ABSTRACT
A horrifying number of people died because of the COVID-19 pandemic. There was an unexpected threat to food systems, public health, and the workplace. The pandemic has severely disturbed society and there was a serious impediment to the economy. The world went through an unprecedented state of chaos during this period. To avoid anything similar, we can only be cautious. The project aims to develop a web application for the preliminary detection of COVID-19 using Artificial Intelligence(AI). This project would enable faster coordination, secured data storage, and normalized statistics. First, the available chest X-ray datasets were collected and classified as Covid, Non-Covid, and Normal. Then they were trained using various state-of-the-art pre-trained Convolutional Neural Network (CNN) models with the help of Tensor-flow. Further, they were ranked based on their accuracy. The best-performing models were ensembled into a single model to improve the performance. The model with the highest accuracy was transformed into an application programming interface (API) and integrated with the Decentralized application (D-App). The user needs to upload an image of their chest X-ray, and the D-App then suggests if they should take a reverse transcription-polymerase chain reaction (RT-PCR) test for confirmation. © 2022 IEEE.
ABSTRACT
Background: Covid redefined how the world functions. The electrophysiology (EP) community identified multiple needs that arose due to this paradigm and redefined workflows. The geographic paucity of experienced clinical mapping support was a crucial issue that limited the worldwide adoption of complex ablation procedures. Objective(s): To ascertain the feasibility and safety of utilizing a novel software for remote mapping and remote clinical support for all spectrums of cardiac ablation procedures and to compare the adoption of ablation technology in that geography. Method(s): Ablation procedures performed at Metromed International Cardiac Centre (MICC), India were included in this early feasibility analysis (EFA). All procedures were performed by a single EP operator. Remote Clinical support was provided by an EP physician (primary operator's sibling) in the USA. All mapping was performed by an experienced mapper from a remote location 400 miles away from the primary EP operator in India. The mapping system utilized was Ensite Precision with SJM Connect software. Result(s): 300 contiguous ablation procedures from 2020 to 2022 were included in this EFA. The proprietory SJM Connect software allows remote access to the Ensite console via a secured connection. The software requires the operator to be granted access to the Ensite console via a permission request that must be acknowledged on the Ensite Console. The software will then allow the remote operator to levels of access to the system, view-only access, or complete control of the console to provide full remote support. Communication occurs between the remote user and the console via a chat function and over a voice call. This remote connection can be terminated at any time from either the console or the remote operator. There is no PHI displayed. Results detailing case demographics and acute procedural success and safety will be presented. Results comparing the adoption of ablation technology with the previous 3 years in this geography will be presented. Conclusion(s): This EFA demonstrates the safety and efficacy of using remote clinical support and remote mapping for ablation procedures. This opens a world of possibilities including the expansion of ablation technology to all corridors of the world with experienced clinical and mapping support connecting the EP community on a worldwide platform. Additional studies and strategies are needed to further understand the implication of remote support algorithms in bridging the healthcare gaps in the field of cardiac EP. [Formula presented]Copyright © 2023
ABSTRACT
Key content: Thromboembolism is a major cause of preventable morbidity and mortality. Hospital acquired thrombosis (HAT) accounts for 50-60% of all thromboembolic events. As well as effects on patient safety, there are considerable cost implications to both prophylaxis and treatment. While guidance exists on thromboprophylaxis for patients in obstetrics and those undergoing general surgery, there is a paucity of guidance relating to gynaecological practice. Increasing prevalence of risk factors and multimorbidity is paralleled by higher risk of thromboembolic events. Gynaecological surgery presents some unique risk factors for thrombosis. Learning objectives: To understand the basic pathophysiology of thrombosis in relation to risk factors particularly relevant to gynaecology and pelvic surgery. To know the current evidence in key areas relevant to gynaecological practice: early pregnancy;day case surgery;minimally invasive gynaecological surgery;open and complex benign gynaecology and gynaecological oncology. To be aware of proposed guidance on risk assessment and prophylaxis in thrombosis as relevant to the gynaecologist based on current evidence. Ethical issues: Problems with thromboprophylaxis in high-risk patients include noncompliance and refusing animal products/injections. Clinicians may be reluctant to institute thromboprophylaxis, most times because of the possible risks of bleeding. Copyright © 2022 Royal College of Obstetricians and Gynaecologists.
