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1.
Applied Sciences ; 12(6):3190, 2022.
Article in English | ProQuest Central | ID: covidwho-1760321

ABSTRACT

Visual acuity (VA) is a measure of the ability to distinguish shapes and details of objects at a given distance and is a measure of the spatial resolution of the visual system. Vision is one of the basic health indicators closely related to a person’s quality of life. It is one of the first basic tests done when an eye disease develops. VA is usually measured by using a Snellen chart or E-chart from a specific distance. However, in some cases, such as the unconsciousness of patients or diseases, i.e., dementia, it can be impossible to measure the VA using such traditional chart-based methodologies. This paper provides a machine learning-based VA measurement methodology that determines VA only based on fundus images. In particular, the levels of VA, conventionally divided into 11 levels, are grouped into four classes and three machine learning algorithms, one SVM model and two CNN models, are combined into an ensemble method in order to predict the corresponding VA level from a fundus image. Based on a performance evaluation conducted using randomly selected 4000 fundus images, we confirm that our ensemble method can estimate with 82.4% of the average accuracy for four classes of VA levels, in which each class of Class 1 to Class 4 identifies the level of VA with 88.5%, 58.8%, 88%, and 94.3%, respectively. To the best of our knowledge, this is the first paper on VA measurements based on fundus images using deep machine learning.

2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-316294

ABSTRACT

While Deep Neural Networks (DNNs) achieve state-of-the-art accuracy in various applications, they often fall short in accurately estimating their predictive uncertainty and, in turn, fail to recognize when these predictions may be wrong. Several uncertainty-aware models, such as Bayesian Neural Network (BNNs) and Deep Ensembles have been proposed in the literature for quantifying predictive uncertainty. However, research in this area has been largely confined to the big data regime. In this work, we show that the uncertainty estimation capability of state-of-the-art BNNs and Deep Ensemble models degrades significantly when the amount of training data is small. To address the issue of accurate uncertainty estimation in the small-data regime, we propose a probabilistic generalization of the popular sample-efficient non-parametric kNN approach. Our approach enables deep kNN classifier to accurately quantify underlying uncertainties in its prediction. We demonstrate the usefulness of the proposed approach by achieving superior uncertainty quantification as compared to state-of-the-art on a real-world application of COVID-19 diagnosis from chest X-Rays. Our code is available at https://github.com/ankurmallick/sample-efficient-uq

3.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-328615

ABSTRACT

Patients with weak or no symptoms accelerate the spread of COVID-19 through various mutations and require more aggressive and active means of validating the COVID-19 infection. More than 30% of patients are reported as asymptomatic infection after the delta mutation spread in Korea. It means that there is a need for a means to more actively and accurately validate the infection of the epidemic via pre-symptomatic detection, besides confirming the infection via the symptoms. Mishara et al.[1] reported that physiological data collected from smartwatches could be an indicator to suspect COVID-19 infection. It shows that it is possible to identify an abnormal state suspected of COVID-19 by applying an anomaly detection method for the smartwatch’s physiological data and identifying the subject’s abnormal state to be observed. This paper proposes to apply the One Class-Support Vector Machine (OC-SVM) for pre-symptomatic COVID-19 detection. We show that OC-SVM can provide better performance than the Mahalanobis distance-based method used by Mishara et al.[1] in three aspects: earlier (23.5%-40% earlier) and more detection (13.2%-19.1% relative better) and fewer false positives. As a result, we could conclude that OC-SVM using RHR (Resting Heart Rate) with 350 and 300 moving average size is the most recommended technique for COVID-19 pre-symptomatic detection based on physiological data from the smartwatch.

