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1.
Clin Drug Investig ; 42(12): 1031-1047, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2094845

ABSTRACT

BACKGROUND AND OBJECTIVE: Nitazoxanide, a US Food and Drug Administration-approved antiparasitic agent, was reported to be effective in treating coronavirus disease 2019 (COVID-19). The lack of effective and precise treatments for COVID-19 infection earlier in the pandemic forced us to depend on symptomatic, empirical, and supportive therapy, which overburdened intensive care units and exhausted hospital resources. Therefore, the aim of this systematic review and meta-analysis was  to assess the efficacy and safety of nitazoxanide for COVID-19 treatment. METHODS: A systematic review and meta-analysis synthesizing relevant randomized controlled trials from six databases (MedRxiv, WOS, SCOPUS, EMBASE, PubMed, and CENTRAL) until 17 May 2022 was conducted. Risk ratio (RR) for dichotomous outcomes was used and data with a 95% confidence interval (CI) are presented. The protocol was registered in PROSPERO with ID: CRD42022334658. RESULTS: Six randomized controlled trials with 1412 patients were included in the analysis. Nitazoxanide was effective in accelerating viral clearance compared with placebo (RR: 1.30 with 95% CI 1.08, 1.56, p = 0.006) and reducing oxygen requirements (RR: 0.48 with 95% CI 0.39, 0.59, p = 0.00001), but we found no difference between nitazoxanide and placebo in improving clinical resolution (RR: 1.01 with 95% CI 0.94, 1.08, p = 0.88), reducing the mortality rate (RR: 0.88 with 95% CI 0.4, 1.91, p = 0.74), and intensive care unit admission (RR: 0.69 with 95% CI 0.43, 1.13, p = 0.14). Moreover, nitazoxanide was as safe as placebo (RR: 0.9 with 95% CI 0.72, 1.12, p = 0.34). CONCLUSIONS: Compared with placebo, nitazoxanide was effective in expediting viral clearance and decreasing oxygen requirements. However, there was no difference between nitazoxanide and placebo regarding clinical response, all-cause mortality, and intensive care unit admission. Therefore, more large-scale studies are still needed to ascertain the clinical applicability of nitazoxanide in COVID-19.


Subject(s)
COVID-19 , United States , Humans , COVID-19/drug therapy , Randomized Controlled Trials as Topic , Oxygen
2.
ASME 2022 Fluids Engineering Division Summer Meeting, FEDSM 2022 ; 1, 2022.
Article in English | Scopus | ID: covidwho-2088364

ABSTRACT

This multidisciplinary study provides a comprehensive visualization of airborne aerosols and droplets coming into contact with crossflows of moving air utilizing both experimental particle measuring methods and multiphase computational fluids dynamics (CFD). The aim of this research is to provide a Eulerian visualization of how these crossflows alter the position and density of an aerosol cloud, with the goal of applying this information to our understanding of social distancing ranges within outdoor settings and ventilated rooms. The results indicate that even minor perpendicular crossflows across the trajectory of an aerosol cloud can greatly reduce both the linear displacement and density of the cloud, with negligible increases in density along the flow path. © 2022 American Society of Mechanical Engineers (ASME). All rights reserved.

