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1.
Machine Learning for Healthcare Systems: Foundations and Applications ; : 109-129, 2023.
Article in English | Scopus | ID: covidwho-20241481

ABSTRACT

According to Chinese health officials, almost 250 million people in China may have caught Covid-19 in the first 20 days of December. Due to the Covid-19 pandemic and its global spread, there is a significant impact on our health system and economy, causing many deaths and slowing down worldwide economic progress. The recent pandemic continues to challenge the health systems worldwide, including a life that realizes a massive increase in various medical resource demands and leads to a critical shortage of medical equipment. Therefore, physical and virtual analysis of day-to-day death, recovery cases, and new cases by accurately providing the training data are needed to predict threats before they are outspread. Machine learning algorithms in a real-life situation help the existing cases and predict the future instances of Covid-19. Providing accurate training data to the learning algorithm and mapping between the input and output class labels minimizes the prediction error. Polynomials are usually used in statistical analysis. Furthermore, using this statistical information, the prediction of upcoming cases is more straightforward using those same algorithms. These prediction models combine many features to predict the risk of infection being developed. With the help of prediction models, many areas can be strengthened beforehand to cut down risks and maintain the health of the citizens. Many predictions before the second wave of Covid-19 were realized to be accurate, and if we had worked on it, we would have decreased the fatality rate in India. In particular, nine standard forecasting models, such as linear regression (LR), polynomial regression (PR), support vector machine (SVM), Holt's linear, Holt-Winters, autoregressive (AR), moving average (MA), seasonal autoregressive integrated moving average (SARIMA), and autoregressive combined moving average (ARIMA), are used to forecast the alarming factors of Covid-19. The models make three predictions: the number of new cases, deaths, and recoveries over the next 10 days. To identify the principal features of the dataset, we first grouped different types of cases as per the date and plotted the distribution of active and closed cases. We calculated various valuable stats like mortality and recovery rates, growth factor, and doubling rate. Our results show that the ARIMA model gives the best possible outcomes on the dataset we used with the most minor root mean squared error of 23.24, followed by the SARIMA model, which offers somewhat close results to the AR model. It provides a root mean square error (RMSE) of 25.37. Holt's linear model does not have any considerable difference with a root mean square error of 27.36. Holt's linear model has a value very close to the moving average (MA) model, which results in the root mean square of 27.43. This research, like others, is also not free from any shortcomings. We used the 2019 datasets, which missed some features due to which models like Facebook Prophet did not predict results up to the mark;so we excluded those results in our outcomes. Also, the python package for the Prophet is a little non-functional to work on massive Covid-19 datasets appropriately. The period is better, where there is a need for more robust features in the datasets to support our framework. © 2023 River Publishers.

2.
Journal of Indian Association for Child and Adolescent Mental Health ; 16(3):17-31, 2020.
Article in English | EMBASE | ID: covidwho-20240243
3.
Journal of Heart & Lung Transplantation ; 42(4):S353-S353, 2023.
Article in English | Academic Search Complete | ID: covidwho-2288535

ABSTRACT

We report the ethnic and geographical distribution of patients undergoing extracorporeal membrane oxygenation (ECMO) at our institution in Honolulu, Hawaii. Some of the unique aspects of utilizing ECMO in the state of Hawaii include the complex geography of the Hawaiian islands separated by up to 400 km of ocean, as well as the transportation of patients from Hawaii to centers on the mainland that offer advanced cardiac therapies, the nearest which are 4000 km away. Patients who underwent venovenous (VV) and venoarterial (VA) ECMO cannulation from 2015-2022 were included in the analysis. Patient characteristics prior to cannulation and survival outcomes were analyzed. Ethnicity was compared to 2021 census data in the state of Hawaii. A total of 46 patients who underwent ECMO (VV =21 and VA = 25) were analyzed. The majority of ECMO patients were of Asian descent (50%), and 9% were of Native Hawai'ian descent. This reflects the ethnic diversity of Hawaii when compared to 2021 census data (37% Asian and 11% Native Hawai'ian). The most common indication for VA ECMO was cardiogenic shock due to advanced heart failure (26%) and for VV ECMO was COVID ARDS (22%). The majority of patients were from the island of Oahu (76%), and the remainder (26%) were from the other islands combined. In addition, 11% were transported to the mainland for advanced therapies on ECMO support. Survival to hospital discharge was 57% (48% for VA ECMO and 67% for VV ECMO). The patient characteristics of the ECMO program in our institution demonstrate the unique challenges and benefits of maintaining an ECMO program in Hawaii. Some potential solutions to mitigate these challenges include developing outreach programs for cardiac and critical care providers from the outer islands regarding the ECMO capabilities of our institution, consideration for mobile ECMO air units to cannulate patients directly in the outer islands, and the ability to offer end-stage therapies for cardiac and pulmonary failure on island. [ABSTRACT FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