4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-311350

ABSTRACT

Background: Coronavirus disease-2019 (COVID-19) spreads rapidly throughout the world. So far, no therapeutics have yet been proven to be effective. Ribavirin was recommended for the treatment of COVID-19 because of its in vitro activity. However, evidence supporting its clinical use with good efficacy is still lacking. Methods: : A total of 208 confirmed severe or critical COVID-19 patients who were hospitalized in Wuhan Union West Campus between 1 February 2020 and 10 March 2020 were enrolled in the retrospective study. Patients were divided into two groups based on the use of ribavirin. The primary endpoint was the time to clinical improvement. The secondary endpoints included mortality, survival time, time to throat swab SARS-CoV-2 nucleic acid negative conversion, and hospital duration. Results: : 68 patients were treated with ribavirin while 140 not. There were no significant between-group differences in demographic characteristics, baseline laboratory test results, treatment, and distribution of ordinal scale scores at enrollment, except coexisting diseases especially cancer (ribavirin group vs no ribavirin group, P = 0.014). Treatment with ribavirin was not associated with a difference in the time to clinical improvement ( P = 0.483, HR = 0.884, 95% CI = 0.627-1.247). There were also no significant differences between-group in the number of patients with SARS-CoV-2 nucleic acid negative conversion, mortality, survival time, and hospital duration. Conclusion: In hospitalized adult patients with severe or critical COVID-19, no significant benefit was observed with ribavirin treatment.

5.
J Glob Health ; 11: 05023, 2021.
Article in English | MEDLINE | ID: covidwho-1573936

ABSTRACT

BACKGROUND: In response to the COVID-19 pandemic, two new temporary hospitals were constructed in record time in Wuhan, China, to help combat the fast-spreading virus in February 2020. Using the experience of one of the hospitals as a case study, we discuss the health and economic implications of this response strategy and its potential application in other countries. METHODS: This retrospective observational study analyzed health resource utilization and clinical outcomes data for 2011 inpatients diagnosed with COVID-19 and admitted to Leishenshan Hospital during its 67 days of operation from February 8th to April 14th, 2020. We used a top-down costing approach to estimate the total cost of treating patients at the Leishenshan Hospital, including capital cost for hospital construction, health personnel costs, and direct health care costs. We used a multivariate generalized linear model to examine risk factors associated with in-hospital deaths. RESULTS: During the 67 days of hospital operation, 19 medical teams comprising of 933 doctors and 2312 nurses were gradually transferred to Leishenshan Hospital from across China. Of the 2011 admissions, 4.5% used intensive care and 2.0% used ventilators. Overall median length of stay was 19 days, and 21 days for patients in the intensive care unit (ICU). The case fatality rate (CFR) was 2.3% overall, 41.8% in the ICU, and 0.4% in general ward (GW). CFRs were 55% and 50% among patients using non-invasive and invasive ventilators, respectively. The mean total cost and direct health care cost were CNY806 997 (US$114 793) and CNY16 087 (US$2288), respectively. Patients admitted to the ICU had much higher direct health care costs, on average, compared to those in the GW (CNY150 415 vs CNY9720, or US$21 396 vs US$1383). The mean direct health care cost per patient with severe or critical diseases was more than five times higher than those with mild or moderate diseases (CNY45 191 vs CNY8838, or US$6428 vs US$1257). Older age, having comorbidities, and critical disease were associated with higher risks of death from COVID-19. Lower health worker to patient ratio (<2.6) was not associated with in-hospital death. CONCLUSION: An adequate health workforce were mobilized and deployed to a new temporary hospital. The Leishenshan Hospital increased access to care during the surge in COVID-19 infections, facilitated timely treatment, and transferred COVID-19 patients between GWs and ICUs within the hospital, all of which are potential contributors to lowering the CFR. Patients in the ICU experienced a much higher CFR and a greater burden of health care cost than those in GW. Our results have important implications for other countries interested in constructing temporary emergency hospitals, such as the need for adequate infrastructure capacities and financial support, centralized strategies to mobilize health workforce and to provide respiratory protective devices, and improvement in access to health care.


