An observational study on the use of oral vitamin C in critically ill stage-5 patients with COVID-19 infection

Introduction: The evidence-based use of the oral form of Vitamin C as adjuvant treatment for critically ill COVID-19 patients is lacking worldwide despite its intravenous preparation form being demonstrated to be potentially beneficial in some studies. The present study objective was to evaluate the effects of oral Vitamin C in the treatment of severe COVID-19. Method(s): This was an open-label observational study with propensity score matching on unvaccinated, similar medication history, hospitalized stage-5 severe COVID-19 patients, who were treated with daily 2g, 4g, or 6g of oral Vitamin C respectively from November 2020 to December 2021. The clinical data were collected retrospectively for analysis. The study outcomes were 28-day in-hospital mortality, the proportion of mechanical ventilation-free days (MVFD), the Day 1, Day 3, and Day 7 of both the inflammation progression (c-reactive protein) and the Sequential Organ Failure Assessment score (SOFA). Result(s): A total of 147 patients were recruited. The number of subjects in the 2g, 4g, and 6g Vitamin C groups was 43, 44, and 60 respectively. There was no significant difference in the 28-day mortality (p=0.336), the MVFD (p=0.486), the c-reactive protein level on Day 1 (p=0.856), Day 3 (p=0.977), Day 7 (p=0.462), and the SOFA score on Day 1(p=0.540), Day 3 (p=0.149) and Day 7 (p=0.754) between the three Vitamin C dosing groups. Conclusion(s): The present study showed that the oral form of Vitamin C provided no benefit in reducing stage-5 COVID-19 patients' hospital mortality, the mechanical ventilation requirement, or the overall inflammation progression.

Trends in paediatric firearm-related encounters during the COVID-19 pandemic by age group, race/ethnicity and schooling mode in Tennessee.

BACKGROUND: Increases in paediatric firearm-related injuries during the COVID-19 pandemic may be due to changes in where children and adolescents spent their time. This study examines changes in the frequency of paediatric firearm-related encounters as a function of schooling mode overall and by race/ethnicity and age group at a large trauma centre through 2021. METHODS: We use data from a large paediatric and adult trauma centre in Tennessee from January 2018 to December 2021 (N=211 encounters) and geographically linked schooling mode data. We use Poisson regressions to estimate smoothed monthly paediatric firearm-related encounters as a function of schooling mode overall and stratified by race and age. RESULTS: Compared with pre pandemic, we find a 42% increase in paediatric encounters per month during March 2020 to August 2020, when schools were closed, no significant increase during virtual/hybrid instruction, and a 23% increase in encounters after schools returned to in-person instruction. The effects of schooling mode are heterogeneous by patient race/ethnicity and age. Encounters increased among non-Hispanic black children across all periods relative to pre pandemic. Among non-Hispanic white children, encounters increased during the closure period and decreased on return to in-person instruction. Compared with pre pandemic, paediatric firearm-related encounters increased 205% for children aged 5-11 and 69% for adolescents aged 12-15 during the school closure period. CONCLUSION: COVID-19-related changes to school instruction mode in 2020 and 2021 are associated with changes in the frequency and composition of paediatric firearm-related encounters at a major trauma centre in Tennessee.

Guidance on the use of biologic agents in psoriatic patients during COVID-19 outbreak.

The COVID-19 outbreak may have some impact on the use of biologics in psoriatic patients because immunosuppressive effects of biologics may potentially alter the susceptibility of patients to the virus, deteriorate the condition of infected patients or even change the prognosis of infection. According to currently available recommendations from international psoriasis academic organizations and specialists, as well as specific situation in China, the authors provide some guidance on the use of biologics for psoriatic patients undergoing or planning to undergo treatment with biologics, those with low or high risk of infection, and for those with or without COVID-19 infection, so as to provide references for clinical practice.Copyright © 2020 by the Chinese Medical Association.

