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1.
Artificial Intelligence in Covid-19 ; : 59-84, 2022.
Article in English | Scopus | ID: covidwho-20243965

ABSTRACT

Given the time criticality of finding treatments for the novel COVID-19 pandemic disease, drug repurposing has proved to be a vital strategy as the first response while de novo drug and vaccine developments are underway. Furthermore, Artificial Intelligence (AI) has also accelerated drug development in general. Key desirable features of AI that support a rapid and sustained response along the pandemic timeline include technical flexibility and efficiency (i.e. speed, resource-efficiency, algorithm adaptability), and clinical applicability and acceptability (i.e. scientific rigor, physiological applicability and practical implementation of proposed drugs). This chapter reviews a selection of AI-based applications used in drug development targeting COVID-19, including IDentif.AI-a small data platform for a rapid identification of optimal drug combinations, to illustrate the potential of AI in drug repurposing. The benefits and limitations of using Real-World Data are also discussed. The response to the COVID-19 pandemic has offered multiple learnings which highlight the need to strengthen both short- and long-term strategies in developing AI technologies, scientific and regulatory frameworks as well as worldwide collaborations to enable effective preparedness for future epidemic and pandemic risks. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

2.
Asia Pacific Education Review ; 2023.
Article in English | Scopus | ID: covidwho-2262960

ABSTRACT

This paper addresses the pervasive absence of verbal student participation in the online class, a phenomenon observed by many lecturers and instructors expressing the frustrating and uncomfortable experiences of encountering silence from their students, particularly when it came to responding to their questions. Added to the frustration is the observed preference of students to not turn on their videos. Whilst studies on student silence in classroom discourse have been well documented in the research literature, this phenomenon has taken on new significance in the virtual classroom, the new norm in the learning context during, and most likely after, the COVID-19 situation. This study attempts to capture the perceptions of the students themselves on student silence in terms of frequency, reasons and its impact on classroom communication and meaningful learning. A questionnaire was distributed to students at a local university, followed by student focus group interviews. Data collected were then subjected to a combination of quantitative and qualitative methods of analysis. The results show that student silence is a common feature in the online classroom and that students do perceive their silence to negatively affect the flow of communication both between themselves and with their lecturers. However, the question of whether meaningful learning still occurs despite the silence is more complex and less clear, raising questions not only about what is meant by meaningful learning but also the claim by classroom discourse studies and writings that student verbal participation is key to successful learning. © 2023, Education Research Institute, Seoul National University.

3.
Bioengineering and Translational Medicine. ; 2023.
Article in English | EMBASE | ID: covidwho-2208911

ABSTRACT

Despite being a convenient clinical substrate for biomonitoring, saliva's widespread utilization has not yet been realized. The non-Newtonian, heterogenous, and highly viscous nature of saliva complicate the development of automated fluid handling processes that are vital for accurate diagnoses. Furthermore, conventional saliva processing methods are resource and/or time intensive precluding certain testing capabilities, with these challenges aggravated during a pandemic. The conventional approaches may also alter analyte structure, reducing application opportunities in point-of-care diagnostics. To overcome these challenges, we introduce the SHEAR saliva collection device that mechanically processes saliva, in a rapid and resource-efficient way. We demonstrate the device's impact on reducing saliva's viscosity, improving sample's uniformity, and increasing diagnostic performance of a COVID-19 rapid antigen test. Additionally, a formal user experience study revealed generally positive comments. SHEAR saliva collection device may support realization of the saliva's potential, particularly in large-scale and/or resource-limited settings for global and community diagnostics. Copyright © 2023 The Authors. Bioengineering & Translational Medicine published by Wiley Periodicals LLC on behalf of American Institute of Chemical Engineers.