Subject(s)
COVID-19 , Aged , Hospital Mortality , Hospitals , Humans , Mobile Health Units , Pandemics , SARS-CoV-2
6.
Health Sci Rep ; 4(3): e362, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1372731

ABSTRACT

BACKGROUND AND AIMS: This study aimed to examine the quality of life (QoL) and health satisfaction of undergraduate university students in Sarawak during MCO and its association with socio-demographic profiles. METHODS: In this cross-sectional study, QoL and satisfaction of health of 503 undergraduate university students (63.4% females) from a public university was assessed online using the World Health Organization QoL (WHOQOL)-BREF instrument. RESULTS: The overall QoL and satisfaction with health were 3.7 ± 0.87 and 3.9 ± 0.82, respectively. Male students showed significantly lower mean scores for the environmental domains than female students (63.37 ± 16.21 vs 68.10 ± 14.00, P < .01). Students who lived inside the campus (vs outside campus) showed significantly lower mean score for the physical health (61.49 ± 13.94 vs 67.23 ± 13.93, P < .01), environmental health (58.35 ± 15.07 vs 70.49 ± 13.21, P < .01), overall QoL (3.39 ± 0.90 vs 3.84 ± 0.83, P < .01), and satisfaction with health (3.71 ± 0.90 vs 3.97 ± 0.77, P < .01). Students with parent's income below RM5000 (vs parent's income more than RM5000) had significantly lower mean score for the environmental domain (65.06 ± 14.35 vs 68.20 ± 15.74, P < .05). Others ethnicity scored significantly lower than Bumiputera Sarawak and Malay while Bumiputera Sarawak scored significantly lower than Chinese in physical health domain (Malay = 65.73 ± 13.40, Chinese = 63.24 ± 15.35, Bumiputra Sarawak = 67.35 ± 13.30, Others = 60.84 ± 15.88, P < .05). Malay (69.99 ± 15.20) scored significantly higher than other ethnicities (Chinese = 63.58 ± 15.80; Bumiputera Malaysia = 65.23 ± 13.66; others = 63.98 ± 15.59) in environmental domain (P < .01). When comparing between religions, the results also showed there were significant differences between different religion groups in overall QoL (Islam = 3.75 ± 0.93, Christianity = 3.77 ± 0.79, Others = 3.34 ± 1.14, P < .05), physical health (Islam = 65.00 ± 13.86, Buddhism = 68.40 ± 11.99, Christianity = 64.77 ± 14.94, Others = 61.00 ± 16.03, P < .05), and environmental health (Islam = 69.66 ± 15.48, Buddhism = 64.99 ± 11.36, Christianity = 64.87 ± 15.61, Others = 62.13 ± 16.28, P < .05). CONCLUSION: By understanding university students' QoL in this global disaster, relevant authorities would provide a better rehabilitation and assistance to those affected ones.

7.
Front Public Health ; 9: 664214, 2021.
Article in English | MEDLINE | ID: covidwho-1367763

ABSTRACT

Background: The outbreak of novel coronavirus disease 2019 (COVID-19) has been challenging globally following the scarcity of medical resources after a surge in demand. As the pandemic continues, the question remains on how to accomplish more with the existing resources and improve the efficiency of existing health care delivery systems worldwide. In this study, we reviewed the experience from Wuhan - the first city to experience a COVID-19 outbreak - that has presently shown evidence for efficient and effective local control of the epidemic. Material and Methods: We performed a retrospective qualitative study based on the document analysis of COVID-19-related materials and interviews with first-line people in Wuhan. Results: We extracted two themes (the evolution of Wuhan's prevention and control strategies on COVID-19 and corresponding effectiveness) and four sub-themes (routine prevention and control period, exploration period of targeted prevention and control strategies, mature period of prevention and control strategies, and recovery period). How Wuhan combatted COVID-19 through multi-tiered and multi-sectoral collaboration, overcoming its fragmented, hospital-centered, and treatment-dominated healthcare system, was illustrated and summarized. Conclusion: Four lessons for COVID-19 prevention and control were summarized: (a) Engage the communities and primary care not only in supporting but also in screening and controlling, and retain community and primary care as among the first line of COVID-19 defense; (b) Extend and stratify the existing health care delivery system; (c) Integrate person-centered integrated care into the whole coordination; and (d) Delink the revenue relationship between doctors and patients and safeguard the free-will of physicians when treating patients.


