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The diagnosis of COVID-19 requires chest computed tomography (CT). High-resolution CT images can provide more diagnostic information to help doctors better diagnose the disease, so it is of clinical importance to study super-resolution (SR) algorithms applied to CT images to improve the reso-lution of CT images. However, most of the existing SR algorithms are studied based on natural images, which are not suitable for medical images;and most of these algorithms improve the reconstruction quality by increasing the network depth, which is not suitable for machines with limited resources. To alleviate these issues, we propose a residual feature attentional fusion network for lightweight chest CT image super-resolution (RFAFN). Specifically, we design a contextual feature extraction block (CFEB) that can extract CT image features more efficiently and accurately than ordinary residual blocks. In addition, we propose a feature-weighted cascading strategy (FWCS) based on attentional feature fusion blocks (AFFB) to utilize the high-frequency detail information extracted by CFEB as much as possible via selectively fusing adjacent level feature information. Finally, we suggest a global hierarchical feature fusion strategy (GHFFS), which can utilize the hierarchical features more effectively than dense concatenation by progressively aggregating the feature information at various levels. Numerous experiments show that our method performs better than most of the state-of-the-art (SOTA) methods on the COVID-19 chest CT dataset. In detail, the peak signal-to-noise ratio (PSNR) is 0.11 dB and 0.47 dB higher on CTtest1 and CTtest2 at x3 SR compared to the suboptimal method, but the number of parameters and multi-adds are reduced by 22K and 0.43G, respectively. Our method can better recover chest CT image quality with fewer computational resources and effectively assist in COVID-19.
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Population ageing is a global phenomenon. This trend poses healthcare ser-vices, social care, and political challenges, yet implies a growing demand for ageing-related products and services. Smart textile technology has been increas-ingly applied in healthcare applications to support healthy ageing from many aspects. This research indicated the challenges for older people to stay in their own house in later life from the previous literature and reviewed smart home healthcare products and smart textiles for healthy ageing. We found that the current development of elderly textile products neglects the real needs of older people in healthcare products in the home environment from their perspectives. Thus, this research aims to discover the health and well-being needs of people aged 60+ living independently at home in the UK, especially during COVID-19. This research conducted interviews with 12 individuals and questionnaires with 43 individuals for questionnaires. Results highlighted the current unmet healthcare-related needs at home and participants' experiences and attitudes towards healthcare products. Finally, it indicated the potential opportunity for inclusive smart textile design for healthy ageing in the future. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.
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Background: Hepatocellular carcinoma (HCC) is the second leading cause of malignancy-related mortality and the fifth most common worldwide. Immuno-cancer microenvironment (ICME) was highlighted recently because scientists want to unlock the detailed mechanism in carcinogenesis pathway and find the novel interactions in ICME. Besides, single cell analysis could mitigate the interrupted signals between cells and tissues. On the other hand, COVID-19 angiotensin I converting enzyme (ACE) previously was reported associated with cancer. However, the robust association between COVID-19 and HCC ICME is still unaddressed. Aim(s): We plan to investigate the COVID-19 ACE relevant genes to HCC ICME regarding survival. Method(s): We used Reactome for COVID-19 ACE gene pathway mapping and explored the positive relevant gene expression. DISCO website was applied for single cell analyses using the above-collected genes from Reactome. Finally, we implanted the biomedical informatics into TIMER 2.0 for ICME survival analyses. Result(s): In Fig. 1, the gene-gene interaction mapping was shown. We collected 13 genes (CPB2, ACE2, AGT, MME, ANPEP, CPA3, ENPEP, GZMH, CTSZ, CTSD, CES1, ATP6AP2, and AOPEP) for further single cell relevant analyses, in Table 1, with detailed expression level (TPM). Among the above 13 genes, AGT, GZMH, CTSZ, CTSD, CES1, and ATP6AP2 were strongly expressed in liver tissue. We then applied the initial 13 genes to TIMER 2.0 for HCC ICME 2-year survival analyses. CPA3 and GZMH low expressions with high macrophage infiltration in HCC ICME showed significantly worse 2-year cumulative survival [hazard ratio (HR):CPA3 2.21, p-value 0.018;GZMH 2.07, p-value 0.0341]. ACE2, CPB2, AGT, MME, ANPEP, ENPEP, CTSZ, CTSD, CES1, and ATP6AP2 high expressions with high macrophage infiltration in HCC ICME revealed significantly worse 2-year cumulative survival. Conclusion(s): We demonstrate that ACE2 was strongly associated with HCC clinical survival with macrophage infiltration. However, the bidirectional translational roles about ACE2 relevant genes in HCC should be documented.
