ABSTRACT
Background With the COVID-19 pandemic there was an acute drop in procedural volume for trainees, highlighting the need and potential of simulation-based training (SBT). Prior to the pandemic, the uptake of simulation was poorly categorized and inconsistent across programs despite the variety of endoscopic simulators available. We aimed to evaluate the current state of endoscopy training internationally in the wake of the pandemic as perceived by trainees. Methods This cross-sectional study utilized a survey composed of 21 questions eliciting demographic data, COVID-19-related training experiences, and experience with SBT. This survey was distributed internationally (USA, Canada, EU, Philippines, Singapore) to gastroenterology trainees between August 2021 to October 2021. Results The questionnaire was completed by 182 fellows, with 55 (30.2%) from the USA and 127 (69.8%) from other countries. Of the respondents, 79.1% were fellows during the first year of the pandemic. A majority (69.2%) found endoscopy training in general to be negatively impacted. Of those who reported a negative impact from the pandemic, 75.0% attributed it to a decline in endoscopic volume, 40.0% to institutional/regional guidelines, 25.0% to a shortage of personal protective equipment. Overall, 47.2% of respondents believed COVID-19 will negatively affect their endoscopic proficiency upon fellowship completion. A total of 71 respondents (39.0%) had experienced SBT before or during fellowship, with 27 from the USA (49.1% of respondents from USA) and 44 from other countries (34.6% of respondents from other countries). In the USA, 63.0% had used virtual reality (VR), 37.0% mechanical models, and 37.0% animal models compared to 47.7% VR, 68.2% mechanical models, and 27.3% animal models in other countries. Respondents agreed that SBT was most helpful with developing technical skills such as ergonomic handling, torque steering, and fine tip control. A majority (52.1%) found SBT appropriate to their level of training. Respondents believed increased access to SBT (43.7%) and mentored training (54.9%) would improve the experience. Conclusion While current data supports the use of SBT early in training, the cumulative uptake of SBT across programs before and during the COVID-19 pandemic remained low. In the USA and abroad, fellows perceive a negative impact of COVID-19 on their training and proficiency upon graduation. Compared to other countries, the USA had higher utilization of VR and lower utilization of mechanical models. Decrease in endoscopic volume was reported as the main factor negatively impacting endoscopic training. This survey highlights the potential benefit of SBT with low case volumes and further prospective evaluation of SBT in achieving endoscopic competence. (Table Presented)
ABSTRACT
In accordance with the development of new technologies, e-commerce is revolutionizing the world, especially in the COVID-19 pandemic. It becomes a major part of the industry in improving revenue. A lot of potential time-consuming in traditional purchasing may lead to failing customer's trust in apparel industry. So, in e-commerce purchasing, customers get more new collections of apparel, saving money and time. Buying apparel through e-commerce has certain limitations of trying apparel before buying it. However, the proposed system allows customers to experience the fit virtually according to their needs. The main motive of the project is experiencing customer's outfits before purchasing so that customers can improve their decision-making process. A virtual trial room system improves the accessibility of the garments virtually without any discomfort, enhances customers to feel free to try the fit, comfortable to engage with the environment and there are fewer chances of returning and cancelling products. It detects the customer's posture and provides 2D virtual garments that are adjusted according to the posture, thus predicting the right fit by measuring the height and width of the body. This application provides interactive, rich and engaging surroundings to the clients. © 2022 IEEE.
