Sentiment Analysis on COVID-19 Tweets

The global proliferation of COVID-19, as well as the growth of platforms as a primary source of information for many individuals, has elicited a wide spectrum of reactions. However, keeping up with this mass scenario is difficult. A large number of people offer their opinions and perspectives on current events on social media, making it difficult for a human to read and comprehend everything. Tweets disseminate a great deal of information. Using public Twitter comments, our study attempted to conduct a sentiment analysis of the entire discourse about COVID-19 in a paper. We improved on earlier methodologies and methods for sentiment analysis. Our primary goal is to examine tweets concerning COVID-19 from the previous year using natural language processing and neural network methods. We used a multiclass dataset and applied it to BOW, TFIDF, and One Hot Encoding. Furthermore, after training four distinct classifiers with these different pre-processing algorithms in each classifier, we performed a competitive analysis and found RoBERTa as the best performing with 90% accuracy. © 2022 IEEE.

Clinical Efficacy of an Extraoral Dental Evacuation Device in Aerosol Elimination During Endodontic Access Preparation.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has caused many concerns in the dental field regarding aerosol production and the transmission of the severe acute respiratory syndrome coronavirus 2 virus during dental procedures. Because of the abrupt arrival of COVID-19, there has been little to no published research on the efficacy of dental suction devices in the removal of aerosols related to COVID-19 or the impact extraoral suction devices have on patients' experiences. Therefore, the aim of this study was to measure the amount of aerosol produced during endodontic access preparation for root canal therapy with and without the use of an extraoral dental suction device and to gather information through a survey regarding patients' experiences. METHODS: Aerosol measurements were recorded in 8 closed-door resident operatories each morning before the procedures, 1 minute during the procedure, and 15 minutes after the access was complete. The CICADA DTO KN99 Extraoral Dental Suction Device (Foshan Cicada, Guangdong, China) was placed in 4 operatories, whereas no DTO extraoral suction device was used in 4 control operatories. Twenty cases with DTO and 20 cases without it were completed, and the data were analyzed. RESULTS: Aerosols 1 minute after access were higher with and without DTO. There was a significant reduction after 15 minutes when the DTO device was used compared to high-volume suction alone. Composite and zirconia produced the most aerosols at 1 minute. CONCLUSION: The results show that the reduction of aerosols is enhanced when the extraoral suction device is used in combination with traditional high-volume evacuation. However, the increased noise level when using the device can have a negative impact on patients' dental experience.

Was the Coronavirus Disease 2019 Pandemic Associated with an Increased Rate of Cracked Teeth?

INTRODUCTION: There is lack of data on whether the coronavirus disease 2019 (COVID-19) pandemic was associated with changes in the etiology of pathosis in endodontic patients. The aim of this study was to determine the rate of cracks and other etiologic factors during the period of March 16th to May 31st in 2020 (COVID-19 initial outbreak) and 2021 (COVID-19 ongoing pandemic) compared with figures from the same period in 2019 (pre-COVID era) in 2 endodontists' practices. METHODS: The etiologies of patients' chief complaints were determined from records of 2440 teeth (740 in 2019, 651 in 2020, and 1049 in 2021). Changes in the proportion of etiologic factors among all 3 periods were analyzed. The association between the rate of cracked teeth and patients' age and sex was determined using a logistic regression model. RESULTS: The rates of all etiologies collectively during the studied periods showed a significant change (P < .0001). The rate of cracks significantly increased in 2020 (11.8%) (P = .0001) and 2021 (8%) (P = .0018) compared with 2019 (4.3%). The rate of persistent infections decreased in 2020 (22.3%) (P = .0013) and then increased in 2021 (27.5%) (P = .0153) compared with 2019 (30%). Cracked teeth were associated with the age group of 40-60 years (odds ratio [OR] = 1.882; 95% confidence interval [CI], 1.063-3.330) in 2020 and with age ranges of 40-60 years (OR = 2.051; 95% CI, 1.120-3.759) and >60 years (OR = 2.038; 95% CI, 1.050-3.956) and male sex (OR = 1.599; 95% CI, 1.019-2.510) in 2021. CONCLUSIONS: The rate of cracked teeth increased during the initial outbreak of the COVID-19 pandemic and 1 year later. This study provided evidence on the association between the COVID-19 pandemic and changes in the rate and presentation of endodontic etiologic factors.

Endodontic Specialists' Practice During the Coronavirus Disease 2019 Pandemic: 1 Year after the Initial Outbreak.