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In December 2019, the endemic of COVID-19 broke out in Wuhan, China. The disease is highly contagious and quickly spreads at home and abroad, causing great concern. However, there are no definite effective antiviral drugs in clinical use. Given the urgency of the COVID-19 outbreak, based on the diagnosis and treatment recommendation and relavant researches, this article describes the optional antiviral drugs such as remdesivir, oseltamivir, arbidol, lopinavir/ritonavir, ribavirin, and interferon-alpha to provide a reference for treatment of COVID-19.Copyright © 2020 by the Chinese Medical Association.
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Objective: To investigate the safety and protection level of radiological treatment in the CT modules in the makeshift hosptials in Wuhan during the prevention and treatment of COVID-19 cases. Method(s): The layout of the CT modules in makeshift hospitals, radiological protection facilities and personal protective equipment were investigated. Based on the national standards, the CT dose index was estimated and the radiological protection level at the CT modules were measured. Result(s): The layout of the CT modules in makeshift hospitals is reasonable, with well-equipped radiological protection facilities. Of 23 CT modules, 20 were up to standards with acceptability of 87.0%. The other three were unqualified each with 1 detection points having values in excess of the national standards. Which, after being modified immediately reached the national standards. In addition, CT dose index for 7 CT modules were estimated, with CTDIW within +/-7.5%. Conclusion(s): The CT modules in Wuhan meet the requirements of radiological safety and protection during the prevention and treatment of COVID-19 cases.Copyright © 2020 by the Chinese Medical Association.
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In December 2019, the endemic of COVID-19 broke out in Wuhan, China. The disease is highly contagious and quickly spreads at home and abroad, causing great concern. However, there are no definite effective antiviral drugs in clinical use. Given the urgency of the COVID-19 outbreak, based on the diagnosis and treatment recommendation and relavant researches, this article describes the optional antiviral drugs such as remdesivir, oseltamivir, arbidol, lopinavir/ritonavir, ribavirin, and interferon-alpha to provide a reference for treatment of COVID-19.Copyright © 2020 by the Chinese Medical Association.
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Given the COVID-19 pandemic, this paper aims at providing a full-process information system to support the detection of pathogens for a large range of populations, satisfying the requirements of light weight, low cost, high concurrency, high reliability, quick response, and high security. The project includes functional modules such as sample collection, sample transfer, sample reception, laboratory testing, test result inquiry, pandemic analysis, and monitoring. The progress and efficiency of each collection point as well as the status of sample transfer, reception, and laboratory testing are all monitored in real time, in order to support the comprehensive surveillance of the pandemic situation and support the dynamic deployment of pandemic prevention resources in a timely and effective manner. Deployed on a cloud platform, this system can satisfy ultra-high concurrent data collection requirements with 20 million collections per day and a maximum of 5 million collections per hour, due to its advantages of high concurrency, elasticity, security, and manageability. This system has also been widely used in Jiangsu, Shaanxi provinces, for the prevention and control of COVID-19 pandemic. Over 100 million NAT data have been collected nationwide, providing strong informational support for scientific and reasonable formulation and execution of COVID-19 prevention plans. © 2022 IEEE.
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COVID-19 has spread quickly worldwide, presenting unprecedented challenges to countries all over the globe. To understand how different countries have responded to COVID-19 during the early stage of the outbreak, we develop a comprehensive research framework drawing on the literature on wicked problems. Specifically, we comparatively investigate the government responses of the United States, China, and South Korea and examine why and how these countries have adopted and implemented various strategies—authoritative, collaborative, and competitive—depending on their policy environment. Although scholars have argued that collaborative strategies are the preferred approach to dealing with wicked problems, it is found that the most applicable, implementable, and effective strategies vary according to the country's cultural, economic, and political contexts. In addition, the urgency and timing of the crisis may affect the choice of appropriate strategies. Our findings can provide lessons for public administration and policy to cope with other wicked problems. © 2023 by INSTITUTE OF KOREAN STUDIES.
