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Objective: To explore the value of low-dose CT in pregnancy with COVID-19. Method(s): A retrospective analysis was performed on the clinical characteristics, laboratory tests, and chest CT findings of 12 pregnant women with COVID-19 diagnosed by nucleic acid testing in the Renmin Hospital of Wuhan University from January 20, 2020 to February 16, 2020. Two radiologists blinded to the reconstruction algorithm independently scored subjective image quality on a 5-point Likert scale. Image quality score >= 3 was acceptable in clinics. The CT radiation doses were recorded, including CT volume dose index (CTDIvol), dose length product (DLP), and effective radiation dose (E). Two radiologists observed the distribution, shape, density, and other characteristics of lung lesions, and they also decided whether hilar, mediastinal lymphadenopathy, and pleural changed. Result(s): A total of 12 pregnant women with COVID-19, 8 had cough, 4 had fever, 2 had chest tightness, and 1 had dyspnea and diarrhea each. The CT image quality score of all patients was 3-4, with an average of 3.46, which fully met the clinical diagnosis requirements. The CTDIvol value was 1.13-4.31 mGy, with an average of 3.02 mGy. The DLP value was 34.48-75.29 mGy*cm, with an average of 55.48 mGy*cm. The Evalue was 0.48-1.05 mSv, with an average of 0.78 mSv. In all cases, chest CT examination showed abnormal manifestations after clinical symptoms, including unilateral lung lesions in 5 cases and bilateral lung lesions in 7 cases, 1 case of ground-glass opacity, 1 case of solidification, 7 cases of ground-glass and consolidation, 1 case of strip opacity, ground-glass, and consolidation and strip cable shadow coexisted in 2 cases. Conclusion(s): The application of low-dose CT scan in pregnant women with COVID-19 is completely feasible. CT mainly manifested as bilateral lung patchy and flaky ground-glass opacity with consolidation. Active and effective treatment can help recover and improve prognosis.Copyright © 2020 by the Chinese Medical Association.
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Special education teacher (SET) burnout is a significant concern, especially for SETs serving students with emotional–behavioral disorders (EBD), as they tend to experience higher burnout than other teachers. Working conditions, especially social support, have the potential to ameliorate burnout, but prior research has not articulated the sources and types of social support that are most important. The authors conducted a longitudinal study, surveying 230 SETs serving students with EBD at three time points across one school year. Data revealed administrative support, adequacy of planning time, and autonomy in fall predicted emotional exhaustion and personal accomplishment in winter and spring. Associations between working conditions and burnout components were partially mediated by SETs' perceptions of workload manageability. SET change in well-being due to COVID-19 during the early months of the pandemic was not associated with burnout. The authors discuss implications, limitations, and directions for future inquiry. © 2022 Teacher Education Division of the Council for Exceptional Children.
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Internet content providers often deliver content through bandwidth bottlenecks that are out of their control. Thus, despite often having massively over-provisioned upstream servers, the content providers still cannot control the end-to-end user experience. This paper explores remote traffic shaping, allowing the content provider to allocate its share of a remote bottleneck link across its users using a metric other than TCP fairness, while remaining TCP-friendly to cross traffic on the bottleneck link. To evaluate this approach, we designed FlowTele, the first system that shapes outbound traffic on an Internet-scale network to optimize provider-selected metrics, using source control with neither in-network support nor special client support. Our extensive evaluations over the Internet show that by strategically reallocating bandwidth among provider-owned co-bottlenecked flows, FlowTele improves the provider's total revenue by roughly 20% - 30% in various network settings, compared with both (i) status quo TCP fairshare and (ii) recent practice by content providers that proactively throttles video quality during the COVID-19 pandemic, while being TCP-friendly to cross-traffic. Besides revenue, we also study other metrics, such as QoE fairness, that a content provider may wish to optimize using FlowTele. © 2022 Owner/Author.