Subject(s)
COVID-19 , China/epidemiology , Humans , Pandemics , Retrospective Studies , SARS-CoV-2
8.
Drug Evaluation Research ; 43(4):601-605, 2020.
Article in Chinese | GIM | ID: covidwho-1352918

ABSTRACT

New coronavirus pneumonia is menacing, and patients with new coronavirus pneumonia combined with other underlying diseases are more at risk. Glycemic control level directly affects the body's immune response and body state. Its low immune status is extremely likely to increase the risk of illness. Infected patients are more likely to aggravate the infection and further cause cytokine storms. Therefore, patients with new type of coronavirus infection and type 2 diabetes need better blood glucose control and management while treating new type of coronavirus infection. This article combines the research on the rational use of diabetes and analyzes the characteristics of the existing clinical data of COVID-19 to explore the pharmacological practice mode and medication monitoring strategy of this special patient. It is hoped to provide COVID-19 patients with diabetes with a more optimized and reasonable medication regimen and improve the clinical medication level.

9.
Int J Clin Pract ; 75(8): e14271, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1201528

ABSTRACT

BACKGROUND: Fangcang Hospitals (cabin hospitals) played a key role in isolation and control of the infection sources during COVID-19 epidemic. Many patients at Fangcang Hospitals had complications or mental stress. As the doctors, nurses and paramedics presented in the emergency, there was a growing demand for clinical pharmacists to provide pharmaceutical care for the affected patients with chronic diseases via telemedicine. OBJECTIVE: This study was a retrospective study to evaluate the usefulness of clinical prevention and control measures of clinical pharmacists at Jianghan Fangcang Hospital. Besides, this study proposed innovative strategies for developing pharmacy services to ensure the medication compliance, accuracy and cure rates under the epidemic. METHODS: A total of 374 patients filled in the questionnaires and 349 patients were enrolled in this study. Patients who refused to receive pharmaceutical care were not included in this study. The pharmaceutical care included medication education via broadcast station, medication reconciliation, optimisation of drug use, monitor of adverse drug events and psychological comfort via WeChat one-to-one service. The data were collected from patients' interviews and the questionnaires of inpatients and discharged patients. RESULTS: In Jianghan Fangcang Hospital, many patients had complications with hypertension (12.9%), hyperlipidaemia (9.2%), thyroid disease (8.9%), diabetes (7.2%), heart disease (3.4%), nephropathy (1.7%), cancer (1.1%) and other diseases (12.6%). After 35 days' pharmacy service, about 200 different questions had been solved by our clinical pharmacists, including drug usage (65.38%), medication reconciliation (55.13%), drug precautions (23.1%), adverse drug reactions (35.9%) and psychological counselling (32.05%). Most patients were satisfied with clinical pharmacist service (66.7% great, 18.0% good). CONCLUSION: The results of the retrospective study indicated that clinical pharmacist can effectively reduce and prevent drug-related, life-related and COVID-19-related problems for COVID-19 patients, which is important for the disease recovery. This study also demonstrated that clinical pharmacist played a key role for patients' healthcare during the pandemic.


