ABSTRACT
In recent years, there has been a great interest in utilizing technology in mental health research. The rapid technological development has encouraged researchers to apply technology as a part of a diagnostic process or treatment of Neurodevelopmental Disorders (NDDs). With the large number of studies being published comes an urgent need to inform clinicians and researchers about the latest advances in this field. Here, we methodically explore and summarize findings from studies published between August 2019 and February 2022. A search strategy led to the identification of 4108 records from PubMed and APA PsycInfo databases. 221 quantitative studies were included, covering a wide range of technologies used for diagnosis and/or treatment of NDDs, with the biggest focus on Autism Spectrum Disorder (ASD). The most popular technologies included machine learning, functional magnetic resonance imaging, electroencephalogram, magnetic resonance imaging, and neurofeedback. The results of the review indicate that technology-based diagnosis and intervention for NDD population is promising. However, given a high risk of bias of many studies, more high-quality research is needed.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Autism Spectrum Disorder , Neurodevelopmental Disorders , Humans , Autism Spectrum Disorder/diagnosis , Autism Spectrum Disorder/therapy , Autism Spectrum Disorder/epidemiology , Neurodevelopmental Disorders/diagnosis , Neurodevelopmental Disorders/therapy , Magnetic Resonance Imaging , Mental HealthABSTRACT
Severe acute respiratory syndrome coronavirus type 2 has been responsible for an unprecedented pandemic, and nowadays, several vaccines proved to be effective and safe, representing the only available strategy to stop the pandemic. While millions of people have safely received vaccine, rare and unusual thrombotic events have been reported and are undergoing investigations to elucidate their nature. Understanding initial trigger, underlying pathophysiology and the reasons for specific site localization of thrombotic events are a matter of debate.We here propose that rare cases of cerebral venous sinus thrombosis, a clinical event that may rapidly evolve to brain death, reported after COVID-19 vaccine, might be consequent to an immune response resulting in inflamed/damaged endothelium, an event similar to that described for cases of cerebral venous sinus thrombosis reported during COVID-19 and not necessarily related to anti-Platelets Factor 4 antibodies, as recently described. Remarkably, in the two patients presenting at our hospital with cerebral venous sinus thrombosis and evolved to brain death, proper tissue perfusion and function maintenance allowed organ donation despite extensive thrombosis in the organ donors, with favorable outcome at 6 months.Increased vigilance, close multidisciplinary collaboration, and further prospective research will help to better elucidate a very rare and still not fully understood pathophysiological event associated with vaccines for severe acute respiratory syndrome coronavirus 2.
ABSTRACT
BACKGROUND: National health-system hospitals of Lombardy faced a heavy burden of admissions for acute respiratory distress syndromes associated with coronavirus disease (COVID-19). Data on patients of European origin affected by COVID-19 are limited. METHODS: All consecutive patients aged ≥18 years, coming from North-East of Milan's province and admitted at San Raffaele Hospital with COVID-19, between February 25th and March 24th, were reported, all patients were followed for at least one month. Clinical and radiological features at admission and predictors of clinical outcomes were evaluated. RESULTS: Of the 500 patients admitted to the Emergency Unit, 410 patients were hospitalized and analyzed: median age was 65 (IQR 56-75) years, and the majority of patients were males (72.9%). Median (IQR) days from COVID-19 symptoms onset was 8 (5-11) days. At hospital admission, fever (≥ 37.5 °C) was present in 67.5% of patients. Median oxygen saturation (SpO2) was 93% (range 60-99), with median PaO2/FiO2 ratio, 267 (IQR 184-314). Median Radiographic Assessment of Lung Edema (RALE) score was 9 (IQR 4-16). More than half of the patients (56.3%) had comorbidities, with hypertension, coronary heart disease, diabetes and chronic kidney failure being the most common. The probability of overall survival at day 28 was 66%. Multivariable analysis showed older age, coronary artery disease, cancer, low lymphocyte count and high RALE score as factors independently associated with an increased risk of mortality. CONCLUSION: In a large cohort of COVID-19 patients of European origin, main risk factors for mortality were older age, comorbidities, low lymphocyte count and high RALE.
Subject(s)
Coronary Disease/diagnosis , Coronavirus Infections/diagnosis , Diabetes Mellitus/diagnosis , Hypertension/diagnosis , Kidney Failure, Chronic/diagnosis , Pneumonia, Viral/diagnosis , Pulmonary Edema/diagnosis , Severe Acute Respiratory Syndrome/diagnosis , Age Factors , Aged , Betacoronavirus/immunology , Betacoronavirus/pathogenicity , COVID-19 , Comorbidity , Coronary Disease/epidemiology , Coronary Disease/immunology , Coronary Disease/mortality , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Coronavirus Infections/mortality , Diabetes Mellitus/epidemiology , Diabetes Mellitus/immunology , Diabetes Mellitus/mortality , Female , Hospitalization , Humans , Hypertension/epidemiology , Hypertension/immunology , Hypertension/mortality , Infectious Disease Incubation Period , Italy/epidemiology , Kidney Failure, Chronic/epidemiology , Kidney Failure, Chronic/immunology , Kidney Failure, Chronic/mortality , Lymphocyte Count , Lymphocytes/immunology , Lymphocytes/pathology , Lymphocytes/virology , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , Pneumonia, Viral/mortality , Pulmonary Edema/epidemiology , Pulmonary Edema/immunology , Pulmonary Edema/mortality , Risk Factors , SARS-CoV-2 , Severe Acute Respiratory Syndrome/epidemiology , Severe Acute Respiratory Syndrome/immunology , Severe Acute Respiratory Syndrome/mortality , Severity of Illness Index , Survival AnalysisABSTRACT
In a pandemic situation such as that we are living at the time of writing of this paper due to the Covid-19 virus, the need of tele-healthcare service becomes dramatically fundamental to reduce the movement of patients, thence reducing the risk of infection. Leveraging the recent Cloud computing and Internet of Things (IoT) technologies, this paper aims at proposing a tele-medical laboratory service where clinical exams are performed on patients directly in a hospital by technicians through IoT medical devices and results are automatically sent via the hospital Cloud to doctors of federated hospitals for validation and/or consultation. In particular, we discuss a distributed scenario where nurses, technicians and medical doctors belonging to different hospitals cooperate through their federated hospital Clouds to form a virtual health team able to carry out a healthcare workflow in secure fashion leveraging the intrinsic security features of the Blockchain technology. In particular, both public and hybrid Blockchain scenarios are discussed and assessed using the Ethereum platform.