST. The individual protocols focus on how to incorporate molecular data, covariates of spread, and individual travel history data into the analysis. © 2021 Wiley Periodicals LLC. Basic Protocol 1: Creating a SARS-CoV-2 MSA using sequences from GISAID Basic Protocol 2: Setting up a discrete trait phylogeographic reconstruction in BEAUti Basic Protocol 3: Phylogeographic reconstruction incorporating travel history information Basic Protocol 4: Visualizing ancestral spatial trajectories for specific taxa. | Bayesian Phylogeographic Analysis Incorporating Predictors and Individual Travel Histories in BEAST. |
INTRODUCTION: Limited evidence exists regarding use of inhaled nitric oxide (iNO) in spontaneously breathing patients. We evaluated the effectiveness of continuous iNO via high-flow nasal cannula (HFNC) in COVID-19 respiratory failure. METHODS: We performed a multicenter cohort study of patients with respiratory failure from COVID-19 managed with HFNC. Patients were stratified by administration of iNO via HFNC. Regression analysis was used to compare the need for mechanical ventilation and secondary endpoints including hospital mortality, length of stay, acute kidney injury, need for renal replacement therapy, and need for extracorporeal life support. RESULTS: A total of 272 patients were identified and 66 (24.3%) of these patients received iNO via HFNC for a median of 88 h (interquartile range: 44, 135). After 12 h of iNO, supplemental oxygen requirement was unchanged or increased in 52.7% of patients. Twenty-nine (43.9%) patients treated with iNO compared to 79 (38.3%) patients without iNO therapy required endotracheal intubation (P = .47). After multivariable adjustment, there was no difference in need for mechanical ventilation between groups (odds ratio: 1.53; 95% confidence interval [CI]: 0.74-3.17), however, iNO administration was associated with longer hospital length of stay (incidence rate ratio: 1.41; 95% CI: 1.31-1.51). No difference was found for mortality, acute kidney injury, need for renal replacement therapy, or need for extracorporeal life support. CONCLUSION: In patients with COVID-19 respiratory failure, iNO delivered via HFNC did not reduce oxygen requirements in the majority of patients or improve clinical outcomes. Given the observed association with increased length of stay, judicious selection of those likely to benefit from this therapy is warranted. | Inhaled Nitric Oxide via High-Flow Nasal Cannula in Patients with Acute Respiratory Failure Related to COVID-19 |
Despite the unprecedented success in the rapid development of several effective vaccines against the Cov-SARS-2, global vaccination rollout efforts suffer from vaccine distribution inequality and vaccine acceptance, leading to insufficient public immunity provided by the vaccine products. While a major current focus in vaccine acceptance research is how to model and inform vaccine acceptance based on social-demographic parameters, characteristics of vaccine acceptance are not well understood and in particular, it is not known whether and how information diffusion influences vaccine acceptance. This study examines how information diffusion can change vaccine acceptance by developing a comprehensive computational model with an agent-based simulation technique to overcome the modeling and quantification complexity associated with socio-demographics, vaccine types, population statistics, and information diffusion. Our analyses, calibrated by the vaccine acceptance survey data from the provinces and territories of Canada, provide clear evidence that the propagation of information can greatly influence vaccine acceptance rates. The results illustrate that spread of negative messages about the COVID-19 vaccines can cause significant vaccine hesitancy that challenges the goal of a high public immunity provided by the vaccines. Our findings might help solve the vaccine hesitancy problem by focusing more on individuals' opinions and behavior. | COVID-19 Vaccine Hesitancy and Information Diffusion: An Agent-based Modeling Approach |
