Online Fuzzy Logic Prediction of Electrical Load Based on Real-Time Measurements During the Covid-19 Pandemic

As technologies advance and the population grows, electrical energy became one of the necessities for many peoples. Because the availability of electrical energy is limited, it requires various ways to be used efficiently. Electrical load monitoring usage in Indonesia still require an electrical officer to come to an electric panel location to record electrical usage. During the COVID-19 pandemic, it is not feasible to locally visit an electric panel because of the many restrictions. Remote monitoring using Internet of Things (IoT) can be used to address the problem. Going further, by knowing the electrical load usage, prediction can be done using fuzzy logic as a way to understand how to use electricity efficiently. Thus, a fuzzy logic load forecasting system IoT is developed in this research. Fuzzy variables used in this system are time of day, days of the week, measured loads, and forecasted loads. The research produced a system that predicts electrical load with one hour of accuracy based on the previous week's data. The average prediction error rate of the system is 9.48%. The implemented system is available on a web server and can be accessed via a web browser, either via a computer or cellphone. The system allows users to monitor and predict electrical load usage regardless of time and place. © 2023, The authors.

EBUS audit: assessing the diagnostic performance of the service at UHL

Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an important diagnostic procedure in the lung cancer pathway. False-negative or inadequate sampling can lead to inaccurate staging or delay in diagnosis. This study was conducted to assess the performance of the Cancer EBUS service at a tertiary hospital. Method(s): We conducted a retrospective analysis of patients who underwent EBUS-TBNA for suspected cancer between 1st June 2021 to 31st May 2022. Request forms, CT reports, EBUS reports and pathology reports were reviewed for analysis. Result(s): 205 EBUS-TBNA procedures were performed. All patients had an appropriate staging CT prior to procedure. The mean time to test was 10.5 days (7.4). 77 (38%) had tests within 7 days of request. 293 lymph nodes and 10 mass lesions were sampled. The mean time to pathological results being received was 2.9 days (1.8). Final histology showed 39 (19%) cases of lung adenocarcinomas, 3 (1%) lung non-small cell carcinomas, 25 (12%) lung squamous cell carcinomas, 25 (12%) small cell cancers, 4 (2%) lung NOS, 3 (1%) pulmonary carcinoid, 2 (1%) lymphoma, 12 (6%) other cancers, 12 granulomata and 1 thyroid tissue (6%). 43 (21%) cases showed lymphoid tissue and 28 (14%) were reported as inadequate. No samples were taken in 8 cases (4%). Adequate tissue for predictive marker testing was available in 93% (66) of cases of non-small cell lung cancer (NSCLC). Complications were encountered in 9 cases (4%). Only 3 cases (1.5%) required any form of intervention. [Figure presented] Conclusion(s): Our data provides assurance of safety while also highlighting specific areas for attention regarding performance and time to test that can be addressed and our sensitivity was comparable to national standards. The increased waiting times may be partly related to COVID-19 precautions and will require reauditing at a later date. Disclosure: No significant relationships.Copyright © 2023 Elsevier B.V.

Vocabulary Index as a Sustainable Resource for Teaching Extended Writing in the Post-Pandemic Era

In the wake of the COVID-19 pandemic, Malaysian English teachers identified a pressing need to support upper primary school pupils, particularly those in the upper levels, in the effective composition of extended writing. Additionally, these educators required more innovative methodologies for teaching vocabulary in this context. Consequently, the current study aimed to develop a vocabulary index as a suggested resource for Malaysian English teachers instructing upper primary school pupils on extended writing. To achieve this, a quantitative computational research strategy and corpus-driven research design were employed. A purposive sampling technique was used to select 560 advanced upper primary school pupils from 28 schools, each with high English performance in the capital of each state and the federal territory of Malaysia, who produced a total of 152,187 words in extended writing for analysis. LancsBox, a primary computational linguistics application, was used for data processing. Given that the vocabulary index for extended writing necessitates a more comprehensive coverage of vocabulary, functional and content words were included, and keywords, raw and normalised frequencies were analysed and reported. Through the vocabulary index built in this study, the researchers found English teachers in Malaysia should utilise local issues in writing prompts, emphasise the use of both positive and negative adjectives, introduce complex sentence structures to enhance pupils‟ writing abilities and also train pupils to organise the ideas in their writing. Future linguistic studies could replicate the present investigation, so that it can respond to their classroom needs. © Annals of Translational Medicine. All rights reserved.

