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The prevalence cloud security has privacy preserving problems that major challenges due to humanity's need protect the sensitive and non-sensitive data to decision-making and resolve data leakage problems. One of the most difficult aspects is the reuse and sharing of accurate and detailed clinical data about PHR collected via Personal Health Records (PHRs) cloud transition is difficult. PHRs are often privacy preserving patient-centric models for exchanging medical information outsourced to third parties, such as Cloud Service Providers (CSP). A unique PHR patient information to ensure security with encryption before storage in the cloud. But still, issues such as security issues, flexible access and a valid user privacy risk management, efficiency and remain an important challenge to achieve better data access sensitive and non-sensitive imposition of control in cloud storage. To achieve high efficiency of PHR and modular data access control, Rail Fence Data Encryption (RFDE) algorithm provided to encrypt the PHR file to make high privacy standards. RFDE is also a form of transposition cipher called zigzag encryption, and the unauthorized user can't access the information. The proposed algorithm encrypts the PHR information it generates the secret key. The receiver decrypts the PHR information using the private key. The proposed algorithm provide efficient performance compared with previous algorithm. © 2023 IEEE.
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Purpose: This study aims to provide insight into consumer behavior regarding the use of food delivery apps when making purchases. To investigate the primary elements affecting users' intentions to use meal delivery applications, this study suggests an extension to the technology acceptance model through some contextual variable such as "various food choices (VFC),” "trust (TRR),” "perception of COVID-19-related risks (PCR)” and "convenience (CONV)” during the pandemic. Design/methodology/approach: A cross-sectional data of 407 was collected in the Indian context. This research adopts the covariance-based structural modeling approach to test the hypotheses along with hierarchical regression to predict the efficiency of constructs. Findings: Considering the outcomes, "perceived usefulness (PU)” was positively influenced by "perceived ease of use (PEOU),” "VFC” and "CONV.” In addition, the attitude (ATT) was positively impacted by "PU,” "TRR” and "PEOU.” Nevertheless, "PCR” negatively influenced ATT. In additional, this research illustrates the positive impact of ATT and PU on behavioral intention to use. Originality/value: By confirming the technology acceptance model's capacity for explanation in relation to food delivery apps, this study adds to the body of knowledge. The primary focus of this study is on determining the direct impact of the identified determinants on the adoption of food delivery applications within the context of a pandemic situation in developing countries. © 2023, Emerald Publishing Limited.
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an etiologic agent of the respiratory disease in humans known as coronavirus disease 2019 (COVID-19). The beginning of the outbreak of the disease was initially reported in Wuhan, Hubei Province, China, in December 2019, where patients felt SARS pneumonia-like symptoms with unknown etiology. Since then, it has been noticed that SARS-CoV-2 positive patients show mild to severe upper respiratory ill-ness.SARS-CoV-2 belongs to the class of Coronavirus, which is known to make its transfer from animals to humans and for the concerned virus;investigators have claimed its origin from bat coro-navirus at whole-genome level with a 96% sequence identity. The COVID-19 virus is extremely contagious and communicable in nature and has spread across the world since its first outbreak doc-umented in Wuhan, China. On March 9, 2020, World Health Organization (WHO) declared it as a pandemic, and within a month, it was already reported to have shown its presence in 213 countries and territories or areas. As of Nov15, 2020, this novel virus has infected approximately. 53.7 million people and caused 1.3 million mortalities worldwide. However, the mortality rate varied between 3-13% and was influenced by a number of factors, including the demographic distribution and maybe age, comorbidities, etc. Diagnosis of the disease is a key component of controlling the spread of the virus, and several techniques, including RT-PCR, ELISA, and sequencing-based ap-proaches, are in use. To cure COVID-19 patients, as of now, we do not have any safe and effective treatment. Currently, there is no safe and effective drug for the disease. Furthermore, various pharmaceutical industries are working on vaccine developments, which are in progress with the final stages of clinical studies. Therapeutic options are also currently under investigation in various re-gions of the world. However, there are various potential therapeutic targets to repurpose the present antiviral therapy for developing potential interventions against SARS-CoV-2 infection. Boosting the immune system can also help to prevent the spread of COVID-19 using various medications and exercises. Here, this review summarizes and discusses the epidemiology, evolution, transmis-sion, and therapeutics scientific advancements related to this novel pandemic.Copyright © 2021 Bentham Science Publishers.
