ABSTRACT
There is a growing need for spatial privacy considerations in the many geo-spatial technologies that have been created as solutions for COVID-19-related issues. Although effective geo-spatial technologies have already been rolled out, most have significantly sacrificed privacy for utility. In this paper, we explore spatial k-anonymity, a privacy-preserving method that can address this unnecessary tradeoff by providing the best of both privacy and utility. After evaluating its past implications in geo-spatial use cases, we propose applications of spatial k-anonymity in the data sharing and managing of COVID-19 contact tracing technologies as well as heat maps showing a user's travel history. We then justify our propositions by comparing spatial k-anonymity with several other spatial privacy methods, including differential privacy, geo-indistinguishability, and manual consent based redaction. Our hope is to raise awareness of the ever-growing risks associated with spatial privacy and how they can be solved with Spatial K-anonymity.
ABSTRACT
The COVID19 pandemic posed unprecedented challenges towards the delivery of neuro-rehabilitation services across the globe. A nation-wide lockdown made the accessibility to neuro-rehab facilities especially difficult for people with disabilities. Since there was not much data available on practices of neuro rehab during the COVID-19 pandemic, a cross sectional observational study was conducted to evaluate the changes in neuro rehabilitation practices in India during this pandemic using an online survey. The pandemic affected the people with disabilities in not merely the physical domains but also social effects, participation restriction and psychological effects and yet majority of both hospital and home-based physiotherapists reported a decrease in referrals and number of therapy sessions provided to the patients. Tele-rehabilitation has emerged as a new model of rehabilitation for delivery of neuro rehabilitation. It offers an alternate way of facilitating communication between the rehab professional and the patient. This includes strategies like low cost virtual reality gaming for rehab in children, mobile based rehab, etc. However, the shift to telerehab provides a tremendous learning opportunity and a huge scope for innovation in improving its accessibility to the community, especially in LMICs. Majority of both Hospital and Home-based Physiotherapists reported a decrease in referrals and number of therapy sessions provided to the patients. Despite evidence on the need for physiotherapy for respiratory care, most respondents did not implement the same. No protocols/guidelines for therapy delivery were implemented or used by our sample of respondents. This paper highlights the needs under three main categories, (1) Development and implementation of suitable clinical-practice-guidelines, clinical-monitoring systems for Neurological Physiotherapy, (2) incorporation of evidence-based respiratory care as part of neurological physiotherapy especially during such pandemics, (3) changes in policies at government and private sectors for inclusion and appropriate implementation of neurophysiotherapy along with public awareness programmes on the need for continued physiotherapy.
ABSTRACT
In this digital world with high advancement of technologies, there is utmost need to perform technological advancement in healthcare domain. In this covid-19 situation each citizen must feel that if the doctor can pass the prescription electronically, then not required to visit the hospitals. At the other end, privacy of patient history or data is again critical task at the time of handling E-prescription. This paper represents different approaches that are taken towards the data privacy in electronic prescription, it talks about different methods through which privacy of any electronic prescription is maintained. Electronic prescription is the digital version of having a prescription, it involves sending of prescription through the internet to the patient's account which it is meant to. Talking about storage despite its utilization, there are also several hindrances with regards to the protection of data which is being stored to the cloud. Highly professional and encouraging hackers are now attempting their possible best to intercept or thieve large amounts of data consisting of vital and critical information that has been transmitted or stored in the cloud. In this paper, thorough study and analysis talk about how a user can be authenticated using different mediums or methods to ensure that prescription is delivered at the right place and a brief comparison between how the electronic prescription has been implemented in several developed countries. We will also look on the usability and the deployability of electronic prescription in these developed countries.
ABSTRACT
Objective: The objectives of this study were to measure the global impact of the pandemic on the volumes for intravenous thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with two control 4-month periods. Background: The COVID-19 pandemic led to widespread repercussions on the delivery of health care worldwide. Design/Methods: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by ICD-10 codes and/or classifications in stroke center databases. Results: There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95%CI,-11.7 to-11.3, p<0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95%CI,-13.8 to-12.7, p<0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95%CI,-13.7 to-10.3, p=0.001). There were greater declines in primary compared to comprehensive stroke centers (CSC) for stroke hospitalizations (-17.3% vs-10.3%, p<0.0001) and IVT (-15.5% vs-12.6%, p=0.0001). Recovery of stroke hospitalization volume (9.5%, 95%CI 9.2-9.8, p<0.0001) was noted over the two later (May, June) versus the two earlier (March, April) months of the pandemic, with greater recovery in hospitals with lower COVID-19 hospitalization volume, high volume stroke center, and CSC. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. SARS-CoV-2 infection was noted in 3.3% (1,722/52,026) of all stroke admissions. Conclusions: The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months, with greater recovery in hospitals with lower COVID-19 hospitalizations, high volume stroke centers, and CSCs.
ABSTRACT
Introduction SARS-CoV-2 has created a hazardous environment for healthcare workers, with some of the riskiest procedures being those that generate aerosolized particles, such as tracheostomy surgery. Tracheostomy is both particle aerosolizing and extremely common, particularly for patients in respiratory distress. We utilized computational fluid dynamics (CFD) to model aerosolized particle spread during tracheostomy to deduce the viral loading risks posed to surgeons and anesthesiologists by aerosolized viruses. Additionally, we studied how these risks change with varying tracheal incision sizes. MethodsAn intubated subject's CT scan was virtually modified to replicate the tracheostomy procedure. An anatomically accurate trachea, thorax, incision, and operating room were created. Airflow simulations were performed to reproduce the exhalation occurring with removal of the intubation tube and opening of the airway to room pressure. Particles were released into the trachea from the primary bronchi, which then escaped into open air via the tracheal incision. Three tracheal incision sizes were modeled. Four particle sizes were released (0.2μ m-20μ m). Airflow was modeled for 20 seconds. ResultsFor small, medium, and large incisions, 68.7%, 68.4%, and 68.5% of particles by mass remained in the trachea, respectively (68.5% average of the three) (Figure1). Average size of escaped particles was 5.31μ m, 5.27μ m, and 5.29μ m for the small, medium, and large incisions respectively, while average particle size remaining in the trachea was 14.0μ m, 14.66μ m, 14.29μ m.From 4 to 8 seconds after initial particle release, the average particle size falling to the level of the patient's forehead increased from 11.6μ m to 18.4μ m. Large particles (10μ -20μ m) fell quickly, while smaller particles (0.2μ m to 2μ m) were more likely to remain suspended in air after 20 seconds. ConclusionsCFD particle aerosolization modeling of tracheostomy procedures can predict the viral loads healthcare workers are exposed to for the purpose of implementing proper safety precautions. These results highlight the extended residence times of aerosols in the absence of room ventilation which should ordinarily clear suspended particles, as well as the importance of considering smaller particles when designing personal protective equipment (PPE) for hospital staff. Large particles fall due to gravity relatively quickly, meaning the largest viral loads are airborne immediately after exhalation. Tracheal incision size was insignificant to the amount of aerosol generated during tracheostomy. In the absence of proper room ventilation, particles remained suspended in highest concentration directly above the patient's forehead, not directly above the tracheal incision. This implies physicians in this relative danger zone, such as anesthesiologists, need additional safety precautions.
ABSTRACT
The outbreak of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in mid-December 2019, from Wuhan, Hubei Province, China, and its spread across China and beyond has taken the world by surprise. On March 11, 2020 WHO (World Health Organization) declared it a global pandemic. Herein, we discuss the epidemiological trends, clinical and diagnostic findings, management, and investigative therapies of this disease and also reflect upon how it might be different in India from the rest of the world.