Trends in Euphorbia hirta Research: A 30-year Bibliometric Appraisal of the Present Realities

Euphorbia hirta L., is a common herb with global spread. Different parts of E. hirta are used in traditional medicine for the treatment of a variety of human and animal conditions, such as skin diseases, inflammation, digestive and respiratory disorders. This bibliometric study aimed to provide a panoramic view of the publication landscape in the last thirty years of Euphorbia hirta research. VOSviewer was used to analyze 603 documents retrieved from Scopus database during the period, 1992 to 2021. Dominant research themes in the last thirty years were centred on the application of crude extracts or isolated compounds from E. hirta against diabetes, oxidative stress, inflammation, tuberculosis, snake bite, gastro-intestinal disorders, respiratory infections, skin pathologies, bacterial, fungal and viral infections. Current paradigm shift in E. hirta research are targeted at improving the efficacy of phytomolecules against resistant bacterial pathogens and cancer cells via green synthesis of nanoparticles and the application of in silico technologies in predicting the activities of nano-phytomolecules against SARS-CoV-2 and the Dengue virus. This study recommends further research in the determination of the bioavailability of molecules in in vivo models. Researchers should carry out more preclinical investigations with the aim of establishing the pharmacokinetic and pharmacodynamic properties of phytocompounds instead of relying solely on in silico predictions.

Identification of potential SARS-CoV-2 papain-like protease inhibitors with the ability to interact with the catalytic triad

Severe acute respiratory syndrome corona virus2 (SARS-CoV-2) is responsible for the current pandemic that led to so many deaths across the globe and still has no effective medication. One attractive target is Papain-like protease (PLpro), which plays a critical role in viral replication. Several important structural features dictate access to the PLpro narrow active site, which includes a series of loops surrounding the area. As such, it is difficult for chemical compounds to fit the SARS-CoV-2 PLpro active site. This work employed a computational study to discover inhibitors that could bind to the SARS-COV-2 PLpro active site, mainly by virtual screening, molecular dynamic simulation, MMPBSA and ADMET analysis. Eight potential inhibitors were identified: carbonoperoxoic acid, Chrysophanol-9-anthrone, Adrenolutin, 1-Dehydroprogesterone, Cholest-22-ene-21-ol, Cis-13-Octadecenoic acid, Hydroxycarbonate and 1-(4-(4-Methylphenyl)-5-phenyl-1,3-oxazol-2-yl) isoquinoline, with binding scores of -4.4, -6.7, -5.9, -6.7, -7.0, -4.6, -4.5 and -5.6 kcal/mol, respectively. All these compounds interacted with critical PLpro catalytic residues and showed stable conformation in molecular dynamics simulations with significant binding energies of -12.73 kcal/mol, -10.89 kcal/mol, -7.20 kcal/mol, -16.25 kcal/mol, -19.00 kcal/mol, -5.00 kcal/mol, -13.21 kcal/mol and -12.45 kcal/mol, respectively, as revealed by MMPBSA analysis. ADMET analysis also indicated that they are safe for drug development. In this study, we identified novel compounds that interacted with the key catalytic residues of SARS-CoV-2 PLpro with the potential to be utilized for anti-Covid-19 drug development.

Hyponatremia in COVID-19 Is Not Always Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH): A Case Series.

Hyponatremia is a common complication in COVID-19-positive patients and is associated with significant mortality and morbidity. Several cases of COVID-19-related hyponatremia secondary to the Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH) have been reported in the literature, which might suggest that SIADH is almost always the underlying cause of hyponatremia in COVID-19 infections. However, COVID-19-related hyponatremia can have diverse underlying etiologies, similar to hyponatremia in non-COVID-19 patients, and requires a thorough assessment to reach a correct diagnosis and implement appropriate management.

Case Report of Thromboembolism Prophylaxis in a Burn Patient With COVID-19.