ABSTRACT
Background: The conduct of clinical trials during COVID-19 created challenges to ensuring access to clinical trials, healthy clinical teams, and patients. Innovative methods such as remote patient follow-up and monitoring visits can lead to successful completion of device trials. Objective(s): The INGEVITY+ Active Fixation Pace/Sense Lead Study examined the safety/ efficacy of the INGEVITY+ Lead in a prospective, non-randomized, multicenter, post-approval study. Method(s): Subjects met indications for a pacing device with INGEVITY+ leads implanted in the RA and RV. The primary safety endpoint was the 3-month lead-related complication-free (LRC-free) rate. The primary efficacy endpoint evaluated the 3-month pacing capture threshold with the secondary efficacy endpoint evaluating the other lead-related electrical parameters. Implanter experience was assessed. Telephone visits with LATITUDE remote transmission of lead measurement data and remote monitoring visits were allowed. Result(s): A total of 201 leads were evaluated in 101 subjects, 46.8% female with a mean age of 73.2 years, at 13 centers in the United States. The study took 6.8 months, with a median follow-up of 3.4 months. The 3-month follow-up was completed by 98% of subjects, of which 36% were remote. A total of 98% of monitoring visits were done remotely. The study met all primary and secondary endpoints. The LRC-free rate through 3-months was 98.5% (lower CL 95.4%). Three leads were repositioned and reimplanted;two were RA dislodgements, and one was a RA perforation and hemothorax requiring thoracentesis. The pacing capture threshold was <= 2V in 98.9% of subjects with a mean of 0.77 V at 0.4-ms pulse width, mean pacing impedance of 712 ohms, and a median P-wave amplitude of 4.3 mV, and median R-wave amplitude of 15.9 mV at 3- months. No helix performance issues were reported. The mean turn count for helix extension was 6.7 and retraction was 7.6. More than 85% of physicians rated the lead as 'very good' or higher on all aspects of lead handling. Conclusion(s): The INGEVITY+ Lead was found to be safe and effective with a very favorable implant experience. This study was entirely conducted successfully during COVID-19 with remote follow-up and monitoring visits, and nearly half of the subjects were females.
ABSTRACT
The traditional machine learning algorithms focus on centralised data repository where the aggregate data used for training is stored in a common location and processed. This approach is not suitable when data is stored in different locations and owned by different entities. Many crucial machine learning applications need computationally efficient and privacy-preserving solution. Also the central data repository has the risk of single point of failure. Federated learning is an emerging field in machine learning where the centralised concept is changed to distributed. Federated learning approach helps to train a model in machine learning without really sharing the data to a common server. In this approach, training is done locally at client side. A technique called federated averaging is applied at server side, where the model parameters from clients are aggregated and the updated parameters are computed. We propose a federated SVM architecture for solving a binary supervised classification problem. Here the experiments are done for MNIST dataset and COVID-19 dataset. Also the results are compared with centralised training approach. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
ABSTRACT
Everyday life and the global economy have been negatively impacted by COVID-19 (Coronavirus). Slowing the spread of coronaviruses through social distance is proven to be an effective strategy in the war against COVID-19. The social distancing is the best way to stop the spread of COVID-19, as it prevents people from coming into intimate touch with each other. Recently, due to the fast spreading outbreak of the COVID-19, one of the obligatory preventive measures to avoid physical contact has become social distance. Surveillance methods that use Deep Learning, Open-CV and Computer vision to follow pedestrians and prevent congestion are the focus of this article. Closed-circuit television (CCTV) and drones can be used for implementation, where the camera will use object detection to identify the crowd and compute the distance between the humans. Local law enforcement will be notified if the Euclidean distance between two persons is less than the standard distance, which is determined by converting it to pixels and comparing it to that value.
