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Case Report: A 28 year old male with a past medical history of hypothyroidism and positive ANA presented to an outpatient dermatology clinic with a diffuse pruritic rash two weeks after the administration of his first Moderna COVID booster vaccine. He denied any other accompanying symptoms such as fever or chills as well as any similar rashes to prior doses of the Moderna COVID vaccine. The rash consisted of pink erythematous minimally scaly papules, thin plaques and patches involving the left and right dorsal hands, forearms, wrists, face, neck and left shoulder. The remainder of the patient's skin including the bilateral lower extremities, the eyelids, conjunctiva and oral mucosa was clear. The patient denied any similar rashes in the past. The patient denied any allergies to medications, or food or environmental allergies. He denied any notable contact allergen exposures, including to soaps, lotions, and cosmetic products. The patient also denied any significant family history or past surgical history. The patient was on Armour Thyroid for hypothyroidism and testosterone for low levels since age eighteen. The patient was started on cetirizine 10 mg once daily for the rash with minimal improvement. Autoimmune workup for the rash was notable for an elevated anti-RNP and as the patient's past medical history included Raynaud's phenomenon and ANA positivity for ten years, the patient was diagnosed with mixed connective tissue disease (MCTD). Autoimmune conditions can often have an indolent course, where symptoms progressively develop and worsen. MCTD is an autoimmune overlap syndrome that can consist of the following three connective tissue diseases: systemic lupus erythematosus, scleroderma, and polymyositis. Millions of individuals across the world are receiving COVID vaccines to protect themselves and members of their community, and it is of utmost importance that we continue to investigate adverse events. Although of low incidence, these rare effects have the ability to impact large numbers of people within both healthy and immunocompromised populations. It is critical that we examine and document them in a rigorous manner, to ensure safe vaccine delivery and reassure the public about vaccine safety overall.
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Purpose of Study: Severe COVID-19 infection has been associated with a hypercoagulable state, contributing to the formation of clots. Retinal vascular occlusion (RVO) is a common cause of vision impairment and is due to blockage of the retinal arteries and veins. There have been reported cases of patients with previous history of COVID-19 presenting with new RVO. Given the minimal research delving into this relationship, the purpose of this study was to investigate the short-term prevalence and risk for RVO following infection by COVID-19 compared to Influenza A. Methods Used: Two cohorts were created using TrinetX, a national federated electronic health record (EHR). The two cohorts consisted of patients with a history of COVID-19 (n=2,352,475) and patients with a history of Influenza A (n=67,065). Both cohorts were balanced using 1:1 propensity score matching (PSM) addressing demographics and medical comorbidities. Outcomes between the two cohorts were compared using adjusted risk ratios (aRR), with a confidence interval of 95%. Summary of Results: After PSM, two cohorts of 67,063 patients each were compared. Patients in the COVID-19 cohort had an average age of 41.4+/-23.0 years compared to 34.4+/-27.7 years in the Influenza cohort. Between the two cohorts, there was no significant difference in risk of developing retinal vascular occlusion (aRR [95% CI] = 0.72 [0.49,1.06];p=0.097) and patients with COVID-19 had a significantly lower risk for developing retinal vein occlusion (aRR [95% CI] = 0.45 [0.27,0.77];p=0.03). Incidence of retinal vascular occlusion was 0.1% between both cohorts. Retinal artery occlusion was excluded from analysis due to obfuscation of the data by the EHR. Conclusion(s): Between the two cohorts, there was no significant difference in risk for developing RVO within 120 days. However, while there was no significant difference, vascular occlusions were found at a relatively younger age than the general population. Although incidence of RVO was low between the two cohorts, both viruses could be considered a risk factor for development of RVO, particularly in younger patients lacking classic risk factors for the disease.