BACKGROUND: The COVID-19 pandemic has affected the health, economic, and social fabric of many nations worldwide. Identification of individual-level susceptibility factors may help people in identifying and managing their emotional, psychological, and social well-being. OBJECTIVE: This study is focused on learning a ranked list of factors that could indicate a predisposition to a mental disorder during the COVID-19 pandemic. METHODS: In this study, we have used a survey of 17,764 adults in the United States from different age groups, genders, and socioeconomic statuses. Through initial statistical analysis and Bayesian network inference, we have identified key factors affecting mental health during the COVID-19 pandemic. Integrating Bayesian networks with classical machine learning approaches led to effective modeling of the level of mental health prevalence. RESULTS: Overall, females were more stressed than males, and people in the age group 18-29 years were more vulnerable to anxiety than other age groups. Using the Bayesian network model, we found that people with a chronic mental illness were more prone to mental disorders during the COVID-19 pandemic. The new realities of working from home; homeschooling; and lack of communication with family, friends, and neighbors induces mental pressure. Financial assistance from social security helps in reducing mental stress during the COVID-19-generated economic crises. Finally, using supervised machine learning models, we predicted the most mentally vulnerable people with ~80% accuracy. CONCLUSIONS: Multiple factors such as social isolation, digital communication, and working and schooling from home were identified as factors of mental illness during the COVID-19 pandemic. Regular in-person communication with friends and family, a healthy social life, and social security were key factors, and taking care of people with a history of mental disease appears to be even more important during this time. | Learning the Mental Health Impact of COVID-19 in the United States With Explainable Artificial Intelligence: Observational Study |
OBJECTIVE: To determine factors associated with diagnostic delays and outcomes in juvenile dermatomyositis (JDM) in the Childhood Arthritis and Rheumatology Research Alliance Legacy Registry (CLR). METHODS: This was a cross‐sectional study of subjects aged 0 to 17 years with JDM enrolled to the CLR from 2010 to 2015. Access to care was measured by calculating the distance from the subject zip code of residence to the treating pediatric rheumatology center and determining the state density of pediatric rheumatologists based on the 2015 American College of Rheumatology Workforce Study. Delay was categorized as early (<30 days), typical (1‐3 months), moderate (3‐12 months), and severe (>12 months). Ordered generalized additive models were used to determine the association between these measures and diagnostic delays. RESULTS: The median time to diagnosis was 3.1 months; 37.2% of patients experienced moderate delays, and 14.6% experienced severe delays. In a univariate analysis, younger age of disease onset and male sex were associated with delays. Using a generalized additive model accounting for age, sex, race, and ethnicity, increasing distance from treating pediatric rheumatologist and younger age at disease onset were associated with diagnostic delay. There was no association between the state density of rheumatologists and diagnostic delays in this model. CONCLUSION: In the CLR, we found moderate to severe diagnostic delays in the majority of subjects with JDM. Our data suggest that access to care, measured as the distance traveled to treating rheumatologist, is an important factor associated with delays in care but also highlight age as a contributing factor, suggesting that JDM may be less recognizable in young children. | Access to Care and Diagnostic Delays in Juvenile Dermatomyositis: Results From the Childhood Arthritis and Rheumatology Research Alliance Legacy Registry |
Systemic lupus erythematosus is a chronic remitting-relapsing autoimmune disease that affects multiple organ systems. In this article we discuss aspects in the management of lupus patients that are particularly relevant during the current SARS-CoV-2 pandemic. We speculate that lupus patients might be more susceptible for a more severe COVID-19 disease course and emphasize the importance of maintaining remission in lupus patients. We discuss the critical role hydroxychloroquine plays in the management of lupus patients and suggest considering the psychosocial implications of the current pandemic on lupus care. | Coronavirus Disease-2019: Implication for the care and management of patients with systemic lupus erythematosus. |