INTRODUCTION: The aims of this observational study were to determine if endodontists' practices in early 2021 experienced changes in patient characteristics compared with a comparable prepandemic period and to determine whether the changes reported during the initial outbreak of coronavirus disease 2019 (COVID-19) in 2020 were reversed 1 year later. METHODS: Demographic, diagnostic, and procedural data of 2657 patient visits from 2 endodontist private offices from March 16 to May 31 in 2019, 2020, and 2021 were included. Bivariate analyses and multiple logistic regression models were used to examine the impact of ongoing COVID-19 pandemic on patient data. RESULTS: Bivariate analyses showed that patients' self-reported pain levels and the number of visits with irreversible pulpitis in 2021 were higher than 2019 (P < .05). Patients' self-reported pain, percussion pain, and palpation pain levels in 2021 were less than 2020 (P < .05). Multiple logistic regression analyses showed that endodontists' practices in 2021 had an increase in the number of nonsurgical root canal treatments (odds ratio [OR] = 1.482; 95% confidence interval [CI], 1.102-1.992), and apicoectomies (OR = 2.662; 95% CI, 1.416-5.004) compared with 2019. Compared with the initial outbreak in 2020, endodontists' practices in 2021 had visits with older patients (OR = 1.288; 95% CI, 1.045-1.588), less females (OR = 0.781; 95% CI, 0.635-.960), more molars (OR = 1.389; 95% CI, 1.065-1.811), and less pain on percussion (OR = 0.438; 95% CI, 0.339-0.566). CONCLUSIONS: The ongoing COVID-19 pandemic was associated with an increase in the number of nonsurgical root canal treatments. Some of the changes observed during the initial outbreak in 2020, including objective pain parameters, returned to normal levels 1 year later.

Endodontics Specialists' Practice during the Initial Outbreak of Coronavirus Disease 2019.

INTRODUCTION: The first outbreak of coronavirus disease 2019 (COVID-19) in the United States resulted in a nationwide closure of dental offices that created an oral health crisis. The aim of this observational study was to analyze and compare the characteristics of patients who visited 2 private endodontics offices from March 16 to May 31, 2020, compared with the same period in 2019. METHODS: Demographic, diagnostic, and procedural data of 1520 (693 in 2020 and 827 in 2019) patient visits were collected. Bivariate and multiple logistic regression analyses were used to assess the impact of the COVID-19 outbreak on patient-related variables. RESULTS: Bivariate analyses showed that the number of patient visits decreased in April and May 2020 (P < .0001). In 2020, patients' self-reported pain level was higher, they were more frequently diagnosed with pulp necrosis and acute apical abscess, and they received more incisions for drainage (P < .05). Multiple logistic regression analyses showed that the COVID-19 outbreak was associated with less visits for older patients (>49.5 years) (odds ratio [OR] = 0.720; 95% confidence interval [CI], 0.573-0.906), more patients with kidney diseases (OR = 2.690; 95% CI, 1.143-6.331), higher levels of pain on percussion (OR = 2.277; 95% CI, 1.718-3.016), less cases with previously initiated treatment (OR = 0.242; 95% CI, 0.080-0.731), less periapical diagnoses of asymptomatic apical periodontitis (OR = 0.510; 95% CI, 0.306-0.849), and a higher number of nonsurgical root canal treatments (OR = 2.073; 95% CI, 1.397-3.074) and apicoectomies (OR = 2.799; 95% CI, 1.367-5.729). CONCLUSIONS: These findings show that the public health burden of endodontic infections was more intense during the initial outbreak of COVID-19.

The role of non-invasive chronic liver disease assessment in reducing the need for endoscopic screening for esophageal varices

