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People are becoming more advanced as technology develops. Nowadays, practically everything has been digitalized to the point where artificial intelligence is used in almost every industry. Al is now essential to many other industries and enterprises, not just those that provide medical services, including healthcare systems, economics, commerce, and industry. Using Al technology in hospital facilities seemed useful during the COVID-19 crisis. Even though surgical robots have several benefits, the rise in legal conflicts that use artificial intelligence to challenge them is concerning. By 2035, technology is expected to have changed significantly, but as with all improvements, there will also be problems. It appears that advances in artificial superintelligence are being made to compete with human intelligence. In the years to come, Al will probably have an increasing impact on healthcare expenditures. Medical malpractice lawsuits are already using AI enabled patient records more and more. This essay aims to look into the specific legal effects of artificial intelligence (Al) in medical services under tort, medical negligence, and other laws that are in place right now.
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COVID-19 is the common enemy of all of us in this world. It created lot of deaths, loss of economy and many more. The pandemic has created a lot of innovation to bring solutions in helping fight the spread of novel coronavirus and other diseases. In this paper, various thermal sensors for detection of COVID-19 in early stage are discussed. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Purpose: The on-going pandemic has impacted the use of anesthesia and the operating room frequency thereby affecting the brachytherapy treatment in various institutions due to the COVID-19 protocols. This has led to single applications of Intracavitary brachytherapy (ICRT) being used to deliver entire treatment boost in cervix cancer. We present our dosimetric and early clinical outcomes comparing traditional weekly three-fractions ICRT with single application/ two-applications ICRT Material(s) and Method(s): In this retrospective analysis conducted in our department, a total of 39 cases, treated between January 2021 to January 2022 were evaluated for the study. Of these, 15 cases were treated with the traditional once a week applicator insertion for 3 fractions and 24 cases underwent lesser application - 20 cases underwent 2 insertions and 4 cases single insertion (all receiving total 3 fractions of 7Gy each). The dosimetric parameters were compared including CTV D90 and D95 along with rectum, sigmoid and bladder D2cc, 1cc and 0.1cc respectively. The acute toxicity assessment was done using the RTOG scale. The follow-up was undertaken as per the institutional protocol and Mann-Whitney U-test were applied to compare the cohorts. Result(s): With a median follow-up of 6 months, the median CTV was D90%: 81.2 vs. 80.9 Gy and the median CTV volume was 44.3 vs 42.9 cc respectively. The 0.1 cm3 and 2 cm3 to bladder, rectum, and sigmoid were 105.6 vs 104.2 Gy and 85.5 vs 85.9Gy, 89.4Gy vs 88.7Gy and 69.1 vs 67.8Gy, and 84.7 vs 84.1Gy and 71.7 vs 69.9Gy, respectively suggesting no significant difference in the dosimetric outcomes with the two forms of applications. The less than three applications had a shorter overall treatment time with median OTT of 43 days vs. 55 days (p = 0.02). On completion of treatment and 6 months follow-up, local control was achieved in all patients. There was no significant difference in the acute toxicities in terms of cystitis and proctitis in both forms of the application. Conclusion(s): The single application/ twice application ICRT procedure showed similar outcomes as the traditional three-week duration treatment in terms of dosimetric outcomes and acute toxicities and ultimately leading to shortened overall treatment time. It also helped reduce the anesthesia burden and various resources associated with the procedure. Copyright © 2022
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Introduction: Nations thorughout the world are imposing mandatory quarantine on those entering the country. While such measures may be effective in reducing the importation of COVID-19, the mental health implications remain unclear. Objective(s): This study sought to assess mental well-being and factors associated with changes in mental health in individuals subject to mandatory quarantine following travel. Method(s): Travellers arriving at a large urban international airport completed online questionnaires on arrival and days 7 and 14 of mandated quarantine. Questionnaire items such as travel history, mental health, attitudes towards COVID-19, and protection behaviours were drawn from the World Health Organization Survey Tool for COVID-19. Result(s): There was a clinically significant decline in mental health over the course of quarantine among the 10,965 eligible participants. Poor mental health was reported by 5.1% of participants on arrival and 26% on day 7 of quarantine. Factors associated with greater decline in mental health were younger age, female gender, negative views towards quarantine measures, and engaging in fewer COVID-19 prevention behaviours. Conclusion(s): While the widespread use of quarantine may be effective in limiting the spread of COVID-19, the mental health implications are profound and have largely been ignored in public policy decision-making. Psychiatry has a role to play in contributing to the public policy debate to ensure that all aspects of health and well-being are reflected in decisions to isolate people from others.