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Cardiovascular inclusion has been accounted for in patients with serious intense respiratory condition Covid 2 contamination, which might be reflected by electrocardiographic changes. Cardiovascular injury is additionally connected with humanity, need for intensive care, and seriousness of illness in patients due to Coronavirus. Some case features cardiovascular contribution as an intricacy related with Coronavirus, even without indications and indications of interstitial pneumonia. Two Coronavirus incidents in our report displayed diverse ECG indications by means of the sickness caused decay. The main case introduced brief SI QIII TIII sound structure followed by changeable almost whole atrioventricular square, and the second exhibited ST-section height joined by choroidal ventricular tachycardiac. The hidden systems of these ECGs irregularities in the serious phase of Coronavirus might be ascribed to hypoxia and incendiary harm brought about by the infection. Since the scourge of Coronavirus pulled in the consideration, hearsays were encompassing ECG variations in the contaminated people. We pointed toward indicative dissimilar noticed ECG discoveries and talking about their experimental importance. This deliberate audit recommends that recognizing ECG designs that may be connected with Coronavirus is fundamental. Given that doctors don't perceive these examples, they may mistakenly hazard the existences of their patients. Moreover, significant medication instigated ECG changes give attention to the medical care laborers on the dangers of potential treatments. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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PurposeThis study aims to examine the effect of motivating language on employee performance and assesses the mediating roles of organisational citizenship behaviour and employee engagement between motivating language and employee performance in the Indian health-care sector, which is a highly demanding work environment, wherein employee burnout is high. Design/methodology/approachThe study was in the context of COVID-19 pandemic set for health-care workers in India. To collect data and test the proposed research model, 328 questionnaires were respondent by multi-level health-care professionals from private and government hospitals in North India. FindingsThe findings suggest that leader's motivating language is crucial for health-care leaders, inducing employee's performance in context to patientcare, safety and satisfaction. Underpinning theory of leader member exchange substantiates that the role of leader is pivotal in daily interaction with the stakeholders. Self-determination theory of motivation is determined by psychological needs satisfaction inducing employee engagement and organisational citizenship behaviour, amplified through the leader's motivating language, resulting into improved patientcare and patient safety. The findings state that leader's motivating language impacts the high culture context like health-care professionals, as observed in the Indian health-care sector during COVID-19. The findings are indicative of developing non-cognitive personality traits for managerial skills. Practical implicationsThe study substantiates the pivotal role of the leader's communication with stakeholders such as patients/attendants and health-care staff. The findings, which are an indicator of patientcare, as an outcome of patient compliance, will be indicative of developing the non-cognitive skills in the personality traits of managerial skills, inducing patients' trust in their health-care providers, using motivating language. Therefore, the health-care professionals must be trained in the application of motivating language with stakeholders, namely, patients/attendants and staff. Originality/valueThe findings state that leader's motivating language impacts on employees of high culture context like health-care professionals, as observed in the Indian health-care sector during the recent global medical emergency of COVID-19, whereas the earlier studies posited leader's motivating language to be effective on employees with low-cultural context. The role of leader is pivotal in daily interaction with the stakeholders, namely, patients/attendants and health-care staff.
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INTRODUCTION: COVID-19 can manifest in the lungs as acute respiratory distress syndrome leading to poor lung compliance and increasing susceptibility to barotrauma, which is hypothesized to cause an airleak resulting in pneumomediastinum (PM) and pneumothorax (PTX). Pneumopericardium (PP), a more rare complication, has been documented in relatively few cases to date. This study sought to review the relationship between positive pressure ventilation (PPV) and development of PP and to survey treatment options for COVID-19 patients with PP. METHOD(S): A systematic search was conducted on full text articles, including case reports and case series, for COVID-19 patients with comorbid PP from January 1st, 2019 to April 12th, 2022. Demographic data, presence of PM, PTX, PP and subcutaneous emphysema (SE), treatment information regarding respiratory support, use of steroids and other medications were recorded along with in-hospital mortality. RESULT(S): 51 articles met final inclusion criteria, reporting 76 cases of COVID-19 patients with PP. The average age was 54.5 years with a range of 17-82. Fifty-eight (76.3%) patients were male. 27 (35.5%) patients with PP died. PP occurred in isolation in 5 (6.6%) patients. PP was most comorbid with PM (n=65, 85.5%). SE occurred in 44 (57.9%) patients and PTX in 25 (32.9%) patients. 18 (23.7%) patients developed all of the sequalae of airleak. 64 (84.2%) patients received some degree of respiratory support: 35 (46.1%) patient's maximum support was supplemental oxygen, six (7.9%) were on non-invasive PPV, and 22 (28.9%) required mechanical ventilation. 29 (38.2%) patients with PP were given steroids. Only 1 patient received pericardiocentesis for presumed tamponade physiology. CONCLUSION(S): There was a high mortality in COVID-19 patients with PP. Previous reports hypothesized that PPV may be the etiology of PP in COVID-19 patients;however, only 36.8% of patients with PP in this review received PPV. It is unclear if the COVID-19 patients with PP not receiving PPV had tachypnea causing air trapping thus leading to self-induced barotrauma. Decompressive maneuvers have been studied in PTX and PM, however only one patient in this review received pericardiocentesis. Further research is needed to provide further etiology and treatment guidelines as this pandemic continues.
