Exploration of hybrid deep learning algorithms for covid-19 mRNA vaccine degradation prediction system

Coronavirus causes a global pandemic that has adversely affected public health, the economy, including every life aspect. To manage the spread, innumerable measurements are gathered. Administering vaccines is considered to be among the precautionary steps under the blueprint. Among all vaccines, the messenger ribonucleic acid (mRNA) vaccines provide notable effectiveness with minimal side effects. However, it is easily degraded and limits its application. Therefore, considering the cruciality of predicting the degradation rate of the mRNA vaccine, this prediction study is proposed. In addition, this study compared the hybridizing sequence of the hybrid model to identify its influence on prediction performance. Five models are created for exploration and prediction on the COVID-19 mRNA vaccine dataset provided by Stanford University and made accessible on the Kaggle community platform employing the two deep learning algorithms, Long Short-Term Memory (LSTM) as well as Gated Recurrent Unit (GRU). The Mean Columnwise Root Mean Square Error (MCRMSE) performance metric was utilized to assess each model's performance. Results demonstrated that both GRU and LSTM are befitting for predicting the degradation rate of COVID-19 mRNA vaccines. Moreover, performance improvement could be achieved by performing the hybridization approach. Among Hybrid_1, Hybrid_2, and Hybrid_3, when trained with Set_1 augmented data, Hybrid_3 with the lowest training error (0.1257) and validation error (0.1324) surpassed the other two models;the same for model training with Set_2 augmented data, scoring 0.0164 and 0.0175 MCRMSE for training error and validation error, respectively. The variance in results obtained by hybrid models from experimenting claimed hybridizing sequence of algorithms in hybrid modeling should be a concerned. © 2022, Universitas Ahmad Dahlan. All rights reserved.

Does the Covid-19 Pandemic Have an Impact on the Care of Acute Appendicitis (Aa) in Children?

BACKGROUND AND AIM: The coronavirus disease 2019 (COVID-19) has deepened the existing health inequalities and has limited access to health services. The aim of this study was to assess the impact of the COVID-19 pandemic on the care of AA in children at a single institution in Sfax, Tunisia. METHOD(S): We divided our patients into two groups: the first (COVID group) included patients who had surgery during covid-19 pandemic (between March 02, 2020, and December 31, 2020), while the second (pre-COVID group) included those who had appendectomy before the pandemic (between March 02, 2019, and December 31, 2019). RESULT(S): A total of 275 patients were included. The COVID-19 group included 136 patients and the pre- COVID-19 group 139 patients. Multivariate logistic analyses revealed that time from onset of abdominal pain to arrival to the emergency department was higher in COVID group patients (36 [24-48] hours vs 30 [12-48] hours, p-value = 0.023). Patients undergoing surgery during the COVID era had a significantly higher Alvarado score (7 [5-8] vs 6 [5-7], p value = 0.002). We have found no differences between the two study groups with respect to outcomes including length of hospital stay, re-admission rate, re-operation rate, and postoperative complications rate. CONCLUSION(S): this is the first study, in Tunisia, to assess the impact covid-19 pandemic on the care of AA in children. We suggest that strategies should be implemented to educate parents and to encourage them to seek for an emergent care of potentially serious conditions such as AA.

Differences in Prevalence of Haematological Abnormalities on Presentation to Hospital in COVID 19 Infected adult and Paediatric Patients: A Retrospective Multicenter Descriptive Study

Background: It is well known that COVID 19 infection affects multiple systems in the body. Reports have documented many changes in the hematopoietic system in the pathophysiology of the disease. Aim: The aim of the study was to find out the prevalence and any significant difference in routine haematological parameters on presentation in Paediatric and adult patients with COVID 19 infection. Methodology: We conducted a multicenter retrospective descriptive observational study and investigated the prevalence of haematological abnormalities at presentation of 1000 PCR swab confirmed COVID 19 infected randomly selected adult and Paediatric patients admitted to 3 tertiary hospital in Dubai. Data was gathered through their electronic medical records and all analysis was done using the Statistical Package for the Social Sciences software (SPSS). Results: The prevalence of at least one abnormal haematological parameter was 95.1% (794/835) on first presentation to the hospital. After adjusting of age and gender the prevalence of any white cell abnormality was 34.7% (290/835) (5.7% leukopenia, 9.6% leucocytosis, 25.4% lymphopenia, 5.5% neutropenia, 16.4% had neutrophilia, 7.3% monocytosis, and 1.2% eosinopenia). A prevalence of 15.3% (128/835) anaemia, 9.5% (79/835) thrombocytopenia and 4.3% (36/ 835) thrombocytosis was also observed. The prevalence of other abnormal blood parameters: C reactive protein 69.5%(573/835), D dimer 57.5% (280/835), high LDH 52%(383/835), high ferritin 72.1%(452/835), high INR 5.1%(38/835), prolonged PT 32.2% (240/835), and prolonged APTT 35.6%(264/835). A significant difference in prevalence of these abnormalities was evident between adult and Paediatric population, these abnormalities were much more prevalent in adults but interestingly paediatric population tended to have higher incidence of neutropenia, eosinophilia and monocytosis (p<0.001). Conclusion: The effects of COVID 19 infection are different in adult and paediatric patients. Many mechanisms have been hypothesized for this observation. This study revealed another less studied and interesting variation in the manifestation among the two populations.

