ABSTRACT
This study investigated the effect of hybrid working on the productivity and environmental satisfaction in an activity-based office. Activity-based working is a work style in which workers choose where and when they work. Offices that introduced this concept are known as activity-based offices. To prevent the transmission of COVID-19, hybrid working has become common in Japan after the declaration of the state of emergency. We conducted three surveys in an activity-based office, before, during, and after the state of emergency. The results showed that hybrid working improved workers' perceived productivity. However, the results were influenced by whether the workers valued working with team members at the same location. Workers who valued on-site collaboration saw their productivity decline at home since they found it difficult to communicate. In contrast, others reported higher productivity at home since they found it easier to concentrate, mainly due to the sound environment. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.
ABSTRACT
Due to the COVID-19 pandemic, numerous companies have implemented telework to balance business continuity with employees' safety. However, telework was not a widespread phenomenon in Japan until recently. Why is a geographically decentralized workstyle not as widespread in Japan as in other nations? In a previous study, based on collected samples from 529 Japanese companies, we used statistical analyses and clarified that the communication style aligned with Japanese collectivism seriously hinders telework. The present study used qualitative analysis to investigate how the communication style associated with Japanese collectivist culture hinders the introduction of telework. Finally, we concluded that if a non-Western cultural company introduces telework, it should remove the negative aspects of the communication style associated with collectivist culture to bring about organizational change that leads to a new organizational identity. © 2022 IEEE Computer Society. All rights reserved.
ABSTRACT
We describe the curation, annotation methodology, and characteristics of the dataset used in an artificial intelligence challenge for detection and localization of COVID-19 on chest radiographs. The chest radiographs were annotated by an international group of radiologists into four mutually exclusive categories, including "typical," "indeterminate," and "atypical appearance" for COVID-19, or "negative for pneumonia," adapted from previously published guidelines, and bounding boxes were placed on airspace opacities. This dataset and respective annotations are available to researchers for academic and noncommercial use.
ABSTRACT
Aim/Introduction: Neurological sequelae of Covid-19 have been widely documented by anatomic and functional methods [1,2]. Brain metabolism studies using 18F-FDG PET/CT during the subacute phase of the disease have also been published [1]. On the other hand, there is a lack of information about the influence of SARS-Cov2 infection on brain metabolism during the acute phase of the disease. The aim of this study was to identify and quantify changes in brain metabolism during the acute onset of Covid-19. Material(s) and Method(s): We studied 23 patients (13 women, median age 55.5[33-78] years) hospitalized with positive nasopharyngeal swab test (RT-PCR) for Covid-19 and requiring supplemental oxygen. Dedicated PET/CT images of the brain were acquired for 10 minutes, 1h after injection of 4.4 MBq/kg of 18F-FDG. Visual analysis was performed by two nuclear medicine specialists and one radiologist. Quantitative analysis was performed using dedicated software. 18F-FDG uptake in multiple brain regions was evaluated and the standard deviation (SD) of brain uptake in each region was automatically calculated in comparison with a group of normal subjects. More than 2 SD above or below the control group was considered significant in each area. Result(s): Serum C-reactive protein at admission ranged from 6.43 to 189.0 mg/L (mean 97.0 +/- 55.5 mg/L). The mean supplemental oxygen demand was 2.8 +/- 1.5 L/min. PET/CT images were acquired between 4 and 20 days of symptoms (mean 12.9 +/- 3.8 days). The images showed increased glycolytic metabolism in basal ganglia and relatively reduced brain metabolism in cortical regions. Basal ganglia metabolism was bilaterally increased in 18/23 (78.3%) and normal in 5 (21.7%) patients. Lenticular nucleus presented increased metabolism in 21/23 (91.3%) and was normal in 2 (8.7%) patients. Frontal and parietal lobes metabolism was respectively reduced in 9/24 (37.6%) and 8/23 (34.8%) patients. The whole brain metabolism was normal in 20/23 (86.9%) patients. Olfactory cortex metabolism was normal in 18/23 (78.3%) patients. Conclusion(s): Brain metabolism is clearly affected during the acute phase of SARS-Cov2 infection. The most frequent finding was increased basal ganglia metabolism, with most patients presenting marked lenticular nucleus hypermetabolism. Frontal and parietal lobes presented reduced metabolism in some patients. Interestingly, olfactory cortex is not affected in most patients, suggesting that anosmia, reported by some patients, is not related to the direct involvement of the brain by the disease.
ABSTRACT
In this study, a fabricated silicon (Si) microring resonator biosensor was able to detect 500 fg/mL of the SARS-CoV-2 nucleocapsid protein in phosphate-buffered saline. The relationship between the amount of wavelength shift and refractive index change is investigated in this work. © 2022 IEICE.