Rabies is an ancient disease but remains endemic in most parts of the world and causes approximately 59,000 deaths annually. The mechanism through which the causative agent, rabies virus (RABV), evades the host immune response and infects the host central nervous system (CNS) has not been completely elucidated thus far. Our previous studies have shown that lab-attenuated, but not wild-type (wt), RABV activates the innate immune response in the mouse and dog models. In this present study, we demonstrate that lab-attenuated RABV causes abortive infection in astrocytes, the most abundant glial cells in the CNS. Furthermore, we found that lab-attenuated RABV produces more double-stranded RNA (dsRNA) than wt RABV, which is recognized by retinoic acid-inducible gene I (RIG-I) or melanoma differentiation-associated protein 5 (MDA5). Activation of mitochondrial antiviral-signaling protein (MAVS), the common adaptor molecule for RIG-I and MDA5, results in the production of type I interferon (IFN) and the expression of hundreds of IFN-stimulated genes, which suppress RABV replication and spread in astrocytes. Notably, lab-attenuated RABV replicates in a manner identical to that of wt RABV in MAVS−/− astrocytes. It was also found that lab-attenuated, but not wt, RABV induces the expression of inflammatory cytokines via the MAVS- p38/NF-κB signaling pathway. These inflammatory cytokines increase the blood–brain barrier permeability and thus enable immune cells and antibodies infiltrate the CNS parenchyma, resulting in RABV control and elimination. In contrast, wt RABV restricts dsRNA production and thus evades innate recognition by RIG-I/MDA5 in astrocytes, which could be one of the mechanisms by which wt RABV evades the host immune response in resident CNS cells. Our findings suggest that astrocytes play a critical role in limiting the replication of lab-attenuated RABV in the CNS. | Lab-Attenuated Rabies Virus Causes Abortive Infection and Induces Cytokine Expression in Astrocytes by Activating Mitochondrial Antiviral-Signaling Protein Signaling Pathway |
Despite the high safety profile demonstrated in clinical trials, the immunogenicity of adeno-associated virus (AAV)-mediated gene therapy remains a major hurdle. Specifically, T-cell-mediated immune responses to AAV vectors are related to loss of efficacy and potential liver toxicities. As post-translational modifications in T cell epitopes have the potential to affect immune reactions, the cellular immune responses to peptides derived from spontaneously deamidated AAV were investigated. Here, we report that highly deamidated sites in AAV9 contain CD4 T cell epitopes with a Th1 cytokine pattern in multiple human donors with diverse human leukocyte antigen (HLA) backgrounds. Furthermore, some peripheral blood mononuclear cell (PBMC) samples demonstrated differential T cell activation to deamidated or non-deamidated epitopes. Also, in vitro and in silico HLA binding assays showed differential binding to the deamidated or non-deamidated peptides in some HLA alleles. This study provides critical attributes to vector-immune-mediated responses, as AAV deamidation can impact the immunogenicity, safety, and efficacy of AAV-mediated gene therapy in some patients. | Differential T cell immune responses to deamidated adeno-associated virus vector |
Introduction: The purpose of this study was to determine the impact of COVID-19 and stay-at-home (SAH) orders on collegiate student-athletes' training, nutrition, sleep habits, and mental health and to identify disparities between sexes and competitive divisions. Methods: Collegiate student-athletes (n = 401;age, 20 +/- 2 yr) completed an 84-question anonymous survey regarding demographics, sport/exercise training, nutrition, sleep habits, and mental health. Response frequencies were calculated for each question, and chi 2 analyses were used to determine statistical significance (alpha = 0.05). Results: Although 80.7% of respondents indicated training for their sport, only 38.7% could fully perform their training programs. More D1 versus D3 athletes reported they could perform their training plan as written (D1: 44.4% [n = 83] vs D3: 27.3% [n = 50];P < 0.01), but there were no differences between sexes. Cardiovascular exercise was the most common mode (87.5%) followed by resistance exercise (78.4%). Although there were no differences for cardiovascular exercise, more males (87.5%) than females (74.8%) indicated resistance training (P < 0.01). Average number of meals consumed per day remained similar before and during SAH, but females reported consuming less food and perceived increased healthfulness of their diets. Although most athletes did not use nutritional supplements, rates were higher among D3 and females. Respondents reported longer sleep durations but increased sleep disturbances, negative psychological states, and overall concerns during SAH. Maintaining fitness and sport-specific skills (similar to 70.0%) were the most common concerns. In addition, similar to 60.6% of females and 41.9% of males indicated increased mental health concerns. Conclusions: Our findings suggest that while attempting to be diligent with training during SAH, many student-athletes reported difficulties regarding limited equipment, motivation, and mental health concerns such as heightened anxiety. Many of these difficulties were division- and sex-specific. Discussions between coaches and student-athletes regarding SAH training and mental stressors may aid in determining student-athletes' readiness to return to sport. | The Impacts of COVID-19 on Collegiate Student-Athlete Training, Health, and Well-Being |