4.
Open Forum Infectious Diseases ; 9(Supplement 2):S124, 2022.
Article in English | EMBASE | ID: covidwho-2189546

ABSTRACT

Background. Molnupiravir is an orally available prodrug of the antiviral nucleoside analog N-Hydroxycytidine (NHC). In preclinical studies NHC has shown broad-spectrum antiviral activity against multiple RNA viruses including SARS-CoV-2. Incorporation of NHC by viral polymerases impairs replication by introducing errors into the viral genome. NHC has been shown to have a high barrier to the development of resistance in vitro with RSV, Influenza and Venezualen Equine Encephalitis viruses. In these studies, we have explored the potential for SARS-CoV-2 to develop resistance to NHC in cell culture. Methods. Vero E6 cells were infected with SARS-CoV-2 (WA-1) in triplicate in the presence of NHC or a C3L-protease inhibitor (MRK-A). Culture supernatants from wells with the highest drug concentration exhibiting a cytopathic effect (CPE) score of>=2+ were repassaged and at each passage, IC50 values were estimated based on CPE scoring. At each passage, full genome next generation sequencing (NGS) was performed on the viral RNA Results. No change in susceptibility to NHC (EC50 fold change <= 1.1) was noted in 2 of 3 cultures and a 2-fold change was observed in one culture after 30 passages. In contrast, a 3- to 4-fold decreases in susceptibility to the 3CL protease inhibitor were seen by passage by 12, with increasing resistance of 4.6- to 15.7-fold observed by passage 30. NHC passaged viruses exhibited 53 to 99 amino acid changes, including substitutions and deletions (both in-frame and frameshift), across 25 different viral proteins as compared with 10 to 13 changes in 13 proteins in the MRK-A cultures. With NHC, 3 to 4 changes were observed in the viral polymerase;however, these were randomly distributed, and none were observed more than once. In contrast, the 3CL protease passaged virus had a nsp5 T21I substitution detected in all 3 cultures. Conclusion. No evidence of SARS-CoV-2 phenotypic or genotypic resistance was observed following 30 passages with NHC. A random pattern of amino acid changes were observed across multiple proteins consistent with the mechanism of action of NHC. In the same study, resistance was readily selected to a control 3CL protease inhibitor. Together these data support previous reports demonstrating the high barrier to resistance of NHC.

5.
Annals of the Academy of Medicine Singapore ; 49(6):415-416, 2020.
Article in English | EMBASE | ID: covidwho-2114109
6.
J Endocr Soc ; 6(Suppl 1):A345, 2022.
Article in English | PubMed Central | ID: covidwho-2109238

ABSTRACT

Introduction: Diabetes is an independent predictor of poor outcomes in patients with COVID-19. We compared the effects of the preadmission use of antidiabetic medications on the in-hospital mortality of patients with COVID-19 having type 2 diabetes. Methods: A systematic search was performed until November 30, 2021. We used a random-effects meta-analysis to calculate the pooled OR (95% CI). Results: We included 61 studies (3,061,584 individuals). We found some medications protective against COVID-related death, including metformin, GLP-1RA and SGLT-2i. DPP-4i and insulin users were more likely to die during hospitalization. SU, TZD, and AGI were mortality neutral. Metformin use was associated with better outcome in a dose-response manner. Conclusions: Metformin, GLP-1RA, and SGLT-2i were associated with lower mortality rate in patients with COVID-19 having type 2 diabetes. DPP-4i and insulin were linked to increased mortality. SU, TZD and AGI were mortality neutral.Presentation: No date and time listed

8.
NEJM Catal Innov Care Deliv ; 3(4), 2022.
Article in English | PubMed Central | ID: covidwho-2077190

ABSTRACT

AI THEME ISSUE: How can health care organizations ensure that there is accountability of algorithms for accuracy, bias, and the wide range of unintended consequences when deployed in real-world settings? A machine-learning system for Covid-19 contact tracing serves as a model to scope out, develop, interrogate, and assess an algorithmic solution that produces improvements in care, mitigates risk, and enables evaluation by many stakeholders.

9.
International Journal of Urology ; 29:96-96, 2022.
Article in English | Web of Science | ID: covidwho-2067915
10.
medrxiv; 2022.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2022.07.31.22278236

ABSTRACT

ABSTRACT Rationale Lung mucins are an understudied component of the mucosal immune response and may influence tuberculosis pathogenesis and outcomes. Objectives To assess if variants in lung mucins MUC5B and MUC5AC are associated with Mycobacterium tuberculosis immune responses, susceptibility, and outcomes. Methods We characterized four haplotype tagging single nucleotide polymorphisms (SNPs) in MUC5B and MUC5AC for association with log 2 TNF concentrations in cerebral spinal fluid (CSF) from TBM patients. SNPs associated with CSF TNF concentrations were carried forward for analyses of pulmonary and meningeal TB susceptibility and TBM mortality. Measurements and Main Results MUC5AC SNP rs28737416 T allele was associated with lower CSF concentrations of TNF(p=1.8*10 −8 ) and IFNγ(p=2.3*10 −6 ), and higher TBM, but not pulmonary TB, susceptibility (OR 1.24, 95% confidence interval 1.03, 1.49; p=0.021). Mortality from TBM was higher among participants with the rs28737416 T/T and T/C genotype (35/119, 30.4%) versus the C/C genotype (11/89, 12.4%; log-rank p=0.005) in a Vietnamese cohort (N=211). This finding was confirmed in an independent Vietnamese validation cohort (N=87; 9/87, 19.1% vs 1/20, 2.5%; log-rank p=0.02) and an Indonesian validation cohort (N=468, 127/287, 44.3% vs 65/181, 35.9%, log-rank p=0.06). Conclusions The MUC5AC rs28737416 T/T and T/C genotypes were associated with higher susceptibility and mortality from TBM and lower CSF concentrations of TNF and IFNγ compared to the C/C genotype, suggesting that MUC5AC contributes to immune changes that influence TBM outcomes.