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INTRODUCTION: COVID-19 can manifest in the lungs as acute respiratory distress syndrome leading to poor lung compliance and increasing susceptibility to barotrauma, which is hypothesized to cause an airleak resulting in pneumomediastinum (PM) and pneumothorax (PTX). Pneumopericardium (PP), a more rare complication, has been documented in relatively few cases to date. This study sought to review the relationship between positive pressure ventilation (PPV) and development of PP and to survey treatment options for COVID-19 patients with PP. METHOD(S): A systematic search was conducted on full text articles, including case reports and case series, for COVID-19 patients with comorbid PP from January 1st, 2019 to April 12th, 2022. Demographic data, presence of PM, PTX, PP and subcutaneous emphysema (SE), treatment information regarding respiratory support, use of steroids and other medications were recorded along with in-hospital mortality. RESULT(S): 51 articles met final inclusion criteria, reporting 76 cases of COVID-19 patients with PP. The average age was 54.5 years with a range of 17-82. Fifty-eight (76.3%) patients were male. 27 (35.5%) patients with PP died. PP occurred in isolation in 5 (6.6%) patients. PP was most comorbid with PM (n=65, 85.5%). SE occurred in 44 (57.9%) patients and PTX in 25 (32.9%) patients. 18 (23.7%) patients developed all of the sequalae of airleak. 64 (84.2%) patients received some degree of respiratory support: 35 (46.1%) patient's maximum support was supplemental oxygen, six (7.9%) were on non-invasive PPV, and 22 (28.9%) required mechanical ventilation. 29 (38.2%) patients with PP were given steroids. Only 1 patient received pericardiocentesis for presumed tamponade physiology. CONCLUSION(S): There was a high mortality in COVID-19 patients with PP. Previous reports hypothesized that PPV may be the etiology of PP in COVID-19 patients;however, only 36.8% of patients with PP in this review received PPV. It is unclear if the COVID-19 patients with PP not receiving PPV had tachypnea causing air trapping thus leading to self-induced barotrauma. Decompressive maneuvers have been studied in PTX and PM, however only one patient in this review received pericardiocentesis. Further research is needed to provide further etiology and treatment guidelines as this pandemic continues.
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Introduction: Health inequities in COVID-19 have led to disproportionate access to care and health outcomes. Research Question or Hypothesis: To describe the demographics of patients accessing COVID-19 monoclonal antibodies (mAb) at an urban, tertiary medical center. Study Design: A retrospective descriptive study. Method(s): Patients >=18 years of age with a positive SARS-CoV-2 viral test and received bamlanivimab or casirivimab/imdevimab at the University of California San Francisco (UCSF), between December 3, 2020, and October 3, 2021. Patients were stratified by race/ ethnicity and geographic area. Covariates included sex, age, days of symptoms, vaccination status/type, hospitalization, and length of hospital stay. For comparison, data describing race/ethnicity, COVID-19 cases, death, and the California Healthy Places Index (HPI) and Healthcare Access (HA) scores associated with zip codes were obtained from the City and County of San Francisco and the Public Health Alliance of Southern California. Statistical significance was determined at p < 0.05. This study was approved by the UCSF Institutional Review Board. Result(s): Of 559 patients who received mAb, 45.5% were White/ Caucasian, followed by Latinx (16.2%), Asian (14.4%), and Black/ African American (10.4%). Compared to White/Caucasian, Latinx patients were significantly younger, unvaccinated, and predominantly female. Asian patients were more likely to receive mAbs in the Emergency Department;Black/African American patients were more likely to be unvaccinated. More than half of the cohort who received mAb were from higher HPI and HA areas. There was a significant positive correlation between HPI score and White/ Caucasian population (R2=0.21, p< 0.05). Significantly less Latinx, Asian, and Black/African American who received mAb were observed in the higher HPI and HA score groups compared with White/Caucasian (p < 0.05). The rate of hospitalization was significantly higher in Asian patients (18.6%) compared to White/ Caucasian patients (6.7%) (p < 0.001). Conclusion(s): Imbalances in the racial/ethnic makeup, HPI and HA scores highlight potential inequities to mAb utilization and subsequent clinical outcomes.