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Introduction: Cutaneous manifestations such as morbilliform rashes, lichen planus, and local injection site patches have been recently published in case reports to occur within days of receiving the coronavirus disease 2019 (COVID-19) vaccine. The most common drug eruptions have been noted to be delayed hypersensitivity reactions. Objective: To spotlight a vaccine drug eruption case in a patient with a long history of the autoimmune condition, psoriasis vulgaris. Case Presentation: A 51-year-old Caucasian female presented with pruritic and erythematous rashes covering her back, abdomen, pelvis, and both upper extremities emerging one week after receiving the Pfizer BioNTech mRNA vaccine. The rashes worsened, rapidly spreading toward the lower extremities within five days after her second dose. The patient was diagnosed with psoriasiform spongiotic dermatitis compatible with a drug eruption and began loratadine and clobetasol cream treatment and phototherapy. Conclusion: With limited published data available on skin reactions to the COVID-19 vaccine, our case report is among one of the first presentations to describe a morbilliform rash induced by a Pfizer BioNTech mRNA drug-eruption. Although this is a rare case, we may expect more reported drug eruptions to be documented as mass vaccinations continue to be dispensed across the globe. Physicians must be prepared to accurately diagnose and treat dermatologic conditions on patients with and without pre-existing illnesses. © 2022 THE AUTHORS. Published by the National Society for Cutaneous Medicine.
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Background: Globally, the coronavirus disease-19 (COVID-19) pandemic has had a devastating psychological impact on people, especially the healthcare workers/students, in many different community settings. Limited research has been reported on the mental health issue of healthcare students in Vietnam. Objective(s): This study investigated and quantified depression, anxiety, and psychological distress levels among healthcare students, with an emphasis on comparing those studying pharmacy to students in other healthcare-related disciplines, in Vietnam during the COVID-19 pandemic. Method(s): A cross-sectional study recruited 2246 respondents between September 7 and October 7, 2021, in which 230 were pharmacy students with a mean age of 20.0 +/- 1.6 years and most of them had a low COVID-19 fear level. The standardized Patient Health Questionnaire-4 (PHQ-4) scale, consisting of two subscales of PHQ-2 and Generalized Anxiety Disorder-2 (GAD-2), was utilized for the screening of depression and anxiety levels. Result(s): Pharmacy students scored significantly higher on the PHQ-4 psychological distress measure than non-pharmacy students (mean 2.23 vs. 1.90, p = 0.039). Compared to non-pharmacy students, pharmacy students had higher rates of anxiety (10.4% vs. 6.5%, p = 0.028). Conclusion(s): The prevalence of anxiety was higher among pharmacy students in comparison to non-pharmacy students. These findings present a need to recognize and conduct early intervention measures for mental health problems in healthcare students, especially pharmacy students, during recovery from the COVID-19 pandemic.Copyright © 2022 Pharmacotherapy Publications, Inc.
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Backgrounds: Understanding public opinion in relation to vaccination is critical, as there are several COVID-19 vaccines approved for use in Vietnam. This study aimed to assess public COVID-19 vaccine preferences and intention in Can Tho, Vietnam. Methods: An analytical cross-sectional study was performed between September 20 and October 20, 2021. in people aged 18 and over living in Can Tho, Vietnam, A questionnaire captured demographic information, vaccination intention, preference for vaccine selection, and barriers and motivations related to COVID-19 vaccination. Predictors for vaccination willingness among unvaccinated people were determined using multivariable logistic regression. Results: Out of the proposed vaccines that have been approved by the Vietnam Ministry of Health, AstraZeneca (31.4%), Pfizer (23.5%), and Moderna (14.7%) were the most preferred by participants. Out of 1,470 respondents, 35.8% have received at least one vaccine dose, and of these, 76.9% intended to continue to receive vaccinations. Among the unvaccinated, 74.8% reported that they would be willing to complete the vaccination. Most participants stated that they would receive a COVID-19 vaccine if provided with adequate information on effectiveness and safety (92.7%). The possibility of side effects after vaccination (75.4%) was the most important barrier to vaccination. Education, health status, and prior flu-vaccination were associated with the intention to receive a COVID-19 vaccination among those who had not previously received one. Conclusions: Many unvaccinated adults were willing to receive a COVID-19 vaccination, with AstraZeneca being the preferred choice. These findings could help in the planning of vaccination campaigns to increase vaccination uptake in Vietnam.
