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1.
Lancet Oncology ; 23(7):E334-E347, 2022.
Article in English | Web of Science | ID: covidwho-1980468

ABSTRACT

The International Initiative on Thrombosis and Cancer is an independent academic working group of experts aimed at establishing global consensus for the treatment and prophylaxis of cancer-associated thrombosis. The 2013, 2016, and 2019 International Initiative on Thrombosis and Cancer clinical practice guidelines have been made available through a free, web-based mobile phone application. The 2022 clinical practice guidelines, which are based on a literature review up to Jan 1, 2022, include guidance for patients with cancer and with COVID-19. Key recommendations (grade 1A or 1B) include: (1) low-molecular-weight heparins (LMWHs) for the initial (first 10 days) treatment and maintenance treatment of cancer-associated thrombosis;(2) direct oral anticoagulants for the initial treatment and maintenance treatment of cancer-associated thrombosis in patients who are not at high risk of gastrointestinal or genitourinary bleeding, in the absence of strong drug-drug interactions or of gastrointestinal absorption impairment;(3) LMWHs or direct oral anticoagulants for a minimum of 6 months to treat cancer-associated thrombosis;(4) extended prophylaxis (4 weeks) with LMWHs to prevent postoperative venous thromboembolism after major abdominopelvic surgery in patients not at high risk of bleeding;and (5) primary prophylaxis of venous thromboembolism with LMWHs or direct oral anticoagulants (rivaroxaban or apixaban) in ambulatory patients with locally advanced or metastatic pancreatic cancer who are treated with anticancer therapy and have a low risk of bleeding.

3.
INTERNATIONAL JOURNAL OF MULTICULTURAL EDUCATION ; 23(3):43-61, 2021.
Article in English | Web of Science | ID: covidwho-1905171

ABSTRACT

This article reviews the extant literature showing impacts of theCOVID-19 pandemic on access to inclusive education for students with disabilities. It also explores the disproportionate impacts of distance learning and school closures during the COVID-19 pandemic on the legal rights, social emotional supports, and quality of instruction for special education students and their families. Early data show that educational impacts of COVID-19 have exacerbated long-standing issues of inequity;these impacts may have long-term repercussions for this underserved group of students. The authors introduce frameworks that may inform future instructional practices to successfully teach students with disabilities in virtual learning environments.

4.
Italian Sociological Review ; 12(1):41-64, 2022.
Article in English | Scopus | ID: covidwho-1732500

ABSTRACT

In this article, the authors present the results of an empirical research regarding people over 65 years old living in Central Italy, that have contracted the Sars-CoV-2 virus. The choice of such target is strictly dependent on the need to investigate, specifically, how this category, in a risky situation, was able to deal with the illness and cope with the whole condition;both in relation to the management of health and governmental information, and in relation to the use of information channels and technological devices. Through a research carried out with qualitative methodology, a series of analysis emerged around: 1) the idea of promoting and ensuring digital literacy with a view to the social innovation to cope with the risks of ‘infodemic’;2) the urge to reflect on the necessity of keeping active and constant the dialogue between scientific community and user/citizen in the view of a transfer of knowledge and techno-scientific information, especially in periods of health crisis, in order to mitigate the effects due to digital divide;3) the need to analyze the life of older people in a context of indeterminacy and fear in which social habits and consolidated certainties have been subjected to a totalizing tension. © 2022,Italian Sociological Review.All Rights Reserved

7.
Intelligent Decision Technologies-Netherlands ; 15(4):655-665, 2021.
Article in English | Web of Science | ID: covidwho-1677650