4.
Kidney International Reports ; 8(3 Supplement):S455, 2023.
Article in English | EMBASE | ID: covidwho-2259937

ABSTRACT

Introduction: Covid-19 results in a wide spectrum of illness ranging from asymptomatic, mild to severe respiratory disease and multi-organ involvement. Transplant recipients are at increased risk of severe Covid-19. The risk of transmission from a Covid-19 positive donor to recipient in kidney transplantation is unknown. National Health Service Blood and Transplant, UK recommended respiratory polymerase chain reaction (PCR) testing for all donors for Covid-19 and advice against organ donation if positive within the last 28 days. However, a recent amendment of guideline (www.odt.nhs.uk, POL304/3) supports organ donation from selected donors with positive or indeterminate SARS-CoV-2 PCR results. Method(s): We report two cases of kidney transplantation including one unvaccinated recipient where donors had tested SARS-CoV-2 PCR positive. Result(s): 1: Mrs A is a 38-year old Caucasian with end-stage kidney disease (ESKD) secondary to reflux nephropathy, established on haemodialysis (HD). She had declined Covid-19 vaccinations. The donor died of traumatic brain injury and he had a positive lateral flow test 3 weeks prior. The PCR test was positive. Decision was made to proceed with deceased donor kidney transplantation. She was high immunological risk with a HLA antibody calculated reaction frequency (CRF) of 79%, donor specific antibody negative. She was given Basiliximab induction followed by Tacrolimus, Mycophenolate Mofetil and steroids. Graft function was immediate and at 3 week post-transplant, she is well with excellent graft function and no evidence of Covid-19. 2: Mrs B is a 63-year old Asian with ESKD secondary to diabetes and hypertension. She was established on HD and fully vaccinated (three doses of Pfizer-BNT162b2 mRNA vaccine). The donor died of subarchnoid haemorrhage. He had a positive lateral flow test 15 days prior with flu-like symptoms. Respiratory PCR for SARS-CoV-2 was positive. The decision was to proceed with deceased donor transplantation. She was low immunological risk with a HLA antibody CRF of 0%. There were no peri-operative complications and she had immediate graft function. She had Basiliximab induction and was discharged on Tacrolimus and Mycophenolate mofetil with prednisolone withdrawn on day 7 (our low immunological risk protocol). At 3 week post-transplant, she is well with no evidence of Covid-19 and excellent graft function. Conclusion(s): We report 2 cases of kidney transplantation from Covid-19 positive donors in whom the cause of death was not Covid-19 pneumonia. Covid-19 status of the donor was discussed with the patients who both consented. Neither recipient developed Covid-19 in the early post-transplant period, despite being heavily immunosuppressed. Although there remains a theoretical risk, there are no reports of transmission of Covid-19 to kidney transplant recipients from positive donors. Prophylactic antivirals or monoclonal antibodies for the recipient post-transplant or spike antibody test to guide decision making are not currently recommended. We used clinical details of the donor and virology advice which accounts for PCR cycle threshold value to make a decision to transplant. The outcomes of 2 patients reported along with similar experience from other centres is encouraging and supports use of kidneys from selected SARS-CoV-2 positive deceased donors after obtaining virological advice and appropriate consent. No conflict of interestCopyright © 2023

5.
Open Forum Infectious Diseases. Conference: Infectious Diseases Week, IDWeek ; 9(Supplement 2), 2022.
Article in English | EMBASE | ID: covidwho-2189836