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Introduction: To date, there has been no reported case of adverse reaction characterized by chest pain related to neither myocarditis nor pericarditis after the administration of COVID-19 mRNA vaccines (Pfizer-BioNTech or Moderna). We report 33 such cases. Case: A total of 33 patients with a mean age of 32+/-9 years sought medical attention at the hospital outpatient clinic after vaccination (30 were administered Pfizer-BioNTech and 3 were administered Moderna). The chief complaint of all patients included chest pain, and both myocarditis and pericarditis were ruled out in the diagnosis. Chest pain occurred 0-89 days (median = 4 days;mode = 0 days) after vaccination. Twenty-nine patients (88%) were treated with bisoprolol, 19 (58%) with acetaminophen+carisoprodol, and 17 (52%) with prednisolone. After treatment, major improvement or recovery was achieved in 16 patients, slight improvement was achieved in 9, no improvement was achieved in 4, and 4 were lost to follow-up. Discussion(s): Reports of chest pain without excluding myocarditis and pericarditis were not found in electronic databases (Micromedex, PubMed, and UpToDate) or package inserts of Pfizer-BioNTech or Moderna. The symptoms of the 33 patients in this study were speculated to have therapeutic relationships with the following drug responses: bisoprolol decreases cardiac stressrelated chest pain, acetaminophen+carisoprodol alleviates muscle pain near the chest, and prednisolone decreases inflammation of muscle or lung tissue. Limitations of this study include that patient heterogeneity was not analyzed and that there are many factors affecting chest pain. Conclusion(s): If chest pain occurs after COVID-19 mRNA vaccine administration when myocarditis and pericarditis diagnoses are ruled out, increased cardiac stress, muscle pain, or inflammation near the chest must be considered. Treatment with bisoprolol, acetaminophen, carisoprodol, or prednisolone should be considered.
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Lianhua Qingwen combined with Western medicine (LHQW+WM) has been proposed as a viable treatment for coronavirus disease 2019 (COVID-19). Interestingly, umbrella reviews of systematic reviews (SRs), which provide the most comprehensive evidence, are the best evidence in evidence-based medicine. Therefore, an umbrella review of SRs that summarizes and evaluates the efficacy of LHQW+WM for COVID-19 is urgently required.Methods:: Overall, 6 databases were used to conduct a comprehensive literature search from inception to January 22, 2022. The corrected covered area (CCA) was used to analyze the overlapping between SRs. Meta-analysis was conducted when that of the included SRs was inappropriate. A MeaSurement Tool to Assess Systematic Reviews (AMSTAR-2) was also employed to assess the quality of the included SRs. Results:: In total, 12 SRs were identified, which included 12 unique primary studies. The included SRs ranged in quality from moderate to critically low and had an extremely high CCA (36.4%). Compared to conventional treatment, LHQW+WM showed efficacy concerning fatigue recovery [risk ratio (RR) = 1.69, 95% confidence interval (CI): 1.04–2.73, n = 2, I2 = 0%], cough recovery (RR = 1.65, 95% CI: 1.09–2.51, n = 3, I2 = 39.1%), and overall effective rates (RR = 1.17, 95% CI: 1.07–1.28, n = 3, I2 = 17.5%). Conclusion:: LHQW+WM may improve the clinical symptoms of patients with COVID-19;however, the results should be interpreted cautiously because of the rigorous processes in the included SRs. Graphical :: http://links.lww.com/AHM/A32.