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Purpose: The on-going pandemic has impacted the use of anesthesia and the operating room frequency thereby affecting the brachytherapy treatment in various institutions due to the COVID-19 protocols. This has led to single applications of Intracavitary brachytherapy (ICRT) being used to deliver entire treatment boost in cervix cancer. We present our dosimetric and early clinical outcomes comparing traditional weekly three-fractions ICRT with single application/ two-applications ICRT Materials and Methods: In this retrospective analysis conducted in our department, a total of 39 cases, treated between January 2021 to January 2022 were evaluated for the study. Of these, 15 cases were treated with the traditional once a week applicator insertion for 3 fractions and 24 cases underwent lesser application - 20 cases underwent 2 insertions and 4 cases single insertion (all receiving total 3 fractions of 7Gy each). The dosimetric parameters were compared including CTV D90 and D95 along with rectum, sigmoid and bladder D2cc, 1cc and 0.1cc respectively. The acute toxicity assessment was done using the RTOG scale. The follow-up was undertaken as per the institutional protocol and Mann-Whitney U-test were applied to compare the cohorts. Results: With a median follow-up of 6 months, the median CTV was D90%: 81.2 vs. 80.9 Gy and the median CTV volume was 44.3 vs 42.9 cc respectively. The 0.1 cm3 and 2 cm3 to bladder, rectum, and sigmoid were 105.6 vs 104.2 Gy and 85.5 vs 85.9Gy, 89.4Gy vs 88.7Gy and 69.1 vs 67.8Gy, and 84.7 vs 84.1Gy and 71.7 vs 69.9Gy, respectively suggesting no significant difference in the dosimetric outcomes with the two forms of applications. The less than three applications had a shorter overall treatment time with median OTT of 43 days vs. 55 days (p = 0.02). On completion of treatment and 6 months follow-up, local control was achieved in all patients. There was no significant difference in the acute toxicities in terms of cystitis and proctitis in both forms of the application. Conclusion: The single application/ twice application ICRT procedure showed similar outcomes as the traditional three-week duration treatment in terms of dosimetric outcomes and acute toxicities and ultimately leading to shortened overall treatment time. It also helped reduce the anesthesia burden and various resources associated with the procedure.
ABSTRACT
COVID-19 is the common enemy of all of us in this world. It created lot of deaths, loss of economy and many more. The pandemic has created a lot of innovation to bring solutions in helping fight the spread of novel coronavirus and other diseases. In this paper, various thermal sensors for detection of COVID-19 in early stage are discussed. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Many COVID-19 studies are about epidemiological and clinical features but information about secondary bacterial infections is limited. The present study was conducted to determine the prevalence and characteristics of bloodstream infections in COVID-19 patients admitted to a tertiary care academic health care organization. All blood samples were obtained from patients with COVID-19 admitted were included in the study. Blood cultures were performed using BD BACTEC ™ FX40, and the diagnosis and bacterial identification and antimicrobial sensitivity was performed by manual method. 2200 patients with COVID-19 were hospitalized during a 6-month study period in which 315 blood cultures were performed. Of these, 24 (7.61%) were positive. The median age of patients with positive blood culture was 38 years and included 13 males and 11 females. Seventeen patients (70.83%) needed intensive care in the ICU. Significant correlations with blood culture positivity have been noted with parameters such as admission to the ICU, availability of accommodation, basic illness and adverse clinical outcomes. Bloodstream infections prevalence in COVID-19 patients is low. However, antibiotic prophylaxis needs to be used with caution, and immediate discontinuation should be made based on clinical judgment.