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Background: Globally, the coronavirus disease-19 (COVID-19) pandemic has had a devastating psychological impact on people, especially the healthcare workers/students, in many different community settings. Limited research has been reported on the mental health issue of healthcare students in Vietnam. Objective(s): This study investigated and quantified depression, anxiety, and psychological distress levels among healthcare students, with an emphasis on comparing those studying pharmacy to students in other healthcare-related disciplines, in Vietnam during the COVID-19 pandemic. Method(s): A cross-sectional study recruited 2246 respondents between September 7 and October 7, 2021, in which 230 were pharmacy students with a mean age of 20.0 +/- 1.6 years and most of them had a low COVID-19 fear level. The standardized Patient Health Questionnaire-4 (PHQ-4) scale, consisting of two subscales of PHQ-2 and Generalized Anxiety Disorder-2 (GAD-2), was utilized for the screening of depression and anxiety levels. Result(s): Pharmacy students scored significantly higher on the PHQ-4 psychological distress measure than non-pharmacy students (mean 2.23 vs. 1.90, p = 0.039). Compared to non-pharmacy students, pharmacy students had higher rates of anxiety (10.4% vs. 6.5%, p = 0.028). Conclusion(s): The prevalence of anxiety was higher among pharmacy students in comparison to non-pharmacy students. These findings present a need to recognize and conduct early intervention measures for mental health problems in healthcare students, especially pharmacy students, during recovery from the COVID-19 pandemic. Copyright © 2022 Pharmacotherapy Publications, Inc.
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Physical exercises are important for a healthy life. However, many people do the exercises without professional assistance, especially when practicing at home during Covid-19. Inappropriate exercising can negatively impact and even result in muscle pain. In this paper, an exercise coaching application is developed to understand what the user is doing and provide useful assessments and guidelines to assist the users. The proposed application takes RGB image sequences from any off-the-shelf cameras widely integrated into smartphones or laptops as input. First, skeleton sequences are extracted from RGB images using the public tool Google MediaPipe. Then, a real-time action recognition based on the temporal sliding window and DD-Net model is proposed to determine the action class. Two frame-based and sequence-based scores are estimated to provide a quantitative assessment. Finally, a tool with GUI and a database are developed. © 2022 IEEE.
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Purpose : SARS-CoV-2, the viral infection that causes COVID-19, is known to induce a hypercoagulable state in patients. While there have been isolated reports of retinal vascular occlusion among patients with a pre-existing COVID-19 infection, research into this topic remains scant. Therefore, the purpose of this study is to investigate the shortterm prevalence and risk for retinal vascular occlusion between COVID-19 and influenza A patients. Methods : TrinetX is a national, federated database that was utilized in this retrospective cohort analysis. At the time of the study, electronic medical records from over 80 million patients across 57 healthcare organizations were analyzed to create two cohorts of patients. At the time of the analysis, 1,224,770 patients with a previous history for COVID19 were compared to 61,555 patients with a previous history for influenza A. Then, 1:1 propensity score matching (PSM) was utilized to balance each cohort by demographics and comorbidities (age, sex, BMI, history of hypertension, chronic lower respiratory disease, diabetes mellitus, nicotine dependence, heart failure, and alcohol related disorders). Adjusted risk ratios (aRR) using 95% confidence intervals (CI) were used to assess risk of retinal vascular occlusion 120 days after initial diagnosis for COVID-19 or influenza A. Results : Before PSM, COVID-19 patients were at significantly lesser risk for retinal vascular occlusion within 120 days of initial diagnosis than influenza A patients (aRR [95% CI] = 0.58 [0.42,0.8];p<0.001). However, the incidence for influenza patients to develop retinal vascular occlusion was very small (0.1%). After PSM, two balanced cohorts of 61,555 patients were compared to one another and revealed that there is no significant difference in developing a retinal vascular occlusion after a previous diagnosis of COVID19 or influenza A (0.92 [0.58,1.46];p=0.725). Likewise, the incidence for retinal vascular occlusion remained very small (0.1% between both cohorts) (Table 1). Conclusions : This is the first large-scale study investigating the risk of retinal vascular occlusion among COVID-19 and influenza A patients. We found that each cohort was at similar risk for developing retinal vascular occlusion within 120 days. Likewise, the incidence for retinal vascular occlusion was miniscule among patients in this study.
