ABSTRACT
The recent pandemic of COVID-19 has changed the way people socially interact with each other. A huge increase in the usage of social media applications has been observed due to quarantine strategies enforced by many governments across the globe. This has put a great burden on already overloaded cellular networks. It is believed that direct Device-to-Device (D2D) communication can offload a significant amount of traffic from cellular networks, especially during scenarios when residents in a locality aim to share information among them. WiFi Direct is one of the enabling technologies of D2D communications, having a great potential to facilitate various proximity-based applications. In this work, we propose power saving schemes that aim at minimizing energy consumption of user devices across D2D based multi-hop networks. Further, we provide an analytical model to formulate energy consumption of such a network. The simulation results demonstrate that a small modification in the network configuration, such as group size and transmit power can provide considerable energy gains. The observed energy consumption is reduced by 5 times for a throughput loss of 12 %. Additionally, we measure the energy per transmitted bit for different configurations of the network. Furthermore, we analyze the behavior of the network, in terms of its energy consumption and throughput, for different file sizes.
ABSTRACT
This paper takes a retrospective view of the year 2020, with a focus on how Higher Education policy development was undertaken on a Transnational Education (TNE) program between the University of Glasgow (UofG) and the University of Electronics, Science and Technology in Chengdu (UESTC), China in response to the COVID-19 pandemic. It explores the approach to policy development under normal circumstances, contrasting this with the approach taken during the emergence of the epidemic and how the unfolding situation impacted on those policies. It demonstrates how the application of management tools for scenario planning and crisis management can be used effectively to develop a clear and prescriptive policy for staff. It also demonstrates how the use of such tools, combined with careful analysis and planning, can minimize disruption to student learning, teaching, and assessment. The paper then goes on to explain the creation and implementation of policies addressing three main areas: learning and teaching, Final Year Projects, and assessment. Finally, it reflects on the student and staff perspectives on the policies, considering how this information might be used to enhance the policy development process in future. © Copyright © 2021 Bremner, Ansari, MacDougall, Hussain, Ma, Ponciano, Liu, Gamage, Abbas and Imran.
ABSTRACT
Type 2 Myocardial Infarction is characterized as a myocardial infarction which is caused by factors other than Coronary Artery Disease (CAD). The causative factor for a secondary myocardial infarction is a disbalance between oxygen supply and its demand. There have been cases where there was 90% blockage in the coronaries but still myocardial infarction was classified as type 2 as the causative factor was not Coronary artery disease but the disbalance between oxygen demand and supply. Thus there is a diagnostic challenge with considerable overlap in Type 2 and Type 1 Myocardial Infarction. COVID19 has brought a tremendous load on healthcare ever since it's identification in the late 2019. There is increased demand of Oxygen due to hypoxia caused by severe pneumonia leading to a disbalance between oxygen supply and demand causing a type 2 myocardial infarction, though the cases of Type 1 myocardial infarction due to COVID19 are well documented this is the first case series showing Type 2 myocardial infarction in the world to our knowledge.
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This paper focuses on policy development in a Higher Education context and provides a model fur ensuring sustainable educational practice in TNE partnerships under disruptive situations. The focal point of policy initiation and development was the Covid-19 virus outbreak in China and the ensuing impact on program delivery and assessment. The development takes a novel approach by applying a combination of commercial scenario planning and crisis management techniques to create a coherent and prescriptive educational policy for staff operating in a Transnational Education (TNE) partnership based on the fly-in, fly-out (FIFO) faculty model. It demonstrates the application of these management tools and describes how, through careful analysis and planning, disruption to student learning, teaching and assessment can be minimized.
ABSTRACT
The COVID-19 pandemic outbreak and the lockdown and social distancing strategies adopted to contain it have drastically affected our daily lives and the routine businesses. Provision of educational services in a continuous and useful manner in such circumstances is a massive challenge and requires innovative methods. Effective assessment and feedback play a pivotal role in traditional teaching and learning approaches and it is of even more vital importance in disruptive conditions. This paper discusses different assessment and feedback techniques in the online delivery of higher education courses in kickdown scenarios. The effectiveness of these approaches is evaluated through qualitative and quantitative study of student and staff feedback for an engineering course being delivered as part of a transnational education (TNE) program. In the light of the results, recommendations are made to improve the assessment and feedback activities in disruptive circumstances.
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Objective: To determine the association of adverse outcomes in term of mortality in patients with cirrhosis presented with coronavirus disease. Study Design: Retrospective/observational study Place and Duration of Study: Department of Medicine, Chandka Medical College Hospital, Larkana from 1stMarch 2019 to 31stDecember 2020. Methodology: Two hundred and twenty covid-19 patients of both genders with or without chronic liver disease were enrolled in this study. Patients were categorized in to two groups. Group A (with cirrhosis 60 patients) and group B (without cirrhosis 60 patients). Outcomes in term of mortality between both groups were examined. Results: There were 38 (63.33%) males and 22 (36.67%) were females with mean age 46.14±8.44 years in group A while in group B, 40 (66.67%) and 20 (33.33%) patients were males and females with mean age 45.26±9.34 years. Patients with cirrhosis had high mortality rate as compared to patients without cirrhosis (33.33% Vs 13.33%) with p-value 0.0001. Conclusion: A significant association of adverse outcomes was found in cirrhotic patients with coronavirus disease.
