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1.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P287, 2022.
Article in English | EMBASE | ID: covidwho-2064409

ABSTRACT

Introduction: To limit the spread of COVID-19 and keep faculty and applicants safe, many otolaryngology subspecialties conducted their fellowship interviews via a virtual format, including within the field of rhinology. Given the novel virtual format of interviews during the 2021 rhinology interview cycle, our study looked to determine how virtual interviews compared with in-person interviews from the perspective of rhinology fellowship directors. Method(s): A web-based anonymous survey was developed consisting of 15 questions. Electronic letters were sent to all fellowship directors participating in the 2021 rhinology match requesting their participation. Fourteen of the 15 questions from our survey were based on a 5-point Likert-type scale, with 1 representing strong disagree and 5 representing strongly agree;there was 1 one open-ended question. Result(s): Overall, 70% of rhinology fellowship directors responded. Fellowship directors were divided on whether they were satisfied with the virtual interview but overall felt the process was convenient (74%). Most (74%) reported that virtual interviews did not allow them to sufficiently display their program. In addition, 70% felt that the virtual interview process did not allow them to establish rapport with applicants and also to determine who would be the best fit for their program (70%). Most also reported placing more emphasis on applicants' curriculum vitae and letters of recommendation. Overall, 65% said they would not plan to offer virtual interviews in the future despite similar or better match results. Conclusion(s): While virtual interviews result in notable cost reductions and increased convenience to programs and applicants, fellowship directors were mixed in their level of satisfaction with the overall process. This was primarily related to the perceived inability to accurately reflect their program remotely and also an increased difficulty evaluating applicants via a virtual format. These limitations led to most fellowship directors not planning to offer virtual interviews in the future despite similar match results to when conducting traditional interviews.

2.
Pediatric Infection and Vaccine ; 29(2):70-76, 2022.
Article in English | EMBASE | ID: covidwho-2044251

ABSTRACT

Coronavirus disease 2019 (COVID-19) in patients with underlying diseases, is associated with high infection and mortality rates, which may result in acute respiratory distress syndrome and death. Mucopolysaccharidosis (MPS) type II is a progressive metabolic disorder that stems from cellular accumulation of the glycosaminoglycans, heparan, and dermatan sulfate. Upper and lower airway obstruction and restrictive pulmonary diseases are common complaints of patients with MPS, and respiratory infections of bacterial or viral origin could result in fatal outcomes. We report a case of COVID-19 in a 16-year-old adolescent with MPS type II, who had been treated with idursulfase since 5 years of age. Prior to infection, the patient’s clinical history included developmental delays, abdominal distension, snoring, and facial dysmorphism. His primary complaints at the time of admission included rhinorrhea, cough, and sputum without fever or increased oxygen demand. His heart rate, respiratory rate, and oxygen saturation were within the normal biological reference intervals, and chest radiography revealed no signs of pneumonia. Consequently, supportive therapy and quarantine were recommended. The patient experienced an uneventful course of COVID-19 despite underlying MPS type II, which may be the result of an unfavorable host cell environment and changes in expression patterns of proteins involved in interactions with viral proteins. Moreover, elevated serum heparan sulfate in patients with MPS may compete with cell surface heparan sulfate, which is essential for successful interaction between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein and the host cell surface, thereby protecting against intracellular penetration by SARS-CoV-2.

3.
Journal of the American Academy of Dermatology ; 87(3):AB204, 2022.
Article in English | EMBASE | ID: covidwho-2031397

ABSTRACT

A highly visual practice, dermatology as a field has significant potential to use emerging technology such as mobile applications for research and patient-centered mapping of the disease process. The UCSF team is working to create SkinTracker, a mobile application for patients with skin disease to remotely participate in clinical trials and research studies. The initial iteration of the application focuses on atopic dermatitis. The application includes an enrollment and consent module, validated surveys including the Patient Oriented Eczema Measure (POEM), Dermatology Life Quality Index (DLQI), Numerical Rating Scale (NRS) for itch, link to a wearable device that collects biometric data, a voice diary, and a patient-directed photography module to facilitate physician evaluation of disease. Also included is the ability to report medication use, adverse events, and the ability to chat with the study team. The patient information is available to the research team on a secure online website, where researchers can assess patient photographs to perform Eczema Area and Severity Index (EASI) scoring, note important patient observations from the voice diary, and view quantitative data from both patient surveys and health measures like physical activity, sleep, and environmental factors. We believe this application and website will facilitate patient interest and participation in research, continue research despite in-person restrictions placed during the COVID-19 pandemic, and allow enrollment of more diverse patients for clinical studies who would otherwise be less likely to participate in research due to time or financial constraints.