ABSTRACT

Background. Children <=5 years of age have the highest rates of pneumococcal colonization and play an important role in the spread of pneumococcus. Our objective was to determine whether the public health measures (physical distancing, masking, and shelter-in-place orders) implemented to slow the spread of SARS-CoV-2 pandemic had an impact on pneumococcal colonization rates among children aged <=5 years with and without respiratory symptoms during the first year of SARS-CoV-2 pandemic (4/1/20 to 3/31/21). Methods. This is a single center retrospective cohort study. The study period was divided in 3 four-month periods to represent the initial period of strict adherence to public health measures (period 1: Apr-Jul), relaxation of some of these measures (period 2: Aug-Nov) and Northern hemisphere winter season (period 3: Dec-Mar). We used salvaged mid-turbinate samples obtained as part of routine care from patients without respiratory symptoms but screened for SARS-CoV-2 prior to surgery or aerosol generating procedures (asymptomatic) or from patients with respiratory symptoms tested for SARS-CoV-2 and/or other respiratory viruses (symptomatic). Samples were evaluated for pneumococcal colonization by real-time PCR using CDC lytA primers. Sample size was calculated based on the assumption of lower colonization rates in period 1 and gradual increase (10-15%) in the following study periods. Results. A total of 311 patients were included (185 asymptomatic and 126 symptomatic). Demographics, SARS-CoV-2 PCR and pneumococcal colonization results are shown in Table 1. Pneumococcal colonization rates for asymptomatic and symptomatic children were 14% and 22% (p=0.06), respectively. The odds of colonization of asymptomatic children were similar during period 2 (OR 0.96 [95%CI 0.34-2.67]) and period 3 (OR 0.53 [95%CI 0.17-1.62]), using period 1 as reference and after adjusting for age, sex, and SARS-COV-2 results. The odds of colonization of symptomatic children were also similar across the 3 study periods (period 2 OR 1.28 [95%CI 0.41-4.01] and period 3 OR 0.73 [95% CI 0.24-2.18]). Table 1. Characteristics of asymptomatic and symptomatic groups Conclusion. Pneumococcal colonization rates were not significantly impacted by public health measures implemented during the first year of the SARS-CoV-2 pandemic and did not correlate with SARS-CoV-2 positivity.

6.
Alzheimer's and Dementia ; 18(S8) (no pagination), 2022.
Article in English | EMBASE | ID: covidwho-2172390

ABSTRACT

Background: The COVID-19 pandemic has renewed attention to the conflicting demands placed on caregivers worldwide. Nowhere is this more evident than in South Asia, where cultural norms and a scarcity of long-term care facilities have made the home the locus of caregiving for individuals with brain health conditions and disabilities. A hidden cost of this informal arrangement is the burden experienced by the primary caregiver. This may be exacerbated when traditional caregiving expectations clash with personal aspirations outside the family. Method(s): The COVID-19 pandemic has renewed attention to the conflicting demands placed on caregivers worldwide. Nowhere is this more evident than in South Asia, where cultural norms and a scarcity of long-term care facilities have made the home the locus of caregiving for individuals with brain health conditions and disabilities. A hidden cost of this informal arrangement is the burden experienced by the primary caregiver. This may be exacerbated when traditional caregiving expectations clash with personal aspirations outside the family. Result(s): The COVID-19 pandemic has renewed attention to the conflicting demands placed on caregivers worldwide. Nowhere is this more evident than in South Asia, where cultural norms and a scarcity of long-term care facilities have made the home the locus of caregiving for individuals with brain health conditions and disabilities. A hidden cost of this informal arrangement is the burden experienced by the primary caregiver. This may be exacerbated when traditional caregiving expectations clash with personal aspirations outside the family. Conclusion(s): Role strain may be a significant driver of burden when the caretaker's educational and professional potential collide with traditional South Asian family obligations. The burden reported by our respondents suggests that role strain may elevate stress among young, educated caregivers. Our results, therefore, provide indirect evidence concerning the changing economic and socio-cultural context of caregiving in South Asian households. Copyright © 2022 the Alzheimer's Association.