3.
Frontiers in public health ; 10, 2022.
Article in English | EuropePMC | ID: covidwho-2083927

ABSTRACT

Background COVID-19 is a respiratory disease caused by SARS-CoV-2, a new coronavirus discovered in December 2019 in China. COVID-19 symptoms are similar to those of viral flu but may be more severe, these symptoms can be defended by vaccines, the most distributed 6 candidate vaccines are Pfizer, BioNTech, Moderna, Johnson & Johnson/Janssen AstraZeneca, Sinopharm, Sinovac. In Sudan, the virus has rapidly spread in the country, causing a total of 37,138 confirmed cases with 2,776 deaths till July 21, 2021. We are targeting health workers, medical students, and the general public to assess their behavior regarding COVID-19 vaccines in Sudan, recognize the determinants of their behavior, and identify the factors increasing vaccine acceptance among them. Methods We conducted a pretested cross-sectional online survey involving healthcare workers, medical students, and the general population in Sudan in July and August. We collected the data by sending the survey to social media platforms (e.g., Facebook and WhatsApp). The survey was conducted anonymously without identity-related data. We used both convenience sampling and snowball sampling methods as the participants were asked to forward the survey link to their contacts. The sample size was calculated using Slovin's formula and we estimated the sample size to be 400. Results Of our 400 participants, 36.8% (n = 147) were males and 63.2% (n = 253) were females, the mean age of the participants was 24.17 ± 8.07. The overall vaccine acceptance rate was 48.2% (n = 193) and “Occupation” was the only sociodemographic domain significantly associated with vaccine acceptance, showing a higher acceptance rate among health care workers (p = 0.009). “Afraid of unknown side effects” was the most commonly reported barrier to vaccination (p = 0.33). Conclusion The vaccine acceptance rate is low, and public health authorities and the government in Sudan have a heavy mission for implementing successful vaccination programs with high coverage.

4.
International Journal of Medicine and Public Health ; 12(3):107-115, 2022.
Article in English | CAB Abstracts | ID: covidwho-2080788

ABSTRACT

Objectives: The study makes a bibliometric evaluation of global publications on "Application of Stem Cell Therapy to Covid-19" during 2020-22.

5.
Journal of AAPOS ; 26(4):e31, 2022.
Article in English | EMBASE | ID: covidwho-2076287

ABSTRACT

Introduction: A paucity of data exists regarding reimbursement trends in pediatric ophthalmology, especially regarding the consequences of national policy enacted to minimize the COVID-19 pandemic's effect on access to healthcare. The purpose of this study was to evaluate monetary trends for common pediatric ophthalmology procedures among the Arizona Medicaid population, compared to Medicare data. Method(s): Publicly available Arizona Medicaid and Medicare Physician Fee Schedules from 2015-2021 were utilized. Collected data included reimbursement for common procedural and nonprocedural (examination, imaging) billing codes used in pediatric ophthalmology. Data was adjusted for inflation to 2021 dollars. Result(s): From 2015-2020, the inflation-adjusted average Arizona Medicaid and Medicare reimbursement for all procedures decreased by 9% from 2015-2020 (-2% per year) and 12% (-2% per year), respectively. From 2020-2021, average procedural Medicaid reimbursement increased by 11%, while Medicare decreased by 6%. From 2015 to 2020, average nonprocedural Medicaid and Medicare reimbursement decreased by 16% (-3% per year) and 18% (-4% per year), respectively. Average non-procedural Medicaid reimbursement increased by 8% from 2020-2021, while Medicare decreased by 2%. No significant difference was observed between Arizona and national Medicare trends (P > 0.05). Conclusion/Relevance: Arizona Medicaid and Medicare reimbursement steadily decreased from 2015-2020, but Medicaid reimbursement markedly increased from 2020-2021. This reflects a 6.2% increase in federal Medicaid funding to states enacted by Congress in 2020, which will end after the public health emergency. In light of recent decreases in outpatient utilization due to the COVID-19 pandemic, increased awareness of these trends is needed to maintain adequate access to pediatric ophthalmologic care, particularly among Medicaid enrollees. Copyright © 2022

6.
Protective Textiles from Natural Resources ; : 199-226, 2022.
Article in English | Scopus | ID: covidwho-2075813

ABSTRACT

This chapter highlights the new approaches to producing personal protective clothing (PPC) as antimicrobial fabrics such as gloves, gowns and face masks. Antimicrobial colorants, either natural or synthetic dyes, are widely employed in textile applications as bifunctional agents. This chapter also focuses on the potent nanometals (metal nanoparticles, MNPs) in the finishing process and their finishing techniques. Furthermore, many studies have reported on the antimicrobial activities of metal nanoparticles and dyes, however their antiviral activity has not been adequately investigated. The COVID-19 pandemic has increased the urgency of studying the antiviral potentiality of those agents in addition to their cytotoxicity and applicability. Moreover, there are many kinds of PPC according to their application that require different finishing techniques. This chapter provides a review of the applicability of antimicrobial and antiviral agents and the modern techniques used in textile finishing processes to achieve the highest antimicrobial and antiviral activities. © 2022 Elsevier Ltd. All rights reserved.