The recent coronavirus disease 2019 (COVID-19) pandemic has worse medical consequences, especially when affecting people with comorbidities such as diabetes, lung disease, hypertension, burn and trauma. The pathophysiology of COVID-19 infection includes thromboembolic events that were described in previous studies as a risk of venous thromboembolism (VTE). This risk is higher in burn patients, especially in the electrical type, which is generally attributed to their hypercoagulable state. This article reviews a detailed history, examination, and investigations of a 38-year-old male hospitalized burn patient with COVID-19 infection. Although on chemical thromboembolic prophylaxis, the patient developed extensive pulmonary embolism (PE) and, more interestingly, had atypical PE signs and symptoms. The present case aims to develop a special venous thromboembolism prophylaxis protocol between prophylactic and therapeutic dosages for COVID-19 burn patients.

Global Impact of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events: One-Year Follow-up.

BACKGROUND AND OBJECTIVES: Declines in stroke admission, intravenous thrombolysis, and mechanical thrombectomy volumes were reported during the first wave of the COVID-19 pandemic. There is a paucity of data on the longer-term effect of the pandemic on stroke volumes over the course of a year and through the second wave of the pandemic. We sought to measure the impact of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), intravenous thrombolysis (IVT), and mechanical thrombectomy over a one-year period at the onset of the pandemic (March 1, 2020, to February 28, 2021) compared with the immediately preceding year (March 1, 2019, to February 29, 2020). METHODS: We conducted a longitudinal retrospective study across 6 continents, 56 countries, and 275 stroke centers. We collected volume data for COVID-19 admissions and 4 stroke metrics: ischemic stroke admissions, ICH admissions, intravenous thrombolysis treatments, and mechanical thrombectomy procedures. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. RESULTS: There were 148,895 stroke admissions in the one-year immediately before compared to 138,453 admissions during the one-year pandemic, representing a 7% decline (95% confidence interval [95% CI 7.1, 6.9]; p<0.0001). ICH volumes declined from 29,585 to 28,156 (4.8%, [5.1, 4.6]; p<0.0001) and IVT volume from 24,584 to 23,077 (6.1%, [6.4, 5.8]; p<0.0001). Larger declines were observed at high volume compared to low volume centers (all p<0.0001). There was no significant change in mechanical thrombectomy volumes (0.7%, [0.6,0.9]; p=0.49). Stroke was diagnosed in 1.3% [1.31,1.38] of 406,792 COVID-19 hospitalizations. SARS-CoV-2 infection was present in 2.9% ([2.82,2.97], 5,656/195,539) of all stroke hospitalizations. DISCUSSION: There was a global decline and shift to lower volume centers of stroke admission volumes, ICH volumes, and IVT volumes during the 1st year of the COVID-19 pandemic compared to the prior year. Mechanical thrombectomy volumes were preserved. These results suggest preservation in the stroke care of higher severity of disease through the first pandemic year. TRIAL REGISTRATION INFORMATION: This study is registered under NCT04934020.

Humoral response to SARS-CoV-2 vaccines among healthcare workers in a tertiary hospital in Malaysia.

INTRODUCTION: Healthcare workers (HCWs) were among the first to be fully vaccinated against SARS-CoV-2. However, the antibody responses to the vaccines and potential decline among Malaysian HCW are still unclear. The objective of this study is to follow-up anti-S antibody levels among HCW vaccinated with mRNA vaccine (BTN162b2) and inactivated vaccine (CoronaVac). MATERIALS AND METHODS: Plasma samples were collected prevaccination, 2 weeks and 6 months post-vaccination and tested for total immunoglobulin levels using ELISA method. RESULTS: A small percentage of HCW (2.2%, 15/677) had elevated anti-S antibody levels in their pre-vaccination plasma samples (median 20.4, IQR 5.8), indicating that they were exposed to SARS-CoV-2 infection prior to vaccination. The mRNA vaccine significantly increased anti-S levels of both previously infected and uninfected individuals to saturation levels (median 21.88, IQR.0.88) at 2 weeks postsecond dose of the vaccine. At 6 months post-vaccination, the antibody levels appeared to be maintained among the recipients of the mRNA vaccine. However, at this time point, anti-S antibody levels were lower in individuals given inactivated vaccine (median 20.39, IQR 7.31, n=28), and interestingly, their antibody levels were similar to anti-S levels in pre-vaccination exposed individuals. Antibody levels were not different between the sexes. CONCLUSION: Anti-S levels differ in individuals given the different vaccines. While further study is required to determine the threshold level for protection against SARSCoV- 2, individuals with low antibody levels may be considered for boosters.