Subject(s)
COVID-19 , Pharmacy Service, Hospital , Hospitals , Humans , Medication Reconciliation , Pandemics , Pharmacists , Retrospective Studies , SARS-CoV-2
10.
J Infect Chemother ; 27(6): 876-881, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1091770

ABSTRACT

INTRODUCTION: Coronavirus disease-2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) swept rapidly throughout the world. So far, no therapeutics have yet proven to be effective. Ribavirin was recommended for the treatment of COVID-19 in China because of its in vitro activity. However, evidence supporting its clinical use with good efficacy is still lacking. METHODS: A total of 208 confirmed severe COVID-19 patients who were hospitalized in Wuhan Union West Campus between 1 February 2020 and 10 March 2020 were enrolled in the retrospective study. Patients were divided into two groups based on the use of ribavirin. The primary endpoint was the time to clinical improvement. The secondary endpoints included mortality, survival time, time to throat swab SARS-CoV-2 nucleic acid negative conversion, and the length of hospital stay. RESULTS: 68 patients were treated with ribavirin while 140 not. There were no significant between-group differences in demographic characteristics, baseline laboratory test results, treatment, and distribution of ordinal scale scores at enrollment, except for coexisting diseases especially cancer (ribavirin group vs no ribavirin group, P = 0.01). Treatment with ribavirin was not associated with a difference in the time to clinical improvement (P = 0.48, HR = 0.88, 95% CI = 0.63-1.25). There were also no significant differences between-group in SARS-CoV-2 nucleic acid negative conversion, mortality, survival time, and the length of hospital stay. CONCLUSIONS: In hospitalized adult patients with severe COVID-19, no significant benefit was observed with ribavirin treatment.


Subject(s)
COVID-19/drug therapy , Ribavirin , Aged , China , Female , Humans , Male , Middle Aged , Retrospective Studies , Ribavirin/therapeutic use , Treatment Outcome
11.
Eur J Radiol ; 137: 109602, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1084604

ABSTRACT

PURPOSE: Differentiating COVID-19 from other acute infectious pneumonias rapidly is challenging at present. This study aims to improve the diagnosis of COVID-19 using computed tomography (CT). METHOD: COVID-19 was confirmed mainly by virus nucleic acid testing and epidemiological history according to WHO interim guidance, while other infectious pneumonias were diagnosed by antigen testing. The texture features were extracted from CT images by two radiologists with 5 years of work experience using modified wavelet transform and matrix computation analyses. The random forest (RF) classifier was applied to identify COVID-19 patients and images. RESULTS: We retrospectively analysed the data of 95 individuals (291 images) with COVID-19 and 96 individuals (279 images) with other acute infectious pneumonias, including 50 individuals (160 images) with influenza A/B. In total, 6 texture features showed a positive association with COVID-19, while 4 features were negatively associated. The mean AUROC, accuracy, sensitivity, and specificity values of the 5-fold test sets were 0.800, 0.722, 0.770, and 0.680 for image classification and 0.858, 0.826, 0.809, and 0.842 for individual classification, respectively. The feature 'Correlation' contributed most both at the image level and individual level, even compared with the clinical factors. In addition, the texture features could discriminate COVID-19 from influenza A/B, with an AUROC of 0.883 for images and 0.957 for individuals. CONCLUSIONS: The developed texture feature-based RF classifier could assist in the diagnosis of COVID-19, which could be a rapid screening tool in the era of pandemic.


Subject(s)
COVID-19 , Humans , Machine Learning , Retrospective Studies , SARS-CoV-2 , Tomography, X-Ray Computed
12.
SciFinder; 2020.
Preprint | SciFinder | ID: ppcovidwho-3575

ABSTRACT

A review. At present, the diagnosis and treatment of corona virus disease 2019 (COVID-19) has entered a critical period. The treatment of complex and changeable disease requires the cooperation of doctors, nurses and pharmacists. Therefore, from the perspective of pharmaceutical service, this article introduced some important aspects to improve the treatment of COVID-19, including the formulation of pharmaceutical care standards, prescription and medical order review, remote pharmaceutical care for COVID-19, pharmaceutical care for COVID-19 patients in the hospital and science popularization of COVID-19. As an important part of the prevention and control of epidemic disease, clin. pharmacy service has played an active role in ensuring the safety and effectiveness of patients′ medication, thereby making contribution to the effective control of the epidemic.