Diachronic Analysis of Users' Stances on COVID-19 Vaccination in Japan using Twitter

To prevent and curb viral outbreaks, such as COVID-19, it is important to increase vaccination coverage while resolving vaccine hesitancy and refusal. To understand why COVID-19 vaccination coverage had rapidly increased in Japan, we analyzed Twitter posts (tweets) to track the evolution of people's stance on vaccination and clarify the factors of why people decide to vaccinate. We collected all Japanese tweets related to vaccines over a five-month period and classified the vaccination stances of users who posted those tweets by using a deep neural network we designed. Examining diachronic changes in the users' stances on this large-scale vaccine dataset, we found that a certain number of neutral users changed to a pro-vaccine stance while very few changed to an anti-vaccine stance in Japan. Investigation of their information-sharing behaviors revealed what types of users and external sites were referred to when they changed their stances. These findings will help increase coverage of booster doses and future vaccinations. © 2022 IEEE.

How to Cope With Emergency Remote Teaching for University Academics: The Case of a High-Profile Language University in China

Despite the growing body of literature on the structural problems of emergency remote teaching during the COVID-19 pandemic, far too little empirical research has been conducted on university academics' challenges in online pedagogy and what is needed to facilitate their teaching during a time of educational crisis. Thus, this study selects a high-profile Chinese language university as a case study to explore how university academics in China have dealt with the challenges of emergency remote teaching during the pandemic. This paper conducts open-ended interviews with 22 academic faculty members and adopts TPACK concepts to interpret the findings. The results demonstrate how participants find avenues to deal with emergency remote teaching, effective measures universities need to adopt, and ways to facilitate TPACK with academic faculty. © The Author(s) 2023.

Trends in Pediatric Firearm-Related Encounters during the COVID-19 Pandemic by Age Group, Race/Ethnicity, and Schooling Mode in Tennessee (preprint)

Purpose Increases in pediatric firearm-related injuries during the COVID-19 pandemic may be due to changes in where children and adolescents spent their time. This paper examines changes in the frequency of pediatric firearm-related encounters as a function of schooling mode overall and by race/ethnicity and age group at a large trauma center through 2021. Methods We use data from a large pediatric and adult trauma center in Tennessee from January 2018 to December 2021 (N=211 encounters) and geographically linked schooling mode data. We use Poisson regressions to estimate smoothed monthly pediatric firearm-related encounters as a function of schooling mode overall and stratified by race and age. Results Compared to pre-pandemic, we find a 42% increase in pediatric encounters per month during March 2020 to August 2020, when schools were closed, and a 23% increase in encounters after schools returned to in-person instruction. Effects of schooling mode are heterogeneous by race. Encounters increased among non-Hispanic Black children and adolescents across all periods relative to pre-pandemic. Among non-Hispanic white children and adolescents, encounters increased during the closure period and decreased on return to in-person instruction. Effects of schooling mode are also heterogeneous by age. Relative to pre-pandemic, pediatric firearm-related encounters increased 205% for children aged 5 to 11 and 69% for adolescents aged 12 to 15 during the school closure period. Conclusion COVID-19-related changes to school instruction mode in 2020 and 2021 are associated with changes in the frequency and composition of pediatric firearm-related encounters at a major trauma center in Tennessee.

Assessment of Symptom, Disability, and Financial Trajectories in Patients Hospitalized for COVID-19 at 6 Months.

Importance: Individuals who survived COVID-19 often report persistent symptoms, disabilities, and financial consequences. However, national longitudinal estimates of symptom burden remain limited. Objective: To measure the incidence and changes over time in symptoms, disability, and financial status after COVID-19-related hospitalization. Design, Setting, and Participants: A national US multicenter prospective cohort study with 1-, 3-, and 6-month postdischarge visits was conducted at 44 sites participating in the National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Network's Biology and Longitudinal Epidemiology: COVID-19 Observational (BLUE CORAL) study. Participants included hospitalized English- or Spanish-speaking adults without severe prehospitalization disabilities or cognitive impairment. Participants were enrolled between August 24, 2020, and July 20, 2021, with follow-up occurring through March 30, 2022. Exposure: Hospitalization for COVID-19 as identified with a positive SARS-CoV-2 molecular test. Main Outcomes and Measures: New or worsened cardiopulmonary symptoms, financial problems, functional impairments, perceived return to baseline health, and quality of life. Logistic regression was used to identify factors associated with new cardiopulmonary symptoms or financial problems at 6 months. Results: A total of 825 adults (444 [54.0%] were male, and 379 [46.0%] were female) met eligibility criteria and completed at least 1 follow-up survey. Median age was 56 (IQR, 43-66) years; 253 (30.7%) participants were Hispanic, 145 (17.6%) were non-Hispanic Black, and 360 (43.6%) were non-Hispanic White. Symptoms, disabilities, and financial problems remained highly prevalent among hospitalization survivors at month 6. Rates increased between months 1 and 6 for cardiopulmonary symptoms (from 67.3% to 75.4%; P = .001) and fatigue (from 40.7% to 50.8%; P < .001). Decreases were noted over the same interval for prevalent financial problems (from 66.1% to 56.4%; P < .001) and functional limitations (from 55.3% to 47.3%; P = .004). Participants not reporting problems at month 1 often reported new symptoms (60.0%), financial problems (23.7%), disabilities (23.8%), or fatigue (41.4%) at month 6. Conclusions and Relevance: The findings of this cohort study of people discharged after COVID-19 hospitalization suggest that recovery in symptoms, functional status, and fatigue was limited at 6 months, and some participants reported new problems 6 months after hospital discharge.