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Education in Asia has been considered as a source of utmost precedence and opportunity for socioeconomic development in every stratum of society. The inexorable approach has given birth to an instructive plethora that is impracticable for the conventional system to cover. The initiation of education over the Internet appeared as an elucidation, but the same has been unable to completely eradicate the dual competencies of accentuating needs and quickly transforming didactic matter. The present technological advancement in terms of learning has made a huge impact on convenience, suitability, affordability, and profusion;however, it lacks in certain crucial areas. This study aims to contemplate about the prospects and obstacles faced by the South Asian countries with special reference to India. It also examines the relevance and expansion of e-learning during the moment of COVID-19 when physical interaction is strictly avoided.
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Background: The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup provides a weak conditional recommendation in support of hemodialysis (HD) for select patients with severe phenytoin poisoning. Despite this recommendation, the HD clearance of phenytoin is poorly studied. We present a patient who developed phenytoin toxicity that was treated with hemodialysis and report on the efficacy of phenytoin removal during HD. Case report: An 87-year-old man with epilepsy who was maintained on a stable dose of 300mg phenytoin extended-release daily was admitted to the hospital for treatment of Coronavirus Disease 2019 and congestive heart failure. On hospital day 14, the patient had a gradual onset of depressed mental status with hypothermia (nadir 35 degrees Celsius). At this time, he had a rising total blood phenytoin concentration (peak 49.3 mcg/mL [therapeutic 10-20mcg/mL] with an albumin of 3.8 g/dL [normal 3.4-5.4 g/dL]). The patient's other medications included furosemide, aspirin, atorvastatin, digoxin, doxycycline, metoprolol tartrate, and warfarin;he was also receiving albumin and crystalloid for hypovolemia (albumin nadir on hospital day 14: 2.5 g/dL). Free phenytoin concentrations were not available. Alternate etiologies of hypothermia (endocrine, infectious) were excluded. The Poison Control Center was consulted and recommended HD because of the concern for prolonged coma, as per EXTRIP guidelines. The patient received three sessions of HD over a period of 6 days at 2.5-3 h per session using an F160 Optiflux membrane filter (Fresenius Medical Care, Waltham, MA, USA), with a blood flow rate of 350mL/min and a dialysate flow rate of 700mL/min. After the first session of HD (2.5 h) on hospital day 21, his hypothermia resolved and his phenytoin concentration fell from 39.2mcg/mL to 34.2 mcg/mL with only mild improvement in his mental status. After 6 days (hospital day 27), his phenytoin concentration decreased to 19.5 mcg/mL and his mental status normalized. Effluent from the first HD session had phenytoin concentrations below the limit of detection (0.50mcg/mL). Thus, no greater than 52mg of phenytoin was removed during a 2.5-h session of hemodialysis. Discussion(s): The reason for the sudden increase in blood phenytoin concentrations in this patient is unclear in the absence of drug-drug interactions or dosing changes to the phenytoin. Although uncommonly reported, patients with phenytoin toxicity can experience hypothermia. In this case, the patient's hypothermia resolved during HD, although it is unclear if this was related to changes in phenytoin concentration or (more likely) direct extracorporeal warming via the HD machine. If the patient's phenytoin clearance from the first session were extrapolated to subsequent sessions an estimated maximum of 166.4mg of phenytoin would be removed in 8 total hours of HD, which is far less than previously reported phenytoin clearances on the order of grams. This difference may be related to the use of high cutoff dialysis membranes in prior studies, which are not routinely used. Conclusion(s): Although HD rapidly resolved this patient's hypothermia, a minimal amount of phenytoin was recovered in the patient's dialysate. Prior studies suggesting consequential clearance and efficacy of phenytoin removal by extracorporeal treatment may not apply to routine HD methods. Further studies on the utility of extracorporeal treatment for phenytoin toxicity are needed.