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Sanitization having a Lion Share of Attention on a Global dais in all the three-time zone Pre-COVID, COVOID, and Post-COVID is a matter of concern, especially for countries, which in the pre-era were striving hard to achieve it. Indian Government knitting the Spheris of Central and State Government has in the recent past shown bend towards the burning issue of Municipal Solid Waste Management. The Government had launched the schemes Swatch Bharat Mission, and it has been successful but is still on the backstage of its optimal potential as the basic motor of planning, i.e., “Master Plan” is missing in tier II and III cities when it comes to execution of such schemes. An attempt has been made in this paper to prepare a comprehensive plan for Dehradun city of Uttarakhand named “Solid waste Management Master Plan for Dehradun City 2041”. The following study will provide a complete spectrum approach towards the management of each component of Municipal Solid Waste Management of the city, including Waste Generation, Collection, Transportation, Treatment, and Disposal. Also, a service Level Benchmarking of both the Existing and Proposed System has been done to quantify the Output of the proposals and recommendations in the Existing System. Software such as GIS, GPS, and Remote Sensing is used in the study and has given an extra edge of Real-time and locational management for the Waste Management system of Dehradun until 2041. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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The covid-19 pandemic was affected many sectors due to disintegration in work. The supply chain was affected and the firms had to face the labor shortage due to illness, death and travel restrictions. The goods could not reach the customers on time and the companies suffered a loss due to its deterioration. In this paper, we study about supply chain network for the cooperative dairy industry. We study how labor shortage affects the supply chain. We derive an equilibrium supply chain model with the labor shortage and risk factors to increase the company's profitability. In the end, we look at some examples that how profit is affected by the labor shortage. © 2021 IEEE.
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Background. Neutralizing antibody therapies targeting SARS-CoV-2 have been released for emergency use authorization by the FDA. Little is published on their real-world experience. In this retrospective study we share the results of our early experience on patient outcomes from use of these neutralizing antibodies within a large healthcare system. Methods. We retrospectively analyzed results of a healthcare system wide program to pro-actively identify and treat COVID-19 patients with neutralizing antibody therapy. Results. The 449 patients identified for SARS-CoV-2 neutralizing antibody therapy during the study period were retrospectively classified as falling in one of the three groups: untreated (199), bamlanivimab (87) and casirivimab/indevimab (125) treated patients (Table 1). Reasons identified patients were not treated most commonly were patient declined (n=74), unable to be contacted (n=36), out of treatment window (n=23), asymptomatic and feeling better (n=21) or did not have transportation (n=9). Bamlanivimab infusion did not reduce emergency room (ER) visits or hospitalization compared to untreated patient within 30-days of follow up (Table 2), and among all patients treated with antibody therapy only treatment with bamlanivimab and non-white race were predictors of need for hospitalization (Table 3). Casirivimab/ indevimab did reduce subsequent ER visits or hospitalization within 30 days post-infusion when compared to the untreated group. However, patients treated with either antibody therapy had lower acuity of COVID-19 disease as reflected in need for intensive care unit (ICU) stay, mechanical ventilation or death (Table 2). Conclusion. Either neutralizing antibody therapy appears to markedly reduce acuity of COVID-19 disease even if patients do progress to requiring hospitalization. However, casirivimab/indevimab therapy also decreased ER visits and hospitalization suggesting better efficacy in our experience.
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With the growing understanding of coronavirus disease-2019 (COVID-19) pathogenesis, different therapeutic targets are being considered for the management of COVID-19. The development of new drugs is a time-consuming process;hence, many drugs acting on similar therapeutic targets/sites in the COVID-19 treatment are repurposed in COVID-19. In this article, an expert panel deliberated on the existing evidence on the immunopathogenesis, therapeutic targets under consideration for treatment of COVID-19, and the place of mefenamic acid in the therapy landscape of COVID-19. The expert panel has also provided recommendations regarding the dose and regimen of mefenamic acid in different phases of the COVID-19 disease.
