New COVID-19 challenges and response strategies adopted by a national suicide prevention hotline: A qualitative study.

Crisis helplines provide important support for vulnerable individuals during the COVID-19 pandemic, which may also impact the helplines. We explored the challenges that the pandemic brought to Taiwan's national suicide prevention hotline and the hotline's responses. We interviewed 14 hotline workers and conducted data analysis using the framework method. The pandemic posed two new challenges to the hotline: potential service interruption and the adjustment of perceived role among hotline workers. The hotline's well-formulated response plan helped it sustain its services during the pandemic, although the workers also experienced stress and frustration resulted from role ambiguity. Our data highlighted the hotline workers' need for accurate COVID-19 information, relevant training, and timely support.

A deep ensemble learning-based automated detection of COVID-19 using lung CT images and Vision Transformer and ConvNeXt.

Since the outbreak of COVID-19, hundreds of millions of people have been infected, causing millions of deaths, and resulting in a heavy impact on the daily life of countless people. Accurately identifying patients and taking timely isolation measures are necessary ways to stop the spread of COVID-19. Besides the nucleic acid test, lung CT image detection is also a path to quickly identify COVID-19 patients. In this context, deep learning technology can help radiologists identify COVID-19 patients from CT images rapidly. In this paper, we propose a deep learning ensemble framework called VitCNX which combines Vision Transformer and ConvNeXt for COVID-19 CT image identification. We compared our proposed model VitCNX with EfficientNetV2, DenseNet, ResNet-50, and Swin-Transformer which are state-of-the-art deep learning models in the field of image classification, and two individual models which we used for the ensemble (Vision Transformer and ConvNeXt) in binary and three-classification experiments. In the binary classification experiment, VitCNX achieves the best recall of 0.9907, accuracy of 0.9821, F1-score of 0.9855, AUC of 0.9985, and AUPR of 0.9991, which outperforms the other six models. Equally, in the three-classification experiment, VitCNX computes the best precision of 0.9668, an accuracy of 0.9696, and an F1-score of 0.9631, further demonstrating its excellent image classification capability. We hope our proposed VitCNX model could contribute to the recognition of COVID-19 patients.

Analysis of CT scan images for COVID-19 pneumonia based on a deep ensemble framework with DenseNet, Swin transformer, and RegNet.

COVID-19 has caused enormous challenges to global economy and public health. The identification of patients with the COVID-19 infection by CT scan images helps prevent its pandemic. Manual screening COVID-19-related CT images spends a lot of time and resources. Artificial intelligence techniques including deep learning can effectively aid doctors and medical workers to screen the COVID-19 patients. In this study, we developed an ensemble deep learning framework, DeepDSR, by combining DenseNet, Swin transformer, and RegNet for COVID-19 image identification. First, we integrate three available COVID-19-related CT image datasets to one larger dataset. Second, we pretrain weights of DenseNet, Swin Transformer, and RegNet on the ImageNet dataset based on transformer learning. Third, we continue to train DenseNet, Swin Transformer, and RegNet on the integrated larger image dataset. Finally, the classification results are obtained by integrating results from the above three models and the soft voting approach. The proposed DeepDSR model is compared to three state-of-the-art deep learning models (EfficientNetV2, ResNet, and Vision transformer) and three individual models (DenseNet, Swin transformer, and RegNet) for binary classification and three-classification problems. The results show that DeepDSR computes the best precision of 0.9833, recall of 0.9895, accuracy of 0.9894, F1-score of 0.9864, AUC of 0.9991 and AUPR of 0.9986 under binary classification problem, and significantly outperforms other methods. Furthermore, DeepDSR obtains the best precision of 0.9740, recall of 0.9653, accuracy of 0.9737, and F1-score of 0.9695 under three-classification problem, further suggesting its powerful image identification ability. We anticipate that the proposed DeepDSR framework contributes to the diagnosis of COVID-19.

The Impact of the COVID-19 Pandemic on Calls to a National Suicide Prevention Hotline in Taiwan: An Analysis of Time Trend and Characteristics of Calls.

