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Digital and smart technologies have been widely used during the coronavirus disease 2019 (COVID-19) pandemic to control severe acute respiratory syndrome coronavirus 2 transmission, to perform rapid diagnosis, and for monitoring. Although the pandemic has caused economic, social, and diverse health problems, it has spurred developers of digital and smart technologies to fight the disease. Science and technology sectors constituting mainly of data science, machine learning, and artificial intelligence are contributing toward controlling the COVID-19 pandemic. Robots and smart technologies along with IoT (Internet of Things) structures have been digitizing the fight against the pandemic, which has enormous gains in terms of reducing contamination/transmission. This chapter provides a detailed revision about such technologies, describing and discussing their advantages, disadvantages, and limitations. We concluded that some of these innovative solutions, as they require the patient's personal information, are concerning authorities and researchers about ethical issues, such as data safety and personal privacy. Modern technologies have contributed to improving people's lives, presenting a significant advantage in helping people to control this infection. © 2023 Elsevier Inc. All rights reserved.
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Background: SB5, a biosimilar to reference adalimumab (ADL), received EU marketing authorisation in 2017, based on pre-clinical and clinical phase I and III studies that demonstrated bioequivalence and comparable efficacy, safety and immunogenicity to ADL. Objectives: The real-world study 'PROPER' is designed to provide insights into outcomes of the transition from ADL to SB5 outside the randomised, controlled, clinical trial setting. Methods: Under an umbrella design, 1000 patients with immune-mediated infammatory disease were enrolled at centres in Belgium, Germany, Ireland, Italy, Spain and the UK, and followed for 48 weeks post-transition. Eligible patients with a diagnosis of rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), ulcerative colitis or Crohn's disease had been transitioned to SB5 as part of routine treatment following a minimum of 16 weeks' treatment with ADL. Data were captured from patient charts retrospectively for 24 weeks prior to and prospectively and/or retrospectively up to 48 weeks after SB5 initiation. This analysis of the rheumatology cohort reports clinical characteristics, disease scores, persistence on SB5, clinical management and safety up to the closing date of November 30th, 2021. Results: Of the 496 patients included in this analysis, the majority were enrolled in UK (n=174), Germany (n=145) and Spain (n=73);Italy, Ireland and Belgium enrolled 45, 44 and 15 patients respectively. At study close, 487 patients had completed 48 weeks of follow-up;397 of those remained on SB5 throughout. Methotrexate was received as concomitant therapy by 37% of patients and 20% had received a biologic therapy prior to reference ADL. Most patients (89.3% of RA, 92.1% of axSpA, 97.3% of PsA) transitioned to SB5 at the same dose regimen received for ADL. Clinical characteristics, SB5 dose and fare are detailed in Table 1, disease scores in Figure 1. Fifteen patients each experienced one unrelated Serious Adverse Event (SAE): 2 in the axSpA cohort [tachycardia, intracranial haemorrhage];6 in the PsA cohort [myocardial infarct (2), breast carcinoma, COVID-19, gallbladder calculus, dyspnoea];7 in the RA cohort [facial numbness, depression, COVID-19, pneumonia, diverticulitis, parvovirus, coronary occlusion]. Tw o patients reported SAEs considered causally related to SB5: Herpes zoster and pneumonia (RA cohort), and ALS with worsening (PsA cohort). Conclusion: This analysis of a large, contemporary cohort of EU patients with established RA, axSpA or PsA shows treatment effectiveness maintained at 48 weeks after switching from ADL to SB5, with most patients continuing on SB5 Q2W throughout. Episodes of fare were uncommon, and the importance of patient-reported symptoms in recognition of fare is evident. No new safety signals were observed.
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Objective: The link with angiotensin-converting-enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) is because of the known association between angiotensin-converting enzyme 2 (ACE) and SARS-COV 2. ACE 2 has been shown to be a co-receptor for viral entry for SARS-COV-2 in the respiratory epithelium. It has been a global concern that the use of this drugs may be a risk for patients with COVID-19 infection. It has been published many studies about this subject. Even today there are still controversies regarding to the impact of these drugs. The aim of this study was to determine the association between the previous use of ACEI/ARB and the prognosis of patients with COVID-19 infection Design and method: Single-center, restrospective, cohort study included 608 patients with hypertension diagnosed with COVID-19, who where hospitalized in Macarena's hospital from Mars to December 2020. Analyses of main outcomes (mortality, need of intensive cares (ICU), and days of mean study) were adjusted by multivariate logistic regression. Results: Of a total population of 500,000, 608 patients (0.12%) required admission for COVID-19. A total of 83.7% were hypertensive, specifically 75.9% were under antihypertensive treatment (35.7% with only 1 drug, 29.9% were taking two drugs, 9% with three drugs, and 1.3% with 4 drugs). 26.2% were treated with an ACEI and 24.8% with ARBs. Treatment with ACEI / ARB-II (combined or individually) had no impact on mortality (OR = 1.29;95% CI, 0.829-2.014;p = 0.257), nor ICU admission (OR = 1, 7;95% CI, 0.68 - 4.95;p = 0.232), nor on the days of mean stay (OR = 0.98;95% CI, 0.95-1.04;p = 0.325). Conclusions: It is unlikely that previous treatment with ACEI/ARB was associated with an increased mortality risk, neither ICU admission or an increase in days of mean stay. This study supports current guidelines that discourage discontinuation of ACEIS or ARBs in COVID-19 patients.
