ABSTRACT
Context: The number of pediatric anterior cruciate ligament reconstructions (ACLRs) occurring yearly increased almost 6-fold from 2004-2014. We find it interesting that limited recent data exist on rates of ACL injury and reconstruction in children and adolescents, especially in the context of COVID-19. Objective: Given the effect of the COVID-19 pandemic on youth sports seasons and the postponement of many elective surgeries, we sought to examine the changes in rates of ACLR during this period. Design: Retrospective cohort study. Setting: This study used the Pediatric Health Information System (PHIS) database to identify eligible patients at PHIS-participating hospitals nationwide from January 2016-June 2021, with March 1, 2020, considered the start of the COVID-19 pandemic. Patients or other participants: Using Current Procedural Terminology codes, patients 18 years old and younger who underwent ACLR surgery were identified. Main outcome measure(s): Patient demographics and overall rates of surgery prepandemic and intrapandemic were compared. Data were analyzed using bivariate, mixed-model, and time series analyses. Results: A total of 24 843 ACLRs were identified during this time period. In total, 1853 fewer surgeries than expected were performed after March 2020 given prepandemic trends. Intrapandemic demographics revealed an increase in the proportion of patients who identified as White and with private insurance and a decrease in the proportion who identified as Black and with public insurance. Also, the proportion of ACLRs by region shifted, with more surgeries performed in the Midwest and fewer in the Northeast. In the model adjusted for hospital-level variability, only race and insurance status remained significant. Conclusions: Based on prepandemic trends, fewer patients than projected underwent ACLR once the pandemic began, likely due to a combination of decreased rates of injury and delayed surgery.
ABSTRACT
In this paper, a novel compact planar coronavirus antenna is proposed for wide band applications. In the design of this antenna, the idea of the radiating part has been taken from the 3-D model of the coronavirus, which is fed by a 50 omega coplanar waveguide. The patch structure and the feed line of the proposed antenna, which have been made of gold, are located on a polyamide substrate with a thickness and dielectric constant of 45 mu m and 3.5, respectively, and the antenna has compact physical dimensions of 300 x 300 mu m(2). The simulation results of the antenna have been analyzed in terms of S-11, VSWR, radiation pattern, gain and surface current distribution. The designed antenna covers the frequency band from 0.3627 to 0.5918 THz for S-11 <= - 0 dB with a fractional bandwidth of > 47.98% and with a bandwidth ratio of 1.63:1. This extended bandwidth coverage allows the antenna to be suitable for a wide range of applications including wireless communications, internet of things, wearable devices, on-chip antennas and multiple-input multiple-output systems. Also, the results of the far-field show an omnidirectional radiation pattern with an average gain and efficiency of 4 dBi and 93% throughout the frequency band, respectively.