CVD19-Net: An Automated Deep Learning Model for COVID-19 Screening using Chest CT Images

COVID-19 is the most recent coronavirus-related disease that has been declared a pandemic by the World Health Organization (WHO), causing a global emergency that has resulted in a large number of deaths and is rapidly spreading around the world. It causes respiratory illness and is highly contagious, putting a strain on health and medical systems worldwide. With the help of various deep learning (DL) techniques, chest CT scans are considered an effective tool for diagnosing COVID-19 because it directly affects the lungs. In addition, the visual similarities between COVID-19 and pneumonia make identification even more challenging, as COVID-19 is also a virus. In this paper, we designed a unique lightweight DL model named CVD19-Net with fewer layers as an accurate diagnostic method for COVID-19. Different regularization techniques such as dropout layers, batch normalization layers and data augmentation are injected into the CVD19-Net model to improve classification accuracy and reduce overfitting. We considered three different publicly available datasets for our experiments. (1) Dataset 1: 2482 CT images were collected;(2) Dataset 2: 7544 CT images were collected;(3) Dataset 3: 3190 CT images were collected. The experimental results show that the proposed model achieves 98.59% accuracy on dataset 1, 98.21% on dataset 2, and 95.61% on dataset 3, which is better than the existing methods. The proposed model requires less training time and storage space, which makes it computationally efficient while maintaining a high level of accuracy, which can help clinicians quickly identify COVID-19 patients. © 2022 IEEE.

Optimization of Needle Plane Measurement for Dorsal Hand Injection Based on Linear Structured Light Scanning

Medical professionals have started favoring the use of non-contact intravenous injection robots owing to their importance during the COVID-19 outbreak. However, there are currently few studies considering the robot's needle insertion angle, and most of the needle insertion operations are performed at a steep angle. This increases the rate of puncture failure, and sometimes causes significant pain in patients depending on their individual differences. Therefore, the intravenous injection of the dorsal hand is performed in this study to investigate the determination of the robot's needle insertion angle. with a focus on the optimization of the measurement data to ensure accuracy in the calculation of the needle insertion angle. First, the space point cloud of the needle insertion area on the dorsal hand is obtained by combining a monocular camera with the linear structured light scanning method , and the dorsal hand plane is obtained via fitting dorsal hand point clouds using the least squares method. During the calibration process for the linear structured light system , the measurement error is eliminated by formulating an error function and using the optimization method to iteratively solve it. Subsequently. the needle insertion angle is determined based on the obtained needle insertion area plane. Finally, experiments are conducted for the accuracy verification of the proposed method. Based on the experimental results, the average error in the optimized structured light plane position is approximately 0. 1 mm, and this serves as a foundation for subsequent automatic injection studies.

Oxygen-Saturation Targets for Critically Ill Adults Receiving Mechanical Ventilation.