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Objective: Hypertension is one of the most important factors for cardiovascular disease. It has been repeatedly proposed as a prognostic factor of severe COVID- 19 and has been included in clinical risk scores to predict the occurrence of critical illness in ospitalised with COVID-19. Also, it has been postulated the relation between antihypertensive drugs and the severity of COVID-19. The aims of our study were to analyze whether hypertension and antihypertensive treatment represent an independent risk factor for death or intensive care unit admission in patients with SARS-COV2. Design and method: Observational, retrospective, single-center cohort study of all patients admitted to Hospital Virgen Macarena diagnosed with COVID-19 between the months of March and December 2020. A bivariate analysis was performed using Pearson's chi-square Results: 608 patients required admission for COVID-19. A total of 83.7% were hypertensive, specifically 75.9% were under antihypertensive treatment (35.7% with only 1 drug, 29.9% were taking two drugs, 9% with three drugs, and 1.3% with 4 drugs). 26.2% were treated with an ACEI, 24.8% with ARA-II, 16.8% with calcium-antagonists, 30.9% with diuretics, 21.2% with beta-blockers, 0, 5% with alpha-blockers). Hypertension did not show a statistically significant relationship with mortality (p = 0.34), increase in mortality and ICU admissions. Neither treatment with ACEI (p = 0.4), ARB-II (p = 0.45), calcium antagonists (p = 0.53), diuretics (p = 0.68), alpha blockers (p = 0.07) demonstrated relation with those items. Surprisingly, beta-blockers increased the mortality in patients with SARS-COV2 (p = 0.048). Probably this results can be explained as these drugs were indicated for rate control in patients with atrial fibrillation (p = 0.006). The number of antihypertensive drugs used also did not show a statistically significant relationship with an increase in mortality (p = 0.978). Conclusions: Hypertension is a highly prevalent pathology in patients ospitalised with COVID-19 infection. However, high blood pressure was not associated with a higher risk for mortality in patients with SARS-COV-2, neither the type or the number of antihypertensive drug used. Only beta-blockers alter outcomes in hypertensive patients with COVID-19, as they were associated with more deaths.
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The pandemic by COVID-19 is causing a devastating effect on the health of the global population. Currently, there are several efforts to prevent the spread of the virus. Among those efforts, cleaning and disinfecting public areas have become important tasks and they should be automated in future smart cities. To contribute in this direction, this paper proposes a coverage path planning method for a spraying drone, an unmanned aerial vehicle that has mounted a sprayer/sprinkler system, that can disinfect areas. State-of-the-art planners consider a camera instead of a sprinkler, in consequence, the expected coverage will differ in running time because the liquid dispersion is different from a camera's projection model. In addition, current planners assume that the vehicles can fly outside the target region; this assumption can not be satisfied in our problem, because disinfections are performed at low altitudes. Our method presents i) a new sprayer/sprinkler model that fits a more realistic coverage volume to the drop dispersion and ii) a planning method that efficiently restricts the flight to the region of interest avoiding potential collisions in bounded scenes. The algorithm has been tested in several simulation scenes, showing that it is effective and covers more areas with respect to two approaches in the literature. Note that the proposal is not limited to disinfection applications, but can be applied to other ones, such as painting or precision agriculture.