4.
Journal of General Internal Medicine ; 37:S601, 2022.
Article in English | EMBASE | ID: covidwho-1995633

ABSTRACT

STATEMENT OF PROBLEM/QUESTION: Personal protective equipment (PPE) has allowed medical students to return to the hospital to continue their clinical responsabilities during the COVID-19 pandemic, however problems with use remain. Throughout the pandemic, stewardship of personal protective equipment has been an immense challenge. Multiple surveys have shown that less than 40% of healthcare providers wore all mandatory PPE during a patient encounter. One potential explanation for challenges in compliance, is that no standardized practices exist for keeping track of an individual's PPE during the work day. As a result, resources can be lost or mixed up between individuals, ultimately increasing exposure risks and decreasing compliance with hospital PPE use guidelines. In response, this study sought to design two innovative and inexpensive solutions to promote the effective use of masks and safety glasses in compliance with hospital guidelines. The aim was to determine if providing stewardship devices would increase compliance. DESCRIPTION OF PROGRAM/INTERVENTION: Seventy-eight medical students in their third and fourth year clinical rotations at the Icahn School of Medicine at Mount Sinai participated in the study. The study lasted three weeks. Each intervention week, participants were provided with a new set of PPE stewardshp devices. Device one was a disposable eye protection lanyard. Device two was a breathable and water-dissolvable PPE pocket storage device that could be attached to a hospital gown. MEASURES OF SUCCESS: To monitor whether the devices increased PPE compliance, participants were administered a pre-survey consisting of 21 questions. Three identical surveys were administered each subsequent intervention week, to assess effectiveness of the devices on PPE compliance. The surveys used a likert scale model to measure whether students' PPE use and ease of use and availability differed pre- and post-intervention. FINDINGS TO DATE: These interventions helped students better adhere to hospital PPE guidelines- 75% for lanyard wearers and 44% for PPE pocket users. Our results further showed 86% of participants reported that PPE was more accessible when provided with lanyards. The attachable pocket similarly increased PPE compliance, however there was a high attrition rate with its usage. KEY LESSONS FOR DISSEMINATION: PPE has served as an incredibly effective tool for limiting the spread of COVID-19. These results suggest that providing medical students with a PPE lanyard device can increase the compliance of eye protection use.

5.
14th International Conference on Advanced Computer Theory and Engineering, ICACTE 2021 ; : 27-31, 2021.
Article in English | Scopus | ID: covidwho-1932089

ABSTRACT

With the insurgence of cryptocurrency and the thriving business of mobile games, games related to cryptocurrency have gained enormous interests in recent years. This paper presents a real time online multiplayer board game, Cryptocoinopoly, which is a hybrid of the existing Cryptocoinopoly board game and Monopoly. Unity (a cross-platform game engine) has been used in the development process together with Photon Unity Networking (PUN), which is a Unity package for creating online multiplayer games. At the level, Cryptocoinopoly is represented by Remote Database, Game Server, Network, Application (Game), Local Database and Client components. Notable functions such as allowing users to play the game with multiple people and for no matter how many rounds they desire;allowing users to invest into the cryptocurrency market at any time and allowing users to trade their assets with other players have been successfully implemented. Functionality testing and debugging have been conducted under constrained conditions with limited resources due to the on-going Covid-19 situation. Despite the challenges, all functional and non-functional requirements of the prototype have been fulfilled. © 2021 IEEE.