ABSTRACT

Reliable and rapid non-invasive testing has become essential for COVID-19 diagnosis and tracking statistics. Recent studies motivate the use of modern machine learning (ML) and deep learning (DL) tools that utilize features of coughing sounds for COVID-19 diagnosis. In this paper, we describe system designs that we developed for COVID-19 cough detection with the long-term objective of embedding them in a testing device. More specifically, we use log-mel spectrogram features extracted from the coughing audio signal and design a series of customized deep learning algorithms to develop fast and automated diagnosis tools for COVID-19 detection. We first explore the use of a deep neural network with fully connected layers. Additionally, we investigate prospects of efficient implementation by examining the impact on the detection performance by pruning the fully connected neural network based on the Lottery Ticket Hypothesis (LTH) optimization process. In general, pruned neural networks have been shown to provide similar performance gains to that of unpruned networks with reduced computational complexity in a variety of signal processing applications. Finally, we investigate the use of convolutional neural network architectures and in particular the VGG-13 architecture which we tune specifically for this application. Our results show that a unique ensembling of the VGG-13 architecture trained using a combination of binary cross entropy and focal losses with data augmentation significantly outperforms the fully connected networks and other recently proposed baselines on the DiCOVA 2021 COVID-19 cough audio dataset. Our customized VGG-13 model achieves an average validation AUROC of 82.23% and a test AUROC of 78.3% at a sensitivity of 80.49%.

8.
Salute e Societa ; 20:68-84, 2021.
Article in Italian | Scopus | ID: covidwho-1643464

ABSTRACT

The Sars-Cov2 pandemic has demonstrated the strong link between health risk and perception of the disease for various reasons: Because it is an event that is being faced for the first time and because the consequences of the disease are still completely unknown. The objective of the article is to give a voice to people who have experienced the disease. Following a qualitative approach, twenty in-depth interviews were conducted with people recovered from Sars- Cov2 living in southern Lazio, using the R-Text Mining Package software as an analysis tool. From the analysis of the interviews, conducted through text mining, word relationships and sentiment analysis, a series of particularly relevant areas and dimensions emerged in order to assess the impact that the disease has had on people's experiences, both on an individual and social level. Specifically, three main topics emerged: Communication, fear and danger. © 2021 Franco Angeli Edizioni. All rights reserved.

9.
Salute e Societa ; 20:68-84, 2021.
Article in Italian | Scopus | ID: covidwho-1632091

ABSTRACT

The Sars-Cov2 pandemic has demonstrated the strong link between health risk and perception of the disease for various reasons: Because it is an event that is being faced for the first time and because the consequences of the disease are still completely unknown. The objective of the article is to give a voice to people who have experienced the disease. Following a qualitative approach, twenty in-depth interviews were conducted with people recovered from Sars- Cov2 living in southern Lazio, using the R-Text Mining Package software as an analysis tool. From the analysis of the interviews, conducted through text mining, word relationships and sentiment analysis, a series of particularly relevant areas and dimensions emerged in order to assess the impact that the disease has had on people's experiences, both on an individual and social level. Specifically, three main topics emerged: Communication, fear and danger. © 2021 Franco Angeli Edizioni. All rights reserved.

10.
QJM ; 114(12): 865-871, 2022 Jan 09.
Article in English | MEDLINE | ID: covidwho-1546019

ABSTRACT

BACKGROUND: The definition of 'long-COVID syndrome' (LCS) is still debated and describes the persistence of symptoms after viral clearance in hospitalized or non-hospitalized patients affected by coronavirus disease 2019 (COVID-19). AIM: In this study, we examined the prevalence and the risk factors of LCS in a cohort of patients with previous COVID-19 and followed for at least 6 months of follow-up. DESIGN: We conducted a prospective study including all hospitalized patients affected by COVID-19 at our center of Infectious Diseases (Vercelli, Italy) admitted between 10 March 2020 and 15 January 2021 for at least 6 months after discharge. Two follow-up visits were performed: after 1 and 6 months after hospital discharge. Clinical, laboratory and radiological data were recorded at each visit. RESULTS: A total of 449 patients were included in the analysis. The LCS was diagnosed in 322 subjects at Visit 1 (71.7%) and in 206 at Visit 2 (45.9); according to the post-COVID-19 functional status scale we observed 147 patients with values 2-3 and 175 with values >3 at Visit 1; at Visit 2, 133 subjects had the score between 2-3 and 73 > 3. In multivariate analysis, intensive care unit (ICU) admission (OR = 2.551; 95% CI = 1.998-6.819; P = 0.019), time of hospitalization (OR = 2.255; 95% CI = 1.018-6.992; P = 0.016) and treatment with remdesivir (OR = 0.641; 95% CI = 0.413-0.782; P < 0.001) were independent predictors of LCS. CONCLUSIONS: Treatment with remdesivir leads to a 35.9% reduction in LCS rate in follow-up. Severity of illness, need of ICU admission and length of hospital stay were factor associated with the persistence of PCS at 6 months of follow-up.


