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1.
Journal of Cystic Fibrosis ; 20:S52-S53, 2021.
Article in English | EMBASE | ID: covidwho-1596611

ABSTRACT

Background: Regular microbiological sampling via cough swab or sputum collection is vital in CF care to detect early infection and implement timely optimal treatment [1]. Our service identifies on average 34 new Pseudomonas aeruginosa growths per year. Prior to the COVID-19 pandemic samples were performed routinely in pediatric CF outpatient clinic every 2-3 months by health care professionals and more frequently during pulmonary exacerbation;9 samples per patient per year on average. In March 2020 the UK went into its first lockdown, and 90% of our CF clinic appointments became virtual (video). A remote sampling service was rapidly implemented by the pediatric physiotherapy team. Methods: Sample packs with paid postage and compliant with Royal Mail regulations (UN3373) were sent out with written instructions. Parents wereaskedtotaketheirchild's sample, and avideo ofhowto complete and package the sample were provided. A physiotherapist was available virtually to guide the parent in sampling where necessary. Results: From July to December 2020, 640 sample packs were sent out to 340 children with CF in advance of their virtual clinic or following an urgent request. Only 588 (81.7%) specimens were returned, despite chasing late samples during the virtual clinic or sending reminders via text, required in approximately 25% of cases. Returned samples were received between 2 and 26 days of being taken. Conclusion: The postage delays experienced were concerning, not onlyas it increased the risk of the CF team missing the result, but also as Public Health England UK standards for microbiology investigations state that sputum should be processed promptly to reduce overgrowth with contaminants. Therefore, allresults received via post should be interpreted with caution, particularly if delayed [2]. The remote sample service was time-consuming, introduced a newcost to the service, and became harder to maintain as face-to-face services increased. However, as an urgent service improvement initiative it was successful as it picked up 35 new P. aeruginosa cases in 2020, which was in keeping with previous years' P. aeruginosa growths. This model has led to a more sustainable hospitalwide remote sampling service being established, now run by non-clinical teams. Remote sampling can now be requested electronically, saving time. Individualized QR codes are sent with the packs to be scanned by patients whenpostingthe specimen backThis informs the clinical teamso samples are not missed and can be actioned in a timely fashion.

2.
Front Immunol ; 12: 732913, 2021.
Article in English | MEDLINE | ID: covidwho-1504188

ABSTRACT

Obesity prevails worldwide to an increasing effect. For example, up to 42% of American adults are considered obese. Obese individuals are prone to a variety of complications of metabolic disorders including diabetes mellitus, hypertension, cardiovascular disease, and chronic kidney disease. Recent meta-analyses of clinical studies in patient cohorts in the ongoing coronavirus-disease 2019 (COVID-19) pandemic indicate that the presence of obesity and relevant disorders is linked to a more severe prognosis of COVID-19. Given the significance of obesity in COVID-19 progression, we provide a review of host metabolic and immune responses in the immunometabolic dysregulation exaggerated by obesity and the viral infection that develops into a severe course of COVID-19. Moreover, sequela studies of individuals 6 months after having COVID-19 show a higher risk of metabolic comorbidities including obesity, diabetes, and kidney disease. These collectively implicate an inter-systemic dimension to understanding the association between obesity and COVID-19 and suggest an interdisciplinary intervention for relief of obesity-COVID-19 complications beyond the phase of acute infection.


Subject(s)
COVID-19/immunology , COVID-19/metabolism , Obesity/immunology , Obesity/metabolism , COVID-19/complications , Disease Progression , Host-Pathogen Interactions/immunology , Humans , Immunity , Metabolic Diseases/immunology , Metabolic Diseases/metabolism , Obesity/complications , Prognosis , SARS-CoV-2/pathogenicity , Severity of Illness Index
3.
Wireless Networks (10220038) ; : 1-28, 2021.
Article in English | Academic Search Complete | ID: covidwho-1491310