We investigated the impact of the COVID-19 pandemic on call volumes and call characteristics using data from a national crisis helpline. Data were extracted for 215,066 calls to Taiwan's national suicide prevention hotline (January 2018-May 2020). We used negative binomial regression to investigate changes in the weekly number of calls during the early period of the COVID-19 outbreak (January 21, 2020-May 25, 2020), relative to that expected according to the pre-pandemic trend. The call characteristics during the pandemic period (February 18, 2020-May 31, 2020) were compared between COVID-19 related vs unrelated calls. Higher-than-expected call volumes started from the 6th week of the pandemic and reached a peak in the 14th week, which was 38% (rate ratio = 1.38, 95% confidence interval 1.26-1.51) higher than that expected based on the pre-pandemic trend. The higher-than-expected call volumes were mainly attributable to higher-than-expected calls from non-suicidal and male callers. Calls in which COVID-19 was mentioned (13.2%) were more likely to be from male and first-time callers, occur outside 12 am-6 am, last less than 5 min, and were less likely to be from callers who had previous suicide attempts, recent suicidal ideation or suicide plans or actions than COVID-19 unrelated calls. Callers who made COVID-19 related calls were more likely to request information than other callers. Crisis helplines should strategically adapt to the increased need and callers' specific concerns related to the outbreak.

"I Can't See an End in Sight." How the COVID-19 Pandemic May Influence Suicide Risk.

Background: The COVID-19 pandemic and its consequences may affect population mental health and suicide risk. Aims: To explore the experiences among suicidal individuals who made calls to a suicide prevention hotline and to identify factors and psychological responses that may influence suicide risk. Method: We identified 60 eligible recorded calls to Taiwan's suicide prevention hotline (January 23, 2020-May 31, 2020) and analyzed the transcripts using a framework analysis. Results: We identified three themes: (a) effects of the COVID-19 pandemic on society (impacts on local economies, the fear of contagion, and disruptions caused by outbreak control measures); (b) stress experienced by callers, including increased challenges (financial burden, restricted freedom of movement, interpersonal conflicts, feelings of uncertainty, and education/career interruption) and reduced support (reduced access to health services and social support); and (c) the callers' psychological responses to stress, including anxiety, sleep disturbance, depression, loneliness, hopelessness, and entrapment, which may increase suicide risk. Limitations: Only the experiences among those who sought help by calling the hotline during the early months of the pandemic in 2020 were explored. Conclusion: Our findings revealed the potential process underlying the impact of the COVID-19 pandemic on suicide risk and have implications for prevention and intervention strategies.

Discovery of Potential Therapeutic Drugs for COVID-19 Through Logistic Matrix Factorization With Kernel Diffusion.

Coronavirus disease 2019 (COVID-19) is rapidly spreading. Researchers around the world are dedicated to finding the treatment clues for COVID-19. Drug repositioning, as a rapid and cost-effective way for finding therapeutic options from available FDA-approved drugs, has been applied to drug discovery for COVID-19. In this study, we develop a novel drug repositioning method (VDA-KLMF) to prioritize possible anti-SARS-CoV-2 drugs integrating virus sequences, drug chemical structures, known Virus-Drug Associations, and Logistic Matrix Factorization with Kernel diffusion. First, Gaussian kernels of viruses and drugs are built based on known VDAs and nearest neighbors. Second, sequence similarity kernel of viruses and chemical structure similarity kernel of drugs are constructed based on biological features and an identity matrix. Third, Gaussian kernel and similarity kernel are diffused. Forth, a logistic matrix factorization model with kernel diffusion is proposed to identify potential anti-SARS-CoV-2 drugs. Finally, molecular dockings between the inferred antiviral drugs and the junction of SARS-CoV-2 spike protein-ACE2 interface are implemented to investigate the binding abilities between them. VDA-KLMF is compared with two state-of-the-art VDA prediction models (VDA-KATZ and VDA-RWR) and three classical association prediction methods (NGRHMDA, LRLSHMDA, and NRLMF) based on 5-fold cross validations on viruses, drugs, and VDAs on three datasets. It obtains the best recalls, AUCs, and AUPRs, significantly outperforming other five methods under the three different cross validations. We observe that four chemical agents coming together on any two datasets, that is, remdesivir, ribavirin, nitazoxanide, and emetine, may be the clues of treatment for COVID-19. The docking results suggest that the key residues K353 and G496 may affect the binding energies and dynamics between the inferred anti-SARS-CoV-2 chemical agents and the junction of the spike protein-ACE2 interface. Integrating various biological data, Gaussian kernel, similarity kernel, and logistic matrix factorization with kernel diffusion, this work demonstrates that a few chemical agents may assist in drug discovery for COVID-19.