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SESSION TITLE: Late Breaking Pulmonary and Education Topics Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/18/2022 01:30 pm - 02:30 pm PURPOSE: Healthcare professionals working in intensive care units (ICU) report high burnout levels, especially during the COVID-19 pandemic. Residents are particularly at risk for burnout and sleep deprivation, associated with increased medical errors. However, the relationship between sleep, burnout, and psychomotor vigilance has not been extensively studied in residents working in the medical ICU. METHODS: Fifty residents rotating in the ICU at an academic, tertiary care center were recruited for a prospective controlled trial during a consecutive four-week period from August 2021 – May 2022. Study parameters for two weeks in non-ICU rotations were compared with two week during ICU rotation. Residents wore a wearable sleep tracker for two weeks before and during their ICU rotation. ICU rotation dates were randomized based on a fixed annual schedule. Residents ranged in post-graduate training years one through four. Specialties included internal medicine, transitional year, emergency medicine, anesthesia, and medicine/pediatrics combined residency. Data collected included the Oldenburg burnout inventory score, Epworth Sleepiness Scale (ESS), a computer-based psychomotor vigilance test, American Academy of Sleep Medicine sleep diary, and wearable sleep tracker data. Statistical analysis was performed in Excel and R statistical software. RESULTS: Total sleep minutes detected by the wearable sleep-tracker decreased from 402 minutes (95% CI: 377-427) before ICU to 389 minutes (95%CI: 360-418) during ICU (p<0.05). Residents overestimated the amount of sleep they obtained via their validated daily log at 464 (95% CI: 452-476) minutes before ICU and 442 (95% CI: 430-454) minutes during ICU, which reflected a decrease in sleep of 22 minutes (p<0.02). ESS increased significantly from 5.93 (95% CI: 4.89, 7.07) before to 8.33 (95% CI: 7.09,9.58) during ICU (p<0.01). Oldenburg burnout inventory scores significantly increased during ICU by 8.30 (p<0.001). The total score before ICU was 34.50 (95% CI: 32.87-36.15) and after was 42.82 (95% CI: 40.65-44.98). Exhaustion and disengagement sub-scores significantly increased during ICU (3.94, 4.64, respectively;p<0.001). Interestingly, psychomotor vigilance testing scores showed no significant difference during ICU. CONCLUSIONS: ICU rotations are associated with significantly reduced sleep as objectively measured by sleep wearable and decreased self-reported sleep minutes. Residents overestimate the amount of sleep they obtain. Significant worsening of ESS was noted along with increased burnout in residents working in the ICU. Interestingly, the psychomotor testing remains unchanged. Further research is needed in this area to better understand this phenomenon. CLINICAL IMPLICATIONS: Residents may benefit from increased mandatory wellness events or days off to combat burnout and fatigue while in the ICU. DISCLOSURES: No relevant relationships by Varun Badami No relevant relationships by Danielle DeCicco No relevant relationships by Abhinav Mittal No relevant relationships by Christopher Pham No relevant relationships by Steven Sagun No relevant relationships by Sunil Sharma No relevant relationships by Robert Stansbury No relevant relationships by Jesse Thompson
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SESSION TITLE: Cardiovascular Complications in Patients with COVID-19 SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/19/2022 12:45 pm - 1:45 pm INTRODUCTION: Pneumopericardium is the presence of air or gas in the pericardial space, usually secondary to blunt or penetrating trauma. Most pneumopericardium are non-tension. The use of positive pressure ventilation (PPV) increases the chances of developing a tension pneumopericardium. We report the case of a 22-year-old male patient admitted for COVID-19 pneumonia who developed pneumopericardium with cardiac tamponade features. CASE PRESENTATION: A 22-year-old male was admitted for acute respiratory distress syndrome due to COVID-19 pneumonia and required intubation on hospital day 10. The next day, he became febrile with new leukocytosis. A chest x-ray showed new extensive pneumomediastinum and pneumopericardium. Vasopressor support and broad-spectrum antibiotics were started for septic shock, however he continued to decompensate rapidly, requiring maximal medical support. His arterial line waveform showed pulsus paradoxus, leading to concern for underlying tension pneumopericardium. Bedside echo was unrevealing as imaging was obstructed by the air