ABSTRACT
Introduction Erectile dysfunction (ED) is usually a symptom of another medical condition. People with poor overall health are more likely to develop severe form of coronavirus disease 2019 (COVID-19) and may have unwanted symptoms such as ED. COVID-19-related stress, anxiety, and depression can also impact sexual health and possibly lead to ED. There are various treatment options for patients with ED. However, real-world evidence of the impact of COVID-19 on the treatment and comorbidities of patients with ED is limited. Objectives To estimate the impact of COVID-19 on the treatment and comorbidities of patients with ED in the United States. Methods This retrospective real-world data (RWD) analysis used the IQVIA PharMetrics® Plus claims database, which is a patient-Centric, closed claims database of fully adjudicated pharmacy, hospital and medical claims anonymized at the patient level, that captures the complete patient journey for all services billed to and covered by the patient's health plan. We compared the ED treatment and comorbidities in adult males aged 18+ years with ED in the same 3-month periods before (01March - 31May, 2019) and during (01March – 31May, 2020) the COVID-19 pandemic. ED treatment included any ED-related claims, prescriptions of any and individual phosphodiesterase-5 inhibitor (PDE5i) medications (avanafil, sildenafil, tadalafil and vardenafil). Results See the table below for number of patients having ED-related claims, having any and individual PDE5i prescriptions, number of patients with COVID-19 diagnosis, and percentage of patients with each of the top 10 comorbidities, in the 3-month periods before and during COVID-19. Conclusions RWD showed that ED-related claims significantly decreased during the COVID-19 pandemic, reflecting the pandemic's impact on ED patients’ health. However, the use of PDE5i medications remained stable during the pandemic. Key comorbidities including hypertension, hyperlipidemia, type 2 diabetes mellitus, benign prostatic hyperplasia with lower urinary tract symptoms, testicular hypofunction, and malignant neoplasm of the prostate, during the pandemic, compared with pre-pandemic period, highlighted the impact of the pandemic on ED patients’ health and need for managing their other comorbid chronic diseases. Disclosure Work supported by industry: yes, by Viatris. A consultant, employee (part time or full time) or shareholder is among the authors (Viatris).
ABSTRACT
Background: SARS-Cov-2 infection (COVID-19) and associated gastrointestinal manifestations have been well documented during the pandemic. To date, several centers have reported isolated cases of COVID-19 and its effect on the pancreas. Here, we present a case series of 13 patients with acute pancreatitis (AP) due to COVID-19, which represents one of the larger case series to date. Methods: A retrospective review was performed from 3/1/2020 through 4/1/2020 at 4 NYC academic medical centers. Patients with a diagnosis of AP and COVID-19 were included. AP was diagnosed based on AGA criteria. COVID-19 infection was confirmed via nasopharyngeal viral PCR testing. All patients with a prior history of AP were excluded. Patients with apparent/suspected etiologies of AP (including gallstones, alcohol, hypertriglyceridemia, post ERCP, medication, and other viral etiologies) were excluded. 13 patients met our inclusion and exclusion criteria. Outcomes studied included mortality, ICU admission, length of stay, BISAP scores on admission and at 48 hours. Results: 7 of the 13 patients in this cohort were African American, 8 of 13 were men, and the median age was 51 years of age. The youngest patient was 18 years old and the oldest patient was 71 years old. Of the 13 patients, 5 patients died during their hospital course. Of those 5 who passed, 4 were African American, and all 5 were > 50 years of age. 6 of the 13 required ICU level of care. The mean length of stay for all patients was 23 days. On admission, 4 patients had BISAP scores > 3, at 48 hours 3 patients had BISAP scores > 3. Discussion: We report the characteristics of 13 patients with confirmed SARS-Cov-2 infection and AP without other common etiologies. We suspect that SARS-Cov-2 was a direct cause of AP in these patients. 5 patients died (38.5%) due to multiorgan failure from Acute Respiratory Distress Syndrome. Patients with COVID-19 and AP had a higher mortality rate than the overall mortality reported with COVID-19 during the same period. The mortality of patients in our series far exceeds the reported mortality in mild or moderate AP (less than 1%)1,2. Currently molecular theories suggest that viral attachment to ACE-2 receptors on pancreatic acinar cells leads to apoptosis, inhibition of nitric oxide production, and programmed cell death that ultimately leads to AP. Conclusion: This case series indicates a possible association between COVID-19 and AP and the increased mortality in this subset of patients. Further research is needed concerning the molecular mechanisms and clinical management of this entity. Larger studies are needed to confirm the worse outcomes with AP associated with COVID-19. Ref: 1. Russo MW et al. Digestive and liver diseases statistics, 2004. Gastroenterology. 2004;126:1448–53. 2. Triester SL et al. Prognostic factors in acute pancreatitis. J Clin Gastroenterol. 2002;34:167–76.