6.
Sleep ; 45(SUPPL 1):A325, 2022.
Article in English | EMBASE | ID: covidwho-1927441

ABSTRACT

Introduction: Central to the pathophysiology of SARS-CoV-2 is immune dysregulation and systemic inflammation, however, it is yet unknown whether sleep-related hypoxemia-which we have recently noted to be associated with worse COVID-19 clinical outcomes-is mediated by these biomarkers and pathways. Methods: Data from patients who tested positive for SARS-CoV-2 and part of the integrated Cleveland Clinic COVID-19 and sleep laboratory registries from March-November 2020 were included. To assess the mediation effect of biomarkers, the relationship between sleep-related hypoxia measures (% sleep time<90%SaO2,T90) and moderate/severe WHO-7 COVID-19 score (use of supplemental oxygen, non-invasive ventilation, mechanical ventilation/ ECMO or death) was first tested. The mediation effect, or natural indirect effect, of biomarkers of inflammation (C-Reactive Protein (CRP), white blood cell (WBC) count (with a focus on lymphocyte count) and lactate) was then estimated by logistic regression models adjusted for demographics, comorbidities, smoking pack year and site location using PROC CAUSALMED statement in SAS software (version 9.4, Cary, NC). Results: The analytic sample included 446 patients hospitalized due to COVID-19: age:63.3.±13.8 years,51.3% female,39% African American with body mass index(BMI)=36.1±9.3kg/ m2. Thirty-six percent used supplemental oxygen, 4% used highflow or non-invasive ventilation,5% required ECMO or mechanical ventilation and 2% died. Hypoxic measures were associated with moderate/severe WHO-7 COVID-19 outcome: T90 median (>1.8%vs.≤1.8%) (OR=2.04, 95%CI:1.28-3.23,p=0.003), 5% increases in both mean SaO2 (OR=0.43, 95%CI: 0.26-0.70,p=<0.001) and minimum SaO2 (OR=0.84, 95%CI: 0.72-0.99,p=0.03). CRP was associated with mean SaO2 (p=0.040) and minimum SaO2 (p=0.029), likewise mediation analysis showed that there was a significant natural indirect effect of CRP in both hypoxia measures (OR=0.86,95%CI 0.73-0.99,p=0.036;OR=0.95,95%CI 0.90- 1.00,p=0.034 respectively). WBC count, but not lymphocyte count subset, was associated with mean SaO2 (p=0.044), but the natural indirect effect was not significant (p=0.23. Lactate was associated with minimum SaO2 (p=0.044), but the natural indirect effect was not significant (p=0.23). T90 median was not associated with CRP(p=0.13), WBC count(p=0.87) or lactate(p=0.28). Conclusion: CRP appears to represent a relevant mediator of sleep-related hypoxia and WHO-7 clinical outcomes. Further investigation is needed to elucidate if treatment of sleep-related hypoxia downregulates biomarkers of systemic inflammation to modify disease course.

9.
Clinical and Experimental Obstetrics and Gynecology ; 49(4), 2022.
Article in English | Scopus | ID: covidwho-1848101

ABSTRACT

Background: To evaluate whether the ongoing coronavirus disease 2019 (COVID-19) pandemic has had an impact on assisted reproductive technology (ART) outcomes and assess the possible role of geographic differences in the pandemic's trajectory on these outcomes. Methods: Multi-center retrospective cohort study involving patients who underwent oocyte cryopreservation, in vitro fertilization (IVF), embryo cryopreservation, or frozen euploid embryo transfer in 2019 and 2020 at two academic fertility centers located in regionally distinct areas of the US with high coronavirus infection rates. Patients were screened for infectious symptoms, exposure to sick contacts, and fevers, and tested with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction testing within 5 days of oocyte retrieval. The primary outcomes were the number of oocytes retrieved, embryos fertilized, blastocyst or euploid embryos produced in oocyte retrieval and IVF cycles, and rates of embryo implantation, biochemical pregnancy or no pregnancy following frozen embryo transfer (FET). Results: We found no consistent significant differences in the number of oocytes retrieved, embryos fertilized, blastocysts or euploid embryos produced at either institution over the study period. Furthermore, we did not detect any differences in FET outcomes, including rates of embryo implantation, biochemical pregnancy, or no pregnancy, at either institution during the study time period. Conclusions: There were no significant differences in ART outcomes in patients who received fertility treatment during the pandemic at our centers. Patients and providers can be reassured that with proper testing, sanitizing, and distancing measures, treatments can continue safely during the pandemic without compromising outcomes. © 2022 S.O.G. CANADA Inc.. All rights reserved.

