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In a catastrophic medical situation caused by an infectious disease, such as COVID-19, it is very important to quickly determine who and where to be tested and supervised. The current COVID-19 screening test is conducted by identifying people with high probability of infection, such as who made direct or indirect contact with the confirmed person, by identifying the moving path of the confirmed person. Currently, various methods are being employed, such as interviewing or location tracking through cell phone forensics, to determine the moving path of the confirmed person. Mostly, however, these methods are time consuming, inaccurate, and easy to invade privacy while promptness, accuracy and anonymity are key values of epidemiological surveillance. There is still no preemptive management methods for a space where infection occurs are possible. Investigation and action on the area where the infection occurred are just carried out only after a confirmed person has been confirmed. In order to solve these problems, it is necessary to develop an automatic system for evaluating space for compliance of infectious disease prevention guidelines, or simply risk estimation system, using artificial intelligence and computer vision technology. In this paper, we discuss the system for evaluation of COVID-19 prevention guidelines compliance which has been researching and developing by ASSIST. © 2022 IEEE.
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Study Objectives: To evaluate the impact of a general practitioner (GP) programme on low-acuity patient load (patient acuity scale P3 or P4) presenting at a participating emergency department (ED) of a regional public hospital in Singapore. Secondly, to analyse the appropriateness of participating GPs' referrals to ED based on programme criteria. Study Design/Methods: This is a descriptive observational study of a regionally implemented, government funded programme called GPFirst, from 2014 to 2019 (pre-COVID). In this programme, a patient attended to at a GPFirst clinic and subsequently referred to ED, will qualify for an ED attendance fee discount. Data are retrospectively collected from referral letters of GPs participating in the programme and the hospital's electronic health record system. Results/Findings: During the study period, 207 GPs were progressively enrolled. The annual number of low acuity attendances reduced from 62,213 in 2013 (pre-GPFirst) to 53,480 in 2019 even though the annual number of ED attendances increased gradually from 138,784 in 2014 to 141,072 in year 2019. Moreover, the annual proportion of low-acuity, self-referred cases decreased from 63.4% (39,425) in 2013 to 57.1% (30,528) in year 2019. The annual percentage of GPFirst referrals to the ED which meet referral appropriateness criteria increased from 94.5% (FY2014) to 97.6% (FY2019) and 98.0% (FY2020). Overall, the roll out of GPFirst appears to coincide with a reduction in low acuity patient load without compromising the appropriateness of GP referrals to the ED. Conclusion(s): A multi-faceted regional programme which included campaigned public education, regular GP continuous education, a supportive administrative team and financial incentive for patients, is able to reduce low acuity attendances. An ecosystem emerges which contributes to GPFirst's success. Further research is needed to evaluate safety and the effects of scaling this programme to a national level. No, authors do not have interests to disclose Copyright © 2022
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The Seoul Metropolitan Government is promoting and implementing eco-friendly transportation policies covering the revitalization of public transportation, establishment of green transportation promotion areas, and the expansion of shared-bicycle use. With the prevalence of the COVID-19 pandemic, cities worldwide have been paralyzed by lockdowns, the strict implementation of social-distancing policies, and the shutdown of different industry sectors. People's movement and traffic volume have decreased significantly. The pandemic has forced to people change their travel-related decision-making tendencies. Against this backdrop, this study analysed the changes in shared-bicycle traffic in Seoul during the pandemic. This study analyzed the relationship between social distancing levels and shared bicycle usage using regression analysis. This study conducted an analysis of spatially formed clusters through Moran's I test and hotspot analysis. The results indicate that an important correlation between the spread of COVID-19 and shared bicycle use has been found. When social distancing levels increased by one level, the number of shared bicycle rental per day increased by about 10,000 times. As a result of spatial analysis, changes in shared bicycle usage are spatially forming clusters, and Moran's I test showed statistically significant results with a p-value very close to zero. The study results indicate that under special circumstances, government policy plays an important role in promoting green transportation. The use of green transportation is directly related to falling atmospheric pollution in the city. Such transportation can significantly benefit the environment. The government can produce more effective results by considering local characteristics to revitalize eco-friendly transportation. © 2021, AIDIC Servizi S.r.l.
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The spread of infectious diseases is a spatial process, including Coronavirus disease 2019 (COVID-19). Cluster infections of COVID-19 have arisen globally in various urban spaces, implying that tracking the spread necessitates a spatial approach to understanding the dynamics of the disease. In this study, we employ an online survey in the Seoul metropolitan area in South Korea to examine changes in the use of urban spaces and factors that affect individual's choice in using urban spaces in the COVID-19 era. We classify various urban spaces into three activity types according to the previous studies: spaces for mandatory activities, maintenance activities, and discretionary activities. The results show that every type of urban space is visited less than before the COVID-19 outbreak. Factors involved in the use of spaces for mandatory activities include the preference for offline consumption, gender, and risk perception of COVID-19. In the case of non-mandatory activity spaces, factors that commonly influence the use of the spaces are compliance with social distancing regulations, preference for offline consumption, refraining from outdoor activities, risk perception of COVID-19, and perceived safety in the city concerning COVID-19. The present study is significant as it identified not only different factors affecting the choice of mandatory and non-mandatory activity spaces but also distinctive variables determining the choice of urban spaces for maintenance activity and discretionary activity. From the analysis, this study draws policy implications to effectively prevent and control infectious disease in the context of urban spaces. © 2021 SPSD Press from, SPSD Press, Kanazawa. All Rights Reserved.