7.
J Pediatr Hematol Oncol ; 2022 Oct 12.
Article in English | MEDLINE | ID: covidwho-2063087

ABSTRACT

During the COVID-19 pandemic, major challenges are facing pediatric cancer centers regarding access to cancer centers, continuity of the anti-cancer therapy, hospital admission, and infection protection precautions. Pediatric oncologists actively treating children with cancer from 29 cancer centers at 11 countries were asked to answer a survey from May 2020 to August 2020 either directly or through the internet. COVID-19 pandemic affected the access to pediatric cancer care in the form of difficulty in reaching the center in 22 (75.9%) centers and affection of patients' flow in 21 (72.4%) centers. Health care professionals (HCP) were infected with COVID-19 in 20 (69%) surveyed centers. Eighteen centers (62%) modified the treatment guidelines. Care of follow-up patients was provided in-hospital in 8(27.6%) centers, through telemedicine in 10 (34.5%) centers, and just delayed in 11 (38%) centers. Pediatric oncologists had different expectations about the future effects of COVID-19 on pediatric cancer care. Seventy-six percent of pediatric oncologists think the COVID-19 pandemic will increase the use of telemedicine. Fifty-five percent of pediatric oncologists think if the COVID-19 pandemic persists, we will need to change chemotherapy protocols to less myelosuppressive ones. Collaborative studies are required to prioritize pediatric cancer management during COVID-19 era.

8.
Cureus ; 14(8): e27736, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-2030300

ABSTRACT

Background It has been established that patients with COVID-19 pneumonia are more vulnerable to developing thromboembolic complications. Computed tomography (CT) scan of the chest is an essential investigation modality in patients with COVID-19 pneumonia and has an important role in the diagnosis and identification of complications. Methods A retrospective observational study was conducted on patients admitted with COVID-19 pneumonia who underwent CT scans of the chest. The data regarding demographic information, clinical information, and CT findings were collected from electronic health records. Multivariable regression analysis was used to identify the independent factors associated with thromboembolic complications. Results The study included a total of 276 patients, including 178 (64.5%) men and 98 (35.5%) women. In total, 64 patients were found to have thromboembolic events, yielding a complication rate of 23.2%. Multivariable logistic regression revealed that patients aged 51-65 years (Odds ratio [OR] = 8.9; 95% confidence interval [CI]: 3.0-26.5) and >65 years (OR = 18.7; 95% CI: 7.6-46.1) had a higher likelihood of having thromboembolic complications compared to those aged 18-35 years. Further, the crazy-paving appearance of opacity was identified as an independent factor associated with thromboembolic events (OR = 14.2; 95% CI: 6.9-29.4). Further, patients with severe pulmonary parenchymal involvement were 30 times (OR = 30.6; 95% CI: 9.8-95.5) more likely to have thromboembolic complications compared with those having mild involvement. Conclusions The radiological findings on the CT scan of the chest can provide crucial prognostic information for patients with COVID-19 in terms of thromboembolic events. Clinicians need to keep a high index of suspicion for pulmonary embolism and deep venous thrombosis when they encounter patients with crazy-paving opacity appearances on CT scans, particularly among patients with severe parenchymal involvement.

9.
2nd International Conference on Computing Advancements: Age of Computing and Augmented Life, ICCA 2022 ; : 316-322, 2022.
Article in English | Scopus | ID: covidwho-2020421

ABSTRACT

Blood cell identification and counting are essential nowadays for healthcare professionals and therapists treating a variety of diseases. Platelet detection and counting are commonly performed for various disorders such as COVID-19 and others. However, it is the most costly and time-consuming. Furthermore, it is not available everywhere. From that standpoint, it is necessary to develop an effective technological model for detecting and counting three fundamental kinds of blood cells: Platelets, Red Blood Cells (RBCs), and White Blood Cells (WBCs). So, a deep learning-based model is proposed in this study comparing two versions of YOLOv5 model such as YOLOv5s and YOLOv5m. It is found that the YOLOv5m model outperforms with 0.799 precision, where YOLOv5s produces 0.797 precision. The study suggests that the YOLOv5m model is highly capable of detecting and counting the blood cells individually. Doctors, physicians, and other clinicians will be capable to identify and quantify blood cells from real-time photos. It will save money and time by identifying and counting blood cells using real-time blood photos. © 2022 ACM.