Challenges to education during the COVID-19 pandemic: A SIDS perspective with special reference to the situation in the Maldives

In the wake of the COVID-19 pandemic, which emerged in 2019 in China, countries worldwide have been grappling with the numerous challenges required of them to protect their citizens and respond to the consequences of multiple lockdowns on the global economy and their education systems. The devastating socio-economic impact is apparent worldwide, but Small Island Developing States (SIDS) have been identified as some of the most vulnerable contexts. In this paper, we build on the international literature and discourse on SIDS, giving special consideration to the context of the Maldives. We highlight the challenges to providing education in this Indian Ocean nation and the disproportionately negative impact of lockdown conditions on students’ learning. In the light of original field research carried out with school principals, teachers, students, and parents, we identify and discuss how learners and schools coped with a rapid change to online schooling. In doing so, we highlight what has been achieved and how the pandemic has contributed to the widening disparity between urban and rural schools. Our findings point to the importance of SIDS governments having contingency plans in place to manage education in socially just and equitable ways during emergencies. © This work is licensed under the Creative Commons Attribution-NoDerivatives 4.0 International License. To view a copy of this license

Remdesivir for patients with Coronavirus disease 2019 pneumonia requiring high oxygen support.

BACKGROUND: Treatment options for patients with critical Coronavirus Disease 2019 (COVID-19) are limited. This study aimed to describe the clinical characteristics and outcomes associated with remdesivir therapy in patients with COVID-19 who require non-invasive (NIV) ventilation or invasive mechanical ventilation (IMV). METHODS: Data were retrospectively extracted for adults with COVID-19 confirmed using polymerase chain reaction (PCR) between August 1, 2020 and January 28, 2021 who received ≥ 48 hours of remdesivir therapy while on NIV or IMV. Clinical improvement was defined as two-category improvement on an eight-point ordinal severity scale. RESULTS: A total of 133 individuals were included, of which 114 (85.7%) were on NIV and 19 (14.3%) were on IMV at the time of remdesivir initiation. The majority of the patients were males (62.4%), and the median age was 56 years. All the patients received concomitant dexamethasone therapy. Remdesivir treatment was commenced after a median of 7 days from onset of symptoms and was continued for a median of 5 days. Clinical improvement within 28 days was achieved in 101 patients (75.9%); among which, 78.1% and 63.2% were subjected to baseline NIV and IMV, respectively. Among the 11 (8.3%) patients who died of any cause by day 28, 9 (7.9%) and 2 (10.5%) were subjected to baseline NIV and IMV, respectively. The most frequent adverse events were sinus bradycardia (21, 13.1%) and alanine transaminase increase (18, 11.3%). Almost all adverse events were classified as Grades 1-3. CONCLUSION: The use of remdesivir in combination with systemic corticosteroids is associated with high recovery rates and low all-cause mortality in patients with COVID-19 pneumonia who require NIV or IMV. The results need confirmation from clinical trials of appropriate design and size.