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The pandemic situation caused by COVID-19 amplifies the volatility, uncertainty, complexity, and ambiguity of society, suggesting that the unpredictability of this will be further maximized in 2021. Each field in society is selecting and executing digital transformations as one of the strategies to flexibly cope with such uncertainty and sudden changes in an environment that requires different lifestyles to lead daily lives. The education field is not an exception and universities are implementing digital transformations that move from face-to-face education that is held in a classroom environment to online learning in the virtual environment. Hanyang University has developed and operated an innovative teaching and learning model called IC-PBL (Industry-Coupled Problem/Project-Based Learning) to flexibly respond to rapid social changes and to cultivate outstanding individuals with capabilities needed in society. IC-PBL, which has been based on the face-to-face classroom environment, is also in the process of digital transformation due to such environmental changes. Previously, in IC-PBL, the online learning environment played an auxiliary role to support learning. However, as the online learning environment has suddenly been highlighted as the main learning environment of IC-PBL, various issues related to the design and operation of PBL classes in actual education fields are being raised. In this study, the results of participation observations, in-depth interviews with instructors and learners were analyzed through qualitative research on 8 classes in Hanyang University's engineering department. As a result, PBL courses strategies, in accordance with 5G, were presented to make PBL classes in blended environments into successful digital transformations. This demonstrates that PBL courses that have been mostly conducted only in face-to-face environments successfully achieved digital transformation in the post COVID-19 era and have presented strategies that can be used in educational attempts and practices necessary to create sustainable performance as a qualified class. © The authors, 2021.
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There is a demand for one-pot, portable (solid-phase), sensitive, and user-friendly immunosensors for future point-of-care (POC) self-testing. However, current immunoassays such as the enzyme-linked immunosorbent assay (ELISA) typically involve several complicated steps, and they are not readily adaptable by nonexpert users. Herein, we present a rapid (∼30 min) one-pot, solid-phase immunosensor, based on nanomaterials, by combining a nanometer-thick Au/TiO2 photocatalytic film and Cy5/capture antibody/gold nanorod (GNR) conjugates immobilized on a membrane (the fluorescence of Cy5 was enhanced by the GNR). The one-pot immunoassay is started by adding a drop of a mixture containing 4-chloro-1-naphthol (CN), a horseradish peroxidase (HRP)-labeled detection antibody, and an antigen onto the one-pot immunosensor and illuminating UV light. The UV illumination on the Au/TiO2 film results in the production of H2O2, which promotes a CN precipitation reaction. 4-Chloro-1-naphthol precipitates produced by the HRP, which was bound to the conjugates via the antibodies and antigens, could preliminarily quench Cy5 fluorescence via Förster resonance energy transfer, because of their proximity to Cy5. The sensitivity of the developed one-pot immunosensor was similar to that of a commercially available ELISA kit. Given the increasing interest in the early diagnosis of various diseases, including cancers, dementia, and coronavirus disease 2019, the application of nanomaterials such as a porous thin-film photocatalyst and GNR-based fluorescent probes could pave way for the development of next-generation POC biosensors. © 2021 American Chemical Society.
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Background: Social isolation from COVID-19 has been shown to affect the mental health of all socioeconomic, ethnic and age groups. One of the most affected populations is long-term care (LTC) residents. This increased separation from their families and society has created an additive effect to their baseline physical and mental ailments. We investigated the change in depression and anxiety over time in residents of one LTC facility during this crisis. Aim: The aim of the intervention was to reduce the impact of social isolation by modifying recreational activities to include faceto-face visits, music therapy, and similar activities. Methods: Staff collected PHQ-9 and NPIQ (Neuropsychiatric inventory questionnaire) scores of all residents in the facility before implementing modified activities. Between 8/10 and 10/3/2020 we had a modified event calendar. Following the 8-week intervention, PHQ-9 and NPIQ scores were re-recorded. All LTC residents were eligible. Short-term residents, hospice patients, and those who did not participate in the intervention were excluded from analysis. Our primary outcome was change in depression and anxiety. Our secondary outcomes were change in weight, ulcers, and falls (MDS quality metrics). We hypothesized there would be a positive change in PHQ9 and NPIQ scores over time. We analyzed our data using paired sample t-tests. Analyses were conducted using SPSS v. 26. Results: 97 residents participated this intervention with an age range of 63-103 (mean = 86;SD 8). Participants' mean PHQ-9 scores improved significantly after participation in activities (9.1 vs 6.3) with a mean difference of 2.804 (CI 1.924-3.684, p<.001). Similarly, mean NPIQ scored showed a similar trend (18.74 vs 14.94) with a mean difference of 3.804 (CI 3.098-4.510, p <.001). There were no significant differences in falls, weight, or ulcers. Conclusions: This study highlights how COVID-19 has impacted LTC residents' mental health and suggests implementing modified recreational activities can improve the mental health of LTC residents. This is especially important as the pandemic, and associated restrictions, have lasted longer than anticipated. Therefore, LTC facilities should slowly and safely increase social interaction for residents whenever possible.