ABSTRACT
Computer-based test or assessment has been used widely, especially in the current COVID-19 pandemic, where many schools are conducting distance learning as well as distance examination. The need for a computer or software system to support education is inevitable. A range of solutions, from the free/open source software systems to the paid/proprietary ones have been publicly available. Still, an organization with limited resources prefers to find free or low-budget, while yet demanding reliable solutions. We have reported the use of the computer-based test in a new student recruitment test which is held country-wide. We developed the system based on TCExam, a free and open source computer-based test software, and successfully fulfilled the requirements, but with some tweaks. We found that the TCExam has a performance degradation when used by a large number of examinees concurrently, especially during specific phases during the test. This paper reports the result of our investigation to address the problem and suggests some modifications to the base codes as well as a recommendation of the hardware configuration. We evaluated the modified system in a simulated environment. We successfully achieved up to 56% performance gain using the modified system.
ABSTRACT
Objectives An effective vaccine against SARS-CoV-2 is essential to mitigate the COVID-19 pandemic. In these several months, a number of groups have started to report humoral responses and side effects after BNT162b2 vaccinations. Although these reports demonstrate the safety and efficacy, further studies are warranted to verify these findings. Here we examined the levels of SARS-CoV-2 antibodies in Japanese healthy volunteers who underwent BNT162b2 vaccine, to assess the humoral responses and side effects. Methods Forty-one healthy volunteers' samples were used for the measurement of SARS-CoV-2 antibodies with chemiluminescent assays against the Receptor Binding Domain (RBD) of the virus. We also measured the side effects of the vaccination. Results Although the levels of IgM varied, all participants were seronegative for IgM and IgG before vaccination, and both IgM and IgG were significantly increased after the vaccinations. We further analyzed the humoral responses in relation to age, and found that the IgG levels for 14 days and 35 days, and IgM levels for 14 days after vaccination showed clear declining trends with age. Commonly reported side effects in the participants were sore arm/pain (90.0%) after the first dose, and generalized weakness/fatigue (70.0%), fever (57.5%), and sore arm/pain (90.0%) after the second dose. Conclusions BNT162b2 vaccination generates sufficient production of IgG especially after the second dose, though the response decreases age-dependently. The high frequencies of generalized weakness/fatigue, fever, and sore arm/pain were not negligible, especially after the second dose. This may be associated with the age characteristics of the population.
ABSTRACT
Introduction: Previous observational and randomized studies suggested potential benefit of therapeutic anticoagulation during hospitalization, but this treatment remains controversial Objective: We aimed to investigate the association of prophylactic and therapeutic anticoagulation with mortality for patients with COVID-19 who were treated with steroids and Remdesivir, which is the current standard treatments. Methods: This retrospective study was conducted by review of the electronic medical records for 9,565 patients with laboratory confirmed COVID-19 hospitalized in the Mount Sinai Health system between March 1 2020 and March 30 2021. The primary outcome of interest was the in-hospital mortality. Acute kidney injury was defined as any increase of creatinine by more than 0.3mg/dL or to more than 1.5 times baseline. A propensity score analysis (matching and weighting by inverse probability treatment weights) and multiple imputation was performed. Results: Of the 1,443 patients, 420 (29.1%) had therapeutic anticoagulation therapy. The 1,023 (70.9%) patients with prophylactic anticoagulation were older and had more comorbidities. After matching by propensity score (N=334 in each group), in-hospital mortality was not significantly different between patients with therapeutic anticoagulation and those with prophylactic anticoagulation (26.9% vs. 22.8%, P=0.24). Furthermore, IPTW and multiple imputation for missing data did not change the result (therapeutic versus prophylactic;odds ratio [95% confidential interval]: 1.14 [0.83-1.59], P=0.40];1.20 [0.84-1.73], P=0.31, respectively). Interestingly, patients with therapeutic anticoagulation had higher rate of acute kidney injury as compared to patients with prophylactic anticoagulation (26.6% vs. 16.8%, P=0.003). Conclusions: In conclusion, prophylactic versus therapeutic anticoagulation showed similar inhospital mortality of COVID-19 patients treated with steroids and remdesivir, but therapeutic anticoagulation increased the risk of acute kidney injury compared to prophylactic anticoagulation.