VDA-RWLRLS: An anti-SARS-CoV-2 drug prioritizing framework combining an unbalanced bi-random walk and Laplacian regularized least squares.

BACKGROUND: A new coronavirus disease named COVID-19, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is rapidly spreading worldwide. However, there is currently no effective drug to fight COVID-19. METHODS: In this study, we developed a Virus-Drug Association (VDA) identification framework (VDA-RWLRLS) combining unbalanced bi-Random Walk, Laplacian Regularized Least Squares, molecular docking, and molecular dynamics simulation to find clues for the treatment of COVID-19. First, virus similarity and drug similarity are computed based on genomic sequences, chemical structures, and Gaussian association profiles. Second, an unbalanced bi-random walk is implemented on the virus network and the drug network, respectively. Third, the results of the random walks are taken as the input of Laplacian regularized least squares to compute the association score for each virus-drug pair. Fourth, the final associations are characterized by integrating the predictions from the virus network and the drug network. Finally, molecular docking and molecular dynamics simulation are implemented to measure the potential of screened anti-COVID-19 drugs and further validate the predicted results. RESULTS: In comparison with six state-of-the-art association prediction models (NGRHMDA, SMiR-NBI, LRLSHMDA, VDA-KATZ, VDA-RWR, and VDA-BiRW), VDA-RWLRLS demonstrates superior VDA prediction performance. It obtains the best AUCs of 0.885 8, 0.835 5, and 0.862 5 on the three VDA datasets. Molecular docking and dynamics simulations demonstrated that remdesivir and ribavirin may be potential anti-COVID-19 drugs. CONCLUSIONS: Integrating unbalanced bi-random walks, Laplacian regularized least squares, molecular docking, and molecular dynamics simulation, this work initially screened a few anti-SARS-CoV-2 drugs and may contribute to preventing COVID-19 transmission.

Medical-VLBERT: Medical Visual Language BERT for COVID-19 CT Report Generation With Alternate Learning.

Medical imaging technologies, including computed tomography (CT) or chest X-Ray (CXR), are largely employed to facilitate the diagnosis of the COVID-19. Since manual report writing is usually too time-consuming, a more intelligent auxiliary medical system that could generate medical reports automatically and immediately is urgently needed. In this article, we propose to use the medical visual language BERT (Medical-VLBERT) model to identify the abnormality on the COVID-19 scans and generate the medical report automatically based on the detected lesion regions. To produce more accurate medical reports and minimize the visual-and-linguistic differences, this model adopts an alternate learning strategy with two procedures that are knowledge pretraining and transferring. To be more precise, the knowledge pretraining procedure is to memorize the knowledge from medical texts, while the transferring procedure is to utilize the acquired knowledge for professional medical sentences generations through observations of medical images. In practice, for automatic medical report generation on the COVID-19 cases, we constructed a dataset of 368 medical findings in Chinese and 1104 chest CT scans from The First Affiliated Hospital of Jinan University, Guangzhou, China, and The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China. Besides, to alleviate the insufficiency of the COVID-19 training samples, our model was first trained on the large-scale Chinese CX-CHR dataset and then transferred to the COVID-19 CT dataset for further fine-tuning. The experimental results showed that Medical-VLBERT achieved state-of-the-art performances on terminology prediction and report generation with the Chinese COVID-19 CT dataset and the CX-CHR dataset. The Chinese COVID-19 CT dataset is available at https://covid19ct.github.io/.

Probing antiviral drugs against SARS-CoV-2 through virus-drug association prediction based on the KATZ method.

It is urgent to find an effective antiviral drug against SARS-CoV-2. In this study, 96 virus-drug associations (VDAs) from 12 viruses including SARS-CoV-2 and similar viruses and 78 small molecules are selected. Complete genomic sequence similarity of viruses and chemical structure similarity of drugs are then computed. A KATZ-based VDA prediction method (VDA-KATZ) is developed to infer possible drugs associated with SARS-CoV-2. VDA-KATZ obtained the best AUCs of 0.8803 when the walking length is 2. The predicted top 3 antiviral drugs against SARS-CoV-2 are remdesivir, oseltamivir, and zanamivir. Molecular docking is conducted between the predicted top 10 drugs and the virus spike protein/human ACE2. The results showed that the above 3 chemical agents have higher molecular binding energies with ACE2. For the first time, we found that zidovudine may be effective clues of treatment of COVID-19. We hope that our predicted drugs could help to prevent the spreading of COVID.