ABSTRACT
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is well described as an etiology to severe acute respiratory distress syndrome (ARDS). However, rare immunologic and allergic manifestations may also occur from this infection. We report a novel case of angioedema occurring in the setting of COVID-19 infection in a fully vaccinated patient. Case Report: A 61-yearold COVID-19 vaccinated female with hypertension presented to the emergency department with tongue and lip swelling, odynophagia, dysphonia, and difficulty breathing. She denied personal or family history of allergies, anaphylaxis, or angioedema. Her home medications included Aspirin, methadone, Seroquel, and Klonopin, with no recent changes reported. Physical exam was notable for significant lip and tongue edema, audible dysphonia, and bilateral end-inspiratory wheezing. She was hypoxemic and placed on nasal cannula. Laboratory findings revealed lymphopenia, elevated inflammatory proteins, including C-reactive protein (57), Lactate dehydrogenase (LDH) (238), and D-dimer (11.52). Functional C1 esterase inhibitor levels (>91) were normal. Nasal PCR swab returned positive for SARS-CoV-2. Ear, nose, and throat specialist was consulted given concern for angioedema, and flexible nasolaryngoscopy was performed revealing uvular, epiglottic, and bilateral arytenoid edema concerning for impending airway compromise. The patient was initiated on intravenous methylprednisolone, epinephrine, antihistamines, tranexamic acid and admitted to the medical intensive care unit (ICU). She was monitored closely in the ICU with subsequent improvement of the angioedema and resolution of the hypoxemia. She was discharged with an oral steroid regimen and scheduled for a follow-up appointment with an allergist. Discussion: There exists only a handful of case reports describing angioedema in patients with COVID-19 infection. In those reports, patients also had normal C1 esterase inhibitor levels and no personal or family history of inherited angioedema. Interestingly, our patient was vaccinated six months prior to her presentation. The association between SARS-CoV-2 and angiotensinconverting enzyme 2 (ACE-2), the primary receptor for viral entry into the epithelial cells of the lungs, could be a potential explanation for the occurrence of angioedema. ACE-2 plays a pivotal role in inhibiting a potent ligand of bradykinin receptor 1, Arginine bradykinin. It has been postulated that SARS-CoV-2 downregulation of ACE-2 leads to elevated angiotensin II levels and subsequent activation of the bradykinin pathway. Excessive bradykinin production generates high levels of nitric oxide and prostaglandins, resulting in vasodilation, increased vascular permeability, and angioedema. This case highlights the importance of recognizing atypical and rare presentations of COVID-19 infection, especially angioedema, given its sudden onset and life-threatening complications.
ABSTRACT
Introduction: The Coronavirus Disease 2019 (COVID-19) epidemic is caused by SARS-CoV-2, a recently discovered virus that causes severe acute respiratory syndrome. Influenza-related mortality poses an important risk factor for COVID-19, and comorbidity with diabetes is another important factor. Aim: The present study evaluated the biochemical features of COVID-19 positive patients with and without diabetes mellitus was admitted in DMWIMS Hospital Wayanad, Kerala state. Materials and Methods: Demographic, clinical, laboratory, treatments, complications, and clinical outcomes data of 194 patients were extracted from hospital management software and compared between diabetes (n=64) and non-diabetes (n=130) groups. The biochemical parameters such as D-Dimer, CRP, HbA1C, serum Potassium and albumin values were obtained from the Laboratory management software -medical records of the patients were analysed. Results: Compared with non-diabetic patients, diabetic patients had higher levels of S. Potassium (p=.014), C-reactive protein (p=.008), HbA1C (p<.01), and D-dimer (p=.033), and lower levels albumin (p=.035). Conclusion: COVID-19 is associated with diabetes as an independent risk factor. Diabetes patients, especially those who require insulin therapy, need more attention when it comes to prevention and treatment.