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Background: Nutritional risk increases with advanced age due to may factors including socioeconomic limits, medications, physical impairments, and overall diminished body reserves. Although it is important to assess protein deficiency when treating geriatric patients, one should also consider trace elements and vitamins, as deficiency can lead to disease, including dermatitis. Presentation: A 74-year-old woman presented to the hospital following a fall and was diagnosed with septic shock due to infected open skin lesions on her left knee causing MSSA bacteremia. On examination, she had a scaly diffuse rash involving her face, trunk and extremities with no mucosal involvement. She was treated with antibiotics and dermatology initially thought she had psoriasis vulgaris. Punch biopsy and histopathology revealed focal intracorneal bulla with subjacent spongiotic dermatitis and intraepidermal dyskeratotic keratinocytes suggesting nutritional deficiencies after ruling out autoimmune causes. Laboratory workup revealed decreased levels of Vitamins A, B6, B12, C, D, zinc and iron. She was given nutritional supplements and vitamins and discharged to a skilled nursing facility with continued treatment and the addition of vitamin B12 and D. Within 2 months, all levels were normal, with the exception of vitamin C. Her skin lesions improved significantly. Conclusion: This case demonstrates the importance of considering nutritional deficiencies when assessing elderly patients, especially in regards to skin lesions. Nutritional assessments and interventions are easily accessible and are an efficient way to help diagnose dermatological conditions in geriatric patients. The tragedy of this COVID-19 pandemic is that this already vulnerable population is facing enormous challenges and that this is manifesting in uncommon ways such as skin lesions caused by nutritional deficiencies.
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Background: As only few studies have analyzed viral kinetics between the incubation and symptomatic periods of COVID-19 patients, we investigated the viral kinetics and compared viral loads between patients with mild and severe COVID-19. Methods: We determined the viral kinetics of 10 patients diagnosed with COVID-19 at Chosun University Hospital. Six patients were classified into the “mild” group and 4 into the “severe” group according to supplemental oxygen use during admission. Samples were collected via nasopharyngeal swabs and sputum specimens. SARS-CoV-2 was detected using real-time reverse transcription-polymerase chain reaction (RT-PCR). Chest radiograph scores during hospitalization were obtained Results: Ct values of the upper respiratory tract specimens were low during the early stages after symptom onset but gradually increased over time in both groups. The severe group had lower Ct values than the mild group. The Ct values of the RdRP and E genes on day 6 after symptom onset were significantly lower in the severe group than in the mild group (p < 0.05). Three of 6 patients had positive results on RT-PCR even before symptom onset;2 of them had the lowest Ct values. The chest radiograph scores were higher in the severe group than in the mild group, and the score in the severe group was the highest at approximately 3 weeks after symptom onset. Ct values when the RdRP gene and E gene were targeted to detect SARS-CoV-2 on the basis of the days after symptom onset in all the patients Conclusion: Viral load and chest radiograph scores were significantly different between the severe and mild groups of COVID-19 patients. (Figure Presented).
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INTRODUCTION: We describe our evaluation of the Abbott SARS-CoV-2 IgG assay on the Architect immunoassay analyser. METHODS: We assessed assay precision, sensitivity, specificity, positive/negative predictive values (PPV/NPV), cross-reactivity (influenza/dengue/hepatitis B and C/rheumatoid factor/anti-nuclear/double-stranded DNA/syphilis) and sample throughput in samples from real-time polymerase chain reaction (RT-PCR) positive patients/healthcare workers (HCWs)/pre-pandemic samples. We compared the cut-off indexes (COIs) between all control samples (HCWs and pre-pandemic) to generate an optimised COI limit for reactivity. RESULTS: The assay specificity was 99.8% (n = 980) and sensitivity was 45.9-96.7% (n = 279). When tested ≥ 14 days post-positive RT-PCR (POS), the PPV/NPV was 96.4%/99.8%. The difference between the COIs of HCWs/pre-pandemic samples was small (0.01, p < 0.0001). There was minimal cross-reactivity with other antibodies. A lower COI limit for reactivity (≥0.55, using the 99th percentile COI of our controls and ROC analysis) improved diagnostic sensitivity, especially at 0-6 days POS (45.9-55.8%), with a small decrease in specificity (98.9%). The assay throughput was 100 samples in 70 min. CONCLUSION: The Abbott SARS-CoV-2 IgG assay shows excellent performance in patients ≥ 14 days POS. The difference between the COIs of HCWs and pre-pandemic samples was numerically small. A lower COI limit improves assay sensitivity with a slight decrease in specificity.