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Introduction L'étude nationale française ANRS EN20 a rapporté qu'en 2010, les décès des PVVIH survenaient en l'absence de contrôle virologique (CV≥ 50 cp/mL) chez 44% d'entre elles, avec un taux de CD4 à 243/mm3 en médiane, et 25% des décès étaient liées au SIDA. Depuis, les caractéristiques des décès chez les PVVIH n'ont pas été étudiées, malgré l'évolution attendue en lien avec l'introduction de plus en plus précoce des tARV et l'optimisation de leur efficacité. L'étude MORTIFO a eu pour objectif de décrire les caractéristiques des décès des PVVIH, survenus entre 2016 et 2020. Matériels et méthodes Etude observationnelle ayant inclus les PVVIH suivies au sein de 12 centres hospitaliers et décédées entre 2016 et 2020. Résultats Parmi les 6754 PVVIH prises en charge entre 2016 et 2020, 293 (4%) PVVIH sont décédées et ont été incluses. Il s'agissait d'hommes pour n=206 (70%), ayant un âge médian de 58 ans (Q1-Q3, 52-66) et nées en France pour n=164 (55%). Le groupe à risque de transmission du VIH était les personnes déclarées « Hétérosexuelles » (n=135, 46%), « UDIV » (n=80, 27%), et « HSH » (n=56, 19%). L'infection VIH était connue depuis 22 ans (12-27), traitée depuis 17 ans (10-22), avec un nadir de CD4 à 109/mm3 (39-219). Au décès, 236 (82%) avaient une CV< 50 cp/mL, avec des CD4 à 388/mm3 (186-806) et un ratio CD4/CD8 à 0.6 (0.3-0.9). La coinfection VHC (Ig anti-VHC+) concernait 101 (35%) PVVIH dont 74/101 (73%) étaient guéries au décès;Par ailleurs 18 PVVIH (6%) étaient coinfectées par le VHB (Ag HBs+). Au dècès, 193 (62%) PVVIH étaient fumeurs actifs ou sevrés, 38 (14%) consommaient au moins 40g d'alcool par jour et 31 (10%) consommaient d'autres drogues. Enfin, 174 (59%) PVVIH sont décédées à l'hôpital et 62 (21%) n'avaient pas de logement personnel au moment du décès. Les décès liés au SIDA représentaient 29 (10%) des causes de décès. La première cause de décès était les cancers non classant SIDA (n=96, 33%) dont 32/96 (33%) cancers pulmonaires, 11/96 (11%) hémopathies, 9/96 (9%) cancers du sein et 7 (7%) cancers anaux. Concernant les autres causes, 40 (14%) PVVIH sont décédées de pathologies cardio-neurovasculaires, 22 (8%) d'hépatopathie (cirrhose ou CHC) et 9 (3%) sont décédées de la COVID en 2020. Conclusion La part des décès liée au SIDA semble avoir nettement diminué par rapport aux données nationales de 2010, en lien avec un contrôle virologique plus fréquent et des CD4 plus élevés au décès. Les cancers non SIDA représentent la première cause de décès entre 2016 et 2020, en particulier les cancers pulmonaires. Le jeune âge au décès s'explique possiblement par l'exposition fréquente à divers facteurs de risque de comorbidités (tabac, alcool, drogues, coinfection VHC, précarité), et possiblement par l'activation immunitaire qui persiste à un niveau élevé, comme en témoigne le ratio CD4/CD8 bas au décès (< 0.9 chez 75% des PVVIH). Améliorer la prise en charge des PVVIH passe par le contrôle des facteurs de risque et le dépistage/traitement précoce des comorbidités telles que les cancers non classant SIDA. Aucun lien d'intérêt
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PURPOSE: Researches revealed that probiotics maybe a potential strategy for COVID-19, whereas there is a lack of related evidence. This study aims to analyze the role of probiotics on severe COVID-19 patients. METHODS: In the current retrospective single-center study, we collected data of 311 consecutive severe patients with confirmed COVID-19 in Wuhan Union Hospital from Feb 3rd to Feb 20th, 2020. Epidemiological, clinical and medication characteristics were compared and analyzed between patients with or without probiotics. RESULTS: In total, 93 of the 123 patients (75.61%) who were treated with probiotics survived to hospital discharge with the median inpatient day of 32 days and mean virus clearance time of 23 days, which were significantly longer than those of patients without probiotics. There were no bias in laboratory parameters, except for IL-6 and ESR, which were significantly higher in patients treated probiotics. We tracked the dynamic changes of 8 selected laboratory parameters (IL-6, CRP, total T lymphocytes, NK cells, B lymphocyte, CD4 + T cells, CD8 + T cells and CD4/CD8 ratio) and found that probiotics could not reduce the increased IL-6 levels but possessed the ability to moderate the immunity and decreased the incidence of secondary infection in COVID-19 patients. CONCLUSIONS: Probiotics could be an effective strategy for the treatment of COVID-19 patients to reduce the secondary infection and moderated the immunity.
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Objective: To analyze the viral nucleic acid and cytokines in 12 children with 2019-nCoV infection. Methods: Clinical and laboratory data of the children diagnosed with 2019-nCoV infection in Guangzhou Women and Children's Medical Center from January to April 2020 were retrospectively analyzed. Throat and anal swabs were collected on alternate days for the detection of 2019-nCoV nucleic acid by fluorescence quantitative PCR. Flow cytometry was used to detect serum cytokines including IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-17F, IL-22, TNF-α and TNF-β during the early (both throat and anal swab tests were positive), the intermediate (throat swab test was negative, while anal swab test remained positive), and the convalescence (both throat and anal swab tests were negative) stages of infection. Results: A total of 12 children were enrolled in this study. The male-to-female ratio was 5: 1. The average age was (7.0±4.3) years. There were two asymptomatic, five mild and five common cases. No severe or critical cases were involved. Initially, throat and anal swab nucleic acid tests were simultaneously positive in nine children newly diagnosed in our hospital and the median time of viral shedding in throat swab was longer than that in throat swab [32 (4.5, 45.0) d vs 3 (2, 9) d, Z=11.0, P=0.010]. The median difference of viral shedding time between anal swab and pharyngeal swab was 25.5 (1.5, 42.8) d. The overall levels of serum cytokines IL-17A, IL -4 and IL-5 in different stages of the disease (early, intermediate and convalescence stage) were statistically different (Z or F, P values were 8.33, 0.016;5.36, 0.010 and 6.56, 0.004, respectively), and a significant increase was observed in the intermediate stage of infection. IL-17F, IL-2 and IL-22 were all increased during the infection, but there was no significant statistical difference among the three stages (P>0.05). Conclusions: It was noted that intestinal viral shedding needed a longer time. Although the infectivity has not been determined, higher requirements have been put forward for disease prevention and control. Cytokines secreted by Th2 and Th17 cells were involved in the immune response in children with non-severe 2019-nCoV infection. Monitoring viral shedding and cytokine changes in pediatric patients would be conducive to disease assessment.