10.
Journal of Physics: Conference Series ; 2304(1):012002, 2022.
Article in English | ProQuest Central | ID: covidwho-2017572

ABSTRACT

Corona Virus Syndrome (COVID-19) is a contagious disease and it is considered one of the deadliest viruses ever known to humanity. In this work, the transmission dynamics of the COVID- 19 has been studied using an enhanced SEIR epidemic compartmental model with a vaccination compartment. This model divides the whole population into five categories: susceptible (S), exposed (E), infectious (I), recovered (R), and vaccinated (V). Firstly, Positivity, Existence and Uniqueness of solution are illustrated. Secondly, a mathematical analysis is done to study the equilibrium points of the model and the basic reproduction number has been computed using Next Generation Matrix method. Thirdly, by using analytical computation the Stability of disease free equilibrium (DFE) point of the model is discussed and the Existence, and uniqueness of the endemic equilibrium are proved. Finally, Bifurcation coefficient is computed using the available data and Simulations are made to illustrate the effect of the transmission rate and vaccination rate on the value of the basic reproduction number.

11.
Pediatrics ; 149, 2022.
Article in English | EMBASE | ID: covidwho-2002979

ABSTRACT

Background: The first COVID-19 case was reported in Kuwait in February 2020, and the pandemic rapidly spread in the country. To better understand the impact of COVID-19 on children, a pediatric registry was established, recording all cases of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) in children, focusing on disease presentation, complications, severity of the disease and early outcomes. Methods: A retrospective, national-level, cohort study was performed and included all children aged ≤ 12 years with a confirmed SARS-CoV2 infection by polymerase chain reaction (PCR) in Kuwait between February 24th to December 31st, 2020. Cases were identified through reviewing national electronic SARS-CoV-2 testing, hospital admission records, and medical transfer services. During the study period infected children were identified through symptomatic testing, contact tracing, routine screening upon hospitalization, and screening before and after travel. Children who were older than 12 years at the time of sample collection or had equivocal RT-PCR result were excluded. Also, patients who had positive SARS-CoV-2 specific antibodies without documentation of positive SARS-CoV-2 RT-PCR were excluded in the analysis. Patient demographics, medical history, SARS-CoV-2 testing, signs and symptoms, therapeutic and medical intervention, complications, laboratory tests and outcome were obtained using The Kuwait Pediatric COVID-19 Registry (PCR-Q8). Descriptive analysis was performed. Results: During the study period, a total of 14,322 children aged ≤12 were diagnosed with SARS-CoV-2 infection in Kuwait. The first pediatric case was reported in March 2020. The monthly number of cases peaked during the summer of 2020 (July-September), and this was followed by a rapid decline during the beginning of winter of 2020 (figure 1). The median age was 7.6 years (IQR 4.1- 10.5) and half were male. Less than one-third (29.4%) were symptomatic (table 1). The number of children with pre-existing comorbidities was 228 (1.59%);the most common comorbidities were asthma (54, 0.37%), chronic neurological disorder (29, 0.2%) and acquired/congenital heart disease (25, 0.17%). The number of hospitalized children was 1599 (11.2%). The most common symptoms of those who were hospitalized were fever (39.8%), cough (17.6%), runny nose (11.1%) and diarrhea (8.4%). A total of 32 children were admitted to intensive care (0.22%), and 5 deaths were recorded (0.035%). Conclusion: Overall, the pediatric COVID-19 registry has invaluable information about the effect of COVID-19 on children in Kuwait. Such information can guide clinical practices for better understanding and management of COVID-19 in children.