Emergency remote teaching of foreign languages at Saudi universities: Teachers' reported challenges, coping strategies and training needs.

Though considerable research has been reported on COVID-19-related distance education, some dimensions of remote foreign language teaching experiences during the pandemic crisis remain to be explored. The study reported in this paper investigated Saudi university foreign language teachers' accumulated experiences and reflective beliefs of emergency remote instruction. The study focused specifically on: a) the general educational challenges the teachers encountered and their attempts to overcome them; b) the teachers' perceived difficulties in remotely teaching and assessing foreign language areas and their strategies for coping with them; and c) their reflective evaluation of remote foreign language teaching after doing it for three academic terms. Questionnaire data was collected from 112 teachers of Arabic and English as foreign languages, and semi-structured interviews were conducted with 14 teachers. The analysis of both data types showed that the participants had a number of general educational and language-teaching-specific challenges in their COVID-19-related remote teaching. The teachers generally viewed the remote assessment of language areas is a more challenging task than teaching them. Reading was rated as the least difficult language area to teach and assess remotely, whereas writing was the most difficult one. The teachers reported using various coping strategies to overcome the educational and language teaching-specific challenges. They perceived their remote teaching experiences positively, but reported their needs for further training in developing better online assessment methods, using different teaching platforms and technological tools, and managing classroom interactions. The paper ends by discussing the results of the study and their implications.

Hyponatremia in COVID-19 Is Not Always Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH): A Case Series

Hyponatremia is a common complication in COVID-19-positive patients and is associated with significant mortality and morbidity. Several cases of COVID-19-related hyponatremia secondary to the Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH) have been reported in the literature, which might suggest that SIADH is almost always the underlying cause of hyponatremia in COVID-19 infections. However, COVID-19-related hyponatremia can have diverse underlying etiologies, similar to hyponatremia in non-COVID-19 patients, and requires a thorough assessment to reach a correct diagnosis and implement appropriate management.

An investigation into factors affecting corporate risk management in ASEAN-4 Countries

This study investigated the effect of corporate governance on corporate risk management. By using the regression analysis method, different results on the effects of the variables independent commissioners, female commissioners, meeting frequency, and audit committee members' expertise background on corporate risk management were obtained. In addition, companies in Singapore that had high levels of risk management activities were found to experience faster recovery after the crisis caused by the COVID-19 pandemic compared to other countries (Malaysia, Indonesia, and the Philippines). Overall, this study concludes that corporate governance has an important role in improving the risk management activities of a firm. This study may serve as a consideration for corporate governance implementation to improve corporate risk management.

Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality.

BACKGROUND AND PURPOSE: Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. METHODS: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). RESULTS: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. CONCLUSIONS: During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.

Sourcing Strategies for Adopting in-house Additive Manufacturing (AM) in the Automotive Supply Chain – A Post-COVID-19 Perspective

Additive manufacturing (AM) is recognized by many supply chain professionals and global automakers as the best alternatives to manage disruptions and boost automotive supply chain resilience. A semi-structured interview was conducted among Indian auto firms’ industry experts to determine the current status of AM implementation in the Indian auto industry. The industry experts of Indian and foreign-based automakers operating in India have suggested in-house AM production to tackle the upstream automotive supply chain’s complexity during disruptions. This choice’s significant cause is to protect the auto components’ design secrecy from private exposure and retain the firm’s competitive advantage. In addition, the overall difficulties prevailing in the outsourcing activities, particularly in the upstream automotive supply chain due to various uncertain events such as COVID-19, also influenced their choice towards in-house AM production. Hence, it is necessary to analyze the feasibility of initiating in-house AM production in the upstream automotive supply chain for the post-COVID-19 unusual scenario. The resource-based view (RBV) and knowledge-based view (KBV) of strategic sourcing are suitable for establishing in-house AM production in the OEM’s plant location. In this regard, a step-wise procedure has been proposed to guide OEM’s management towards significant adoption of in-house AM production. The RBV theory states that resources and capabilities have to be precious, unique, and organizationally active to achieve sustainable competitive advantage. The KBV theory, an extension of RBV theory, states that intangible resources, such as human capital and knowledge, are a firm’s unique resources to help achieve a competitive advantage. As per the RBV/KBV theories, the firms may contract outsourcing with the leading resource and knowledge providers to pass knowledge and resources currently not owned by the firm. With the guidance of RBV/KBV theories, OEM’s management has to make a short-term collaboration with an AM service provider to transfer the knowledge, human capital, and other resources from them to OEM. This short-term collaboration may help OEM to develop its internal capabilities with the knowledge and resource transfer offered by the AM service provider. Similarly, OEM can benefit from hiring technical personnel from the AM service provider to develop its employees’ knowledge and technical skills on AM. © IEOM Society International.