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Background: Several recently completed clinical trials in NASH patients have included fibrosis stage reductions in 20-30% of the patients in placebo cohorts(a,b,c). The mechanisms driving these reductions have not yet been identified. Reductions of alcohol intake could be influential, as moderate alcohol intake has been shown to enhance hepatic de novo lipogenesis (d). Moreover, alcohol consumption is common in populations worldwide and has increased in some populations during the COVID-19 pandemic (e,f). NASH clinical trial protocols do not exclude moderate alcohol consumers (20-30 g/d, equivalent to 1.5-2 standard drinks/d). A quantitative systems pharmacology (QSP) model, NAFLDsym (g), was employed to test the hypothesis that reductions in daily moderate alcohol intake could reduce liver lipid burden, lipotoxicity, and fibrosis stage in NASH patients. Method(s): NASH SimCohorts (n=50;liver fat = 22+/-7%, ALT = 48+/-10 U/L, fibrosis stage 3) regularly consuming 30 g/d alcohol were used to simulate reductions in daily alcohol intake. Baseline alcohol administration was simulated as two 15 g drinks over one hour, coincident with the dinner meal. GastroPlus was used to simulate the rate of hepatic metabolism. Consistent with previous reports, 20% of the metabolized alcohol was able to contribute to hepatic de novo lipogenesis in the simulations (d,h). Reductions of alcohol intake to 15 g/d or 0 g/d were simulated for 52weeks in the SimCohorts, with changes in liver fat, plasma ALT, and fibrosis stage predicted. Result(s): Decreased alcohol intake elicited fibrosis stage reductions, with a greater frequency of patients with an improved fibrosis stage in the 0 g/d vs. 15 g/d simulations. Twentyfour-hour average de novo lipogenesis was predicted to decline 56+/-8% and 30+/-5% in the 0 g/d or 15 g/d simulations. Liver fat was predicted to decrease 5+/-3% and 1+/-1% and ALT decreased 10 +/-7 % and 1+/-1% when alcohol intake was reduced to 0 or 15 g/d, respectively. Conclusion(s): Reductions in moderate alcohol intake for NASH patients who are regular consumers may lead to improvements in fibrosis stage due to decreased de novo lipogenesis. This behavioral adjustment may influence the frequency of observed fibrosis stage reductions in clinical trials whether on placebo or treatment, particularly in studies conducted in regions with a higher prevalence of moderate alcohol consumption. a Newsome 2021 b Francque 2022 c Harrison 2022 d Siler 1999 e Holmes 2017 f Pelham 2022 g Siler 2022 h Lundquist 1962.
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Since the global pandemic of coronavirus disease 2019 (COVID-19) in late 2019, artificial intelligence technology has shown increasing values in the research and control of tropical infectious diseases. The introduction of artificial intelligence technology has shown remarkable effectiveness to reduce the diagnosis and treatment burdens, reduce missing diagnosis and misdiagnosis, improve the surveillance and forecast ability and enhance the medicine and vaccine development efficiency. This paper summarizes the current applications of artificial intelligence in tropical infectious disease control and research and discusses the important values of artificial intelligence in disease diagnosis and treatment, disease surveillance and forecast, vaccine and drug discovery, medical and public health services and global health governance. However, artificial intelligence technology suffers from problems of single and inaccurate diagnosis, poor disease surveillance and forecast ability in open environments, limited capability of intelligent system services, big data management and model interpretability. Hereby, we propose suggestions with aims to improve multimodal intelligent diagnosis of multiple tropical infectious diseases, emphasize intelligent surveillance and forecast of vectors and high-risk populations in open environments, accelerate the research and development of intelligent management system, strengthen ethical security, big data management and model interpretability.
Subject(s)
COVID-19 , Medicine , United States , Humans , Artificial Intelligence , COVID-19/diagnosis , Communicable Disease Control , PandemicsABSTRACT
As the COVID-19 continues to spread globally, more and more companies are transforming into remote online offices, leading to the expansion of electronic signatures. However, the existing electronic signatures platform has the problem of data-centered management. The system is subject to data loss, tampering, and leakage when an attack from outside or inside occurs. In response to the above problems, this paper designs an electronic signature solution and implements a prototype system based on the consortium blockchain. The solution divides the contract signing process into four states: contract upload, initiation signing, verification signing, and confirm signing. The signing process is mapped with the blockchain-linked data. Users initiate the signature transaction by signing the uploaded contract's hash. The sign state transition is triggered when the transaction is uploaded to the blockchain under the consensus mechanism and the smart contract control, which effectively ensures the integrity of the electronic contract and the non-repudiation of the electronic signature. Finally, the blockchain performance test shows that the system can be applied to the business scenario of contract signing. © 2022 IEEE.