The first case of the coronavirus disease 2019 (COVID-19), the novel contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was reported in Wuhan, China in December 2019 [...]. | Preventing Airborne Transmission of SARS-CoV-2 in Hospitals and Nursing Homes |
BACKGROUND The purpose of this study was to examine the impact of the sequential implementation of the enhanced recovery program (ERP) and surgical site infection bundle (SSIB) on short-term outcomes in colorectal surgery (CRS) to determine if the presence of multiple standardized care programs provides additive benefit. STUDY DESIGN Institutional ACS-NSQIP data were used to identify patients who underwent elective CRS from September 2006 to March 2013. The cohort was stratified into 3 groups relative to implementation of the ERP (February 1, 2010) and SSIB (July 1, 2011). Unadjusted characteristics and 30-day outcomes were assessed, and inverse proportional weighting was then used to determine the adjusted effect of these programs. RESULTS There were 787 patients included: 337, 165, and 285 in the pre-ERP/SSIB, post-ERP/pre-SSIB, and post-ERP/SSIB periods, respectively. After inverse probability weighting (IPW) adjustment, groups were balanced with respect to patient and procedural characteristics considered. Compared with the pre-ERP/SSIB group, the post-ERP/pre-SSIB group had significantly reduced length of hospitalization (8.3 vs 6.6 days, p = 0.01) but did not differ with respect to postoperative wound complications and sepsis. Subsequent introduction of the SSIB then resulted in a significant decrease in superficial SSI (16.1% vs 6.3%, p < 0.01) and postoperative sepsis (11.2% vs 1.8%, p < 0.01). Finally, inflation-adjusted mean hospital cost for a CRS admission fell from $31,926 in 2008 to $22,044 in 2013 (p < 0.01). CONCLUSIONS Sequential implementation of the ERP and SSIB provided incremental improvements in CRS outcomes while controlling hospital costs, supporting their combined use as an effective strategy toward improving the quality of patient care. | Improving Outcomes in Colorectal Surgery by Sequential Implementation of Multiple Standardized Care Programs. |
Purpose: To determine the risk of invasive mechanical ventilation and death in obese individuals with history of bariatric surgery compared to standard ones admitted for Covid-19 infection. Methods: Nationwide retrospective observational study based on electronic health data. 4 248 253 individuals aged 15 to 75 years with a diagnosis of obesity were included. All obese inpatients, undergoing bariatric surgery or not, recorded during a hospital stay by the French National Health Insurance were followed, during a mean observation time of 5.43 ± 2.93 years. This exposition was bariatric surgery (n=389,671) including adjustable gastric banding, sleeve gastrectomy, gastric bypass versus no bariatric surgery (n=3,858,582). The primary outcome was Covid-19 related death and the secondary outcome was the need for invasive mechanical ventilation. Results: 8 286 (0.2%) obese individuals were admitted for Covid-19 infection between January 1 st and May 15 th 2020 with a diagnosis of Covid-19 infection. 541 (0.14%) had a history of bariatric surgery and 7,745 (0.2%) did not. Invasive mechanical ventilation was necessary in 14.54% of patients and death occurred in 13.58% of cases. The need for an invasive mechanical ventilation and death occurred in 7% and 3.5% in the bariatric surgery group versus 15% and 14.2% in the non-bariatric surgery group, respectively (both p <0.0001). After a logistic regression, the risk of invasive mechanical ventilation significantly increased with age being higher in the age class 61-75, male gender, and hypertension, whereas bariatric surgery showed an independent protective effect. Mortality was independently associated with increasing age, male gender, known history of heart failure, cancer, and diabetes, whereas BS was in favor with a protective effect. Conclusion: This nationwide administrative study showed that bariatric surgery is independently associated with a reduced risk of death and invasive mechanical ventilation in obese individuals with Covid-19 infection. | The impact of previous history of bariatric surgery on outcome of Covid-19: A nationwide medico-administrative French study |