ABSTRACT

The rapid spread of contagious diseases poses a colossal threat to human existence. Presently, the emergence of coronavirus COVID-19 which has rightly been declared a global pandemic resulting in so many deaths, confusion as well as huge economic losses is a challenge. It has been suggested by the World Health Organization (WHO) in conjunction with different Government authorities of the world and non-governmental organizations, that efforts to curtail the COVID-19 pandemic should rely principally on measures such as social distancing, identification of infected persons, tracing of possible contacts as well as effective isolation of such person(s) for subsequent medical treatment. The aim of this study is to provide a framework for monitoring Movements of Pandemic Disease Patients and predicting their next geographical locations given the recent trend of infected COVID-19 patients absconding from isolation centres as evidenced in the Nigerian case. The methodology for this study, proposes a system architecture incorporating GPS (Global Positioning System) and Assisted-GPS technologies for monitoring the geographical movements of COVID-19 patients and recording of their movement Trajectory Datasets on the assumption that they are assigned with GPS-enabled devices such as smartphones. Accordingly, fifteen (15) participants (patients) were selected for this study based on the criteria of residency and business activity location. The ensuing participants movements generated 157, 218 Trajectory datasets during a period of 3 weeks. With this dataset, mining of the movement trace, Stay Points (hot spots), relationships, and the prediction of the next probable geographical location of a COVID-19 patient was realized by the application of Artificial Intelligence (AI) and Data Mining techniques such as supervised Machine Learning (ML) algorithms (i.e., Multiple Linear Regression (MLR), k-Nearest Neighbor (kNN), Decision Tree Regression (DTR), Random Forest Regression (RFR), Gradient Boosting Regression (GBR), and eXtreme Gradient Boosting regression(XGBR) as well as density-based clustering methods (i.e., DBSCAN) for the computation of Stay Points (hot spots) of COVID-19 patient. The result of this study showed clearly that it is possible to determine the Stay Points (hot spots) of a COVID-19 patient. In addition, this study demonstrated the possibility of predicting the next probable geographical location of a COVID-19 patient. Correspondingly, Six Machine Learning models (i.e., MLR, kNN, DTR, RFR, GBR, and XGBR) were compared for efficiency, in determining the next probable location of a COVID-19 patient. The result showed that the DTR model performed better compared to other models (i.e., MLR, kNN, RFR, GBR, XGBR) based on four evaluation matrices (i.e., ACCURACY, MAE, MSE, and R2) used. It is recommended that less developed Countries consider adopting this framework as a policy initiative for implementation at this burgeoning phase of COVID-19 infection and beyond. The same applies to the developed Countries. There is indication that GPS Trajectory dataset and Machine Learning algorithms as applied in this paper, appear to possess the potential of performing optimally in a real-life situation of monitoring a COVID-19 patient. This paper is unique given its ability to predict the next probable location of a COVID-19 patient. In the review of extant literature, prediction of the next probable location of a COVID-19 patient was not in evidence using the same Machine Learning algorithms. [ABSTRACT FROM AUTHOR] Copyright of Wireless Networks (10220038) is the property of Springer Nature 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.
Irish Medical Journal ; 114(6), 2021.
Article in English | EMBASE | ID: covidwho-1444809

ABSTRACT

Aim To assess whether virtual clinics result in a reduction in unnecessary clinic appointments, whilst maintaining a high parental satisfaction rate. Methods Parents of children waiting greater than 36 months were called about the continued need for their appointment. Clinic outcome data was quantified and a phone survey of a random sample of participating parents was undertaken to assess their virtual clinic experience. Results 66% (154 children) no longer required appointments. 20 parents participated in the phone survey. 90% (18) agreed/strongly agreed that they had enough time to speak to the Consultant/CNS. 80% (16) reported they were satisfied with the telephone consultation. 35% (7) highlighted their frustration at not being contacted sooner. Positive remarks included the personal nature of the phone consultations, and reassurance that their children hadn’t been removed from the waiting list. The main disadvantage voiced was the lack of warning for the phone call. Conclusion Virtual clinics lead to a reduction in required face-to-face appointments, whilst maintain parental satisfaction. However, it is important to note, our study referenced patients waiting greater than 36 months. Introducing this new type of effective consultation is more important than ever given the need to reduce social interactions during this COVID-19 Pandemic.

6.
Journal of Cystic Fibrosis ; 20:S29, 2021.
Article in English | EMBASE | ID: covidwho-1368814

ABSTRACT

Background: In the first wave of the COVID-19 pandemic, people with cystic fibrosis (pwCF) in the UK were asked to ‘shield’ at home whilst many specialist CF staff were redeployed. CF services had to rapidly adapt to the changing circumstances and traditional roles were blurred as services were redesigned to try to maintain quality CF care alongside minimising risk of COVID-19. Objective: To examine the impact of COVID-19 on the prescribing practice of CF physiotherapist non-medical prescribers (CFPT-NMPs) in the UK. Method: A bespoke online questionnaire was sent to all members of the ACPCF NMP group in July 2020. Results: 19/27 CFPT-NMPs completed the questionnaire (6 adults, 12 kids and 1 both). A greater proportion of adult CFPT-NMPs (6/6, 100%) than kids (3/12, 25%) or both (0/1, 0%) had been redeployed to non-CF areas. All reported COVID-19 had changed their prescribing practice, with an overall trend towards prescribing outside their CF speciality 5/8 (63%). In adults the trend was towards less frequent prescribing (4/5, 80%) with an increase in the different types of medication prescribed (3/4, 75%);in kids there was an increase in frequency of prescribing (7/10, 70%) but no trend in change of types of medication prescribed. 14/18 (78%) reported a delay or cessation in completing non-urgent drug response assessments (DRAs). The 22% of respondents reporting no delay in DRAs were working in kids. The 11/18 (61%) who had completed DRAs reported large variability within the DRA process, specifically around use of PPE and outcome measures. Conclusion: COVID-19 has significantly impacted the delivery of CF care and CFPT-NMP's prescribing practice. Many DRAs, the gateway to pwCF accessing appropriate inhaled medications, have been delayed. This was more likely in the adult population, highlighting the greater impact COVID-19 has had on adult CF services. COVID-19-specific DRA guidance has subsequently been produced by our ACPCF NMP group, facilitating timely and safe practice nationally.