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BACKGROUND: To treat Neisseria gonorrhoeae infection, the CDC recommends a single oral dose of cefixime 800 mg as an alternative to injectable ceftriaxone 500 mg if ceftriaxone is not available. We conducted a systematic review and meta-analysis to describe the efficacy of cefixime 800 mg by mouth in treating gonorrhea at different anatomic sites. METHOD(S): Following PRISMA guidelines, we searched PubMed using a standardized query limited to human studies of oral cefixime 800 mg as a single dose between January 1980 and December 2021. We excluded studies that did not specify the cefixime dose/frequency or single case reports. We ed treatment success rates and cefixime dosage/frequency using Covidence software (Melbourne, Australia). We performed a meta-analysis by anatomic site with 95% Wald confidence intervals with logit transformation. We tested for heterogeneity using chi2 statistic of the likelihood ratio (LR) test comparing the randomand fixed-effects model. RESULT(S): Of the 215 studies returned, 5 met our inclusion criteria. Those 5 studies represented 266 total gonorrhea infections (228 urogenital, 12 rectal, 26 pharyngeal) treated with a single dose of oral cefixime 800 mg. The LR p-value=0.11 suggesting there was heterogeneity between studies. The percent of gonorrhea cured for urogenital, pharyngeal, and rectal infections was 98% (CI: 95%-99%), 81% (CI: 61%-92%) and 100% (CI could not be calculated due to low sample size), respectively. CONCLUSION(S): A single dose of oral cefixime 800 mg was found to be highly efficacious at treating urogenital gonorrhea and less efficacious at treating pharyngeal gonorrhea. Further investigation of multiple doses and efficacy at treating rectal gonorrhea are needed.
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Objectives To estimate the basic reproduction number of the novel coronavirus (2019-nCoV) and to provide support to epidemic preparedness and response. Methods Based on the susceptible-exposed-infected-removed (SEIR) compartment model and the assumption that the infection cases with symptoms occurred before January 26, 2020 were resulted from free propagation without intervention, we estimated the basic reproduction number of 2019-nCoV according to the reported confirmed cases and suspected cases, as well as theoretical estimated number of infected cases by other research teams, together with some epidemiological determinants learned from the severe acute respiratory syndrome. Results The basic reproduction number fall between 2.8 to 3.3 by using the real-time reports on the number of 2019-nCoV infected cases from People's Daily in China, and fall between 3.2 and 3.9 on the basis of the predicted number of infected cases from international colleagues. Conclusions The early transmission capability of 2019-nCoV is close to or slightly higher than SARS. It is a controllable disease with moderate-high transmissibility. Timely and effective control measures are capable to quickly reduce further transmission. Copyright © 2020 West China University of Medical Science. All rights reserved.
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Objective To evaluate the evidence of the experience with medical sewage treatment procedures in medical institutions in China. Methods Databases including CNKI, WanFang Data, PubMed, Web of Science, and EBSCO were electronically searched to collect studies on the medical sewage treatment process, flow, and specifications in medical institutions in China. We used the quality evaluation system to classify and grade the experiences based on the principles and methods of evidence-based science and performed a descriptive analysis. Results After the SARS pandemic in 2003, China systematically established and standardized the technical criteria of medical sewage treatment and discharge. Moreover, a prevention system for the epidemic using medical sewage was constructed, which guaranteed that the quality of medical sewage treatment and discharge would meet the criteria and protect the citizens, and the technical specifications of medical sewage treatment would progress and increase strictly. At present, medical sewage treatment in medical institutions in China was based on mechanical and biological methods, and disinfection was mainly performed using chlorine and its compounds, ozone, and ultraviolet light. Conclusion The COVID-19 pandemic requires a higher quality of medical sewage treatment and discharge criteria for medical institutions in China. To meet these criteria, all medical institutions in China should check, replace, and update their old facilities;strengthen personnel training and effectively ensure the quality of medical sewage treatment.