in pericardial sac. The patient was too unstable for a CT scan of the chest. After extensive discussion with his family, he was placed on palliative measures only and expired. DISCUSSION: Pneumopericardium is due to an abnormal connection between the pericardial space and a source of air or gas. Levin and Macklin describe three main mechanisms by which this connection can be made. The first: acute rises in alveolar pressure and volume or ventilator associated lung injury leading to rupture of alveoli with gas tracking along perivascular and peri bronchial sheaths to the mediastinum. The second: macro-perforation of the pericardial space leading to communication with respiratory or gastrointestinal tracts. Third: existence of a pneumothorax in the presence of traumatic pericardial tear or congenital pleuro-pericardial connection. Spontaneous pneumopericardium without any anatomic connection is rare and is due to a direct extension of infectious etiologies of the lungs or by an infection of the pericardial space with gas forming bacteria. A tension pneumopericardium causing cardiac tamponade can develop from pneumopericardium with PPV where the pericardial sac acts as a shutter valve letting air in but not out as has been reported sparingly in the literature. Cummings et al described 93 patients who developed tamponade out of 252 patients with pneumopericardium. Our patient possibly developed a pleuro-pericardial tract secondary to his pneumonia. With continued PPV his simple pneumopericardium likely developed into a tension pneumopericardium evidenced by arterial waveforms consistent with pulsus paradoxus, worsening hypotension despite maximal vasopressor support and development of ventricular tachycardia. CONCLUSIONS: Our case highlights the importance of considering pneumopericardium causing cardiac tamponade in the setting of mechanical ventilation. Reference #1: Mindaye ET, Arayia A, Tufa TH, Bekele M. Iatrogenic pneumopericardium after tube thoracostomy: A case report. Vol. 76, International journal of surgery case reports. 2020. p. 259–62. Reference #2: Cummings RG, Wesly RL, Adams DH, Lowe JE. Pneumopericardium resulting in cardiac tamponade. Ann Thorac Surg. 1984 Jun;37(6):511–8. Reference #3: Levin AI, Visser F, Mattheyse F, Coetzee A. Tension pneumopericardium during positive-pressure ventilation leading to cardiac arrest. J Cardiothorac Vasc Anesth. 2008 Dec;22(6):879–82. MACKLIN CC. TRANSPORT OF AIR ALONG SHEATHS OF PULMONIC BLOOD VESSELS FROM ALVEOLI TO MEDIASTINUM: CLINICAL IMPLICATIONS. Arch Intern Med [Internet]. 1939 Nov 1;64(5):913–26. Available from: https://doi.org/10.1001/archinte.1939.00190050019003 DISCLOSURES: No relevant relationships by Aarti Mittal No relevant relationships by Beenish Naqvi
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Background & Aims: Prior studies have indicated the presence of hepatic inflammation (as signified by elevated liver function test (LFT) values), as conferring an escalated risk toward adverse outcomes in patients admitted with COVID-19. In line with this hypothesis, we study the various thresholds of LFTs and its associated prognostic risks toward COVID- 19 related hospital deaths Method: This was a single-center retrospective study involving patients admitted with COVID-19. Univariate Cox regression analysis identified the LFT variables significantly associated with our primary endpoint, in-hospital death. Subsequently, 500 iterations of thresholds were generated for each biomarker to estimate the prognostic relationship between biomarker and endpoint. Multivariate Cox regression and event-analyses were performed for each threshold to identify the minimal cutoffs at which the prognostic relationship was significant. Event curves were drawn for each significant relationship. Results: A total of 858 patients with COVID-19 were included with a median follow-up time of 5 days from admission. From the total, 90 patients passed away during admission (10.5%). The deceased cases were more likely to be older (66.2 vs 55.3y p<0.001);however, there was no difference in gender (male: 66 vs 56.2% p=0.11). Between the cases and controls (no-death), deceased cases had higher incidence of nonalcoholic fatty liver disease (7.78 vs 2.99% p=0.042), COPD (18.9 vs 7.80% p=0.001), lung cancer (4.44 vs 0.65% p= 0.009), ICU admissions (81.1 vs 26% p<0.001), and intubation events (84.4 vs 19.5% p<0.001), however there was no difference in alcohol use (21.1 vs 30.6% p=0.083) and alcoholic liver disease (5.56 vs 2.08% p=0.097). Upon univariate Cox analysis, the following LFT parameters were associated with in-hospital death: Bilirubin (p<0.001), AST (p<0.001), ALT (p<0.001). However, alkaline