ABSTRACT
Background: Bleeding events can be critical in hospitalized patients with COVID-19, especially those with aggressive anticoagulation therapy. Objective: We aimed to investigate whether hemoglobin drop associated with increased risk of acute kidney injury (AKI) and in-hospital mortality among patients with COVID-19. Methods: This retrospective study was conducted by review of the medical records of 6,683 patients with laboratory confirmed COVID-19 hospitalized in the Mount Sinai Health system between March 1 , 2020 and March 30 2021. We compared patients with and without hemoglobin drop >3g/dL during hospitalization within a week after admissions, using inverse probability treatment weighted analysis (IPTW). Outcomes of interest were in-hospital mortality and AKI which was defined as increased of creatine 1.5 times or 0.3mg/dL. Results: Of the 6,683 patients admitted due to COVID-19, 750 (11.2%) presented with a marked hemoglobin drop. Patients with hemoglobin drop were more likely to receive therapeutic anticoagulation within two days after admissions. Patients with hemoglobin drop had higher crude in-hospital mortality (40.8% versus 20.0%, P<0.001) as well as AKI (51.4% versus 23.9%, P<0.001) compared to those without. IPTW analysis showed that hemoglobin drop was associated with higher in-hospital mortality compared to those without (odds ratio (OR) [95% confidential interval (CI)]: 2.21 [1.54-2.88], P<0.001) as well as AKI (OR [95% CI]: 2.79 [2.08-3.73], P<0.001). Finally, the smooth spline curve showed the association of hemoglobin drop and adjusted odds ratio for in-hospital mortality, which reflected the association of hemoglobin drop and in-hospital mortality (Figure). Conclusions: Hemoglobin drop during COVID-19 related hospitalizations was associated with a higher risk of AKI and in-hospital mortality. Figure Legends: Smooth spline curve of the association of hemoglobin drop and adjusted odds ratio of in-hospital mortality.
ABSTRACT
Introduction: Statins are frequently prescribed for patients with hypertension, dyslipidemia and diabetes mellitus. These comorbidities are highly prevalent in COVID-19 patients. Statin's beneficial effect on mortalities in COVID-19 infection has been reported in several studies, but still inconclusive. Hypothesis: The inconclusive study results in association of satin use and COVID-19 can be resulted from variable timing of statins used among the studies. Our aim was to investigate whether consistent use of statins before and during hospitalization was effective to decrease the mortality due to COVID-19. Methods: We conducted a retrospective study among 6,095 patients with COVID-19 hospitalized in New York City between March 1st 2020 and May 7th 2021. Patients were stratified into two groups: statins use prior or during hospitalization (N=2,423) versus no statins (N=3,672). We evaluated inhospital mortality as a primary outcome using propensity score matching and inverse probability treatment weighted (IPTW) analysis. In addition, we compared continuous use of statins (N=1,108) versus no statins. Results: Statins use prior or during hospitalization group were older (70.8±12.7 versus 59.2±18.2, P<0.001) and had more comorbidities compared to no statins group. After matching by propensity score (1,790 pairs), there were no significant differences in in-hospital mortality between patients with statins versus those without (28.9% versus 31.0%, P=0.19, odds ratio (OR) [95% confidence interval (CI)]: 0.91 [0.79-1.05]). This result was confirmed using IPTW analysis (OR [95% CI]: 0.96 [0.81-1.12], P=0.53). As the additional analysis comparing continuous use of statins versus no statins group, in-hospital mortality was significantly lower in continuous use of statins compared to no statins group (26.3% versus 34.5%, P<0.001, OR [95% CI]: 0.68 [0.55-0.82]) after matching by propensity score (944 pairs). IPTW analysis showed the similar result (OR [95% CI]: 0.77 [0.64-0.94], P=0.009). Conclusions: Use of statins prior or during hospitalization was not associated with a decreased risk of in-hospital mortality, however, continuous use of statins might have potential benefit of a decreased risk of in-hospital mortality due to COVID-19.
ABSTRACT
Introduction: Obesity is one of the most frequent comorbidities among COVID-19 patients. Although previous studies have shown higher body mass index (BMI) is associated with higher mortality, steroids as the current standard treatment for moderate to severe COVID-19 infection were not applied in most patients in these studies. Hypothesis: We hypothesized that patients with higher BMI still have higher mortality even on steroids. Methods: We conducted a retrospective study of 4,587 hospitalized patients with COVID-19 who received corticosteroids between March 1 , 2020, and March 30 , 2021. We divided patients into 6 groups by BMI[MOU1] (less 18.5, 18.5-25, 25-30, 30-35, 35-40, 40 or greater, kg/m2 ) and investigated in-hospital mortality as the primary outcome, in-hospital mortality among severe COVID-19 patients which was defined as requiring intensive care unit or endotracheal intubation as a subgroup analysis, and acute kidney injury (AKI) incidence rate as the secondary outcome. Results: Patients with higher BMI were younger and more likely to have a history of asthma, obstructive sleep apnea, diabetes, and less likely to have malignancies. The smooth spline curve showed J curve association of BMI with risk adjusted in-hospital mortality with flexion point at BMI between 25 and 30 kg/m2 (Figure 1). Compared to overweight (25≤BMI<30 kg/m2 ) patients, class III obesity (BMI>40 kg/m2 ) was associated with higher risk adjusted in-hospital mortality overall (Table 1) as well as among patients with severe COVID-19 (OR [95% CI]: 3.21 [1.86-5.66], P<0.001). Class III obesity was also associated with a higher risk adjusted incidence of AKI (OR [95% CI]: 1.52 [1.06-2.18], P=0.024) compared to overweight patients. Conclusions: Class III obesity was associated with higher in-hospital mortality and AKI incidence rate in COVID-19 patients with steroids treatment.