The surgical treatment of meningiomas located at the base of the anterior cranial fossa is often challenging, and the evolution of the surgical strategy to resect these tumors parallels the development of craniotomy, and neurosurgery in general, over the past century. Early successful operations to treat these tumors were pioneered by prominent figures such as Sir William Macewen and Francesco Durante. Following these early reports, Harvey Cushing made significant contributions, allowing a better understanding and treatment of meningiomas in general, but particularly those involving the anterior cranial base. Initially, large-sized unilateral or bilateral craniotomies were necessary to approach these deep-seated lesions. Technical advances such as the introduction of electrosurgery, the operating microscope, and refined microsurgical instruments allowed neurosurgeons to perform less invasive surgical procedures with better results. Today, a wide variety of surgical strategies, including endoscopic surgery and radiosurgery, are used to treat these tumors. In this review, the authors trace the evolution of craniotomy for anterior cranial fossa meningiomas. | Craniotomy for anterior cranial fossa meningiomas: historical overview. |
The purpose of this article was to historically review the field of school psychology for the 75th Anniversary of the founding of the Division of School Psychology (DSP) of the APA. Past and present proactive school psychology was evaluated and recommendations for the future were offered in light of historic APA DSP goals. Since its inception, the DSP has worked with APA to protect and expand school psychology as a foundational service area within health service psychology. This article examines the challenges in the field, highlights current issues, and calls for a proactive and transformational future. The article concludes with suggestions from history to adopt current approaches to emulate the transformative vision of proactive school psychology. (PsycInfo Database Record (c) 2021 APA, all rights reserved). | History of the future of proactive school psychology: Historical review at our 75th APA anniversary to transcend the past, excel in the present, and transform the future |
The tip of Brittany was fortunate to be relatively unscathed by the first wave of the Covid-19 pandemic Nevertheless, aware of the national health situation, some student midwives from Brest with whom we spoke have committed themselves, from March 2020, to concrete actions to support hospital professionals © 2020 Elsevier Masson SAS La pointe de la Bretagne a eu la chance d’être relativement épargnée par la première vague de la pandémie de Covid-19 Néanmoins, conscients de la situation sanitaire nationale, certaines étudiantes sages-femmes brestoises, avec qui nous nous sommes entretenues, se sont engagées, dès le mois de mars 2020, dans des actions concrètes, pour soutenir les professionnels de l'hôpital © 2020 Elsevier Masson SAS | Student midwives committed to supporting health professionals |
INTRODUCTION/OBJECTIVE: Hemophagocytic Syndromes are a cluster of disorders related to cytotoxic dysfunction of T/NK-cells and are mainly subdivided into Primary (familial) and Secondary (acquired) forms, with the latter usually linked to patients with viral infections; including EBV, CMV among many others. A myriad of other causes have been associated with hemophagocytic lymphohistiocytosis (HLH), most notably systemic inflammatory conditions; especially Juvenile Rheumatoid Arthritis and hematolymphoid malignancies particularly T/NK-cell lymphomas. METHODS/CASE REPORT: A previously healthy 7-year-old boy, presented to the ER with fever and a skin rash over both lower limbs of 1 week duration. Two weeks prior he was tested for COVID-19 and was found to be positive. Physical examination further revealed slightly palpable liver and spleen. CBC was done and exhibited pancytopenia, further testing showed elevated LDH, hyperferritinemia and hypertriglyceridemia. However, serological testing for rheumatological conditions was unremarkable. Imaging studies were done and were noncontributory. Subsequently, a bone marrow aspirate and biopsy were done. The bone marrow aspirate showed afew histiocytes engulfing red blood cells and nuclear debris (hemophagocytic cells), complete trilineage maturation and normal M:E ratio of 3:1. Trephine biopsy was hypocellular for age and estimated at about 70%, composed of myeloid and erythroid precursors with various degrees of maturation. Megakaryocytes were adequate in number and showed normal morphology. Extensive histiocytic infiltration as highlighted by CD68 immunostain and focal phagocytosis were identified. CD34 highlighted <5% blasts, PAS special stain showed no fungal elements and no fibrosis was evident by Reticulin special stain. The background was devoid of lymphoid aggregates or granulomas. Stainable iron stores were depleted. No sideroblasts were identified. The patient was treated with corticosteroid and showed marked improvement and was discharged after 3 days. RESULTS (IF A CASE STUDY ENTER NA): NA CONCLUSION: Hemophagocytic lymphohistiocytosis can be a critical sequela of COVID-19 infection. Suggested mechanisms include impaired/delayed T-cell response and elevated levels of several inflammatory cytokines. Clinical suspesion is important in the diagnosis of these cases. Further study of this correlation is needed as we explore clinical sequelae of COVID-19 infection. | A rare case of post COVID-19 hemophagocytic lymphohistiocytosis in a pediatric patient |