8.
Chest ; 162(4):A287, 2022.
Article in English | EMBASE | ID: covidwho-2060551

ABSTRACT

SESSION TITLE: Cardiovascular Complications in Patients with COVID-19 SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/19/2022 12:45 pm - 1:45 pm INTRODUCTION: Cardiac manifestations of coronavirus disease 2019 (COVID-19) including bradyarrhythmias (BA) are well documented. Postulated mechanisms include direct myocardial injury through viral invasion, myocyte hypoxia, angiotensin-II receptor downregulation, hypercytokinemia and medication-related adverse events. Currently, there are no clear guidelines on the management of severe BA in the setting of COVID-19, including the threshold for permanent pacemaker (PPM) placement. We present a retrospective case series involving five COVID-19 patients with no prior history of cardiovascular disease, who developed severe BA of heart rate < 45 beats per minute. CASE PRESENTATION: Three females and two males were included in the series, with a median age of 50 years (IQR 36-61.5). Sinus bradycardia and high degree heart block were seen in two patients each. Most of the patients were noted to have sinus pauses. Inflammatory markers including D-dimer, LDH, and CRP were elevated. The median CRP in our patients was 106 mg/L (IQR 83.2-208.1) and median D-dimer was 5.63 ug/ml (IQR 1.8-13.2). All patients were treated with dexamethasone and remdesivir. However only one patient was on remdesivir on the day of onset of bradycardia. Four patients were critically ill, requiring ICU care with mechanical ventilation. Two patients required temporary transvenous pacing, one was supported on extracorporeal membrane oxygenation, and one was given atropine. No patient required PPM placement. Two deaths were observed but were not due to BA. DISCUSSION: In this single center, retrospective case series, 5 patients with COVID-19 infection developed severe BA prompting intervention. Laboratory findings demonstrated significantly elevated inflammatory markers in all our patients. The median CRP and D-Dimer in our patients was higher than the median inflammatory markers seen in a systematic review of patients with COVID-19 associated bradycardia showing that the patients in our series were suffering from severe inflammatory state. It was also observed that despite having no prior cardiac history, those more critically ill with COVID-19 infection developed severe BA requiring intervention. Conservative management and reversal of the underlying etiology prevented need for PPM implantation despite two patients developing high-grade atrioventricular-block, and one recurrent asystole. CONCLUSIONS: This preliminary data suggests that even severe BA that develops after COVID-19 infection may not require PPM placement. Further studies are required to elucidate implications, assess the reversibility, and clarify potential therapeutic targets including the indications for PPM in COVID-19 associated bradycardia. Reference #1: Nagamine, Todd et al. "Characteristics of bradyarrhythmia in patients with COVID-19: Systematic scoping review.” Pacing and clinical electrophysiology : PACE, 10.1111/pace.14466. 19 Feb. 2022, doi:10.1111/pace.14466 Reference #2: Chinitz, Jason S et al. "Bradyarrhythmias in patients with COVID-19: Marker of poor prognosis?.” Pacing and clinical electrophysiology : PACE vol. 43,10 (2020): 1199-1204. doi:10.1111/pace.14042 DISCLOSURES: No relevant relationships by Dipanjan Banerjee No relevant relationships by Monika Bernas No relevant relationships by Sandeep Randhawa No relevant relationships by Parthav Shah

9.
3rd International Conference on Emerging Technologies in Data Mining and Information Security, IEMIS 2022 ; 490:605-611, 2023.
Article in English | Scopus | ID: covidwho-2059760

ABSTRACT

The impact of COVID-19 over various sectors has continued to interest researchers. This work will investigate the impact of COVID-19 for economic uncertainty and gold price across various countries. This investigative research is done with the help of panel data concept programming packages associated with the R programming language, and therefore, we can call it longitudinal research. The current research deals with two important features related to COVID. These two are monthly COVID patient average and monthly COVID death average, and data is collected from countries such as India, China, Russia, USA, UK, Japan and Germany and apply panel data regression techniques to understand whether these two COVID-related factors significantly impact upon economic uncertainty and gold prices. The current work also observes that the monthly confirmed COVID patient average has more impact across the spectrum of countries on the economic policy uncertainty and the gold price in these countries compared to the other feature, i.e. monthly average COVID death tolls. The same conclusions have been made in the graphical as depicted below. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