Background and Aim: Variceal hemorrhage resulting from portal hypertension is a feared complication of cirrhosis. Historically, endoscopic screening of individuals with cirrhosis has been performed to identify those at highest risk of variceal hemorrhage who would benefit from interventions. Non-invasive prediction of esophageal varices may identify patients considered to be at low risk of varices, for whom unnecessary endoscopic screening could be avoided, thus reducing risks to patients and costs to health services. This is relevant during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and for remotely located patients. Liver fibrosis severity is not routinely assessed in known cirrhotic patients. We aimed to examine the role of non-invasive assessments in prediction of esophageal varices. Methods: We assessed data on adult patients with known or suspected cirrhosis from various liver disorders over 8 years at a tertiary hospital. Patient age, sex, liver disease etiology, full blood count, serum liver biochemistry, renal function tests, liver ultrasound (US), transient elastography liver stiffness measurement (LSM), and endoscopy results were retrospectively recorded. Chronic liver disease characteristics using the Fibrosis-4 (FIB-4) score, the Model for End-Stage Liver Disease (MELD) score, and Baveno VI criteria were computed and correlated with LSM, US, and endoscopy. Results: We identified 303 patients (69% male;mean ± SD age, 60 ± 11 years). Liver disease etiologies were predominantly alcohol (23%), hepatitis C (37%), non-alcoholic steatohepatitis (13%), or hepatitis B (5%). Patients with varices had higher LSM, FIB-4 score, MELD score, and international normalized ratio but lower serum albumin level and platelet count compared with those without varices (P < 0.05 for all). The area under the curve for predicting any varices was 0.76, 0.76, and 0.73 for LSM, FIB-4 score, and MELD score, respectively. Sensitivity and specificity for tests were, respectively, FIB-4 ≥ 6.0, 44% and 84%;LSM ≥ 29.0 kPa, 53% and 83%;Baveno VI criteria, 39% and 83%;MELD score ≥ 15.0, 31% and 92%;and US-reported portal hypertension, 62% and 73%. Baveno VI criteria (95% CI, 1.2-4.4), MELD score ≥ 15 (95% CI, 1.8-8.1), and FIB-4 score ≥ 6 (95% CI, 1.3-4.7) independently predicted varices. Calculated costs of transient elastography, FIB-4, and MELD assessments were about 14%, 1%, and 1.5%, respectively, of the cost of endoscopic screening without endoscopic therapy. Conclusion: Although liver fibrosis severity is not routinely assessed in patients with known cirrhosis, non-invasive assessments of liver fibrosis or chronic liver disease severity have high specificity and a potential role in reducing unnecessary endoscopic variceal screening during times of limited endoscopy access. Potential benefits extend to appropriate prioritization of endoscopy resources, including access, sedation, and personal protective equipment.

Impact of COVID-19 on advanced dental education: Perspectives of dental residents in Wuhan.

PURPOSE: This study investigated the impact of coronavirus disease 2019 (COVID-19) from the perspectives of dental residents in Wuhan, the former COVID-19 epicenter of China. METHODS: A survey form was sent to 424 residents in the School of Stomatology, Wuhan University (WHUSS) in September 2020. The form included 23 questions on demographics, study situation of residents during the COVID-19 outbreak, effect of COVID-19 on graduates, and status of residents who returned to clinic training. RESULTS: A total of 361 (85%) survey forms were collected. Over 70% of respondents felt anxious during Wuhan lockdown. Most respondents continued studying (94%) mainly through free online resources (79%). The majority reported improvement in didactic knowledge (80%), but the respondents' perceptions of their clinical skills, especially those in Wuhan, did not change (41%) or worsened (40%) (p < 0.05). Most graduates (88%) reported having found jobs or continued study. Among the 209 responders who returned to clinical training, 52% felt no concern about COVID-19 infection, 89% thought they were equipped with adequate personal protective equipment (PPE), and 57% indicated that they received sufficient knowledge for preventing COVID-19 in clinic. Most respondents agreed that the way to gain the knowledge for preventing COVID-19 in clinic was training at dental school (93%). CONCLUSION: Although online study has been appreciated by residents, concern about clinical skill learning in the COVID-19 hardest-hit area has arisen. Most graduates felt that the impact of COVID-19 on their immediate postgraduation career was limited. Teaching about infection control in dental schools seemed effective to develop a positive attitude for residents after they returned to clinical training.

The role of noninvasive liver fibrosis assessment and meld score in screening for oesophageal varices