BACKGROUND: Multiple sclerosis (MS) is the most common autoimmune disease of the central nervous system (CNS). The main cause of the MS is yet to be revealed, but the most probable theory is based on the molecular mimicry that concludes some infections in the activation of T cells against brain auto-antigens that initiate the disease cascade. OBJECTIVES: The Purpose of this research is the prediction of the auto-antigen potency of the myelin proteolipid protein (PLP) in multiple sclerosis. MATERIALS AND METHODS: As there wasn’t any tertiary structure of PLP available in the Protein Data Bank (PDB) and in order to characterize the structural properties of the protein, we modeled this protein using prediction servers. Meta prediction method, as a new perspective in silico, was performed to fi nd PLPs epitopes. For this purpose, several T cell epitope prediction web servers were used to predict PLPs epitopes against Human Leukocyte Antigens (HLA). The overlap regions, as were predicted by most web servers were selected as immunogenic epitopes and were subjected to the BLASTP against microorganisms. RESULTS: Three common regions, AA(58-74), AA(161-177), and AA(238-254) were detected as immunodominant regions through meta-prediction. Investigating peptides with more than 50% similarity to that of candidate epitope AA(58-74) in bacteria showed a similar peptide in bacteria (mainly consistent with that of clostridium and mycobacterium) and spike protein of Alphacoronavirus 1, Canine coronavirus, and Feline coronavirus. These results suggest that cross reaction of the immune system to PLP may have originated from a bacteria or viral infection, and therefore molecular mimicry might have an important role in the progression of MS. CONCLUSIONS: Through reliable and accurate prediction of the consensus epitopes, it is not necessary to synthesize all PLP fragments and examine their immunogenicity experimentally (in vitro). In this study, the best encephalitogenic antigens were predicted based on bioinformatics tools that may provide reliable results for researches in a shorter time and at a lower cost. | In Silico Perspectives on the Prediction of the PLP’s Epitopes involved in Multiple Sclerosis |
BACKGROUND: Several coronavirus disease (COVID-19) vaccines have already been authorized and distributed in different countries all over the world, including Bangladesh. Understanding public acceptance of such a novel vaccine is vital, but little is known about the topic. OBJECTIVES: This study aimed to investigate the determinants of intention to receive a COVID-19 vaccine and willingness to pay (WTP) among people in Bangladesh. METHODS: An anonymous and online-based survey of Bangladeshi people (mean age = 29.96 ± 9.15 years; age range = 18–60 years) was conducted using a self-reported questionnaire consisting of socio-demographics, COVID-19 experience, and vaccination-related information as well as the health belief model (HBM). Multivariable logistic regression was performed to determine the factors influencing COVID-19 vaccination intent and WTP. RESULTS: Of the 894 participants, 38.5% reported a definite intention to receive a COVID-19 vaccine, whereas 27% had a probable intention, and among this intent group, 42.8% wanted to get vaccinated as soon as possible. Older age, feeling optimistic about the effectiveness of COVID-19 vaccination, believing that vaccination decreases worries and risk of COVID-19 infection, and being less concerned about side effects and safety of COVID-19 vaccination under the HBM construct were found to be significant factors in COVID-19 vaccination intention. Most of the participants (72.9%) were willing to pay for a COVID-19 vaccine, with a median (interquartile range [IQR]) amount of BDT 400/US$ 4.72 (IQR; BDT 200–600/US$ 2.36–7.07) per dose. Factors associated with higher WTP were younger age, being male, having higher education, residing in an urban area, having good self-rated health status, positivity towards COVID-19 vaccination's effectiveness, and being worried about the likelihood of getting infected with COVID-19. Participants who were COVID-19 vaccination intent preferred an imported vaccine over a domestically-made vaccine (22.9% vs. 14.8%), while 28.2% preferred a routine immunization schedule. CONCLUSION: The findings indicate a considerable proportion of Bangladeshi people intended to get vaccinated and had WTP for the COVID-19 vaccine. However, urgent education and awareness programs are warranted to alleviate public skepticism regarding the COVID-19 vaccination. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-021-06406-y. | Understanding the determinants of COVID-19 vaccination intention and willingness to pay: findings from a population-based survey in Bangladesh |