ABSTRACT
For drilling contractors, the moment of truth is the operations at the site. If the technician at the site encounters a problem he can't solve, then everything stops. The team has to wait for a subject matter expert (SME) to arrive at the site to diagnose rectify the problem. Such process of SME mobilization and till that time Non-Productive Time (NPT) results in loss of hundreds of thousands of dollars. Hence the key challenge is converting the Sparse to Adequate availability of Right Knowledge at Right Time at Right Place, for the support of technicians. This paper is focused on the approach of moving from Hand Held devices to Hands-Free environment at sites and connecting local/global support to site support systems, to reduce cost, improve HSE and enhance operational performance. The augmented reality technology-enabled, smart glass laced headsets are rugged, zone 1 certified, and are voice-operated which are better than smart tablets which were considered during Technology Qualification Process. Evaluation criteria were: 1. Availability and follow up of the digital work instruction while operating. Moreover, not missing a single step of work instruction while inspection or maintenance continues was noted carefully. 2. Reduced travel/accommodation cost: Normally at the time of shutdown, the rig crew contacts subject matter experts (SME) and (at times) in turn the SME contacts the OEM support team to mobilize service engineers globally. 3. Response time improvement-Availability of support by SME right at the time of need results from better response time to diagnose and fix the issue at hand. Call logging till final resolution process improvement is considered an important metric. Travel restrictions imposed by Covid-19, are also being addressed through the distanced inspection. A hands-free environment is compared vis a vis handheld device. Better training and knowledge transfer are achieved through better communication methods and this goes better with learning by doing. Subsequent text (NLP-speech to text) analysis is planned through deep learning models to derive related predictions. Sparse to Adequate availability of support to rig staff with Right Knowledge at Right Place at Right Time is the key outcome of this Proof of Value project. © Copyright 2021, Society of Petroleum Engineers
ABSTRACT
Background: Patients with chronic kidney disease (CKD) have disproportionately faced poor health outcomes during the coronavirus disease-19 (COVID-19) pandemic. Barriers and facilitators to patients' and caregivers' emotional well-being and healthcare engagement have not been deeply described, leaving a gap in interventions during future crisis settings. Methods: We conducted a qualitative study among patients with CKD (stages 4-5), kidney failure, kidney transplantation, and their caregivers. Interviews were guided by Leventhal's Model of Self-Regulation that emphasized individual interpretations and emotional responses to health threats as determining factors of health behaviors. Interviews were audio-taped, transcribed, and analyzed thematically. Results: Twenty-eight patients (median age 63, self-reported race: White 57%, Black 18%, Asian 1%, others 14%) and 14 caregivers were interviewed over six months. Barriers and facilitators related to patients' emotional well-being included 1) negative emotional responses (feelings of increased vulnerability, anxiety, social isolation, and depression);2) coping behaviors (adaptive coping via self-preservation and emotion regulation;maladaptive coping via alcohol and unhealthy eating);3) and the need for caregiver support for daily tasks. Barriers and facilitators to healthcare engagement included: 1) continued trust in the medical community ( I put my faith in [my doctor's] knowledge);and 2) technology (telehealth was a facilitator to access for some but inadequate for multidisciplinary care [my] transplant evaluation was stoppedwe could not go to the cardiologist). Caregivers reported higher burden compared to before the pandemic. Conclusions: Patients and caregivers widely reported negative emotional reactions to enforced pandemic-related social isolation. Coping efforts were partially successful. Telehealth provided adequate access to kidney health services for some but was insufficient for those requiring multidisciplinary care. Lessons learned from the COVID-19 pandemic suggest that patients with kidney disease may benefit from psychosocial and multi-modal structural support to offset social isolation, reduce caregiver burden, and bolster access to multidisciplinary care during future crisis settings.
ABSTRACT
High Dimensional Computing (HDC) includes the creation of High Dimensional Vectors, their storage in memory, and their functioning for different mathematical operations. The operations on HD vectors involve binding, bundling, and permutation, making it suitable to generate various kinds of architectures for performing different HDC applications. In this work, the High Dimensional Computing application involves language identification and classification of medical images using our proposed 2-D architectures. For the representation of the entities for the classification applications, 10000-bit random vectors are used. The high-dimensional entities are generated by using different random number generators and image processing techniques depending on the type of application. The experimental results, details about the data set used, architecture design information, benefits, and memory issues of HDC are also presented in this work. This new computational method carried out using high dimensional vectors introduces a new model for machine learning and can be used in different applications such as diagnosing Covid 19, brain tumour, classification of benign and malignant cancer cells, gesture classification and bio signal processing. © 2021 IEEE.
