Pontocerebellar venous infarction caused by COVID-19 in a 13-year-old girl with underlying asymptomatic developmental venous anomaly

Introduction: : COVID-19-associated coagulopathy (CAC) presents as a highly activated thrombotic status, leading to severe clinical outcomes. We report a unique pediatric case of pontocerebellar venous infarction caused by COVID-19 (omicron mutation) and accompanied by abnormal brain venous structure. Case: : A 13-year-old unvaccinated girl with high-grade fever and altered mental status visited our emergency department. In her initial serologic results, all the inflammatory markers were elevated;interleukin-6 was remarkably elevated (above 5000 pg/mL). On brain CT, a suspicious subtle hypo-attenuated lesion in the right interior cerebellar hemisphere area was observed;brain MRI revealed bilateral asymmetric hyperintense lesions in the mid-pons, and extensive cerebellar hemorrhage and engorged venous structure. Despite intensive medications and treatments, the patient failed to maintain her vital signs with a mechanical ventilator because of aggravated pneumonia and bilateral pleural effusion, and she died ten days after her hospital admission. Conclusion: : In our patient, a rapid systemic cytokine storm reaction occurred, and presumably, the resulting inflammation sequentially caused the coagulopathy cascade. One of the significant risk factors was an asymptomatic developmental venous anomaly (DVA) of the cerebellum. The asymptomatic DVA concomitant with COVID-19 may be associated with thrombosis and needs further brain imaging studies.

High Performance Agent-Based Modeling to Study Realistic Contact Tracing Protocols

Contact tracing (CT) is an important and effective intervention strategy for controlling an epidemic. Its role becomes critical when pharmaceutical interventions are unavailable. CT is resource intensive, and multiple protocols are possible, therefore the ability to evaluate strategies is important. We describe a high-performance, agent-based simulation model for studying CT during an ongoing pandemic. This work was motivated by the COVID-19 pandemic, however framework and design are generic and can be applied in other settings. This work extends our HPC-oriented ABM framework EpiHiper to efficiently represent contact tracing. The main contributions are: (i) Extension of EpiHiper to represent realistic CT processes. (ii) Realistic case study using the VA network motivated by our collaboration with the Virginia Department of Health. © 2021 IEEE.

Real-Time Low-Cost Personal Monitoring for Exposure to PM2.5 among Asthmatic Children: Opportunities and Challenges

This study aims to evaluate the accuracy and effectiveness of real-time personal monitoring of exposure to PM concentrations using low-cost sensors, in comparison to conventional data collection method based on fixed stations. PM2.5 data were measured every 5 min using a low-cost sensor attached to a bag carried by 47 asthmatic children living in the Seoul Metropolitan area between November 2019 and March 2020, along with the real-time GPS location, temperature, and humidity. The mobile sensor data were then matched with station-based hourly PM2.5 data using the time and location. Despite some uncertainty and inaccuracy of the sensor data, similar temporal patterns were found between the two sources of PM2.5 data on an aggregate level. However, average PM2.5 concentrations via personal monitoring tended to be lower than those from the fixed stations, particularly when the subjects were indoors, during nighttime, and located farther from the fixed station. On an individual level, a substantial discrepancy is observed between the two PM2.5 data sources while staying indoors. This study provides guidance to policymakers and researchers on improving the feasibility of personal monitoring via low-cost mobile sensors as an alternative or supplement to the conventional station-based monitoring.

Feasibility Analysis of COVID-19 Response Guidelines at Construction Sites in South Korea Using CYCLONE in Terms of Cost and Time

The emergence of the coronavirus disease 2019 (COVID-19) pandemic has led to a cost and time crisis for most construction projects around the world. Adherence to COVID-19 response guidelines for construction sites may prevent the occurrence of COVID-19 cases, which eliminates the risk of site closure. However, adding a disinfection process to the construction process, as mandated in COVID-19 response guidelines, increases overall construction cost and time. Conversely, however, not adding a disinfection process may result in COVID-19 cases among construction workers, which would delay construction and perhaps even cause closure of the construction site. Therefore, this study analyzed the feasibility of COVID-19 response guidelines for construction sites, especially the addition of a disinfection process, in terms of cost and time. To this end, CYClic Operations NEtwork (CYCLONE) models were developed to simulate the construction process, and a case study was conducted to validate the applicability of the suggested approach. The results showed that compliance with COVID-19 response guidelines increased the number of working days and the construction costs of the subject construction project, but because there was no more risk of construction site closure, the construction delays were short, and the liquidated damages were minimized. Through the method proposed in this study, it is possible to estimate construction cost and time before and after the COVID-19 pandemic;this method could be used to provide data for both owners and contractors to pro-actively recognize and respond to situations or damage caused by the COVID-19 pandemic. The data could also be used as evidence in case of future damages or disputes.