Dr Martin Alda is the recipient of the 2020 Heinz Lehmann Award Dr Alda is a professor of psychiatry and the Killam Chair in Mood Disorders at Dalhousie University, Halifax, Nova Scotia He also holds appointments at McGill University, University of Pittsburgh and the National Institute of Mental Health in the Czech Republic This award recognizes the outstanding contributions and distinguished career of a single individual in the field of research in neuropsychopharmacology in Canada, and this year it is being awarded for clinical research The award, donated by Pfizer Canada Inc , consists of a $2000 honorarium and an engraved plaque Congratulations to Dr Alda | Canadian College of Neuropsychopharmacology 2020 award winners |
Mental health problems are associated with poor labour market outcomes. Based on data from a field experiment, this article investigates the extent to which hiring discrimination limits the job opportunities of young applicants who disclose a history of mental health problems. From September 2019 to December 2020, 1398 job applications were sent in pairs to 699 employers with job openings in a broad selection of occupations in the Norwegian labour market. The applicants were equally qualified except that, in each pair, one applicant informed about mental health problems as an explanation for a past employment break. The results show that applicants who disclose mental health problems are discriminated against in hiring processes. Applicants with mental health problems have about 27% lower probability of receiving an invitation to a job interview and about 22% lower probability of receiving any positive employer response. These results do not seem to have been driven by the COVID-19 crisis that unfolded during the course of the study. As such, the study provides suggestive evidence that uncertain economic times might not necessarily increase the level of discrimination against applicants with mental health problems. | The mark of mental health problems. A field experiment on hiring discrimination before and during COVID-19 |
The author’s understanding of the role of the social sciences and humanities in preserving and developing science as a sociocultural phenomenon is substantiated. This justification is built as an explication and critical analysis of the program of philosophical research in science and technology, the main content and results of which are presented in the monograph by I.T. Kasavin Science As a Humanistic Project (2020). This article describes how the search for new strategies for the study of science is carried out within the framework of Russian philosophy. The historicity of science is analyzed, and the complex topology of its genesis is shown, which does not fit into the linear scheme of historical continuity, reflecting the synchronous coexistence of different variations of science as a cultural phenomenon. The historicity of science makes us turn to the question of its cultural and historical agency; it is substantiated that this agency acquires a political character in the current activity. How can the political agency of science be perceived and consistently combined with the ethos of the expert community? According to the author, political agency and the range of interests that scientists defend in public are determined by understanding the essence of science as a cultural phenomenon. The existential and cultural-creative functions of science are emphasized; on this basis the author’s interpretation of the humanistic project suggested by Kasavin is proposed as a program for the humanization of technoscience. | Sociohumanistic Knowledge and the Future of Science |