ABSTRACT
Introduction The Covid-19 pandemic has affected the delivery of teaching with rapid transition from face-to-face (FTF) to virtual sessions. We surveyed staff about their satisfaction and challenges associated with this change, from both the presenter's and learner's perspectives, including the impact on less than full-time (LTFT) trainees. Design Online survey. Method Three online surveys were conducted amongst Obstetrics and Gynaecology doctors in a District General Hospital, including all doctors in the audience cohort and two subgroup surveys for LTFT trainees and presenters. Results The audience cohort (n = 13) reported variable satisfaction rates with FTF teaching pre-Covid. The satisfaction scores were highest amongst the registrars (3.4/5), as compared to SHOs (3/5) or consultants (2.7/5). Nearly half (46%) were very satisfied (score 4) overall. The main issue was difficulty attending the sessions (38%). After the first 10 virtual sessions were delivered, 54% of doctors attended 7-10 sessions, 23% attended 4-6 and 23% joined 1-3 sessions. Increased accessibility and improved consultant presence were identified as the positive aspects. The barriers were low familiarity with technology (31%), insufficient number of consultant-led sessions (8%), lack of social networking (8%) and absence of protected time (8%). The majority of responders reported better attendance virtually and all preferred online or combined learning. All LTFT trainees (n = 10) reported the existence of teaching sessions on their non-working days with 30% attending these most of the time, 50% sometimes and 20% rarely or never. Those unable to attend usually had other personal (n = 4) or academic (n = 2) commitments or did not consider the sessions useful (n = 1). Overall, 70% of LTFT trainees found virtual teaching beneficial and 40% accessed recorded meetings from home. When surveying the presenters (n = 9), only 44% found virtual presenting more enjoyable than FTF and 66% found it more challenging, mainly because of lesser interaction with the audience. The presenters preferred FTF (44%) or combined (33%) teaching. Most presenters (55%) preferred for the audience camera/microphone to be switched on. Conclusion Our surveys showed good attendance at virtual teaching and audience preference for this format. Accessibility was seen as the main advantage and many LTFT trainees value the opportunity to attend on nonworking days. Presenters found virtual teaching more challenging, with lower presenter satisfaction. pandemic has offered an opportunity to accelerate use of virtual learning and our initial surveys show this may be preferable with scope for further development.
ABSTRACT
Background: Coronavirus Disease (COVID-19), caused by novel SARS CoV-2 is rapidly spreading all over the World creating a global public health emergency at unprecedented levels. Till today, no effective treatments or vaccines against this global pandemic is reported and hence to identify lead compounds having potential action in controlling the spread the pandemic is a global concern. This study aimed at in silico screening of phytocompounds from M.oleiera leaf against novel SARS CoV-2 main protease (Mpro) through molecular docking. M.oleiera is an Indian medicinal plant as well as a vegetable, all parts of the plant is medicinally useful and is being used in many of the traditional and Ayurvedic medicinal preparations. Result: When the 19 compounds identified from M.oleifera leaf methanolic extract by Liquid Chromatography Mass Spectrometry (LCMS/MS) analysis and 5 FDA approved anti-viral drugs were screened in silico with SARS CoV-2 main protease (Mpro), the following compounds showed top interaction; apigenin-7-O-rutinoside (-8.8 kcal/mol), Mudanpioside (-8.3 kcal/mol), isoquercetin (-8 kcal/mol), isoquercitrin (-8 kcal/mol), quercetin (-7.8 kcal/mol) and dihydroquercetin (-7.8 kcal/mol). Anti-viral drugs: Raltegravir (-7.2 kcal/mol), Lopinavir-Ritonavir (-7.7 kcal/mol), maraviroc (-8.2 kcal/mol), Nelfinavir (-8.3 kcal/mol) and Tipranavir (-9.2 kcal/mol) also showed active interaction with Mpro. Preliminary phytochemical screening of methanol extract showed the presence of flavonoids, cardiac glycosides, phenols, coumarins, saponins, steroids and phytosteroids. In vitro antioxidant activity of methanolic extract of M.oleifera also showed greater activity, which would ameliorate the post-COVID secondary infection. Conclusion: Hence these compounds from M.oleifera, which are our diet based components, which can interact with the Mpro and curtail COVID-19 virus multiplication in the host cell.
Subject(s)
Coronavirus Infections , COVID-19ABSTRACT
COVID-19 is a zoonotic viral infection caused by severe acute respiratory syndrome coronavirus-2. Although the management of COVID-19 infection is mainly supportive, the arena of infective therapy now also includes drugs such as chloroquine and its substitute, hydroxychloroquine, which are believed to have antiviral properties in addition to their antimalarial and immunomodulating effects. The objective of this review article is to focus on the antiviral effect of chloroquine/hydroxychloroquine in the treatment and prophylaxis of COVID-19 disease.