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In the event of the current COVID-19 pandemic and in preparation for future pandemics, open science can support mission-oriented research and development, as well as commercialization. Open science shares skills and resources across sectors;avoids duplication and provides the basis for rapid and effective validation due to full transparency. It is a strategy that can adjust quickly to reflect changing incentives and priorities, because it does not rely on any one actor or sector. While eschewing patents, it can ensure high-quality drugs, low pricing, and access through existing regulatory mechanisms. Open science practices and partnerships decrease transaction costs, increase diversity of actors, reduce overall costs, open new, higher-risk/higher-impact approaches to research, and provide entrepreneurs freedom to operate and freedom to innovate. We argue that it is time to re-open science, not only in its now restricted arena of fundamental research, but throughout clinical translation. Our model and attendant recommendations map onto a strategy to accelerate discovery of novel broad-spectrum anti-viral drugs and clinical trials of those drugs, from first-in-human safety-focused trials to late stage trials for efficacy. The goal is to ensure low-cost and rapid access, globally, and to ensure that Canadians do not pay a premium for drugs developed from Canadian science. © 2020 Bubela et al. This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
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Introduction: Coronavirus disease-2019 (COVID-19) was announced as a pandemic by the World Health Organization (WHO) on March 11, 2020. According to a WHO report on COVID-19, the disease has nospecific manifestation and the patient's pres-entation can range from completely asymptomatic to severe pneumonia and death. Objective: To retrospectively characterize and interpret the spectrum of chest computed tomography (CT) imaging features of Coronavirus disease-19 (COVID-19) in infected Indian population and to correlate CT total severity score with clinical classification and study extra-pulmonary manifestation of Corona-virus disease 2019 (COVID-19). Methods: A retrospective single-centre study was conducted on patients with COVID-19 from May 10, 2020, to July 13, 2020, in tertiary care Max super specialty hospital, Delhi, India. A total of 532 patients either laboratory-confirmed or strongly suspected of having COVID-19 underwent CT chest and their imaging features were analyzed and interpreted in detail and studied for extra-pulmonary manifestation of COVID-19. The consistency of observers was evaluated for CT total severity score (TSS) and TSS was compared with clinical classification. Result: This study included 532 patients, 10 patients were excluded from the study. Among a total of 522 patients in the study, 362 (69.3%) were males and 160 (30.7%) were females with a mean age of 52.75 years (range 14-88). According to the clinical subtype classification there were mild 17 (3.3%), common 355 (68.0%), severe 105 (20.1%) and critical 45 (8.6%) cases. 57 (10.9%) patients died and 37 (7.08%) patients showed extra-pulmonary manifestation of COVID-19. There were 17 patients with normal CT chest. Only 2 cases had unilateral lung disease and the rest of 503 cases showed bilateral lung involvement with multiple opacities and multiple lobe involvement. Diffuse lung involvement i.e. white lung noted in 10 cases and none of the patient had single lesion. Opacities on CT imaging tended to be both peripheral and central in most cases, followed by purely peripheral and rarely are with the purely central distribution. According to CT attenuation of opacity, Ground glass opacity (GGO), and the mixture of Ground glass opacity & consolidative opacities and consolidative opacities was the dominant abnormality founded almost in all cases. Perilesional or intralesional, thickened small vessel was observed in almost all cases. Accompany-ing signs were crazy paving (40.6%), reverse halo sign (10.9 %), subpleural lines (47.9%), air bronchogram (28.4%), bronchiec-tasis (18.6%), pleural effusion (5.6%) and mediastinal lymphadenopathy (4.8%). Follow up scanning was obtained in 28 cases, showed no change in 2 cases, turned better in 12 cases, and became worse in 14 cases on follow up imaging studies. Conclusions: The typical pattern of COVID-19 pneumonia in Delhi, India, was ground glass opacity in the form of pure ground glass opacity, ground glass opacity with superimposed crazy paving pattern or Ground glass opacity admixed with consolidation with intralesional vascular enlargement were the most dominant lung parenchymal abnormalities with the peripheral and pos-terior distribution encountered in most of the cases. In the short term follow-up, more patients had disease progression rather than absorption. Proportion of patients [17 (3.2%)] with normal CT chest in laboratory-confirmed COVID-19 was relatively low;hence chest CT may play a complementary role in the early detection of COVID-19 pneumonia and could be regarded as a diagnotic standard of COVID-19. COVID-19 is progressive viral pneumonia with broad spectrum of clinical manifestations and can also present with extra-pulmonary manifestations . © IJCRR.