Background and importance An outbreak of multiple sclerosis (MS) is defined as symptoms and neurological signs typical of demyelinating disease, with a duration of at least 24 hours It appears in all forms of MS, contributing to short and long term disability The main treatments for outbreaks are high dose steroids given intravenously or orally for 3-5 days In our clinical practice, we used oral prednisone 1400 mg for 5 days prepared in a hospital pharmacy to avoid staff attendance at health centres Aim and objectives To evaluate oral prednisone effectiveness as a treatment for acute MS outbreaks Material and methods This was a retrospective multidisciplinary study, from March to June 2020 (4 months), during the limited mobility period due to the coronavirus pandemic (SARS-CoV-2) The results of 31 patients were analysed The following data were collected: sex, age, type of MS, expanded disability status scale (EDSS), treatment at the time of the outbreak, symptoms and evolution The programmes used were: patient medical history (DIRAYA), outpatient dispensing (DOMINION) and MRI (CARESTREAM) Specialist role was: the neurologist made the clinical evaluation, the pharmacist prepared the prednisone capsules from original tablets and its dispensation, and the nurse provided patient education Results 31 patients (25 women) with a mean age of 44 85 ±13 years were assessed Every patient had a diagnosis of recurrent remitting MS Treatments were: interferon beta (20), dimethyl fumarate (10) and cladribine (1) The mean EDSS was 3 The main symptoms were: paraesthesias, muscle weakness and urinary incontinence The EDSS progressed positively: 83 78% of patients evolved favourably, a subjective decrease in paraesthesia and weakness was observed and MRI showed less inflammation signs Another aspect was the comfort of the patient in carrying out this treatment at home rather than attending hospital Conclusion and relevance The results suggested that 1400 mg of oral prednisone administration for 5 days could be considered a safe, effective and comfortable alternative treatment for acute outbreaks of MS Multidisciplinary care is essential to obtain better clinical results | Home management of acute multiple sclerosis outbreak: Adaptation to coronavirus pandemic |
For this 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, the Education, Implementation, and Teams Task Force applied the population, intervention, comparator, outcome, study design, time frame format and performed 15 systematic reviews, applying the Grading of Recommendations, Assessment, Development, and Evaluation guidance. Furthermore, 4 scoping reviews and 7 evidence updates assessed any new evidence to determine if a change in any existing treatment recommendation was required. The topics covered included training for the treatment of opioid overdose; basic life support, including automated external defibrillator training; measuring implementation and performance in communities, and cardiac arrest centers; advanced life support training, including team and leadership training and rapid response teams; measuring cardiopulmonary resuscitation performance, feedback devices, and debriefing; and the use of social media to improve cardiopulmonary resuscitation application. | Education, Implementation, and Teams: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations |
OBJECTIVE: The COVID-19 pandemic has created many challenges that need immediate attention Various epidemiological and deep learning models have been developed to predict the COVID-19 outbreak, but all have limitations that affect the accuracy and robustness of the predictions Our method aims at addressing these limitations and making earlier and more accurate pandemic outbreak predictions by (1) using patients' EHR data from different counties and states that encode local disease status and medical resource utilization condition;(2) considering demographic similarity and geographical proximity between locations;and (3) integrating pandemic transmission dynamics into deep learning models MATERIALS AND METHODS: We proposed a spatio-temporal attention network (STAN) for pandemic prediction It uses an attention-based graph convolutional network to capture geographical and temporal trends and predict the number of cases for a fixed number of days into the future We also designed a physical law-based loss term for enhancing long-term prediction STAN was tested using both massive real-world patient data and open source COVID-19 statistics provided by Johns Hopkins university across all U S counties RESULTS: STAN outperforms epidemiological modeling methods such as SIR and SEIR and deep learning models on both long-term and short-term predictions, achieving up to 87% lower mean squared error compared to the best baseline prediction model CONCLUSIONS: By using information from real-world patient data and geographical data, STAN can better capture the disease status and medical resource utilization information and thus provides more accurate pandemic modeling With pandemic transmission law based regularization, STAN also achieves good long-term prediction performance | STAN: Spatio-Temporal Attention Network for Pandemic Prediction Using Real World Evidence |