12.
Hum Antibodies ; 30(3): 151-155, 2022.
Article in English | MEDLINE | ID: covidwho-2002467

ABSTRACT

BACKGROUND: COVID-19 is a highly contagious virus that is rapidly spreading across the world. As the number of COVID-19 patients is quickly rising, and certain nations and areas, such as the third world countries, lack the medical resources, it is critical to track and monitor a patient's status using blood parameters on regular testing. The aim of this study is to compare the serum D-dimer levels, Ferritin, CRP, WBCs, Lymphocytes, and Neutrophils in male and female patients infected with COVID-19. OBJECTIVE AND METHODS: The study procedure includes evaluating the D-dimer level, Ferritin, CRP, WBCs, lymphocytes, and neutrophils in 116 patients infected with COVID-19 (48 Females and 68 Males). RESULT: The result of this study shows a significant increase in the D-dimer level in males 1618 ± 247.7 ng/ml compared to females 684.5 ± 53.69 ng/ml and a significant increase in Ferritin level in males 525.6 ± 69.55 µg/L compared to females 254.1 ± 33.73 µg/L. However, no other significant change is seen in the other parameters (CRP, LDH, and WBCs, L, and N) although all of these parameters are abnormal, compared to the normal reference values. CONCLUSION: This study concludes that there is a significant increase in the D-dimer and Ferritin concentrations in male patients compared to female patients, who were infected with COVID-19. Also there are no significant differences in other parameters (CRP, LDH, WBCs, L, and N) between male and female patients.


Subject(s)
COVID-19 , Female , Ferritins , Humans , Lymphocytes , Male , Neutrophils , SARS-CoV-2
13.
Journal of Hepatology ; 77:S551, 2022.
Article in English | EMBASE | ID: covidwho-1996642

ABSTRACT

Background and aims: Hepatitis C virus (HCV) infection is a major global health problem in adults & children. The recent efficacy of Direct Acting Anti-viral therapy (DAA) has cure rates of 99% in adults and adolescents. These drugs were licensed for children 3–12 yrs during the recent coronavirus pandemic. To ensure equitable access, safe & convenient supply during lockdown, we established a virtual national treatment pathway for children with HCV in England & evaluated its feasibility, efficacy & treatment outcomes. Method: A paediatric Multidisciplinary Team Operational Delivery Network (pMDT ODN), supported by NHS England (NHSE), was established with relevant paediatric specialists to provide a single point of contact for referrals & information. Referral & treatment protocolswere agreed for HCV therapy approved byMHRA& EMA. On referral the pMDT ODN agreed the most appropriate DAA therapy based on clinical presentation & patient preferences, including ability to swallow tablets. Treatment was prescribed in association with the local paediatrician & pharmacist, without the need for children & families to travel to national centres. All children were eligible for NHS funded therapy;referral centres were approved by the pMDT ODN to dispense medication;funding was reimbursed via a national NHSE agreement. Demographic & clinical data, treatment outcomes & SVR 12 were collected. Feedback on feasibility & satisfaction on the pathway was sought from referrers. Results: In the first 6 months, 34 childrenwere referred;30- England;4-Wales;median (range) age 10 (3.9–14.5) yrs;15M;19F: Most were genotype type 1 (17) & 3 (12);2 (1);4 (4). Co-morbidities included: obesity (2);cardiac anomaly (1);Cystic Fibrosis (1);Juvenile Arthritis (1). No child had cirrhosis. DAA therapy prescribed: Harvoni (21);Epclusa (11);Maviret (2). 27/34 could swallow tablets;3/7 received training to swallowtablets;4/7 are awaiting release of granules.11/27 have completed treatment and cleared virus;of these 7/11 to date achieved SVR 12. 30 children requiring DAA granule formulation are awaiting referral and treatment. Referrers found the virtual process easy to access, valuing opportunity to discuss their patient’s therapy with the MDT & many found it educational. There were difficulties in providing the medication through the local pharmacy. However there are manufacturing delays in providing granule formulations because suppliers focused on treatments for COVID, leading to delays in referring and treating children unable to swallow tablets. Conclusion: The National HCV pMDT ODN delivers high quality treatment & equity of access for children & young people, 3–18 yrs with HCV in England, ensuring they receive care close to home with 100% cure rates.