BACKGROUND: Invasive mechanical ventilation in critically ill adults involves adjusting the fraction of inspired oxygen to maintain arterial oxygen saturation. The oxygen-saturation target that will optimize clinical outcomes in this patient population remains unknown. METHODS: In a pragmatic, cluster-randomized, cluster-crossover trial conducted in the emergency department and medical intensive care unit at an academic center, we assigned adults who were receiving mechanical ventilation to a lower target for oxygen saturation as measured by pulse oximetry (Spo₂) (90%; goal range, 88 to 92%), an intermediate target (94%; goal range, 92 to 96%), or a higher target (98%; goal range, 96 to 100%). The primary outcome was the number of days alive and free of mechanical ventilation (ventilator-free days) through day 28. The secondary outcome was death by day 28, with data censored at hospital discharge. RESULTS: A total of 2541 patients were included in the primary analysis. The median number of ventilator-free days was 20 (interquartile range, 0 to 25) in the lower-target group, 21 (interquartile range, 0 to 25) in the intermediate-target group, and 21 (interquartile range, 0 to 26) in the higher-target group (P = 0.81). In-hospital death by day 28 occurred in 281 of the 808 patients (34.8%) in the lower-target group, 292 of the 859 patients (34.0%) in the intermediate-target group, and 290 of the 874 patients (33.2%) in the higher-target group. The incidences of cardiac arrest, arrhythmia, myocardial infarction, stroke, and pneumothorax were similar in the three groups. CONCLUSIONS: Among critically ill adults receiving invasive mechanical ventilation, the number of ventilator-free days did not differ among groups in which a lower, intermediate, or higher Spo₂ target was used. (Supported by the National Heart, Lung, and Blood Institute and others; PILOT ClinicalTrials.gov number, NCT03537937.).

Epidemiological analysis on pertussis cases in Ankang from 2010 to 2019

Objective To study the epidemic characteristics and causes of pertussis cases in Ankang from 2010 to 2019, and to provide basis for prevention and control of pertussis. Methods The pertussis cases in Ankang from 2010 to 2019 were analyzed by descriptive epidemiology, and ARIMA(Autoregressive Integrated Moving Average model) was used to predict the forecast of pertussis from July 2020 to June 2021. Results Pertussis cases in Ankang showed an increasing trend from 2020 to 2019. The incidence rate hits the maximum value in 2019, and increased by 299.00% when compared to 2018. The case with the age distribution under 6 years were dominated by children, accounting for 94.07% of the total onset cases. The incidence was concentrated in three populations including scattered children (75.42%),childcare children(15.25%) and students(9.32%). In 2019,there were 25 on-campus students and 15 scattered children in Hanyin, and some cases have developed aggregated epidemics. According to the prediction model, the incidence of pertussis in Ankang might decrease from July 2020 to June 2021. Conclusion The incidence of pertussis in children in Ankang is on the rise from 2010 to 2019,and they are key points of prevention and control of pertussis to ensure the quality of vaccine production, improve the quality of vaccination, and proper implementation of infectious disease monitoring. Influenced by COVID-19 epidemic in early 2020, China adopted a series of effective measures to control respiratory infectious diseases, and the incidence of whooping cough also declined. © 2022, Editorial Department of Medical Pest Control. All rights reserved.

Commercialization of microcavity plasma devices and arrays: Systems for VUV photolithography and nanopatterning, disinfection of drinking water and air, and biofilm deactivation for medical therapeutics

A little more than two decades after the introduction of the first microcavity plasma devices, a growing body of commercial products based on the remarkable properties of these low‐temperature, atmospheric plasmas is now available. Following a brief review of early microplasma lamp development, this article describes microplasma‐based devices and systems currently being manufactured for applications in photolithography, photopatterning, and other nanofabrication processes, such as atomic layer deposition, spectroscopic identification and analysis of materials (including wide bandgap crystals), the disinfection of drinking water in off‐grid communities, deactivating COVID‐19 and other pathogens in air and on surfaces in public spaces, and vacuum ultraviolet lamps for driving atomic clocks. The microplasma‐based treatment of otitis media in the human ear will also be discussed. [ FROM AUTHOR] Copyright of Plasma Processes & Polymers is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

COVID-19 susceptibility and clinical outcomes in autoimmune inflammatory rheumatic diseases (AIRDs): a systematic review and meta-analysis.