Innovative Nanotechnology a Boon for Fight Against Pandemic COVID–19

COVID – 19 is a contagious disease caused by severe acute respiratory syndrome (SARS-CoV2). The rate at which COVID – 19-virus spread from epidemic to pandemic within a short period is quite alarming. As of July 2020, the Dashboard of the World Health Organization (WHO) recorded over 15 million COVID – 19 cases across 213 countries, with mortality of over 620,000. The governments and healthcare agencies responsible for mitigating the virus's spread have adopted several strategies to end the pandemic. However, all hands were on deck to establish the standard treatment modalities of SARS-CoV-2 through inventing new drugs, vaccine candidates, or repurposing the existing medicines and robust diagnostic tools, in addition to other technological innovations. Therefore, nanotechnology’s employment would play a vital role in bringing multidisciplinary ways of developing affordable, reliable, and powerful tools for diagnosis, in addition to personal protection and effective medicines. Additionally, nanosensors' application would significantly aid the diagnoses of the COVID–19 even on asymptomatic patients, and thus would be an essential means for determining its prevalence. Likewise, nanoscale fibers can optimize personal equipment protection and allow their reusability for medical and economic benefits. Accordingly, the literature was intensively reviewed by searching for the combinations of the research keywords in the official scientific databases such as Science Direct, PubMed, and Google Scholar. Hence, this research highlighted the perspective contributions of nanotechnology in the war against the COVID-19 pandemic. Copyright © 2021 Shehu, Auwal, Musa, Mukhtar, Yusuf, Yau, Muhammad, Baba Dala, Sani, Ahmad and Islam.

Virtual Reality as Learning Media for Lampung Historical Heritage

Lampung Province has a lot of historical heritage which is a world heritage for future human generations. The Lampung Museum, which was founded in 1975, plays a role in ensuring the continuity of history in the people of Lampung. Dissemination of Lampung history can be improved through education 4.0. Virtual Reality is a technology that allows a user to interact with the environment that exists in the virtual world and can provide information. Virtual Reality can help disseminate the history of Lampung with interactive and humanistic interaction models for historical objects that are presented without being bound by space and time. In addition, the ongoing COVID-19 pandemic has had a major impact on the performance of the Lampung museum in disseminating the history of Lampung. The method used to develop Virtual Reality of Lampung Historical Heritage consists of seven stages, namely Problem Formulation, Determination of Motivation, Idea Development, Design, Prototype Making, Testing, Advanced Development, and Implementation/Release. Eight historical objects were modeled and enriched with information regarding their relationship to Lampung history, namely the Lampung Museum, Thay Hin Bio Vihara, Al-Anwar Mosque, Lampung Siger Tower, Krakatau Monument, Kerti Bhuana Temple, Nuwo Sesat Traditional House, and the Japanese Cave. It is hoped that with the availability of Virtual Reality of Lampung Historical Heritage, the dissemination of Lampung history can be carried out more progressively through education 4.0. © 2021 IEEE.

UBNet: Deep learning-based approach for automatic X-ray image detection of pneumonia and COVID-19 patients.