7.
Irish Medical Journal ; 114(6), 2021.
Article in English | GIM | ID: covidwho-1318556

ABSTRACT

Aim: To assess whether virtual clinics result in a reduction in unnecessary clinic appointments, whilst maintaining a high parental satisfaction rate.

8.
American Journal of Respiratory and Critical Care Medicine ; 203(9), 2021.
Article in English | EMBASE | ID: covidwho-1277383

ABSTRACT

RATIONALE Acute kidney injury requiring renal replacement therapy (AKI-RRT) in the intensive care unit (ICU) is associated with significant mortality, with short-term death rates often exceeding 50% in modern cohtorts.1 Similarly high mortality with AKI-RRT has been reported in multiple U.S. cohorts of patients with coronavirus disease 2019 (COVID-19)2-4, but none have specifically focused on the outcomes of AKI treated with continuous RRT (CRRT) in the ICU or compared the outcomes of AKI-CRRT to COVID-negative controls. METHODS We carried out a retrospective review of all patients admitted to the University of New Mexico Hospital and initiated on CRRT in January to October 2020 and compared outcomes between those with and without symptomatic COVID-19. Patients felt to be incidentally infected with COVID-19 and those with end-stage kidney disease (ESKD) were excluded. Crude death rates in AKI-CRRT patients with and without COVID-19 were compared by chisquared test. Patients discharged before 30 days were assumed alive at 30 days. RESULTSA total of 102 patients were treated with 103 CRRT treatments over the 10-month period. Of these, two felt to be incidentally infected were excluded. Ten with ESKD, including three with COVID-19, were also excluded. Of the remaining 90 with AKI-CRRT, 30 were treated for symptomatic COVID-19 starting in April 2020 and had 30-day and in-hospital mortality rates of 67.7% and 80.0%, respectively. Of the 60 COVID-19-negative patients with AKI-CRRT, the 30-day and in-hospital mortality rates were 58.3 and 63.3%, respectively (p = 0.44 and = 0.11, respectively, versus COVID-positive patients). When broken into pre-pandemic and post-pandemic groups, the 30-day and in-hospital death rates for AKI-CRRT in COVID-negative patients were 56.5% and 60.9% in January to March and 59.5% and 64.9% in April to October, respectively (p = >0.05 for both comparisons). CONCLUSIONS These data confirm the high mortality associated with AKI-CRRT in the setting of severe COVID-19. Though not statistically significant in this limited sample, the trend for higher in-hospital mortality in COVID-19 patients suggests the mortality of AKI-CRRT in this setting may be higher than other ICU patients. Notably, the mortality of AKI-CRRT in COVIDnegative patients did not significantly differ before and after the start of the pandemic. Overall, while conclusions about the independent effect of COVID-19 are limited with these unadjusted data, awareness of the high mortality of AKI-CRRT in the setting of COVID-19 may be useful in discussing prognosis and goals of care in these patients.

9.
Materials Today: Proceedings ; 2020.
Article in English | ScienceDirect | ID: covidwho-894111

ABSTRACT

The emerging increasing issues with the use of fossil fuel-derived energy resources and related challenges like pollution, global warming and climate change are boosters for adoption of renewable energy resource. Energy is a key criteria for socio-economic development of any nation, thus the search for an environmentally-friendly solution. Microbial Fuel Cell (MFC) is a promising method for the generation of green energy from waste. This study investigated the use of Nigerian corn starch wastewater as substrate for a dual-chamber MFC set-up. Iron electrodes were used for electron transfer. Up to 1.43 mA current, 0.97 V, 8.10 mA/cm2 maximum current density and 7.7 mW/cm2 maximum power density was achieved in 9 days of the experiment. The results present a relatively improved version when compared to previous studies. The experiment proves a promising alternative energy source for off-grid power solution, during Covid-19 and post-Covid-19 era.

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