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TOPIC: Chest Infections TYPE: Original Investigations PURPOSE: COVID-19 infection is associated with a broad-range of clinical presentations from asymptomatic infection to severe pneumonia with multi-system features. Similarly, short- and long-term outcomes vary widely. Although multiple studies have addressed outcomes of patients hospitalized with COVID-19 infection, Community-based studies are sparse and are needed to provide a broader perspective of the lasting impact of this disease, especially lung damage. METHODS: This is a retrospective, Community-based, cohort study of residents of Rochester, Minnesota, who were enrolled in the Mayo Clinic COVID-19 database. Subjects were included if they were diagnosed with COVID-19 infection from March 01, 2020 to May 31, 2020. The clinical presentation, laboratory results, pulmonary function results, and chest imaging findings at the time of presentation and events in the following months until December 31, 2020 were assessed by review of medical records and imaging studies. RESULTS: We identified 570 community patients with COVID-19 infection;median age 38.5 years (range 18-98 years) - 526 patients did not require hospitalization while 44 (7.5%) patients (median age 51.8 years, range 20 - 81) had hypoxemia warranting admission (moderate to severe disease based on WHO clinical progression scale)[i]. At the time of hospitalization, all has undergone chest radiography, and 42 patients (95%) had chest CT with all demonstrating peripheral patchy ground glass opacities (GGOs) bilaterally.Thirteen patients (29.5%) returned for chest radiograph (median interval, 5.9 months);4 of them (13%) had residual parenchymal opacities, of whom nearly all (94%) were 45 years or older. Twenty-five patients had follow-up CT scans three months after initial diagnosis;8 patients (32%) had complete resolution of the CT infiltrates. Seventeen patients (9 females and 8 males) had residual parenchymal opacities with the most common being peripheral and bibasilar GGOs;5 patients had residual reticulonodular scarring and traction bronchiectasis on imaging. 6 patients (13.6%) underwent pulmonary function testing at follow-up visit (median interval 4.6 months), of whom 2 manifested abnormal findings consisting of mild restriction. Overall, 50% of the patients had evidence of residual lung disease (imaging and/or pulmonary function) three months after presentation. Ten patients (59%) with residual disease on chest CT had been hospitalized (six requiring ICU level of care) and manifested significantly elevated inflammatory markers (ferritin, interleukin-6 and C-reactive protein);9 out of these 10 patients with residual disease did not receive steroids at the time of hospitalization. Seven patients (41%) with residual lung infiltrates on CT scan was not hospitalized and didn’t have evidence of severe inflammatory disease. CONCLUSIONS: In our study, we assessed the initial severity and outcomes of subjects diagnosed with COVID-19 in our community and found 3% to manifest persistent lung abnormalities following the acute infection. The residual radiological findings consisted mainly of GGOs affecting the peripheral zones of the lung;however, in a minority of the patients, fibrotic changes were present. Almost two thirds of the patients with persistently abnormal imaging had been hospitalized for at least two days and had high serologic inflammatory markers (C-reactive protein, Ferritin and interleukin-6). This might indicate that the resultant fibrosis is mainly driven by post-inflammatory processes rather than the direct effect of the virus. conversely a considerable number of patients developed interstitial infiltrates without evidence of acute inflammatory reaction which may suggest another non-inflammatory etiology of these findings. Furthermore, most of our patients who manifested lung fibrosis on follow-up CT had not received steroids. Although the long-term course and significance of these residual radiologic findings are not established, prior data of Middle East Respiratory Syndrome and Se ere Acute Respiratory Syndrome suggest that most of these lesions resolve over time among those who survived hospitalization. CLINICAL IMPLICATIONS: The results of this community-based study will provide a broader perspective of the lasting impact of COVID-19 on the lungs. DISCLOSURES: No relevant relationships by Faysal Al-ghoula, source=Web Response Research - industry initiated (clinical relationship with AstraZeneca Pharmaceuticals, LP Please note: 2020 Added 04/27/2021 by Philippe Bauer, source=Web Response, value=Grant/Research Support Research - industry initiated (clinical relationship with Corvus Pharmaceuticals, Inc Please note: 2021 Added 04/27/2021 by Philippe Bauer, source=Web Response, value=Grant/Research Support No relevant relationships by Eva Carmona, source=Web Response No relevant relationships by Tobias Peikert, source=Web Response No relevant relationships by Jay Ryu, source=Web Response
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the COVID-19 pandemic modified the ways of teaching and learning, switching from face-to-face classes in classrooms and laboratories to non-synchronous or asynchronous non-face to face classes on virtual platforms. Human anatomy courses require internships to understand anatomical structures. Objective: it is intended to explore the perception of the students of Medicine, Nursing and Psychology about the methodologies, content and didactics of learning that were developed in three courses of human anatomy adapted to the pandemic. Methodology: cross-sectional observational study, using fifteen-question on an online survey, conducted at the end of semester 2020-I about perception;scope of expectations;instructions;learning activities;probability of recommending only virtual, combined or face-to-face courses and points for or against the virtual methodology used. The study in 157 students participated, this way: 56 % (88/157) medical anatomy course, 27 % (43/157) morphology course and 17 % (26/157) neuroanatomy course. Results: a variety of assessments were found for or against adaptations made for anatomical virtual education amid the contingency. However, points in favor of virtuality such as the possibility of recording and not physical displacement plus access to models of computer anatomy, fail to overcome the comprehension of a teacher and the enthusiasm that awakens the palpable.