Incidence and significance of vitamin d deficiency at inflammatory bowel disease inception in the covid era

Background: Vitamin D, a key regulator of immune response, is known to be lower in Inflammatory Bowel Disease (IBD) patients than the general population. Disparity in the incidence of deficiency between ethnic groups has previously been demonstrated. We measured vitamin D in a unique multi-ethnic inception cohort to correlate this with traditional IBD scores and patient reported outcome measures including the 'IBD Disk'. Methods: Data regarding demographics, ethnicity, faecal calprotectin (FCAL) and baseline blood results including Vitamin D was collected prospectively from January-October 2021, from adults presenting with suspected IBD. Montreal classification, Harvey-Bradshaw Index or Partial Mayo score, endoscopic disease severity indices and IBD Disk score were documented in those with confirmed diagnosis at endoscopy. Vitamin D deficiency was defined as <50nmol/l. Results: 179 patients had a Vitamin D level recorded;58 Ulcerative colitis (UC), 58 Crohn's disease (CD), 53 non-IBD controls and 10 still awaiting diagnosis. 44(76%) CD, 32(55%) UC and 28(53%) non-IBD control patients were Vitamin D deficient at first presentation. Median levels were lowest in CD, with a significant difference between CD and non-IBD (median 35nmol/l;IQR 24.05 vs. median 48.9nmol/l;IQR 49.1;p=0.004). Regression analysis demonstrated patients with Crohn's disease were four times more likely to have Vitamin D deficiency compared to UC (OR 4.08;95% CI 1.35-12.36) at diagnosis. No correlation was seen between absolute vitamin D levels or vitamin deficiency state and faecal calprotectin when controlled for various factors regardless of the IBD subtype. The cohort distributions are demonstrated in Figure 1. Within the IBD cohort, Vitamin D levels were significantly lower in Black or Asian patients vs White patients (median 28.5;IQR 20.85 vs median 43.3;IQR 33.95;p=0.004). Figure 2 provides an overview of the cohort distributions. Vitamin D levels at presentation, as demonstrated in Table 1, did not correlate with Disease activity markers (DAMS) whereas baseline haemoglobin did, albeit weakly. Interestingly, Vitamin D and Haemoglobin correlated without reaching statistical significance (Spearman's rho 0.149;p=0.08). Conclusion: Our inception dataset demonstrates high rates of Vitamin D deficiency comparable to prior studies in IBD patients. Both CD and Black or Asian ethnicity were strongly associated with Vitamin D deficiency. Baseline Vitamin D did not correlate with disease activity markers whereas anaemia showed consistent weak association. Our study demonstrates the problem of hypovitaminosis D and the importance of measurement and supplementation, particularly in Black and Asian CD patients, from diagnosis.

Central Taurine Attenuates Hyperthermia and Isolation Stress Behaviors Augmented by Corticotropin-Releasing Factor with Modifying Brain Amino Acid Metabolism in Neonatal Chicks.

The objective of this study was to determine the effects of centrally administered taurine on rectal temperature, behavioral responses and brain amino acid metabolism under isolation stress and the presence of co-injected corticotropin-releasing factor (CRF). Neonatal chicks were centrally injected with saline, 2.1 pmol of CRF, 2.5 µmol of taurine or both taurine and CRF. The results showed that CRF-induced hyperthermia was attenuated by co-injection with taurine. Taurine, alone or with CRF, significantly decreased the number of distress vocalizations and the time spent in active wakefulness, as well as increased the time spent in the sleeping posture, compared with the saline- and CRF-injected chicks. An amino acid chromatographic analysis revealed that diencephalic leucine, isoleucine, tyrosine, glutamate, asparagine, alanine, ß-alanine, cystathionine and 3-methylhistidine were decreased in response to taurine alone or in combination with CRF. Central taurine, alone and when co-administered with CRF, decreased isoleucine, phenylalanine, tyrosine and cysteine, but increased glycine concentrations in the brainstem, compared with saline and CRF groups. The results collectively indicate that central taurine attenuated CRF-induced hyperthermia and stress behaviors in neonatal chicks, and the mechanism likely involves the repartitioning of amino acids to different metabolic pathways. In particular, brain leucine, isoleucine, cysteine, glutamate and glycine may be mobilized to cope with acute stressors.

Successful pilot of DIAL digital & interventionless gas lift production optimization system offshore Malaysia