OBJECTIVE: This meta-analysis aims to assess the susceptibility to and clinical outcomes of COVID-19 in autoimmune inflammatory rheumatic disease (AIRD) and following AIRD drug use. MATERIALS AND METHODS: We included observational and case-controlled studies assessing susceptibility and clinical outcomes of COVID-19 in patients with AIRD as well as the clinical outcomes of COVID-19 with or without use of steroids and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). RESULTS: Meta-analysis including three studies showed that patients with AIRD are not more susceptible to COVID-19 compared to patients without AIRD or the general population (OR: 1.11, 95% CI: 0.58 to 2.14). Incidence of severe outcomes of COVID-19 (OR: 1.34, 95% CI: 0.76 to 2.35) and COVID-19 related death (OR: 1.21, 95% CI: 0.68 to 2.16) also did not show significant difference. The clinical outcomes of COVID-19 among AIRD patients with and without csDMARD or steroid showed that both use of steroid (OR: 1.69, 95% CI: 0.96 to 2.98) or csDMARD (OR: 1.35, 95% CI: 0.63 to 3.08) had no effect on clinical outcomes of COVID-19. CONCLUSIONS: AIRD does not increase susceptibility to COVID-19, not affecting the clinical outcome of COVID-19. Similarly, the use of steroids or csDMARDs for AIRD does not worsen the clinical outcome.

Associations between persistent symptoms after mild COVID-19 and long-term health status, quality of life, and psychological distress.

BACKGROUND: We sought to assess whether persistent COVID-19 symptoms beyond 6 months (Long-COVID) among patients with mild COVID-19 is associated with poorer health status, quality of life, and psychological distress. METHODS: This was a multicenter prospective cohort study that included adult outpatients with acute COVID-19 from eight sites during 2-week sampling periods from April 1 and July 28, 2020. Participants were contacted 6-11 months after their first positive SARS-CoV-2 to complete a survey, which collected information on the severity of eight COVID-19 symptoms using a 4-point scale ranging from 0 (not present) to 3 (severe) at 1 month before COVID-19 (pre-illness) and at follow-up; the difference for each was calculated as an attributable persistent symptom severity score. A total attributable persistent COVID-19 symptom burden score was calculated by summing the attributable persistent severity scores for all eight symptoms. Outcomes measured at long-term follow-up comprised overall health status (EuroQol visual analogue scale), quality of life (EQ-5D-5L), and psychological distress (Patient Health Questionnaire-4). The association between the total attributable persistent COVID-19 burden score and each outcome was analyzed using multivariable proportional odds regression. RESULTS: Of the 2092 outpatients with COVID-19, 436 (21%) responded to the survey. The median (IQR) attributable persistent COVID-19 symptom burden score was 2 (0, 4); higher scores were associated with lower overall health status (aOR 0.63; 95% CI: 0.57-0.69), lower quality of life (aOR: 0.65; 95%CI: 0.59-0.72), and higher psychological distress (aOR: 1.40; 95%CI, 1.28-1.54) after adjusting for age, race, ethnicity, education, and income. CONCLUSIONS: In participants with mild acute COVID-19, the burden of persistent symptoms was significantly associated with poorer long-term health status, poorer quality of life, and psychological distress.

eNAMPT neutralization reduces preclinical ARDS severity via rectified NFkB and Akt/mTORC2 signaling.

Despite encouraging preclinical data, therapies to reduce ARDS mortality remains a globally unmet need, including during the COVID-19 pandemic. We previously identified extracellular nicotinamide phosphoribosyltransferase (eNAMPT) as a novel damage-associated molecular pattern protein (DAMP) via TLR4 ligation which regulates inflammatory cascade activation. eNAMPT is tightly linked to human ARDS by biomarker and genotyping studies in ARDS subjects. We now hypothesize that an eNAMPT-neutralizing mAb will significantly reduce the severity of ARDS lung inflammatory lung injury in diverse preclinical rat and porcine models. Sprague Dawley rats received eNAMPT mAb intravenously following exposure to intratracheal lipopolysaccharide (LPS) or to a traumatic blast (125 kPa) but prior to initiation of ventilator-induced lung injury (VILI) (4 h). Yucatan minipigs received intravenous eNAMPT mAb 2 h after initiation of septic shock and VILI (12 h). Each rat/porcine ARDS/VILI model was strongly associated with evidence of severe inflammatory lung injury with NFkB pathway activation and marked dysregulation of the Akt/mTORC2 signaling pathway. eNAMPT neutralization dramatically reduced inflammatory indices and the severity of lung injury in each rat/porcine ARDS/VILI model (~ 50% reduction) including reduction in serum lactate, and plasma levels of eNAMPT, IL-6, TNFα and Ang-2. The eNAMPT mAb further rectified NFkB pathway activation and preserved the Akt/mTORC2 signaling pathway. These results strongly support targeting the eNAMPT/TLR4 inflammatory pathway as a potential ARDS strategy to reduce inflammatory lung injury and ARDS mortality.