ABSTRACT
Background : Coronavirus disease 2019 (COVID-19) is associated with abnormal hemostasis, autopsy evidence of systemic microthrombosis, and a high prevalence of venous thromboembolic disease (VTE). Tissue plasminogen activator (tPA) has been used in COVID-19 patients with severe hypoxia with high clinical suspicion of pulmonary embolism (PE). Aims : We aimed to describe the clinical outcomes of critically ill COVID-19 patients who received tPA. Methods : A retrospective cohort study was conducted on 6,095 hospitalized COVID-19 patients in the Mount Sinai Health System at 5 hospitals in New York. 57 patients with COVID-19, who were admitted from 3/10 to 4/27, 2020 and received tPA for presumed PE were included in the analysis. Baseline demographic and clinical characteristics, indication for tPA, and overall mortality were reported. Results : Among the 57 patients who received tPA, the mean age was 60.8 ± 10.8 years, and 71.9% (41/57) were male. PE was suspected among 75.4% (43/57) of patients with supporting findings who had rapidly worsening hypoxia or hypotension. Right ventricular (RV) strain was present in 15.8% (9/57), deep venous thrombosis (DVT) in 7.0% (4/57), increased dead space ventilation (V d ) in 31.6% (18/57) of patients. RV strain and RV thrombus were present in 3.5% (2/57), RV strain and DVT in 5.3% (3/57), RV strain and increased V d in 8.8% (5/57), and DVT and increased V d in 3.5% (2/57) of patients. No chest CT angiography was performed for any patients due to clinical instability from critical illness. Following tPA infusion, 49.1% (28/57) of patients demonstrated improvement in either of PaO 2 /FiO 2 ratio, blood pressure or partial arterial carbon dioxide. Bleeding complication was seen in 1 patient. Six patients (10.5%) survived to hospital discharge. Overall mortality was 89.5% (51/57). Conclusions : The overall mortality of critically ill COVID-19 patients who received tPA for presumed PE was 89.5 %. The utility of tPA for this indicaition warrants further studies.
ABSTRACT
Introduction: Health care workers are at risk of infection due to the global pandemic of COVID-19, caused by severe acute respiratory syndrome coronavirus 2. Since aerosol are generated during endoscopic procedure, medical staff need to take various countermeasures including standard precautions. However, the details of the aerosol generation during endoscopic procedure are not known. Also, changes in contamination of the environment around patients and equipment before and after the endoscopic procedure have not been clarified. Aims & Methods: We aimed to prospectively evaluate the size and number of the sprayed droplets and aerosol and where they are sprayed during esophagogastroduodenoscopy (EGD) procedure and the changes in contamination of the environment around the patient and equipment before and after EGD procedure. We also evaluated the effect of extraoral suction devices (Free arm arteo®, TOKYO GIKEN, INC.). EGD procedures were performed with the patient in the left lateral position, using a flexible video gastrointestinal scope (GIF-H290Z, H260Z, Olympus Corporation). For aerosol generation, particle counters (KC-01E®, RION CO., LTD.) were placed at two locations, 15 cm from the patient's mouth (Mouth side) and at the channel of the endoscope (Channel side), and the number of particles of 0.3, 0.5, 1.0, 2.0, and 5.0 μm was measured. For the number of particles, the rate of increase was evaluated. Contamination of the environment was assessed using ATP hygiene monitoring tests (Lumitester®, Kikkoman Biochemifa Co., Ltd.). This test was performed at a total of 18 locations, and changes before and after EGD procedures were evaluated. The details of the 18 locations are as follows. 7 locations near the patient (the face shield of the doctor and nurse, the doctor's right and left hands, and three point of the endoscopic equipment, i.e. monitor of endoscope, surface of the video system, under the endoscope tower), 8 locations 1.5 m from the patient (8 locations evenly spaced around the patient), and 3 locations further away (the walls of the endoscopy room) The effect of using an extraoral suction device was also evaluated. This device have air flow rate of 3,000L/min and was placed above the patient's head. Results: From Fe. 12, 2021 to Apr. 15, 2021, 22 patients were recruited into the study. In terms of aerosol generation, both at the Mouth side and the Channel side, high rates of increase were observed at 1.0, 2.0, and 5.0 μm. In the comparison between the Mouth side and the Channel side, the maximum increase rate was higher in the Channel side than in the Mouth side at 1.0 and 2.0 