ABSTRACT
Background: Lead extraction procedures historically involve overnight hospital observation to detect delayed manifestation of procedural complications. The need for routine hospitalization patients after uncomplicated lead extractions remains to be determined. A desire to limit hospitalization during the COVID 19 pandemic provided an opportunity to assess the appropriateness of same-day discharge (SDD) after lead extraction. Objective: To determine the appropriateness of SDD and identify characteristics that identify potential candidates for SDD in a selected cohort after lead extraction. Methods: We reviewed procedural outcomes in consecutive patients undergoing lead extraction between Jan 2020 and October 2021. Events identified as complications during the first 30 days after the procedure include death, the need for rescue cardiac/chest surgery, hemopericardium with or without tamponade, venous tear, septic embolism, hematoma or pneumothorax requiring intervention, and access-associated AV fistula. Results: One-hundred eighty-four patients, 53% women of mean age 65.6± 14 years, underwent lead extraction at our institution during the specified interval. We discharged seventy-three patients (40%) on the same day;we chose to observe another 111 (60%) in the hospital at least one night. Table 1 shows the baseline and procedural characteristics in both groups. The SDD cohort preferentially included older (68 ± 12 vs. 63.2 ± 16.7, p=0.02) patients, women (59% vs. 44%, p=0.02), those with fewer (1.4 vs. 1.9, p<0.001) leads requiring extraction, a shorter lead dwell time (3.5 ± 4.2 years vs.7.4 ± 12 years, p=0.01), and an indication for extraction other than infection (4% vs. 54%, p<0.0001). The SDD patients suffered fewer complications (0 vs. 6%, p<0.001). Complications observed in the non-SDD group include one femoral AV fistula requiring surgical intervention, three pocket hematoma, and three septic emboli causing hemodynamic instability. Four patients died from underlying sepsis during their hospitalization. Conclusion: SDD appears appropriate in selected patients following lead extraction. Women with relatively fewer leads, shorter lead dwell times, and indications other than infection appear reasonable candidates for SDD. Age alone does not identify better candidates for SDD. [Formula presented]
ABSTRACT
Background: A novel Coronavirus first emerging in Wuhan, China, was named severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). The disease caused by SARS-CoV-2 is known as Coronavirus disease 2019 (COVID-19). HIV-1 infected individuals may be at risk of COVID-19. Objectives: This cross-sectional study evaluated the SARS-CoV-2 infection rate and COVID-19 prevalence among Iranian HIV-1-infected people. Methods: The study was conducted on 155 HIV-1-infected patients from June 2020 to October 2020. COVID-19 Ab (IgG) was detected using an enzyme immunoassay in serum specimens. Furthermore, nasopharyngeal and oropharyngeal specimens were collected. Then, the genomic RNA of SARS-CoV-2 was detected using a real-time polymerase chain reaction (RT-PCR). Clinical symptoms of the studied participants with and without COVID-19 were examined. Results: Of 155 HIV-1-infected individuals, 12 (7.7%) had positive real-time PCR results for SARS-CoV-2. Out of 12 (7.7%) patients with COVID-19, four (33.3%) were males. Anti-COVID Ab (IgG) was detected in 10 (6.5%) participants, of whom eight (80.0%) were males. The most common COVID-19 clinical symptoms, including dry cough, fever, runny nose, anosmia, and hypogeusia, were observed in seven (58.3%), five (41.7%), five (41.7%), five (41.7%), and five (41.7%) patients with COVID-19, respectively. Conclusions: A recent study has shown that the risk of SARS-CoV-2 infection in HIV-infected individuals is similar to that in the general population.
ABSTRACT
The outbreak of SARS-CoV-2 (COVID-19) has attracted much attention to study its possible presence and airborne transmission. The possibility of COVID-19 airborne transmission in indoor environments is debatable. The present study examined the concentration of viral RNA-containing particles produced directly or indirectly by breathing or coughing of confirmed COVID-19 patients or by carriers without symptoms. Some studies do not accept this method of transmission (COVID-19 airborne transmission). The present study aimed to measure the possible exposure of health care personnel to SARS-CoV-2 particles that may have been suspended in the air to respond to the hypothesis of COVID-19 airborne transmission. Airborne particle sampling was performed using impingement method based on NIOSH (chapter BA) and ASHRAE. Selection of sampling sections was in line with the WHO guidelines. The samples were analyzed using RT-PCR technique. Based on the given results, airborne particles of COVID-19 may present in the air and affect the health of hospital personnel. In fact, the analysis of gene expression in ambient conditions and thereby aerosol transmission of SARS-CoV-2 through air is possible and may lead to occupational exposure of health care personnel. Furthermore, it was found that airborne emission of COVID-19 through the breathing zone of patients, particularly in ICU wards with confirmed cases of COVID-19, may be higher than in other ICU wards. Also, the demonstrated results showed that there is a possibility of reaerosolization (reintroduction) of previously airborne SARS-CoV-2 particles into the atmosphere due to health care personnel frequently walking between different wards and stations of ICU.