10.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-331977

ABSTRACT

Background: B-cell depleting therapies may lead to protracted disease and prolonged viral shedding in individuals infected with SARS-CoV-2. Viral persistence in the setting of immunosuppression raises concern for viral evolution. Methods: Amplification of sub-genomic transcripts for the E gene (sgE) was done on nasopharyngeal samples over the course of 355 days in a patient infected with SARS-CoV-2 who had previously undergone CAR T cell therapy and had persistently positive SARS-CoV-2 nasopharyngeal swabs. Whole genome sequencing was performed on samples from the patient's original presentation and 10 months later. Results: Over the course of almost a year, the virus accumulated a unique in-frame deletion in the amino-terminal domain of the spike protein, and complete deletion of ORF7b and ORF8, the first report of its kind in an immunocompromised patient. Also, minority variants that were identified in the early samples-reflecting the heterogeneity of the initial infection-were found to be fixed late in the infection. Remdesivir and high-titer convalescent plasma treatment were given, and the infection was eventually cleared after 335 days of infection. Conclusions: The unique viral mutations found in this study highlight the importance of analyzing viral evolution in protracted SARS-CoV-2 infection, especially in immunosuppressed hosts, and the implication of these mutations in the emergence of viral variants. Summary: We report an immunocompromised patient with persistent symptomatic SARS-CoV-2 infection for 335 days. During this time, the virus accumulated a unique in-frame deletion in the spike, and a complete deletion of ORF7b and ORF8 which is the first report of its kind in an immunocompromised patient.

13.
2021 International Conference on Fuzzy Theory and Its Applications, iFUZZY 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1672788

ABSTRACT

This paper describes the application of mobile robots in the current coronavirus epidemic. Localization is a frequently discussed topic in mobile robotics research. Before a robot can start a task, it must know its current location on a map. The system proposed in this paper scans the obstacles and terrain around the robot by LiDAR to obtain a map of the environment and then uses the image recognition algorithm proposed in this paper to achieve the robot's location. This system can be applied to frontline medical robots, which can disinfect the environment or deliver medication, especially in the case of the COVID-19 epidemic, to help healthcare workers. The proposed localization algorithm is different from the traditional Adaptive Monte Carlo Localization (AMCL), which uses a 2D LiDAR sensor with image recognition to complete the localization. By using a modified template matching technique, the local map is compared with the known global map to deduce the robot's position, which is more accurate than AMCL. In this study, an indoor environment is created using Gazebo 3D environment simulation software, and a robot with a 2D LiDAR sensor is used in this environment to conduct the experiment. We designed three scenarios to validate the proposed algorithm, one with simple terrain, the second scene will appear throughout the map with other scenes of similar terrain, and the third with long straight lines. The results show that this method is feasible. © 2021 IEEE.