phosphatase (p=0.449) was not associated with the primary endpoint. The iterations of event regression analyses using 500 sequences of LFT thresholds showed the following cutoffs to be significantly associated with in-hospital death (minimally significant values): ALT (281.71 IU/L), AST (120.94 IU/L), bilirubin (2.615 mg/ dL). On the multivariate analysis, while controlling for demographics and cardiopulmonary/ medical comorbidities, the following adjusted hazard ratios were derived for each cutoff: ALT (aHR: 6.43 95%CI 1.85-22.40), AST (aHR: 3.35 95%CI 1.84-6.11), and bilirubin (aHR: 2.77 95%CI 1.15-6.65). Conclusion: The delineated cutoffs for AST, ALT, and bilirubin levels can serve as clinical benchmarks to help determine when a COVID-19 infection poses significant risk. Given this finding, the cutoffs can be used as part of a risk assessment for patients to support early preventative therapies and medical management. (Table Presented)
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Background and Aims: While the relationship between elevated liver enzymes and COVID- 19 related adverse events is well-established, a liver-dependent prognostic model that predicts the risk of death is helpful to accurately stratify admitted patients. In this study, we use a bootstrapping-enhanced method of regression modeling to predict COVID-19 related deaths in admitted patients. Method: This was a single-center, retrospective study. Univariate and multivariate Cox regression analyses were performed using 30-day mortality as the primary endpoint to establish associated hepatic risk factors. Regression-based prediction models were constructed using a series of modeling iterations with an escalating number of categorical terms. Model performance was evaluated using receiver operating characteristic (ROC) curves. Model accuracy was internally validated using bootstrapping-enhanced iterations. Results: 858 patients admitted to hospital with COVID-19 were included. 78 were deceased by 30 days (9.09%). Cox regression (greater than 20 variables) showed the following core variables to be significant: INR (aHR 1.26 95%CI 1.06-1.49), AST (aHR 1.00 95%CI 1.00- 1.00), age (aHR 1.05 95%CI 1.02-1.08), WBC (aHR 1.07 95%CI 1.03-1.11), lung cancer (aHR 3.38 95%CI 1.15-9.90), COPD (aHR 2.26 95%CI 1.21-4.22). Using these core variables and additional categorical terms, the following model iterations were constructed with their respective AUC;model 1 (core only): 0.82 95%CI 0.776-0.82, model 2 (core + demographics): 0.828 95%CI 0.785-0.828, model 3 (prior terms + additional biomarkers): 0.842 95%CI 0.799-0.842, model 4 (prior terms + comorbidities): 0.851 95%CI 0.809-0.851, model 5 (prior terms + life-sustaining therapies): 0.933 95%CI 0.91-0.933, model 6 (prior terms + COVID-19 medications): 0.934 95%CI 0.91-0.934. Model 1 demonstrated the following parameters at 0.91 TPR: 0.54 specificity, 0.17 PPV, 0.98 NPV. Bootstrapped iterations showed the following AUC for the respective models: model 1: 0.82 95%CI 0.765-0.882, model 2 0.828 95%CI 0.764-0.885, model 3 0.842 95%CI 0.779-0.883, model 4: 0.851 95%CI 0.808-0.914, model 5: 0.933 95%CI 0.901-0.957, model 6: 0.934 95%CI 0.901- 0.961. Conclusion: Model 1 displays high prediction performance (AUC >0.8) in both regression-based and bootstrapping-enhanced modeling iterations. Therefore, this model can be adopted for clinical use as a calculator to evaluate the risk of 30-day mortality in patients admitted with COVID-19. (Table Presented)
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chronic health risks have risen among young individuals due to several factors such as sedentary lifestyle, poor eating habits, sleep irregularities, environmental pollution, workplace stress etc. The problem seems to be more menacing in the near future, with the exacerbation of lifestyle conditions and unforeseen breakout of pandemics such as COVID-19. One possible solution is thus to design health risk prediction systems which can evaluated some critical features of parameters of the individual and then be able to predict possible health risks. As the data shows large divergences in nature with non-correlated patterns, hence choice of machine learning based methods becomes inevitable to design systems which can analyze the critical factors or features of the data and predict possible risks. This paper presents an ensemble approach for health risk prediction based on the steepest descent algorithm and decision trees. It is observed that the proposed work attains a classification accuracy of 93.72%. A simple graphic user interface has also been created for the ease of use and interaction and for prototype testing. © 2022 IEEE.
