ABSTRACT
BACKGROUND: Reports of silent hypoxia in patients with Covid-19 have raised concerns that patients monitored at home should receive pulse oximeters to objectively measure oxygen saturation rather than relying on subjective dyspnea as an indicator of clinical deterioration. METHODS: In this pragmatic randomized control trial, patients with suspected or confirmed Covid-19 were randomly assigned (1:1) to receive a text message based remote monitoring program (“Covid Watch”) or the program supplemented with SpO2 monitoring using a home pulse oximeter (“COVID Watch + Pulse Oximetry”). Covid Watch is a an automated 14-day text program that enquires about patients' symptoms of dyspnea. The primary outcome was days alive and out of hospital (DAOH) at 30 days. RESULTS: A total of 1056 patients (611 Covid-19 positive) were assigned to receive automated remote monitoring of both peripheral oxygen saturation (SpO2) levels and self-reported symptoms of dyspnea and 1041 (606 Covid-19 positive) to receive symptom monitoring alone. Among Covid-19 patients, the addition of SpO2 monitoring provided no significant difference in mean DAOH at 30 days (29.38 vs 29.46;difference -0.08;95% CI, -0.37 to 0.21). Patients in the intervention arm were more likely to use more clinical resources such as telephone calls and telemedicine visits. These finding were consistent across subgroups defined by race, age, and clinical status. CONCLUSIONS: SpO2 monitoring added no clinical value to subjective assessments of dyspnea in an automated text-message remote monitoring program of Covid-19 patients, while simultaneously increasing utilization of clinical resources. These findings reveal that home pulse oximetry may be ineffective and inefficient in supporting the management of Covid-19 patients in outpatient settings relative to remotely monitoring symptoms of dyspnea alone.
ABSTRACT
Creating truly original ideas requires extensive knowledge of existing ideas. Navigating prior examples can help people to understand what has already been done and to assess the quality of their own ideas through comparison. The creativity literature has suggested that the conceptual distance between a proposed solution and a potential inspiration can influence one's thinking. However, less is known about how creators might use data about conceptual distance when exploring a large repository of ideas. To investigate this, we created a novel tool for exploring examples called IdeateRelate that visualizes 600+ COVID-related ideas, organized by their similarity to a new idea. In an experiment that compared the IdeateRelate visualization to a simple list of examples, we found that users in the Viz condition leveraged both semantic and categorical similarity, curated a more similar set of examples, and adopted more language from examples into their iterated ideas (without negatively affecting the overall novelty). We discuss implications for creating adaptive interfaces that provide creative inspiration in response to designers' ideas throughout an iterative design process. © 2021 Owner/Author.
ABSTRACT
Objective: To explore the risk factors and control methods of surgical operation during the outbreak of coronavirus disease 2019 (COVID-19), and to summarize the experience of prevention and treatment methods of COVID-19 under surgical conditions from a single center during the epidemic. Methods: The clinical data of 17 patients diagnosed as COVID-19 postoperatively in Renmin Hospital of Wuhan University from January 3 to January 22, 2020 were collected and analyzed. The diseases were classified according to the Chinese Diagnosis and Treatment of Novel Coronavirus Infected Pneumonia (5th trial edition). The mild and moderate type patients were incorporated into the non-severe group, while the severe and critical ones were categerized into the severe group. Then we compared the general information, clinical symptoms, laboratory test results, and outcomes between the two groups. Results: The clinical data of 3 339 patients underwent surgical operation were reviewed, and 17 patients were diagnosed as COVID-19 after operation, with a 0.51% incidence rate. Among them, 7 cases (41.2%) were severe, and 2 cases (11.8%) died of respiratory failure. The clinical manifestations were mainly fever (76.47%) and cough (58.82%). Laboratory examination results showed that in most patients, the leukocyte count was normal (70.59%), lymphocyte count was lower (88.24%), and C-reactive protein level was higher (88.24%). Immune function tests showed that cellular immune function was significantly impaired in some patients. Among them, 62.5%, 62.5% and 75% of the patients had decreased CD3 count, CD4 count and CD8 count. The percentage of severe COVID-19 cases in open surgery patients was significantly higher than that in minimally invasive surgery ones (71.43% vs 20%, P=0.034). Conclusion: The proportion of severe cases and mortality in COVID-19 patients undergone surgery are higher than those who haven't;and the severity rate of them receiving open surgery is higher than those performed minimally invasive surgery. During the epidemic, elective or confine surgery should be postponed and the indications for emergency surgery should be strictly accorded with;If an emergency surgery is inevitable, minimally invasive surgery should be selected as a priority. Postoperative screening of COVID-19 should be strengthened, while early, detection, early reporting, early isolation and early treatment should be applied to the infected patients. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.