Subject(s)
Adenosine Monophosphate/therapeutic use , Alanine/therapeutic use , COVID-19 , Adenosine Monophosphate/analogs & derivatives , Alanine/analogs & derivatives , COVID-19/complications , COVID-19/drug therapy , Hospitalization , Humans , Incidence , Intensive Care Units , Prospective Studies , Risk Factors , SARS-CoV-2
11.
12th International Conference on Information, Intelligence, Systems and Applications, IISA 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1494291

ABSTRACT

As the COVID-19 pandemic continues, rapid non-invasive testing has become essential. Recent studies and benchmarks motivates the use of modern artificial intelligence (AI) tools that utilize audio waveform spectral features of coughing for COVID-19 diagnosis. In this paper, we describe the system we developed for COVID-19 cough detection. We utilize features directly extracted from the coughing audio and use deep learning algorithms to develop automated diagnostic tools for COVID-19. In particular, we develop a unique modification of the VGG13 deep learning architecture for audio analysis that uses log-mel spectrograms and a combination of binary cross entropy and focal losses. This unique modification enabled the model to achieve highly robust classification of the DiCOVA 2021 COVID-19 data. We also explore the use of data augmentation and an ensembling strategy to further improve the performance on the validation and the blind test datasets. Our model achieved an average validation AUROC of 82.23% and a test AUROC of 78.3% at a sensitivity of 80.49%. © 2021 IEEE.

14.
Journal of Criminal Psychology ; 2021.
Article in English | Scopus | ID: covidwho-1254981

ABSTRACT

Purpose: In early 2020, the world faced a rapid life-changing pandemic in the form of the Coronavirus Disease of 2019 (COVID-19) crisis. Citywide lockdowns with stay-at-home orders and mass closings quickly became the “new normal.” With these new mandates, routine activity, mental health and financial securities all began to experience major deviations, and it became clear that this could prove to be rather valuable in providing the opportunity for large-scale criminology experiments. This study aims to explore New York City's (NYC) crime patterns during this unique social situation. Specifically, has crime as a whole increased or decreased, and have particular crimes increased or decreased during these stressful fluid times? Design/methodology/approach: The authors briefly review previous crises and worldwide trends but focus on NYC crime as collected by the New York Police Department's statistics unit, “CompStat.” An analysis of 13 crime types from March 30 to July 5 was completed, including percent differences and individual weekly incidence rates in citywide crimes compared to the same time in 2019. Findings: The analysis demonstrated that all crimes analyzed, except for murder and burglary, exhibited a statistically significant difference during COVID-19 conditions compared to the same time the previous year. Grand larceny auto and gun violence crimes significantly increased during COVID-19 weeks, whereas rape, other sex crimes, robbery, felony assault, grand larceny, transit, housing, misdemeanor assault and petit larceny all significantly decreased. Originality/value: Due to the ongoing nature of the pandemic, this is amongst the first studies to examine trends in NYC crime during pandemic mandates. Expanding our knowledge in these situations can inform natural disaster responses, as well as criminal justice policy and practice to better protect the public in future crises. © 2021, Emerald Publishing Limited.