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Indian m-health app Aarogya Setu has made a significant contribution in terms of contactability tracing and disease management during the initial days of the COVID-19 pandemic, with its contact tracking approach to infectious individuals and its health tips for eliminating new coronaviruses. The goal of this study is to forecast whether or not Indian consumers will continue to use this app. According to previous studies, the context or setting has a substantial impact on the customer's perceived value. The current study's unique setting is to investigate the parameters impacting Indians' ongoing use of the mobile mHealth app AarogyaSetu. An extended technology adoption model (TAM) has been proposed and tested to achieve this wide goal, with the addition of three additional constructs: social influence, health consciousness, and trust in the app developer. © 2021 IEEE.
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Purpose: This study aims to identify how ICT appeared as an emergent business strategy and to investigate the impact of ICT adoption factors on the perceived benefits of micro, small and medium enterprises (MSMEs). Design/methodology/approach: A total of 393 responses from Indian small and mid-size enterprises (SMEs) were collected for the final analysis. The study presents the partial least-squares structural equation modeling with the Chi-square test and descriptive analysis as a methodology based on numerous independent variables and one dependent variable. Findings: The findings indicate that ICT adoption during and following the COVID-19 pandemic is constant in nature of the enterprise. Moreover, the results indicate that different adoption of ICT factors influence on perceived benefits of organizational performance of Indian MSMEs that lent good support except for the regulatory framework. Research limitations/implications: The implications of the current research help Indian MSMEs to take investment decisions in various technologies that help the organization. Furthermore, managers and practitioners help the organization in deciding which technology adoption factors are more critical to the betterment of the organization. Originality/value: The study found certain ICT adoption factors that have a significant role in organizational performance in Indian MSMEs. Moreover, during COVID-19, investigate ICTs' role as a business strategy. © 2022, Emerald Publishing Limited.
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Covid-19 has thrown a lot of challenges to address the gaps in our existing healthcare ecosystem, especially in the remote areas, where providing quality healthcare services is a challenge. Digital healthcare or the internet of medical things(IOMD) is viewed as a new age weapon to provide healthcare services to the masses at an affordable price. One such way is by connecting the end-user with physicians through mobile applications or devices, however, this demands thorough research and validation to understand the underlying needs of the users and physicians interacting in this connected eco-system Through this study, we intend to probe and analyze the role of user interaction and user experience (UI/UX) in discovering the features and services provided through connected devices and mobile applications and their subsequent usage over a prolonged period of time. This study aims to present a theoretical framework utilizing the UTAUT-2 framework to hypnotize the identified problem statement. © The Electrochemical Society
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Purpose COVID-19 pandemic has exposed that even the best of the developed nations have surrendered to the devastations imposed on the global supply chains. The purpose of this study is to explore how COVID-19 has exaggerated the supply chain of production and distribution of Taiwan-based face masks and also investigate the conscientious factors and subfactors for it. Design/methodology/approach In this study, an analytical hierarchy processes (AHP)-based approach has been used to assign the criterion weights and to prioritize the responsible factors. Initially, based on 26 decision-makers, successful factors were categorized into five main categories, and then main categories and their subcategories factors were prioritized through individual and group decision-maker's contexts by using the AHP approach. Findings The results of this AHP model suggest that "Safety" is the most important and top-ranked factor, followed by production, price, work environment and distribution. The key informers in this study are stakeholders which consist of managers, volunteers, associations and non-governmental organizations. The results showed that good behavior of the employees under the "Safety" category is the top positioned responsible factor for successful production and distribution of face masks to the other countries with the highest global percentage of 15.7% and using sanitizers to protect health is the second most successful factor with the global percentage of 11.7%. Research limitations/implications The limitations faced in this study were limited to only Taiwan-based mask manufacturing companies, and it was dependent on the decisions of the limited company's decision-makers. Originality/value The novelty of this study is that the empirical analysis of this study has been based on a successful Taiwan masks manufacturing company and evaluates the responsible factors for the production and distribution of Taiwan masks to other countries during COVID-19.