14.
Circulation ; 144(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1634724

ABSTRACT

Introduction: The COVID-19 pandemic presented an unexpected intervention to examine the association between activity and AF in patients enrolled in the TRIM-AF (Targeting Risk Interventions and Metformin for AF) clinical trial, which collects daily activity and AF burden through implanted devices. Hypothesis: We tested the hypotheses that: 1) daily activity reduction during the pandemic, compared to pre-pandemic matched periods, can be detected by implanted devices;and 2) activity reduction was associated with increased daily AF burden. Methods: Daily AF burden (%) and active minutes were obtained from manufacturers for 45 subjects (28 male, 17 female, mean age 69.5 years) enrolled in the TRIM-AF 2x2 randomized clinical trial of metformin and lifestyle/risk factor modification in patients with pacemakers/defibrillators (NCT03603912). We defined pre-pandemic and pandemic matched months for each subject, maintaining constancy of pre-vs post-randomization periods and fit a linear mixed model, including age, sex, and pandemic periods, to compare the pre-and during pandemic periods (Figure A).Results: Mean daily active minutes decreased during the pandemic from 148.6 to 144.4 mins (mixed model p =<1E-10). Mean daily AF burden increased during the pandemic from 6.0 to 8.3 (mixed model p= 3.7E-14). Both mean values were compared to matched pre-pandemic time after adjusting for sex, age, and race. AF burden % was associated with age (median AF burden increased by a factor of 1.06/year of age, mixed model p= 1.38E-02) as expected. AF daily duration percent was negatively correlated with the daily active minutes as seen by the Kendall's rank correlation tau is-0.037 (z =-7.6232, p-value = 2.474e-14). Conclusions: The data suggests that activity decreased and device-detected AF burden increased during the pandemic. Further analyses could compare results to historical trends within these patients.

15.
Journal of Gastronomy and Tourism ; 6(1/2):25-44, 2021.
Article in English | CAB Abstracts | ID: covidwho-1633790

ABSTRACT

This research was conducted during the second COVID-19 lockdown in British Columbia, Canada. Its aim was to reveal the opportunities that emerged for gastronomic experience providers which enabled them to build economic, social, and or environmental resilience during the pandemic. Using an interpretative, qualitative approach and case study methodology, data were gathered through semistructured interviews. Nineteen responses were collected and reflected the following key findings. First, technology was a primary tool used in paving the way for strategic and operational changes. Second, expansion into retail as a revenue diversification tool is key to creating sustained economic growth. Finally, the sense of community is at an all-time peak as shown by collaborative spirit, customer loyalty, and philanthropic initiatives across the sector. The findings also suggest a postpandemic gastronomic scene in British Columbia that is heavily supported by domestic palates, a diversified offering, and pandemic-proof experiences.

16.
Circulation ; 144(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1631511

ABSTRACT

Introduction: ACE inhibitor (ACEI) or angiotensin receptor blocker (ARB) use in COVID-19 raised concern due to reported increases in ACE2, the cell receptor for SARS-CoV2. We tested the hypothesis that ARB (Losartan) and ACEI (Captopril) do not impact SARS-CoV2 associated ACE2 expression in cardiomyocytes (CMs). Methods: Beating monolayer ventricular CMs were generated from human iPSCs and grown as engineered heart tissue constructs (EHTs), which mimic a more mature phenotype than monolayer CMs. Drug treatments (24hrs) without pseudovirus were applied to EHTs: (A) Vehicle, 1μM Losartan (ARB), 1μM Angiotensin II (AngII), 1μM Losartan+1μM Ang II;(B) Vehicle, 1μM Captopril, 1μM Ang I, or 1μM AngI+1μM Captopril with 2-3 replicates for each combination and RNAseq as outcome. Drug treatment A only was repeated in monolayer CMs with a 5-6 day to rVSV-SARS-Cov2SpikeLuciferase-FLAG tagged pseudovirus (2-4 replicates) with immunoblotting for ACE2, Cathepsin B (CTSB) and Furin proteins. Results: Immunoblot densitometry showed abundant ACE2 protein in untreated CMs and EHTs. A focused mRNA analysis of 12 genes associated with SARS-Cov2 entry and processing (EHTs) revealed no significant changes in expression of ACE2, NRP1, CTSB, CTSL and FURIN due to Losartan or Captopril treatment. There was a nonsignificant trend towards Losartan-induced increase in AGTR1 with attenuation when AngII was administered, while ITGA5 trended upwards with Losartan+AngII. AGTRI also trended upwards with Captopril and AngI+Captopril. Upon pseudoviral challenge, CMs demonstrated increased ACE2 (55%) and slightly decreased Furin (24%) protein, with unchanged CTSB, although results were not statistically significant. Losartan addition, regardless of AngII, did not alter SARS-CoV2Spike pseudovirus mediated changes of ACE2, Furin or CTSB proteins. Conclusions: Losartan or Captopril did not substantially alter gene expression of ACE2, CTSB, CTSL, FURIN and NRP1 in EHTs without pseudovirus. Losartan did not show convincing evidence for pseudoviral mediated changes of proteins important for viral entry and processing in CM cell models.