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The sudden outbreak of the COVID-19 pandemic has made it difficult for schools and universities to solve numerous pedagogical issues. These educational institutions have to find new solutions to these issues through online learning. Teachers must work out efficient and effective methods and activities in online delivery, and the use of computer technology gradually becomes necessary. This chapter focuses on analyzing online language teacher education in the developing countries such as Vietnam and using computer technology in online EFL classes. Therefore, teacher educators and in-service teachers need to possess knowledge of computer-assisted language learning (CALL) applications to improve teaching and learning practices. The chapter investigates groups of in-service teachers learning to teach EFL. The findings and the critical analysis indicated positive and negative aspects of online language teacher education using CALL. Future CALL research with online courses will focus on language teaching with more linguistic features in accordance with the fast technological enhancements. © 2022, IGI Global. All rights reserved.
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Purpose: Opioid-related morbidity and mortality have risen in many settings. In particular, the prevalence of opioid misuse in incarcerated youth exceeds that of the general adolescent population and overdose mortality within 2 weeks of release is 129 times higher. In 2016, 1 out of 10 adolescent deaths were opioid-related. In King County, WA, since the onset of the COVID-19 pandemic, the number of opioid-related overdose in youth under the age of 20 increased twofold from 10 in 2019 to 21 in 2020. Despite such trends, most incarcerated individuals who could benefit from treatment do not receive it. Our goal was to implement a quality improvement (QI) project to evaluate the prevalence of opioid misuse in adolescents and improve protocols to support youth with opioid use disorder (OUD) at a juvenile detention center in King County, WA. Methods: From March 2020-April 2021, providers at the Clark Children and Family Justice Center (CFJC) implemented a QI project to improve quality of care for youth with opioid misuse and OUD. We conducted a chart review to determine prevalence of opioid misuse among youth. We reviewed the change in percentage of youth referred for substance misuse after the implementation of 2 change interventions: provider buprenorphine waiver training and the development of an opioid use management and referral protocol. Providers completed buprenorphine waiver training in June 2020. We developed and initiated protocols in September 2020 to screen adolescents for opioid use and withdrawal, support buprenorphine induction and maintenance, provide youth with overdose prevention training and naloxone kit, and improve care coordination to ensure a smooth transition of care for youth with OUD returning to their communities. This project was reviewed by the University of Washington IRB and determined to be “not human subjects research” as defined by federal and state regulations. Results: The prevalence of opioid misuse of youth ages 12-17 at CFJC from September 2020-April 2021 was 16.9% in comparison to 3.6% in the general population in 2016. From March-May 2020, prior to providers completing buprenorphine waiver training, only 60% of youth who reported substance misuse were referred to the CFJC-Health Clinic for consultation by the next available clinic day. From June-August 2020, after providers completed buprenorphine waiver training, 81% of youth who reported substance misuse were referred for consultation. From Sept 2020-April 2021, after implementation of a referral and management protocol for opioid use and withdrawal, almost all (90%) of youth reporting misuse were referred. Conclusions: Similar to previous literature, we found that the prevalence of opioid misuse among adolescents at CFJC was significantly higher than in the general population. Our findings demonstrate that two change interventions of provider buprenorphine training and the development of protocols to facilitate the assessment and management of opioid misuse and OUD increased the rate of youth who received treatment for OUD at CFJC. Further refinement of these guidelines is needed to ensure that all youth admitted to CFJC with opioid misuse and OUD receive timely consultation and support to decrease the rate of opioid-related morbidity and mortality in confined youth. Sources of Support: None.
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In recent years, the COVID-19 pandemic has negatively impacted all aspects of social life. Due to ease in the infected method, i.e., through small liquid particles from the mouth or the nose when people cough, sneeze, speak, sing, or breathe, the virus can quickly spread and create severe problems for people???s health. According to some research as well as World Health Organization (WHO) recommendation, one of the most economical and effective methods to prevent the spread of the pandemic is to ask people to wear the face mask in the public space. A face mask will help prevent the droplet and aerosol from person to person to reduce the risk of virus infection. This simple method can reduce up to 95% of the spread of the particles. However, this solution depends heavily on social consciousness, which is sometimes unstable. In order to improve the effectiveness of wearing face masks in public spaces, this research proposes an approach for detecting and warning a person who does not wear or misuse the face mask. The approach uses the deep learning technique that relies on GoogleNet, AlexNet, and VGG16 models. The results are synthesized by an ensemble method, i.e., the bagging technique. From the experimental results, the approach represents a more than 95% accuracy of face mask recognition.