Objectives/Scope: This paper describes a pilot installation of a digital intelligent artificial lift (DIAL) gas lift production optimization system. The work was inspired by PETRONAS' upstream digitalization strategy with five single and dual-string gas lift completions planned from 2018 to 2020, offshore Malaysia. The authors evaluate the impact of the DIAL system in terms of increasing production, optimizing lift-gas injection, reducing well intervention frequency, as well as OPEX and risk reduction. Methods, Procedure, Process: DIAL is a unique technology that enhances the efficiency of gas lift production. Downhole monitoring of production parameters informs remote surface-controlled adjustment of gas lift valves. This enables automation of production optimization removing the need for well intervention. The paper focuses on a well installed in June 2020, the first in a five well campaign. The authors will provide details of the technology, and pilot program phases: system design;pre-job preparations;run in hole and surface hook-up;commissioning and unloading;and subsequent production operations. For each phase, challenges encountered, and lessons learned will be listed together with observed benefits. Results, Observations, Conclusions: DIAL introduces a paradigm shift in the design, installation, and operation of gas lifted wells. This paper will compare the differences between this digital technology and conventional gas lift techniques. It will consider the value added from the design stage through installation operations to production optimization. The DIAL system's ability to operate at greater than 80-degree deviation enabled deeper injection while avoiding tractor interventions for GLV maintenance in the highly deviated section of the well. Built-in downhole sensors provided real-time pressure monitoring that enabled a better understanding of reservoir behaviour and triggered data-driven reservoir stimulation decisions. The technology also proved very beneficial for production optimization, with the intervention-less adjustment of gas injection rate and depth downhole, based on the observed reservoir response in real time. The variable port sizes can be manipulated by means of surface switch/control. Overcoming the completion challenges due to COVID-19 restrictions, the well was unloaded and brought online with the assistance of personnel located in Houston and Dubai using Silverwell's visualization software. The well continues to be remotely monitored and controlled ensuring continuous production optimization, part of PETRONAS' upstream digitization strategic vision. Novel/Additive Information: First deployment worldwide of new and unique gas lift production optimization technology in offshore highly deviated well. The technology deployment was the result of collaborative work between a multi-discipline engineering team in PETRONAS, Silverwell, and Neural Oilfield Service. © 2021, Society of Petroleum Engineers.

Analysis of the healthcare MERS-CoV outbreak in king Abdulaziz medical center, Riyadh, Saudi Arabia, June-August 2015 using a SEIR ward transmission model

Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging zoonotic coronavirus that has a tendency to cause significant healthcare outbreaks among patients with serious comorbidities. We analyzed hospital data from the MERS-CoV outbreak in King Abdulaziz Medical Center, Riyadh, Saudi Arabia, June-August 2015 using the susceptible-exposed-infectious-recovered (SEIR) ward transmission model. The SEIR compartmental model considers several areas within the hospital where transmission occurred. We use a system of ordinary differential equations that incorporates the following units: emergency department (ED), out-patient clinic, intensive care unit, and hospital wards, where each area has its own carrying capacity and distinguishes the transmission by three individuals in the hospital: patients, health care workers (HCW), or mobile health care workers. The emergency department, as parameterized has a large influence over the epidemic size for both patients and health care workers. Trend of the basic reproduction number (R0), which reached a maximum of 1.39 at the peak of the epidemic and declined to 0.92 towards the end, shows that until added hospital controls are introduced, the outbreak would continue with sustained transmission between wards. Transmission rates where highest in the ED, and mobile HCWs were responsible for large part of the outbreak.

Comparison of the clinical outcomes of non-invasive ventilation by helmet vs facemask in patients with acute respiratory distress syndrome.

ABSTRACT: The main aim of this study is to compare the use of non-invasive ventilation (NIV) via helmet versus face mask where different interfaces and masks can apply NIV. However, some of the limitations of the NIV face mask were air leak, face mask intolerance, and requirement of high positive end expiratory pressure, which could be resolved with the use of the helmet NIV. NIV facemask will be applied as per the facial contour of the patient. NIV helmet is a transparent hood and size will be measured as per the head size. Both groups will have a standard protocol for titration of NIV.Patients aged more than 18 years old and diagnosed with acute respiratory distress syndrome as per Berlin definition will be enrolled in the study after signing the informed consent. Subjects who met the inclusion criteria will receive 1 of the 2 interventions; blood gases, oxygenation status [Po2/Fio2] will be monitored in both groups. The time of intubation will be the main comparison factor among the 2 groups. The primary and secondary outcomes will be measured by the number of patients requiring endotracheal intubation after application of helmet device, Improvement of oxygenation defined as PaO2/FiO2 ≥ 200 or increase from baseline by 100, duration of mechanical ventilation via an endotracheal tube, intensive care unit length of stay, death from any cause during hospitalization at the time of enrolment, need for proning during the hospital stay, intensive care unit mortality, and the degree to which overt adverse effects of a drug can be tolerated by a patient including feeding tolerance. TRIAL REGISTRATION NUMBER: NCT04507802. PROTOCOL VERSION: May 2020.