μm. These results did not change depending on an extraoral suction device. In terms of contamination of the environment, ATP hygiene monitoring tests were significantly elevated at near the patient (the face shield of the nurse, the doctor's right hands, and a point of the under the endoscope tower as well as two locations, 1.5 m from the patient (In front of the patient, 45 degrees dorsal to the patient's head). And, the extraoral suction device could reduce points that the number of ATP hygiene was significantly elevated, except for near patients. Conclusion: During EGD, aerosol of 1.0 and 2.0 μm were mainly dispersed, and the Channel side tended to have more droplets and aerosol than the Mouth side. These results indicated that droplets and aerosol are dispersed not only from the patient's mouth but also from the channel of the endoscope. The extraoral suction device could reduce contamination of the endoscopic procedure room due to EGD, except for near patients.
ABSTRACT
TOPIC: Chest Infections TYPE: Original Investigations PURPOSE: Inhaled corticosteroids (ICS) are widely used in patients with asthma and chronic obstructive pulmonary disease (COPD). The pooled epidemiological studies have shown that patients with asthma or COPD are at lower hospitalization risk, which could be related to the protective effect of ICS. However, some studies showed no protective effects of ICS on the prognosis of COVID-19. The very recent study suggested that the use of ICS, within 2 weeks of admission, improved survival only for patients aged 50 years and older with asthma, but not for those with chronic pulmonary disease. Herein, we are highly concerned about whether the use of ICS affects the prognosis of COVID-19. METHODS: We retrospectively analyzed over 6,095 hospitalized patients with laboratory confirmed COVID-19 at the Mount Sinai Health System in New York between March 1stand May 2nd, 2020. Patients were stratified into those with or without ICS before admission and were assessed for in-hospital mortality as a primary outcome. Patients were matched by propensity score using 1:1 matching scheme without replacement. We performed this analysis with and without multiple imputation for missing data and then performed an inverse probability weighted analysis. All statistical calculations and analyses were performed in R, with p-values <0.05 considered statistically significant. RESULTS: Of the 6,095 patients admitted due to COVID-19 infection, 333 patients (5.5%) used ICS before admission. The patients with ICS were older and had more comorbidities compared to the patients without ICS. However, in-hospital mortality, intensive care unit admission, and endotracheal intubation rate were not significantly different, although the d-dimer levels were significantly lower in patients with ICS compared to those without (1.48 [0.88, 2.76] versus 1.66 [0.88, 3.51] mg/mL, P=0.043). After matching by propensity score (N=204 in each group), in-hospital mortality and intensive care unit admission rate were not different, while endotracheal intubation rate was significantly decreased in the patients with ICS. Multiple imputation for missing data and inverse probability weighted analysis revealed no significant difference in in-hospital mortality between the groups (odds ratio [95% confidential interval]: 0.90 [0.61-1.34], P=0.63;odds ratio [95% confidential interval]: 0.83 [0.54-1.29], P=0.42). To identify the population ICS improves the prognosis of COVID-19, we performed a subgroup analysis among patients with asthma and COPD (N=378). There was no significant difference in in-hospital mortality between patients with ICS and those without even after propensity score matched analysis or inverse probability weighted analysis (odds ratio [95% confidential interval]: 0.86 [0.47-1.60], P=0.64) (Table 1). CONCLUSIONS: In our study, antecedent ICS use showed numerically better outcomes in the propensity score matching analysis and the subgroup analysis of patients with asthma and COPD even though the patients with antecedent ICS use had more comorbidities. Particularly, our propensity score matching analysis revealed that patients with antecedent ICS use showed decreased endotracheal intubation rate. CLINICAL IMPLICATIONS: The potential benefit of antecedent ICS use on COVID-19 patients needs to be examined with larger sample size. DISCLOSURES: No relevant relationships by Natalia Egorova, source=Web Response No relevant relationships by Hiroki Kabata, source=Web Response no disclosure on file for Toshiki Kuno;No relevant relationships by Matsuo So, source=Web Response No relevant relationships by Mai Takahashi, source=Web Response