Background: Variceal haemorrhage resulting from portal hypertension is a feared complication of cirrhosis Historically, endoscopic screening of individuals with cirrhosis has been performed to identify those at highest risk of variceal haemorrhage who would benefit from interventions. Noninvasive prediction of oesophageal varices may identify patients considered to be at low risk of varices, for whom unnecessary endoscopic screening could be avoided, thus reducing risks to patients and costs to health services This is relevant during the SARS-COV-2 pandemic and for remote located patients Aims: To examine the role of noninvasive liver fibrosis and chronic liver disease assessments for prediction of oesophageal varices Methods: Data on adult patients with cirrhosis from various liver disorders over 8 years at a tertiary hospital were assessed Patient age, sex, liver disease aetiology, full blood count, serum liver biochemistry, renal function tests, liver ultrasound (US), transient elastography liver stiffness measurement (LSM) and endoscopy results were retrospectively recorded. Noninvasive liver fibrosis and chronic liver disease severity using Fibrosis-4 index (FIB-4), the Model for End-stage Liver Disease (MELD) score and Baveno VI criteria were computed and the LSM was documented The noninvasive assessment results were correlated with US and endoscopy reports of cirrhosis, portal hypertension or oesophageal varices Results: We identified 303 patients, 69% male Mean (standard deviation) age 60 (11) years Liver disease aetiologies were predominantly alcohol (23%), hepatitis C (HCV) (37%), non-alcoholic steatohepatitis (NASH) (13%) or hepatitis B (HBV)(5%) Patients with varices had higher LSM, FIB-4, MELD score, INR, but lower serum albumin and platelet count compared with those without varices (p<0 05 for all) The area under the curve for predicting any varices were 0 76, 0 76 and 0 73 for LSM, FIB-4 and MELD score (Figure 1) Sensitivity and specificity for varices were: FIB-4 ≥6.0 (44% and 84%), LSM ≥29.0 kPa (53% and 83%), Baveno VI criteria (39% and 83%), MELD score ≥15.0 (31% and 92%) and US-portal hypertension (62% and 73%) respectively Baveno VI criteria (OR 2.3, 95%CI 1.2-4.4), MELD score ≥15 (OR 3.8, 95%CI 1.8-8.1) and FIB-4 ≥6 (OR 2.5, 95%CI 1.3-4.7) independently predicted varices Calculated costs of transient elastography, FIB-4 and MELD assessments were approximately 14%, 1% and 1 5% respectively of the cost of endoscopic screening without endoscopic therapy Conclusion: Noninvasive assessment of liver fibrosis or chronic liver disease severity in cirrhotics has high specificity for varices and a potential role in reducing low yield endoscopic variceal screening during times of limited endoscopy access. Potential benefits extend to prioritisation of endoscopy resources, including access, sedation and personal protective equipment during the SARSCOV- 2 pandemic.

Responding to a pandemic: Development of the Carolina Dentistry Virtual Oral Health Care Helpline.

BACKGROUND: A virtual oral health care help line was established to provide consultation and triage for people with dental questions and concerns. Its goal during a pandemic was to keep patients from seeking unnecessary in-person care from emergency departments and urgent care clinics, especially when dental practices were closed or limited to providing essential urgent and emergency oral health care. METHODS: The Adams School of Dentistry, University of North Carolina at Chapel Hill, developed the Carolina Dentistry Virtual Oral Health Care Helpline using a quality improvement framework with faculty and staff member feedback. The process included establishing infrastructure (phone, video, protocols, referrals, documentation), personnel (scheduling, training, calibration), and internal and external communication. The authors collected retrospective information for descriptive evaluation of the first month's operations. RESULTS: There were 337 telephone calls answered, of which 65 (19%) were administrative and 272 (81%) were related to dental concerns. Dental pain (54%) was the most prevalent reason for calling. Triage and Providers referred 107 of 175 callers (61%) to the school's urgent care center. Of the 79 callers who received teleconsultations from virtual providers, 33 (42%) did not require additional follow-up, and 7 (9%) needed a follow-up phone call. Overall, 4 people were referred to community clinics, and 4 were referred to the emergency department. CONCLUSIONS: The Helpline was launched quickly and improved through quality improvement cycles, and it provided a needed community dental service. The process resolved some patient concerns without their seeking urgent or emergency care. PRACTICAL IMPLICATIONS: The pandemic has increased teledentistry practice. The authors describe establishing a dental school's virtual oral health Helpline, which provides a framework for dental practices seeking to use this patient communication modality.

Resumption of Endodontic Practices in COVID-19 Hardest-Hit Area of China: A Web-based Survey.

INTRODUCTION: The purpose of this study was to investigate the resumption of endodontic practices in Hubei Province, China 1 month after the end of the lockdown. METHODS: A Web-based survey was sent to 1069 active endodontic specialists and general dentists who provided endodontic care in Hubei Province from May 7 to May 9, 2020. The survey consisted of 18 questions on demographics, the current situation of endodontic practice for the participants, and concerns regarding contracting or spreading the virus in newly opened endodontic practices. RESULTS: A total of 322 participants completed the survey. Most respondents (62%) were from Wuhan. Almost 83% of the respondents have resumed their endodontic practice partially or fully. Most respondents in practice (99%) would take measures to screen patients before treatment including paid screening measures. More than 93% of the respondents reported having taken special measures for routine endodontic treatment at this stage, with the most common measure taken being wearing an N95 mask. The rubber dam was recognized as efficient in preventing infection by most respondents. Many respondents were concerned about contracting coronavirus disease 2019 (COVID-19) as a result of routine endodontic practice at this stage, and respondents with more than 11 years of endodontic experience were significantly less concerned about infection compared with those with fewer than 5 years of experience (P < .05). CONCLUSIONS: There is a fear of contracting/spreading COVID-19 among endodontic clinicians, the fear is negatively associated with years of practice, and most clinicians believe that rubber dam isolation can protect them and their patients from COVID-19.