ABSTRACT
INTRODUCTION: Increasing functional residual capacity with positive pressure improves ventilation perfusion mismatch and relieves hypoxemia. However, most noninvasive interfaces must be tightly applied for prolonged periods and may lead to facial decubiti and delirium. High flow O2 systems with wide bore nasal cannulas are not widely available in resource-limited settings. We hypothesized that applying CPAP through a high flow nasal cannula (improvised nasal CPAP or iCPAP) may provide sufficient alveolar recruitment and greater patient comfort. The objective of this study was to describe the use of a respiratory support strategy using iCPAP in COVID-19 respiratory failure. METHODS: In a prospective, observational design, hemodynamically stable, non-hypercapnic patients, admitted with COVID-19 hypoxic respiratory failure and on iCPAP, were included. For iCPAP ResMed LumisTM 150 VPAP ST-A was used with Respicare High-flow nasal cannula. iCPAP failure was characterized as advancement to conventional BiPAP or endotracheal intubation. Data on ROX index, iCPAP failure, organ failure, survival to discharge was collected. RESULTS: 113 patients were admitted;improvised CPAP (iCPAP) was applied in 45 (49%), 6 (13%) alternated between bilevel positive pressure and iCPAP. Mean APACHE II score was 19.3 ±4.7, 37 (82%) were male, mean age was 52±12.9 years. Systemic steroids were given to 45 (100%), 41 (91%) patients underwent awake proning, 8 (18%) and 7 (16%) were given concurrent tocilizumab and convalescent plasma. Mean PaO2/FiO2 ratio at admission was 129 ±63 (range 43,380). Mean CPAP applied was 12 ±2.7 cmH20. For patients receiving concurrent BiPAP, mean IPAP was 15 ±3.7 cmH20, EPAP 11 ±4 cmH20 were applied. Mean ROX index 2 hours after iCPAP application was 10.9 ±5.5. iCPAP failure occurred in 3 (6.6%) patients;1 required intubation and invasive ventilation and 2 were advanced to only BiPAP support. 39 (87%) patients were discharged alive from the ICU;2 (4.4%) developed acute kidney injury, 5 (11%) had deranged liver function tests. One patient (2%) had a cerebrovascular event. 1 patient (2%) had a cardiac arrest. CONCLUSIONS: iCPAP application in carefully selected patients and with intensive care monitoring, may represent a valid form of respiratory support in COVID-19 hypoxic respiratory failure.
ABSTRACT
Introduction: Coronavirus disease 2019 (COVID-19) is responsible for a global pandemic. A concern with COVID-19 are co-infections. Studies have reported between 5.8-8.1% of COVID-19 patients having documented co-infection(s);however, no study has reported the prevalence of co-infections during the early pandemic in Detroit, one of the first “hot spots.” While the number of patients with COVID-19 and co-infections is low, there is limited to no information on the impact of acquiring these virulent and/or multidrug-resistant (MDR) pathogens. Research Question or Hypothesis: Investigate the prevalence of coinfections in the early pandemic in patients diagnosed with COVID-19 in Detroit. Study Design: Single-center, retrospective, descriptive study. Methods: All adult patients diagnosed with COVID-19 and admitted to Medical Center were screened from March to April 2020. Any patients with a documented co-infection with any pathogen were included. Descriptive statistics were utilized for analysis. Results: A total of 309 COVID-19 patients were screened, and 45 (14.6%) were found to have ≥1 co-infection (thus, total percentage > 100%;bacterial: 88.9%, fungal: 11.1%, viral: 8.9%). The majority of patients were male (62.2%) and African American (75.6%), while median age and weight were 67 (57-74) years and 85.0 (72.7-104.5) kg, respectively. Of the 40 (88.9%) patients with a bacterial co-infection, 9 (22.5%) were infected with multiple bacteria, and 3 (7.5%) also had fungal and viral 1 (2.5%) co-infections. The majority of bacterial co-infections included Pseudomonas aeruginosa(15.0%), Staphylococcus aureus(12.5%), and Enterococcus faecalis(10.0%). Three (6.7%) and 2 (4.4%) patients had Candida albicans and Candida glabrata, respectively, and 3 (6.7%) patients had influenza. The pathogens were cultured from the blood (46.7%), sputum and/or bronchoalveolar lavage (42.2%), or urine (11.1%). Conclusion: Patients with COVID-19 and documented co-infections were more prevalent in Detroit compared to previous studies. Further studies should be conducted to efficiently identify the presence and impact of co-infections in patients diagnosed with COVID-19 to optimize patient outcomes.
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Aim: To determine the frequency of severe vitamin D deficiency and its association with mortality in patients presented with Covid-19. Study Design: Cross-sectional/Observational Place and Duration of Study: Chandka Medical College Hospital, Larkana and Gambat Medical College Hospital, Gambat from 1st March 2020 to 31st August 2020 Methodology: One hundred and twenty five patients of both genders diagnosed to have severe covid-19 disease by real time PCR were analyzed. Patient’s ages were ranging from 15 years to 70 years. Detailed demographics were recorded after taking written consent. 5 ml blood sample was taken from all the patients to examine the vitamin D level. Severe Vitamin D deficiency was defined as 25(OH)D <25 nmol/L (10 ng/dL). Association between mortality and severe vitamin D deficiency was examined. Results: Seventy five (60%) were males while 50 (40%) were females with mean age 45.58±15.66 years. Severe vitamin D deficiency was observed in 57 (45.6%) patients. Overall mortality was found in 14 (11.2%) patients, Among 57 patients with severe vitamin D deficiency 12 (9.6%) were died while patients with no vitamin D deficiency 2/68 (1.6%), a significant association was observed between severe vitamin D deficiency and mortality in patients with covid-19 disease with p-value <0.05. Conclusion: There was strong relationship between severe vitamin-D deficiency and mortality in patients with covid-19 disease. © 2020 Lahore Medical And Dental College. All rights reserved.