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Introduction and Rationale: No targeted therapies exist that improve the outcomes of patients with Acute Respiratory Distress Syndrome (ARDS), in part to the multifactorial etiology of this devastating disease. Infectious agents remain the most common initiating insults, and besides SARS-CoV-2, Influenza-A virus (IAV) is responsible for more ARDS cases and deaths than any other agent. In fact, IAV increases the risk of mortality in ARDS patients three-fold, and accounts for almost half of all ARDS deaths. We recently identified TREK-1 potassium channels on epithelial cells as important regulators of alveolar inflammation and barrier function, two hallmarks of ARDS, and found that pharmacological activation of TREK-1 protects against hyperoxia-induced lung injury. However, whether TREK-1 channels convey similar protection in a clinically more relevant IAVinduced lung injury model, remains unknown. Methods: We infected adult C57BL/6 wildtype mice intra-tracheally (i.t.) with IAV (PR8 strain;TCID50 400), followed by once-daily i.t. injections (days 5, 6 and 7 post-IAV) with the novel TREK-1 activating compounds ML335 (60mcg/kg), BL1249 (100mcg/kg), or a vehicle control, to create a clinically-relevant treatment model. To evaluate the role of epithelial cells in this model, we infected primary human alveolar epithelial cells (HAEC) with IAV (0.01 pfu) for 24 hours. Endpoint analysis consistent in quantification of quasi-static lung compliance;BAL fluid total protein, cell counts, and ROS concentrations;cytokine levels in BAL fluid and cell supernatants;and HAEC viability (XTT assay). In addition, we measured alterations in epithelial potassium currents (fluorometric FLIPR assays) and in IAV-induced signaling cascades (real-time PCR) following IAV infection and treatment with our TREK-1 activators. Results: Oncedaily treatment of mice with the TREK-1 activating compounds ML335 or BL1249 following IAV infection improved lung compliance, and BAL fluid total protein levels, cell counts, IL-6, CXCL-10, MIP-1alpha, and TNF-alpha concentrations, but not ROS, CCL-2 or IL-10 levels. In HAEC, TREK-1 activation improved IAV-induced IL-6, CXCL-10, and CCL-2 levels, while MIP-1alpha, TNF-alpha and IL-10 levels remained unchanged. XTT assays confirmed that in our model IAV infection did not cause significant cell death. Interestingly, IAV infection decreased HAEC potassium currents, which could be counteracted by TREK-1 activation and cell hyperpolarization. Finally, TREK-1 activationmediated cell hyperpolarization inhibited TLR4- and TNFSF13-mediated downstream signaling in IAV-infected HAEC, whereas NFkB, RIG1, TLR3, and TLR7 signaling was not affected. Conclusions: TREK-1 potassium channel activation may represent a novel approach to protect against IAV-induced acute lung injury.
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Due to the COVID-19 pandemic, E-learning is developed significantly to unlock the key factors that support researchers/students. This paper presents a software solution on an E-learning system to control the humanoid robot, which is essential for students’ knowledge and experimental studies in the academic environment. In particular, the research concentrates on controlling NAO robots in the virtual space. First, by installing Choregraphe software, the programs are developed to calibrate and handle different factors that contribute to the robot's performance, such as joint motions, collision avoidance, navigation, localization. After that, the detailed characteristics of the NAO robot are designed and displayed on the Webot 8.4 monitor. By transmitting the connection signal from the Choregraphe to Webot 8.4, the virtual environment analyzes the effectiveness and competencies of the controllers perceived by users. A case study is investigated to inspect the robot operation and the stability of the software solution. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Introduction: The significance of herbal medicine (HM) during the COVID-19 pandemic has been confirmed. Nevertheless, limited studies have included the people perspectives on COVID-19 prevention/treatment using herbal medicine in Vietnam. Thus, this study tackled the aforementioned issue. Methods: Online-based cross-sectional study was conducted in Vietnamese adults between February-April 2021. Descriptive analysis, regression and Chi-squared tests were implemented for the statistical purposes. Results: total of 787 respondents attended the study, 368 (46.8%) confirmed that they use herbal medicine/nutritional supplements for COVID-19 prevention/treatment. Over 50% of the respondents possessed positive perspective on vitamin C ingestion. Using herbal medicine for external use as a disinfectant was mostly preferred. Respondents who had a 'very good' health self-perception or who lived in rural areas, were more likely to have a positive opinion in the COVID-19 prevention/treatment using herbal medicine. The main barrier for herbal medicine utilization was the deficiency of personal experience or expert advice. Conclusion: The Vietnamese people commonly utilize herbal medicine for the COVID-19 prevention/treatment. These data might help policy-makers in managing the public knowledge and practice on herbal medicine use in Vietnam.