10.
Studies in Big Data ; 114:13-31, 2022.
Article in English | Scopus | ID: covidwho-2048190

ABSTRACT

The outbreak of the deadly Covid-19 virus has snatched smiles from everyone’s face and now the entire world has been affected directly or indirectly by the effects of the virus, this virus keeps on mutating due to which there is no proper medicine or a final vaccine that assures it will curb the spread of the virus, major countries all over the world has lost more people than in a war and is still losing its people even after getting fully vaccinated. The horror is so much imbibed in each human it seems unrealistic to even think that the world will be normal ever again. This outbreak of the unknown virus is certainly a black-swan event that has annihilated people economically, emotionally, and socially and has made each individual realize the importance of one’s health and how to be a responsible person by taking care of whatever finances one has, as in unprecedented times savings are the only resort left with a person. It is a testing time and everyone is at war, we all are soldiers in this pandemic and our health care workers, administration, and government are trying their best to stop the spread of the disease as it has killed more than four lakh people in India only and in the world tally is more than forty lakhs with numbers increasing. In this appalling situation when everything has been shifted to online mode solutions must be looked at in more technologically driven methods, in today’s world due to rapid advancement in the IT and computer science sector there are ways to track the next rising hotspot of the virus and how it can be contained by taking swift actions if predicted within a particular time frame. Data collection, data analysis, and studying trends can help in assessing the upcoming threats, and in this manner, new job opportunities can also be created as it will involve people being prepared with limited medical knowledge to cure the people affected with the virus. In these times government and administration must adopt technologically backed solutions which will help the system to make accurate decisions based on real-time data-driven modeling capable of identifying the relevant information. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

11.
Indian Journal of Psychiatry ; 64, 2022.
Article in English | Web of Science | ID: covidwho-2003429
12.
6th International Conference on Computational Intelligence in Data Mining, ICCIDM 2021 ; 281:433-443, 2022.
Article in English | Scopus | ID: covidwho-1872355

ABSTRACT

COVID-19 has impacted the world unlike any other world event in our recent memory. Entire humanity has been afflicted by this pandemic. As a consequence of the pandemic, the governments around the world have decided to impose lockdowns restricting economic interactions and relationships in a scale and form which has not been witnessed by the modern man ever in his memory. The general assumption here is that growing COVID-19 patient and mortality counts give rise to a greater sense of uncertainty, and this greatly impacts the prices. It is imperative thus for both the researcher community to observe and investigate the influence of COVID-19 patient and mortality counts on geopolitical and economic index indicators as well as the influence of these COVID-19 indicators upon important economic indicators such as the gold price as well as stock market prices. For this specific purpose, this work investigates the influence of COVID-19 patient and monthly death counts on the economic indicators of gold and stock market prices. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

13.
Kidney international reports ; 7(2):S425-S426, 2022.
Article in English | EuropePMC | ID: covidwho-1695166
14.
5th International Conference on Electronics, Materials Engineering and Nano-Technology, IEMENTech 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1662212

ABSTRACT

With the emergence of Covid-19, as more people got affected by the fatal disease, the demand for a device to measure the oxygen content in our body has grown up. Due to unavailability of effective treatments, the outcome for critically ill Covid-19 patients depends on the availability of supportive medical care. In the current scenario of limited resources, it is important to identify patients who require close monitoring and serious care, including supplementary oxygen. The rapid spread of this virus as a global pandemic has brought in prodigious challenges to the healthcare system. Several oximeters are currently available on the market that can be utilized for this purpose. However, because they are powered by batteries, their performance degrades over time as the battery drains. In comparison to the widely utilized IR sensor in pulse oximeters, the MAX sensor employed in the suggested device is better. During the second wave of Covid-19, as more people got affected by this life-threatening illness, India witnessed a surge in the demand for oxygen supply. In light of this, apart from the oximeter, we have also suggested a methodology to construct a DIY oxygen generator that can be made using easily available materials in case of an emergency. Water has a chemical formula H2O which can be broken into its constitutional elements H2 and O2. Water is already rich in hydroxide ions but adding sodium bicarbonate as a catalyst raises the OH-concentration even more, allowing it to be utilized as an electrolyte. This paper aims to design a technique to develop both these devices cost-effectively and reliably. © 2021 IEEE.