15.
Global Health Promotion ; : 17579759211007120, 2021.
Article in English | MEDLINE | ID: covidwho-1208420

ABSTRACT

INTRODUCCION: frente a la identificacion de la ocurrencia de un brote de COVID-19 en el barrio Villa Azul (Buenos Aires, Argentina) y dadas las caracteristicas de vulnerabilidad del barrio que dificultarian cumplir con el aislamiento domiciliario y las medidas de prevencion, se implemento una estrategia de aislamiento comunitario como respuesta sanitaria al brote. OBJETIVO: describir la estrategia de aislamiento comunitario utilizada en el barrio Villa Azul para contener y mitigar un brote de COVID-19. METODOS: se identificaron los limites del barrio y se procedio al cierre del mismo con fuerzas de seguridad. Quedo permitida la circulacion interna asumiendo que todos los habitantes eran casos sospechosos de COVID-19 o bien eran contactos estrechos de algun caso. En los dias subsiguientes se continuo con la busqueda activa de casos sospechosos, se realizaron los hisopados en el barrio y se obtuvieron los resultados a las 24 horas. Todos los dias, luego de la recepcion de los casos se les informaba el resultado a los casos negativos y se iba a las casas de los casos positivos para notificarlos del resultado y sugerirles el aislamiento fuera del barrio para cortar la cadena de contagios. RESULTADOS: en el barrio Villa Azul entre el 22 de mayo y el 20 de junio, se registraron 731 casos sospechosos de los cuales 379 fueron casos confirmados de COVID-19 (tasa de positividad acumulada del 52,1%). La primera semana hubo entre 20 y 40 casos confirmados diarios con un indice de positividad entre el 66 y el 81% pero con el correr del tiempo como consecuencia de la estrategia descripta fueron bajando el numero de casos por dia y tambien la positividad. Se trasladaron 193 pacientes confirmados para aislarlos afuera del barrio. Fallecieron 3 personas (tasa de letalidad 0,8%). DISCUSION: la estrategia de aislamiento comunitario resulto efectiva para contener el brote de COVID-19 en el barrio Villa Azul.

16.
Revista Argentina de Endocrinologia y Metabolismo ; 58(SUPPL 1):190-192, 2021.
Article in English | EMBASE | ID: covidwho-1197964

ABSTRACT

Introduction: Vitamin D (VD) plays a role in immune response. Its benefits on respiratory diseases induced by viruses have been previously described and recent data shows that low levels of VD could worsen COVID-19 outcomes Objectives: To establish association between VD blood levels among COVID-19 patients with their clinical outcomes and biochemical inflammatory markers. Methods: Prospective, multicentric, cohort study. COVID-19 patients were recruited consecutively and grouped as ambulatory or hospitalized, being followed until discharge, transfer to other centers, intensive care unit (ICU) admission or death. The variables evaluated were: age, gender, oxygen mask requirement (O2r), mechanical ventilation (MV), pre-existing comorbidities, inflammatory markers, severity of COVID-19 by News Score. VD levels were classified as: suficient: >30 ng/ml (VDS), insuficient: 20-30 ng/ml (VDI), deficient: <20 ng/ml (VDD). Parametric test, linear multivariate, logistic and cox regressions adjusted by confounders (comorbidities, age) plus survival analysis and long rank were performed. Results: 287 patients were recruited;243 (85%) were hospitalized, showing significant differences in VD levels against ambulatory patients (18±10ng/ml - 24,3±13ng/ml respectively p<0,01). Group classification according to VD and characteristics are expressed in Table1. COVID-19 severe forms and VD levels were negatively associated (p:0,009). VDI and VDD had higher risks for moderate (OR:3,2 95CI:1,1-9 p:0,03) and severe (OR:3 95%CI:1,09-8 p:0,03) disease. VD has also shown correlation with baseline markers as ferritin and LDH (p:0,019 -0,03 respectively). O2r risk was increased between VDI (OR:3,4 95%CI:1,2-9 p:0,016) and VDD (OR:2,74 95%CI:1,1- 6,8 p:0,03) noticing a higher risk in presence of comorbidities, multiplying the odds in 3,39 or 3,6 in presence of 1 or more comorbidities respectively. Lower calcium levels correlated with ICU admission (p:0,02), and noticeably presented itself as a risk factor for mortality ( OR: 7,9 95%CI:1,7-36,3 p:0,008). Image: Conclusion: This study shows that among COVID-19 hospitalized patients, vitamin level was significantly lower, besides its association with O2r, severity and baseline inflammatory markers. Calcium also plays a role in the evolution of this disease and further studies are needed to emphasize the importance of adequate levels of VD and supplementation as an effort to improve COVID-19 outcomes.