DOUBLE TROUBLE: A CASE OF SUSPECTED ANTIPHOSPHOLIPID SYNDROME IN THE SETTING OF HYPERCOAGULABLE COVID-19 PNEUMONIA

SESSION TITLE: Medical Student/Resident Critical Care Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: The hypercoagulable state seen in Covid-19 patients has been well described. Our case of a patient with limb ischemia and elevated Antiphospholipid Syndrome (APS) antibodies raises the question of multiple mechanisms of hypercoagulability with Covid-19 infection. CASE PRESENTATION: 61 year old female with fibromyalgia and osteoarthritis presented with dyspnea and cough. On arrival, she was tachypneic (38 breaths/min) with low oxygen saturation (91%). Chest radiograph showed vascular congestion with bilateral interstitial infiltrates. She tested positive for SARS-CoV2 19 and was started on hydroxychloroquine, ceftriaxone, and azithromycin. She was intubated day 2 and was transferred to ICU, where she required vasopressor support for septic shock. She developed transient thrombocytopenia, which was attributed to sepsis, as Heparin-Induced Thrombocytopenia was ruled out. Her fingertips were cyanotic and toes gangrenous, concerning for limb ischemia. Given her instability, she was not a candidate for vascular intervention. Further workup revealed positive APS antibodies (Table 1) and therapeutic dose lovenox was started. Hospital course was further complicated by polymicrobial pneumonia with Computed Tomography Chest showing bilateral cavitations and traction bronchiectasis. Despite maximal therapy, she expired on day 33 of hospitalization. DISCUSSION: The inclusion of APS antibodies in the ever-evolving body of knowledge regarding Covid-19 may play a crucial role in uncovering an additional mechanism of thrombosis to its already hypercoagulable state. The current literature on Covid-19 suggests direct endothelial injury and complement activation as possible sources of thrombosis. In this case the workup for limb ischemia revealed elevated anti-B2-Glycoprotein 1 IgA and IgM antibodies, anti-Phosphatidylserine IgM and IgG antibodies, and anti-Cardiolipin IgA and IgM antibodies. Although infections have been shown to induce transient elevations in APS antibodies, not necessarily associated with thrombosis, we put forth that our patient’s multiple high titers of IgM and IgG antibodies in the clinical setting of acute thrombosis supports potential superimposed APS. Unfortunately, the patient expired before repeat antibody testing could be completed in congruence with a definitive diagnosis of APS. CONCLUSIONS: This case highlights the need for research regarding the mechanism in which Covid-19 may potentiate Antiphospholipid Syndrome amidst an already thrombotic disease state. Such research would promote the need for early APS antibody testing and initiation of anticoagulation in the amplified hypercoagulable state in Covid-19 with APS, especially in the prevention of life threatening thrombosis. Reference #1: Magro C, Mulvey JJ, Berlin D, et al. Complement Associated Microvascular Injury and Thrombosis in the Pathogenesis of Severe COVID-19 Infection: a Report of Five Cases. Transl Res. 2020;S1931-5244(20)30070-0. doi:10.1016/j.trsl.2020.04.007 Reference #2: McDonnell T, Artim-Esen B, Wincup C, Ripoll VM, Isenberg D, Giles IP, Rahman A, Pericleous C. Antiphospholipid Antibodies to Domain I of Beta-2-Glycoprotein I Show Different Subclass Predominance in Comparison to Antibodies to Whole Beta-2-glycoprotein I. Front. Immunol. 2018;9 (2244): 1-7. DOI: 10.3389/fimmu.2018.02244 Reference #3: Nakayama T, Akahoshi M, Irino K, Kimoto Y, Arinobu Y, Niiro H, Tsukamoto H, Horiuchi T, Akashi K. Transient Antiphospholipid Syndrome Associated with Primary Cytomegalovirus Infection: A Case Report and Literature Review. Case Reports in Rheumatology. 2014;2014 (271548): 1-6. DOI: 10.1155/2014/271548 DISCLOSURES: No relevant relationships by Farah Ashraf, source=Web Response No relevant relationships by Michaela Murphy, source=Web Response No relevant relationships by Saleem Shahzad, source=Web Response No relevant relationships by Sarah Upson, source=Web Response