ABSTRACT
Introduction & Objectives: The current coronavirus disease 2019 (COVID-19) pandemic is creating huge pressure on our health care systems and has led to dramatic changes in our daily lives. Many countries have enforced strict controls on movement and socializing in an effort to manage the pandemic. Both, in-patient and out-patient care has been affected. There is big gap between health care service providers and patients and because of that many people are suffering. But telemedicine appears to be only bridge between them so that patients can get maximum benefit from the experts. This study is being conducted to know the worth of telemedicine in urology during ongoing COVID pandemic and for future prospect. Materials & Methods: All the patients who made a call on telemedicine contact number of department of urology of our tertiary care hospital and took advice for their treatment or follow up from April 2020 to December 2020, were included in this prospective observational study. Patients contacted us through various modalities like Voice/video call, WhatsApp chat, messages. Patients who contacted us for non-urological problem were excluded. All calls were answered by Professional Urologist and advice was given verbally as well as sent them in written on a prescription slip through WhatsApp. Data collection included age, sex, place, symptoms and advice given. Results: During the study period, we received 1102 calls from the patients of North India, 124 patients were excluded for being non-urological and 978 patients were included. 94% patients contacted us through voice call, 4% through video call and 2% through chat only. Average duration of call was 16 minutes and 25 seconds. 68% patients were males, while 32% females. 54% patients were younger than 40 years and only 15% were elder than 60 years. Common reasons for calling us were- urinary tract infection (23%), lower urinary tracts symptoms (21%), renal stone disease (17%), haematuria (11%), post-operated cases (11%) and sexual problems (7%). Approximately 16% patients had some urological malignancy. Only 18% patients contacted us for acute illness of duration <1 week, while 47% patients were sick for >4 weeks. 18% patients needed only counselling for their disease, 65% required prescription and conservative management. 17% patients were requiring in-hospital management so referred to nearby urological center for urgent intervention or care. None of the patients had any problem in getting medications from pharmacy. Conclusions: Telemedicine provides specialized clinical support for urologists and patients just by using mobile phones, as a logistically feasible alternative to face-to-face consultation. 83% of cases were successfully managed just by telemedicine and very useful for reducing the risk of transmission of COVID-19 infection. This novel way of urological practice should be continued in future to reduce unnecessary visits to medical facilities even after this pandemic.
ABSTRACT
Introduction & Objectives: Patients are often given printed information leaflets as part of informed consent for a procedure or explanation of their condition. Challenges of the COVID-19 pandemic and restrictions on face-to-face (F2F) consultations have required alternative methods ofdistributing information. We evaluated frequency of patient information leaflet use;preliminary cost benefit of electronic methods;and effectivenessof using QR codes to access digital leaflets.Materials & Methods: An international online survey of Urologists was distributed, and leaflet costs were estimated. QR codes were generated forcommonly used British Association of Urological Surgeons (BAUS) patient information leaflets and were incorporated into a poster for display in theoutpatient department. Evaluation of poster use was sought from patients through a questionnaire.(Figure Presented)Results: 108 Urologists responded to the initial survey, 44% of whom were Consultant grade. 54% provided >50% of patients with an information leaflet during F2F clinics. During transition to telephone clinics, this fell to 33% during the COVID-19 pandemic. Instead, 47% patients were provided with an internet link or directed to search engine terms in the clinical letter, instead of a printed leaflet. In a F2F clinic, each leaflet costs 40p to print, using a departmental model of 25 clinics/week, each clinician seeing 12 patients, if 53% receive a leaflet, the cost saving could be £3,307per year. In response to the QR codes poster for digital provision of patient leaflets, in a patient population mostly male (82%) and older (60%between 60-80 years), 40% were familiar with QR codes and 73% could access the internet on a personal smartphone. 53% reporting using theirsmartphone to find information, 46% found the poster easy to use or follow, and 61% found it informative.Conclusions: Patient information leaflets are important for a Urologists’ practice, frequently distributed, and printed forms can be costly. Providingpaperless digital leaflets via a QR code offers many benefits including being cost-effective, touch-free, was well received by patients and haspotential to increase patient engagement and education. Patient perception varies with age group and smartphone usage, therefore may not besuitable for all patient groups. This use of QR codes to provide direct access to digital patient information can be easily applied to other societiesand specialties