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COVID-19 , Adult , COVID-19/prevention & control , Cross-Sectional Studies , Herbal Medicine , Humans , Pandemics/prevention & control , Surveys and Questionnaires , Vietnam/epidemiologyABSTRACT
Introduction The management of patients with heart failure who contract COVID-19 and those who develop heart failure as a consequence of the disease is challenging. The use of advanced therapies in the form of durable left ventricular assist device or heart transplant in this patient population remains a data free zone. We present, to our knowledge, the first case of durable LVAD implantation in a recovered COVID-19 patient. Case Report A 63-year old, previously healthy, male was admitted to OSH with COVID-19 pneumonia and acute respiratory distress syndrome requiring prolonged mechanical ventilation. This hospitalization was complicated by anterior STEMI, cardiomyopathy with severe LV dysfunction and cardiogenic shock. Due to widespread COVID-19 pandemic, invasive evaluation was deferred and the patient was medically managed. He was then transferred to our institution after re-admission for recurrent cardiogenic shock. Echocardiogram revealed dilated LV cavity (6.3 cm), LVEF 10% and large apical aneurysm. Chest CT showed sequelae of prior COVID-19 with changes suggestive of fibrosis. CMR which showed LV dilatation, severe LV systolic dysfunction, LVEF 7% and large apical aneurysm with evidence of thrombus. A large transmural infarct in the LAD territory without viability was confirmed. Cardiogenic shock was managed with Dobutamine and attempts to wean inotrope resulted in worsening hemodynamic and clinical profile. Axillary IABP was placed to facilitate physical and respiratory rehabilitation. The patient underwent placement of HeartMate™ 3 device as DT and LV aneurysm repair. Post-operative course was uneventful and he was ultimately discharged to acute rehabilitation in stable condition. Summary As the global case rate continues to climb and the threat of an exponential surge of long-term cardiac complications looms in the not so distant future, the use of durable MCS in recovered COVID-19 patients may evolve. This case highlights LVAD as a feasible option in end-stage HF and emphasizes the importance of a multidisciplinary approach in assessing candidacy for advanced HF therapies in post-COVID-19 patients. Continued international collaboration and further study regarding use of MCS will be paramount in optimizing care and outcomes in this growing patient population.
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Purpose: COVID-19 hits every country’s health-care system and economy. There is a trend toward using automation technology in response to the COVID-19 crisis not only in developed countries but also in those with lower levels of technology development. However, current studies mainly focus on the world level, and only a few ones report deployments at the country level. The purpose of this paper is to investigate the use of automation solutions in Vietnam with locally available materials mainly in the first wave from January to July 2020. Design/methodology/approach: The authors collected COVID-related automation solutions during the first wave of COVID-19 in Vietnam from January to July 2020 through a search process. The analysis and insights of a panel consisting of various disciplines (i.e. academia, health care, government, entrepreneur and media) aim at providing a clear picture of how and to what extent these solutions have been deployed. Findings: The authors found seven groups of solutions from low to high research and development (R&D) levels deployed across the country with various funding sources. Low R&D solutions were widely spread owing to simplicity and affordability. High R&D solutions were mainly deployed in big cities. Most of the solutions were deployed during the first phases when international supply chains were limited with a significant contribution of the media. Higher R&D solutions have opportunities to be deployed in the reopening phase. However, challenges can be listed as limited interdisciplinary research teams, market demand, the local supporting industry, end-user validation and social-ethical issues. Originality/value: To the authors’ best knowledge, this is the first study analyzing the use of automation technology in response to COVID-19 in Vietnam and also in a country in Southeast Asia. Lessons learned from these current deployments are useful for future emerging infectious diseases. The reality of Vietnam’s automation solutions in response to COVID-19 might be a reference for other developing countries with similar social-economic circumstances and contributes to the global picture of how different countries adopt technology to combat COVID-19. © 2020, Emerald Publishing Limited.