17.
Ieee Sensors Journal ; 22(1):900-908, 2022.
Article in English | Web of Science | ID: covidwho-1612806

ABSTRACT

In the Mobile Robotics domain, the ability of robots to locate themselves is one of the most important events. By locating, mobile robots can obtain information about the environment and continuously track their position and direction. Among localization algorithms, the Adaptive Monte Carlo Localization (AMCL) algorithm is applied most often in robot localization, a two-dimensional environment probabilistic localization system to improve the problems such as high computational complexity and hijacking of mobile robots that exist in the traditional MCL method. The proposed method is based on 2D laser information, range finder information, and AMCL to accomplish the localization task. Furthermore, an optimized AMCL algorithm is proposed to increase the accuracy of localization in terrain that is easy to fail to locate, have a chance to locate successfully when a localization error occurs, and apply the optimized AMCL to the mobile robot system. From the experimental results, we know that the improved AMCL algorithm can enhance the positioning accuracy of the robot effectively, which has better practicality than the original AMCL.

18.
IEEE Access ; 2021.
Article in English | Scopus | ID: covidwho-1594852

ABSTRACT

Given its low dose and compactness, chest radiography has been widely used as the first-line test to determine the presence of lung anomalies. Nevertheless, a high-performance diagnosis for initial screening to detect shadows in lungs due to general lung diseases is not available. During initial screening, chest radiography can be used to distinguish any diseased lung shadowing caused by lung diseases. Thus, chest radiography can contribute to the early diagnosis and prevention of novel lung infectious diseases if training for a specific disease is not required. Accordingly, we propose a deep-learning-based diagnostic system called contrast-shifted instances via patch-based percentile (CSIP) to automatically detect diseased lung shadowing via training only on chest X-ray data from healthy subjects. CSIP is the first application of a patch-based percentile approach to state-of-the-art one-class classifiers (OCCs). This application improves the sensitivity of the network to recognize shadowing density differences in each local area of the lung, thereby considerably improving the diagnostic performance of average area under the curve (AUC) by more than 20% and achieving a sufficiently high diagnostic performance (average AUC of 0.96 for various lung diseases), compared to the existing OCC case without applying our patch-based approach (average AUC of 0.74). Therefore, CSIP may contribute to the early detection of anomalies caused by novel infectious diseases such as variants of the coronavirus disease, for whom training data are scarce. The code is available at https://github.com/kskim-phd/CSIP. Author

19.
Acta Informatica Pragensia ; 10(2):123-137, 2021.
Article in English | Scopus | ID: covidwho-1485593

ABSTRACT

COVID-19 causes a jarring impact on the livelihoods of people in Malaysia and globally. To prevent an outbreak in the community, identifying the likely sources of infection (hotspots) of COVID-19 is important. The goal of this study is to formulate a bipartite network model of COVID-19 transmissions by incorporating patient mobility data to address the assumption on population homogeneity made in the conventional models and focus on indirect transmission. Two types of nodes – human and location – are the main concern in the research scenario. 21 location nodes and 31 human nodes are identified from a patient’s pre-processed mobility data. The parameters used in this study for location node and human node quantifications are the ventilation rate of a location and the environmental properties of the location that affect the stability of the virus such as temperature and relative humidity. The summation rule is applied to quantify all nodes in the network and the link weight between the human node and the location node. The ranking of location and human nodes in this network is computed using a web search algorithm. This model is considered verified as the error obtained from the comparison made between the benchmark model and the COVID-19 bipartite network model is small. As a result, the higher ranking of the location is denoted as a hotspot in this study, and for a human node attached to this node will be ranked higher in the human node ranking. Consequently, the hotspot has a higher risk of transmission compared to other locations. These findings are proposed to provide a framework for public health authorities to identify the sources of infection and high-risk groups of people in the COVID-19 cases to control the transmission at the initial stage. © 2021 by the author(s).

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