Symptoms of psychological burden on health care providers regarding Covid-19

The COVID-19 pandemic has affected an increasing number of healthcare providers. However, they face vast physical and psychological challenges. Therefore, we assessed healthcare providers' symptoms of psychological burden concerning their response to the COVID-19 pandemic. A sample of healthcare providers completed the Depression Anxiety Stress Scale online. Analyses were performed on participants 'psychological burden symptoms since the COVID-19 outbreak. COVID-19 caused a relatively significant level of psychological burden among healthcare providers. Analyses showed that academic qualification was the main factor affecting this burden. Applying the online program could reduce the psychological burden on healthcare providers. (English) [ABSTRACT FROM AUTHOR] La pandemia de COVID-19 ha afectado a un número creciente de proveedores de atención médica. sin embargo, enfrentan grandes desafíos físicos y psicológicos. Por lo tanto, evaluamos los síntomas de carga psicológica de los proveedores de atención médica con respecto a su respuesta a la pandemia de COVID-19. Una muestra de proveedores de atención médica completó la Escala de estrés, ansiedad y depresión en línea. Se realizaron análisis de los síntomas de carga psicológica de los participantes desde el brote de COVID-19 que causó un nivel relativamente significativo de carga psicológica entre los proveedores de atención médica. Los análisis mostraron que la calificación académica fue el principal factor que incidió en esta carga. La aplicación del programa en línea podría reducir la carga psicológica en los proveedores de atención médica. (Spanish) [ABSTRACT FROM AUTHOR] Copyright of Utopia y Praxis Latinoamericana is the property of Revista de Filosofia-Universidad del Zulia 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 abstract 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 abstract. (Copyright applies to all Abstracts.)

Rapid detection of SARS-CoV-2 antibodies using electrochemical impedance-based detector.

Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was classified as a pandemic by the World Health Organization and has caused over 550,000 deaths worldwide as of July 2020. Accurate and scalable point-of-care devices would increase screening, diagnosis, and monitoring of COVID-19 patients. Here, we demonstrate rapid label-free electrochemical detection of SARS-CoV-2 antibodies using a commercially available impedance sensing platform. A 16-well plate containing sensing electrodes was pre-coated with receptor binding domain (RBD) of SARS-CoV-2 spike protein, and subsequently tested with samples of anti-SARS-CoV-2 monoclonal antibody CR3022 (0.1 µg/ml, 1.0 µg/ml, 10 µg/ml). Subsequent blinded testing was performed on six serum specimens taken from COVID-19 and non-COVID-19 patients (1:100 dilution factor). The platform was able to differentiate spikes in impedance measurements from a negative control (1% milk solution) for all CR3022 samples. Further, successful differentiation and detection of all positive clinical samples from negative control was achieved. Measured impedance values were consistent when compared to standard ELISA test results showing a strong correlation between them (R2=0.9). Detection occurs in less than five minutes and the well-based platform provides a simplified and familiar testing interface that can be readily adaptable for use in clinical settings.

Rapid Detection of SARS-CoV-2 Antibodies Using Electrochemical Impedance-Based Detector (preprint)

Emerging novel human contagious viruses and pathogens put humans at risk of hospitalization and possibly death due to the unavailability of vaccines and drugs which may take years to develop. Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was classified as a pandemic by theWorld Health Organization and has caused over 550,000 deaths worldwide as of July 2020. Accurate and scalable point-of-care devices would increase screening, diagnosis, and monitoringof COVID-19 patients. Here, we demonstrate rapid label-free electrochemical detection of SARS-CoV-2 antibodies using a commercially available impedance sensing platform. A 16-well plate containing sensing electrodes was pre-coated with receptor binding domain (RBD) of SARS-CoV-2 spike protein, and subsequently tested with samples of anti-SARS-CoV-2 monoclonal antibody CR3022 (0.1 g/ml, 1.0 g/ml, 10 g/ml). Subsequent blinded testing was performed on six serum specimens taken from COVID-19 and non-COVID-19 patients (1:100 dilution factor). The platformwas able to differentiate spikes in impedance measurements from a negative control (1~ milk solution) for all CR3022 samples. Further, successful differentiation and detection of all positive clinical samples from negative control was achieved. Measured impedance values were consistent when compared to standard ELISA test results showing a strong correlation between them (R2 = 0:9). Detection occurs in less than five minutes and the well-based platform provides a simplified and familiar testing interface that can be readily adaptable for use in clinical settings.