13.
Infect Drug Resist ; 13: 3443-3450, 2020.
Article in English | MEDLINE | ID: covidwho-853685

ABSTRACT

PURPOSE: In December 2019, coronavirus disease 2019 (COVID-19) was first identified in Wuhan, and rapidly spread throughout China. Patients with mild symptoms were admitted to Fangcang shelter hospitals for centralized quarantine. We aimed to clarify the medication usage, related adverse reactions, and pharmaceutical interventions in patients with mild COVID-19. PATIENTS AND METHODS: We innovatively carried out targeted pharmacy services. We provided online and off-line pharmaceutical services to patients in the Fangcang shelter hospital. The use of medication, related adverse reactions, and the effects of pharmaceutical intervention were analyzed. RESULTS: Lower blood lymphocyte count was proposed as the most significant risk factor in patients with mild illness. All patients received antiviral treatment (arbidol, oseltamivir, and ribavirin); 78.4% of patients received antibiotic therapy (moxifloxacin, levofloxacin, and cefdinir); patients in the moderate disease group received more antibiotic therapy than those in the mild disease group. Most of the patients were treated with traditional Chinese medicine. Patients with moderate disease preferred to receive sedative hypnotic therapy. Diarrhea, nausea and vomiting, insomnia, arrhythmia, and constipation were the most common adverse reactions. The rate of mild-to-moderate illness in the pharmaceutical intervention and non-intervention groups was 20.6% and 31.7%, respectively. CONCLUSION: Most patients with mild illness were treated with antiviral, antibiotic, and Chinese medicine therapy. However, attention should be paid to patients with mild illness presenting with hypertension and low lymphocyte count at the onset; these patients are more likely to develop moderate or severe disease. Moreover, there were many drug-related problems in Fangcang shelter hospital; pharmaceutical care might contribute to alleviate the progress of the patient's condition. Pharmacists should be prepared to provide skilled and effective services to patients, with the aim to ensure medication safety and promote the overall control of the COVID-19 pandemic.

14.
CAplus; 2020.
Preprint | CAplus | ID: ppcovidwho-2026

ABSTRACT

A review. To analyze the current medication situation of 290 patients in the "Fangcang Hospital" and make recommendations, in order to provide a reference for the prevention and control of coronavirus disease 2019 (COVID-19). The data of 290 patients were collected, the current medication situation was analyzed and analyzed. Then, in view of the existing problems, the suggestions based on the actual clin. situation have been given. Results showed that there are some problems in the current treatment of "Fangcang Hospital", such as long course of treatment and excessive use of antibiotics. It is necessary to standardize the treatment and medication of "Fangcang Hospital", the participation of pharmacists should be strengthened to assist doctors and nurses in fighting against the epidemic. In view of the current medication status in the "Fangcang Hospital", the participation of pharmacist teams in the prevention and treatment of COVID-19 has pos. significance for ensuring the effectiveness and safety of medication for patients.

16.
Mil Med Res ; 7(1): 4, 2020 02 06.
Article in English | MEDLINE | ID: covidwho-405

ABSTRACT

In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province; and then named "2019 novel coronavirus (2019-nCoV)" by the World Health Organization (WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world's attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development; we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control (including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.


Subject(s)
Betacoronavirus , Coronavirus Infections , Cross Infection , Infection Control , Mass Screening , Personal Protective Equipment , Pneumonia, Viral , Anti-Bacterial Agents/therapeutic use , Antiviral Agents/therapeutic use , Betacoronavirus/isolation & purification , Betacoronavirus/pathogenicity , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Coronavirus Infections/drug therapy , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Coronavirus Infections/transmission , Cross Infection/prevention & control , Diagnosis, Differential , Drugs, Chinese Herbal , Evidence-Based Medicine , Fluid Therapy , Humans , Infection Control/standards , Lung/diagnostic imaging , Molecular Epidemiology , Nursing Care , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/etiology , Pneumonia, Viral/therapy , Pneumonia, Viral/transmission , SARS-CoV-2
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