15.
Comparative Studies of South Asia, Africa and the Middle East ; 41(3):312-317, 2021.
Article in English | Scopus | ID: covidwho-1643222

ABSTRACT

The steady rollout of Covid-19 vaccines comes attached with a series of difficult questions. Are vaccines a human right? Should patents be enforced in a way that puts people in the global South behind in a global queue? These questions are not new;the world struggled with these ethical dilemmas during the HIV-AIDS pandemic at the end of the twentieth century, when global South governments led by Nelson Mandela fought multinational pharmaceutical corporations for the right to essential life-saving drugs. Can the same strategies be mobilized to deal with inequalities in the distribution of the Covid-19 vaccine? This article demonstrates a technological and geopolitical shift in the last two decades that hinder global South solidarities actualized during the HIV-AIDS pandemic. Instead, Banerjee argues that in the present, multinational corporations and Euro-American governments are trying to reverse some of the key political visions and victories of HIV-AIDS internationalism, exploiting the urgency of the Covid-19 crisis to put in place a new vaccine apartheid. © 2021 by Duke University Press.

16.
International Psychogeriatrics ; 33:49-50, 2021.
Article in English | Web of Science | ID: covidwho-1548131
17.
International Psychogeriatrics ; 33:27-27, 2021.
Article in English | Web of Science | ID: covidwho-1548130
18.
Rhode Island Medicine ; 104(10):53-55, 2021.
Article in English | MEDLINE | ID: covidwho-1539511
19.
Journal of the American Society of Nephrology ; 32:66, 2021.
Article in English | EMBASE | ID: covidwho-1490028

ABSTRACT

Background: Global reports on the rates, risk factors and outcomes of acute kidney injury (AKI) with COVID-19 exhibit high variability. We evaluated all patients admitted with AKI to our centre where COVID-19 status was determined by PCR, and assessed risk factors for poor outcomes including death. Methods: Retrospective study of all patients admitted with AKI between 13/03/2020 and 13/05/2020. All variables including COVID-19 status, demographics, co-morbidities and laboratory parameters were collected from electronic patient records. We used competing risk-regression models to assess association with mortality by subdistribution hazards ratio (SHR). Results: Of 576 patients admitted with AKI, 257 (43.6%) were positive for COVID-19. Demographics and clinical characteristics of our cohort included: mean age 66.7 years, 58% male, 40.5% Caucasian, 56.3% hypertension, 33.1% diabetes. Overall 52.5% patients had AKI stage 1, 18.6% AKI stage 2, and 28.8% AKI stage 3. Patients with AKI stage 3 were 3.4 (95% CI 2.27-5.02) times more likely to be diagnosed with COVID-19 than those with AKI stage 1. Other factors associated with an increased likelihood of COVID-19 diagnosis adjusted for AKI stage were young age (p=0.004), non-Caucasian ethnicity (p=0.001), low lymphocyte count (p=0.002) and raised CRP, ferritin and D-dimer (p=0.001). Case fatality percentage of this cohort was 32.5% (10%, 19% and 35% mortality in COVID-19 negative patients with AKI stages 1, 2 and 3 respectively, compared with 33%, 52% and 71% in the COVID-19 positive counterparts). Patients with COVID-19 were 3.6 (95% CI 2.2-4.3) times more likely to die than those negative for COVID-19 (p<0.001). Furthermore, death in patients with COVID-19 and AKI stage 3 occurred rapidly, with 50% of patients dying within 10 days, 70% within 15 days and 95% within 21 days of admission. Those in the same group who survived had prolonged recovery, with 50% remaining inpatients in hospital for over 31 days. Conclusions: In patients with AKI, those who were positive for COVID-19 was associated with severe AKI, younger age, non-Caucasian ethnicity, raised inflammatory markers, and suffered from high case fatality. Severity of AKI in conjunction with COVID-19 was associated with high and rapid death rates, or prolonged hospital admission with increased morbidity.

20.
COVID-19 in International Media: Global Pandemic Perspectives ; : 129-138, 2021.
Article in English | Scopus | ID: covidwho-1411275
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