14.
Prace i Studia Geograficzne ; 67(1):109-130, 2022.
Article in English | Scopus | ID: covidwho-1995034

ABSTRACT

Environmental problems can be the public’s concern, and they also feel the ratio of dangerousness. Consequently, collecting their opinions and trying to get to know the way of their thinking regarding their environmental problem and solving them was an attractive case study for the authors of this article. In this research, the authors found the public’s opinion and attitude regarding environmental situations and issues in Kurdistan Region-Iraq throughout a public questionnaire/survey. Around 450 people randomly participated from various geographical locations/cities of the region proportioned to the population rate regarding different demography, gender, age, and academic background. The statistical Package for the Social Sciences (SPSS) program was used to analyze their opinion. Also, the cross-tabulation method was used to understand the relationship between two or more variables. Gender, age, and educational background had effects on the participants’ attitudes toward environmental issues. Females, aged from 20 to 30, and Ph.D. degree holders were paying more attention to the environment. Geographically, the participation ratio for the Sulaimani, Erbil, Duhok, Halabja, and Kirkuk Provinces was 28.48 %, 21.95 %, 17.61%, 16.69%, and 15.00 %, respectively. High and low participation levels of the contributors are a reflection of the environmental awareness of the contributors, providing environmental facilities for the people, background, and culture of the community, and stability of political, economical, and social issues of the areas. Furthermore, COVID-19 affected the environment, and commonly it had a positive impact on the environment. © 2022 Faculty of Geography and Regional Studies, University of Warsaw. All rights reserved.

15.
Pediatr Res ; 2022 Aug 11.
Article in English | MEDLINE | ID: covidwho-1991558

ABSTRACT

BACKGROUND: Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of type 1 diabetes mellitus (T1DM) that has increased during the COVID-19 pandemic. This study will not only shed light on such life-threatening complications but also be a step to increase the awareness of healthcare providers about such complications in the upcoming pandemic waves and increased dependence on telemedicine. Thus, we aimed to further investigate the increase of DKA in pediatrics. METHODS: PubMed, Web of Science, and Scopus were broadly searched for studies assessing the incidence of DKA in pediatrics during the COVID-19 pandemic. RESULTS: Our study included 24 papers with a total of 124,597 children with diabetes. A statistically significant increase occurred in the risk of DKA among newly diagnosed T1DM patients during the pandemic (RR 1.41; 95% CI 1.19, 1.67; p < 0.01; I2 = 86%), especially in the severe form of DKA (RR 1.66: 95% CI 1.3, 2.11) when compared to before. CONCLUSION: DKA in newly diagnosed children with T1DM has increased during the pandemic and presented with a severe form. This may reflect that COVID-19 may have contributed not only to the development but also the severity of DKA. IMPACT: Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes mellitus (T1DM) that has increased during the COVID-19 pandemic. Our study included 25 papers with a total of 124,597 children with diabetes. A statistically significant increase occurred in the risk of DKA among newly diagnosed T1DM patients during the pandemic. Our findings reflect that COVID-19 may have an altered presentation in T1DM and can be related to DKA severity.

16.
IEEE Access ; : 1-1, 2022.
Article in English | Scopus | ID: covidwho-1992567

ABSTRACT

When a learned model has high accuracy under familiar settings (internal testing) and a big drop in accuracy under slightly different circumstances (external testing) we suspect it is using shortcuts to make decisions. This problem is known as shortcut learning. In medical imaging, shortcuts are undesired and unintended features that the model relies on to perform diagnosis. Shortcut-based solutions using medical images could lead to false diagnoses and have dangerous implications for patients. In the current COVID-19 era, a large set of papers have been published proposing the use of deep convolutional neural networks to perform diagnosis or triage of COVID-19 from chest X-rays (CXRs). These studies are reporting high accuracies which could be misleading and overestimated. To our knowledge, none of the currently published papers with high performance reported testing on samples from truly unseen data sources. Studies which did, have noticed a significant performance drop when testing on unseen sources indicating a failure to generalize. In this paper, we elucidate the generalization challenge of deep learning based models trained for disease diagnosis. We use the example of COVID-19 diagnosis from CXRs. Solutions that mitigate shortcut learning are introduced and experimentally shown to be effective. Our proposed methods enable the models to have a statistically significantly reduced performance drop-off on unseen data sources. Thus, lowering the performance drop to only 9% instead of 20%. The issues with convolutional neural networks addressed here generally apply to other imaging modalities and recognition problems, as shown. Author