BACKGROUND: Analysis of chest X-ray images is one of the primary standards in diagnosing patients with COVID-19 and pneumonia, which is faster than using PCR Swab method. However, accuracy of using X-ray images needs to be improved. OBJECTIVE: To develop a new deep learning system of chest X-ray images and evaluate whether it can quickly and accurately detect pneumonia and COVID-19 patients. METHODS: The developed deep learning system (UBNet v3) uses three architectural hierarchies, namely first, to build an architecture containing 7 convolution layers and 3 ANN layers (UBNet v1) to classify between normal images and pneumonia images. Second, using 4 layers of convolution and 3 layers of ANN (UBNet v2) to classify between bacterial and viral pneumonia images. Third, using UBNet v1 to classify between pneumonia virus images and COVID-19 virus infected images. An open-source database with 9,250 chest X-ray images including 3,592 COVID-19 images were used in this study to train and test the developed deep learning models. RESULTS: CNN architecture with a hierarchical scheme developed in UBNet v3 using a simple architecture yielded following performance indices to detect chest X-ray images of COVID-19 patients namely, 99.6%accuracy, 99.7%precision, 99.7%sensitivity, 99.1%specificity, and F1 score of 99.74%. A desktop GUI-based monitoring and classification system supported by a simple CNN architecture can process each chest X-ray image to detect and classify COVID-19 image with an average time of 1.21 seconds. CONCLUSION: Using three hierarchical architectures in UBNet v3 improves system performance in classifying chest X-ray images of pneumonia and COVID-19 patients. A simple architecture also speeds up image processing time.

Spine surgery under awake spinal anesthesia: an Egyptian experience during the COVID-19 pandemic.

OBJECTIVE: Despite tremendous advancements in biomedical science and surgical technique, spine surgeries are still associated with considerable rates of morbidity and mortality, particularly in the elderly. Multiple novel techniques have been employed in recent years to adequately treat spinal diseases while mitigating the perioperative morbidity associated with traditional spinal surgery. Some of these techniques include minimally invasive methods and novel anesthetic and analgesic methods. In recent years, awake spine surgery with spinal anesthesia has gained attention as an alternative to general anesthesia (GA). In this study, the authors retrospectively reviewed a single-institution Egyptian experience with awake spine surgery using spinal anesthesia during the COVID-19 pandemic. METHODS: Overall, 149 patients who were admitted to As-Salam International Hospital in Cairo for lumbar and lower thoracic spine surgeries, between 2019 and 2020, were retrospectively reviewed. Patient demographics and comorbidities were collected and analyzed. Visual analog scale (VAS) and Oswestry Disability Index (ODI) scores were assessed at different time intervals including preoperatively, immediately after surgery, and 1 year postoperatively. Patient satisfaction was queried through a questionnaire assessing patient preference for traditional anesthesia or spinal anesthesia. RESULTS: Of the 149 patients who successfully received spine surgery with spinal anesthesia, there were 49 males and 100 females. The cohort age ranged from 22 to 85 years with a mean of 47.5 years. The operative time ranged from 45 to 300 minutes with a mean estimated blood loss (EBL) of 385 ± 156 mL. No major cardiopulmonary or intraoperative complications occurred, and patients were able to eat immediately after surgery. Patients were able to ambulate without an assistive device 6 to 8 hours after surgery. Decompression and fusion patients were discharged on postoperative days 2 and 3, respectively. VAS and ODI scores demonstrated excellent pain relief, which was maintained at the 1-year postoperative follow-up. No 30- or 90-day readmissions were recorded. Of 149 patients, 124 were satisfied with spinal anesthesia and would recommend spinal anesthesia to other patients. The remaining patients were not satisfied with spinal anesthesia but reported being pleased with their postoperative clinical and functional outcomes. One patient was converted to GA due to the duration of the procedure. CONCLUSIONS: Patients who received spinal anesthesia for awake spine surgery experienced short stays in the hospital, no readmissions, patient satisfaction, and well-controlled pain. The results of this study have validated the growing body of literature that demonstrates that awake spine surgery with spinal anesthesia is safe and associated with superior outcomes compared with traditional GA. Additionally, the ability to address chronic debilitating conditions, such as spinal conditions, with minimal use of valuable resources, such as ventilators, proved useful during the COVID-19 pandemic and could be a model should other stressors on healthcare systems arise, especially in developing areas of the world.