17.
Tumori ; 106(2 SUPPL):209-210, 2020.
Article in English | EMBASE | ID: covidwho-1109859

ABSTRACT

Background: Ensuring treatment continuity during the COVID-19 pandemics was a major commitment of our Institution. To this end a specific response plan, integrating recommendations from relevant networks (AIOM, NCCN, ISS, ANIPIO, FNOPI), was implemented to minimize exposure risks and fatality rates for patients (pts.) and personnel. Methods: From March 10, triage checkpoints at hospital main entrances were activated to regulate access to wards, outpts. chemotherapy facility and diagnostics units (A). From April, additional stations were established at further building allocating outpts. clinics and surgical day care (B). Nursing staff was involved in several intervention domains: 1. development and updating of triage forms for pts. and caregivers (10 updates). 2. Education and guidance on personal protective equipment (PPE). 3. regulation of inflow at triage stations. This was achieved through a specific protocol including support for access forms compilation, collection of travel/contact history, thermoscan survey, monitoring of peripheral oxygen saturation for unfit patients, direct interaction with referral physicians through point-of-care (POC) audits to secure access for symptomatic patients and 'suspect COVID-19 cases' in need of non-deferrable treatments. These POC audits were mainly aimed at separating cancer and treatment-symptoms from indicators of possible SARS-CoV-2 infection. 4. Nasopharyngeal swabbing for personnel and 'suspect cases' at POC and within a precautionary program for all immunocompromised petients accessing the hematology-oncology Unit. 5. From May 15, setup and administration of rapid testing for SARS-CoV-2 IgG/IgM with POC nasopharyngeal swabbing for those displaying positive antibody results. 6. Health education for pts., caregivers, personnel and outsourcing operators, including hand hygiene, selection and use of PPE. Results: Overall results (March-May 2020), are shown below. Conclusions: Efforts made by nursing team significantly contributed to warrant oncology care continuity and operators safety. Nursing triage effectively identified potential SARS-CoV-2 carriers.

18.
Tumori ; 106(2 SUPPL):205-206, 2020.
Article in English | EMBASE | ID: covidwho-1109822

ABSTRACT

Background: Immunotherapies and molecular targeted treatments have improved the prognosis of melanoma patients (pts) both in adjuvant and metastatic setting. Due to their peculiar mechanism of action, these drugs may cause typical adverse events (AEs) and many of these may be severe and life-threatening. In particular, the therapy with check points inhibitors like anti-PD-1 and anti-CTLA4 agents require a careful monitoring of patients during the treatment and also after the end due to possible delayed or permanent adverse events. The aim of our study is to evaluate whether nursing monitoring of pts through periodical phone calls may be useful to reduce the incidence of serious adverse events (SAEs) and hospitalizations in melanoma pts treated with immunotherapy. Methods: We started to collect data from 50 melanoma pts treated with immunotherapy from March 2020 to May 2020 during COVID- 19 pandemia. Thirty-five (70%) pts were treated for metastatic disease and fifteen (30%) for adjuvant aim. Forty-five patients (90%) received an anti-PD-1 treatment (pembrolizumab or nivolumab) and five (10%) an anti- CTL-A4, ipilimumab. Phone calls to patients or to their care-givers were performed by the nurse once weekly and toxicity was evaluated through CTCAE v5.0 (Common Terminology Criteria for Adverse Events). Medical interventation was required according the grade or the type of AE. Results: The incidence of AEs detected on phone calls were the following in metastatic pts : Grade 1-2 diarrhea (15/35, 43%), grade 1pruritus (10/35, 28%), grade 2 rash (5/35,14%), grade 1fatigue (12/35, 34%). Among adjuvant pts : grade 3 diarrhea (3/15, 20%), grade 2 rash (2/15,13%), grade 2 arthralgia (1/15, 6%), grade 2 peripheral neuropathy (1/15,6%). No SAEs were detected. All AEs resolved with an early treatment with corticosteroids taken at home after medical contact. No hospitalization were necessary. Conclusions: Our preliminary results show that using a periodical nursing phone calls during the treatment with immunotherapy may help to detect earlier AEs and to avoid SAEs and complications that bring to hospitalization.

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