17.
Ieee Access ; 10:78726-78738, 2022.
Article in English | Web of Science | ID: covidwho-1985442

ABSTRACT

When a learned model has high accuracy under familiar settings (internal testing) and a big drop in accuracy under slightly different circumstances (external testing) we suspect it is using shortcuts to make decisions. This problem is known as shortcut learning. In medical imaging, shortcuts are undesired and unintended features that the model relies on to perform diagnosis. Shortcut-based solutions using medical images could lead to false diagnoses and have dangerous implications for patients. In the current COVID-19 era, a large set of papers have been published proposing the use of deep convolutional neural networks to perform diagnosis or triage of COVID-19 from chest X-rays (CXRs). These studies are reporting high accuracies which could be misleading and overestimated. To our knowledge, none of the currently published papers with high performance reported testing on samples from truly unseen data sources. Studies which did, have noticed a significant performance drop when testing on unseen sources indicating a failure to generalize. In this paper, we elucidate the generalization challenge of deep learning based models trained for disease diagnosis. We use the example of COVID-19 diagnosis from CXRs. Solutions that mitigate shortcut learning are introduced and experimentally shown to be effective. Our proposed methods enable the models to have a statistically significantly reduced performance drop-off on unseen data sources. Thus, lowering the performance drop to only 9% instead of 20%. The issues with convolutional neural networks addressed here generally apply to other imaging modalities and recognition problems, as shown.

18.
Biomed Pharmacother ; 153: 113499, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1966383

ABSTRACT

The healthy immune system eliminates pathogens and maintains tissue homeostasis through extraordinarily complex networks with feedback systems while avoiding potentially massive tissue destruction. Many parameters influence humoral and cellular vaccine responses, including intrinsic and extrinsic, environmental, and behavioral, nutritional, perinatal and administrative parameters. The relative contributions of persisting antibodies and immune memory as well as the determinants of immune memory induction, to protect against specific diseases are the main parameters of long-term vaccine efficacy. Natural and vaccine-induced immunity and monoclonal antibody immunotherapeutic, may be evaded by SARS-CoV-2 variants. Besides the complications of the production of COVID-19 vaccinations, there is no effective single treatment against COVID-19. However, administration of a combined treatment at different stages of COVID-19 infection may offer some cure assistance. Combination treatment of antiviral drugs and immunomodulatory drugs may reduce inflammation in critical COVID-19 patients with cytokine release syndrome. Molnupiravir, remdesivir and paxlovid are the approved antiviral agents that may reduce the recovery time. In addition, immunomodulatory drugs such as lactoferrin and monoclonal antibodies are used to control inflammatory responses in their respective auto-immune conditions. Therefore, the widespread occurrence of highly transmissible variants like Delta and Omicron indicates that there is still a lot of work to be done in designing efficient vaccines and medicines for COVID-19. In this review, we briefly discussed the immunological response against SARS-CoV-2 and the vaccines approved by the World Health Organization (WHO) for COVID-19, their mechanisms, and side effects. Moreover, we mentioned various treatment trials and strategies for COVID-19.


Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Monoclonal , Antibodies, Viral , COVID-19/drug therapy , COVID-19/prevention & control , Humans , Vaccination
19.
Psychol Res Behav Manag ; 15: 1637-1648, 2022.
Article in English | MEDLINE | ID: covidwho-1933467

ABSTRACT

Background: The novel Coronavirus Disease 2019 (COVID-19) pandemic has posed unprecedented new stressors and challenges to the applied health sciences' education. This study explored the prevalence of burnout among Saudi radiological sciences students at King Saud bin Abdulaziz University for Health Sciences during the COVID-19 pandemic. Methods: A cross-sectional study was conducted between November and December 2020 among 176-Saudi radiological sciences students, using the 16-item questionnaire of Maslach Burnout Inventory-General Survey for Students and through non-probability convenient sampling technique. The 16 items of the questionnaire were scored on a 7-point frequency rating scale ranging from 0 (never) to 6 (every day) and consisted of three distinct burnout dimensions/subscales: a) emotional exhaustion (5-items), cynicism (5-items), and professional efficacy (6-items). The means of individual items that make up each scale of burnout were calculated, and statistical analysis was performed using the Mann-Whitney U-test. Results/Observations/Findings: From the 176-radiological sciences students approached, 96 (54.5%) completed the questionnaire. The percentage of students who were at moderate to high risk of burnout was 70.8% for emotional exhaustion, 75% for cynicism, and 74% for professional efficacy subscales. Emotional exhaustion was significantly higher among fourth-year students (P = 0.042), than third-year students. Cynicism was significantly higher among fourth-year female students (P = 0.035), than third-year female students. The professional efficacy was significantly lower among fourth-year female students (P = 0.007) than males. Conclusion: Our study shows 73.3% moderate to high burnout rates among Saudi radiological sciences students during the COVID-19 pandemic. Burnout increases as students advance to the fourth year. A block/modular curriculum structure for fourth-year courses may be necessary to reduce burnout among fourth-year students. Academic counseling can ease students' emotional stress and reduce burnout risk.

20.
JOURNAL OF THE SCIENTIFIC SOCIETY ; 48(3):156-160, 2021.
Article in English | Web of Science | ID: covidwho-1911872

ABSTRACT

Introduction: COVID 19 is an unknown virus affecting mankind creating a deadly experience to all. It is true for Bangladesh also. So the objectives of the present study are to find the clinicopathological features and outcome of COVID patients admitted to three COVID dedicated hospitals of Chittagong, Bangladesh. Methods: This was an observational study where a total of 209 patients admitted to three COVID dedicated hospital were recruited. Clinicopathological data were recorded and patients were under observation till discharge and thus outcome were recorded. Prior consent was taken from the patients and ethical clearance was also taken. Data were compiled and analyzed by Statistical Package for Social Sciences-20. Results: Among 209 patients most of them were male 139 (66.5%) and male to female ratio was 1.98:1. Age group distribution revealed more were aggregated in the age group of 41-50 years 36 (17.2%), 51-60 years 54 (25.8%), and 61-70 years 57 (27.3%). Among all 92 (44%) patients were reverse transcription-polymerase chain reaction (RT-PCR) positive and 117 (56%) were probable cases. Fever was present in 195 (93.3%) cases, cough in 180 (86.1%), respiratory distress in 105 (50.2%) anosmia in 123 (58.8%), aguesea in 112 (53.58%) and lethargy was present in 143 (68.42%). Chest X-ray findings revealed 73 (34.9%) had bilateral patchy opacities, 20 (9.6%) had unilateral opacities 65 (31.1%) had consolidations, 6 (2.9%) had ground glass opacities, and 2 (1.0%) had pleural effusion. Supplemental O2 was given in 173 (82.8%) patients, Favipiravir in 59 (28.2%), Remdesivir in 111 (53.1%), Methylprednisolone in 87 (41.6%), Dexamethasone in 93 (44.5%), Antibiotics in 204 (97.60%), Toccilizumab in 34 (16.3%), plasma in 18 (8.6%), and low molecular weight heparin (LMWH) in 200 (95.7%) patients. Regarding outcome of the COVID patients admitted, 85 (92.4%) patients improved, 6 (6.5%) died who were RT-PCR positive and 107 (91.15%) improved, 9 (7.7%) died who were probable cases. Total death rate was 7.1%. Conclusion: The present study findings were some early activities among COVID patients in the years 2020. Male were more affected and middle age group people were the most victims.

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