11.
European Urology ; 79:S1221-S1222, 2021.
Article in English | EMBASE | ID: covidwho-1747415

ABSTRACT

Introduction & Objectives: Robot-assisted Radical Prostatectomy (RARP) is an effective cure for organ confined prostate cancer but is associated with considerable post-operative functional toxicity. The NeuroSAFE technique (intra-operative frozen section analysis of the neurovascular structure adjacent margin) may help improve functional outcomes by promoting optimal nerve-sparing (NS) RARP without compromising on oncological outcomes. NeuroSAFE technique has reported favourably in retrospective, single-centre studies but has never been evaluated prospectively by a randomised study. The NeuroSAFE PROOF Feasibility Study has succeeded in demonstrating feasibility and has been succeeded by the fully powered, definitive NeuroSAFE PROOF Randomized Controlled Trial (RCT) (NCT03317990). Materials & Methods: Potent men (IIEF-5>21) with localised prostate cancer at 4 regional uro-oncology centres in the UK (UCLH, Bristol, Sheffield and Glasgow) are eligible. Participants are randomised 1:1 to RARP with NS decision guided by standard of care (clinical information, DRE and pre-operative mpMRI surgical plan) vs. RARP with NS decision guided by standard of care information and the NeuroSAFE technique. The primary outcome is erectile function (EF) recovery assessed by IIEF-5 score at 12-months. Important secondary outcomes include detailed peri-operative outcomes, histological outcomes, post-operative complications, biochemical recurrence rates, urinary continence (assessed by ICIQ), health related quality of life (assessed by Rand-36 and EQ-5D-5L), and health economics. In order to demonstrate a difference of 15% in EF recovery rates between the arms, a total of 404 men will be randomised and treated. Patient follow-up will continue for 5 years after RARP. Results: At the time of writing, 160 men have been recruited and treated with RARP as per random allocation at 4 participating sites. The independent DMC has met twice to ensure the oncological safety of the trial and will continue to review the data at intervals. Covid-19 has led to significant challenges, including suspension of recruitment and difficulties performing follow-up. The trial team have developed new methods of recruitment, consent and follow-up to ensure conduct of the study remains in line with the highest standards of trial conduct, including electronic remote consent processes and remote collection of PROMs. Conclusions: The NeuroSAFE technique has been reported as a method to optimise outcomes for men undergoing RARP for over a decade, but, in the absence of Level 1 evidence, equipoise remains. Despite the Covid-19 pandemic recruitment continues to be favourable. We hope that our

12.
Open Forum Infectious Diseases ; 8(SUPPL 1):S373, 2021.
Article in English | EMBASE | ID: covidwho-1746454

ABSTRACT

Background. Molnupiravir (MOV, MK-4482, EIDD-2801) is an orally administered prodrug of N-hydroxycytidine (NHC, EIDD-1931), a nucleoside with broad antiviral activity against a range of RNA viruses. MOV acts by driving viral error catastrophe following its incorporation by the viral RdRp into the viral genome. Given its mechanism of action, MOV activity should not be affected by substitutions in the spike protein present in SARS-CoV-2 variants of concern which impact efficacy of therapeutic neutralizing antibodies and vaccine induced immunity. We characterized MOV activity against variants by assessing antiviral activity in vitro and virologic response from the Phase 2/3 clinical trials (MOVe-In, MOVe-Out) for treatment of COVID-19. Methods. MOV activity against several SARS-CoV-2 variants, was evaluated in an in vitro infection assay. Antiviral potency of NHC (IC50) was determined in Vero E6 cells infected with virus at MOI ~0.1 by monitoring CPE. Longitudinal SARSCoV-2 RNA viral load measures in participants enrolled in MOVe-In and MOVe-Out were analyzed based on SARS-CoV-2 genotype. Sequences of SARS-CoV-2 from study participants were amplified from nasal swabs by PCR and NGS was performed on samples with viral genome RNA of >22,000 copies/ml amplified by primers covering full length genome with Ion Torrent sequencing to identify clades represented in trial participants. SARS-CoV-2 clades were assigned using clade.nextstrain.org. Results. In vitro, NHC was equally effective against SARS-CoV-2 variants B.1.1.7 (20I), B.1351 (20H), and P1 (20J), compared with the original WA1 (19B) isolate. In clinical trials, no discernable difference was observed in magnitude of viral response measured by change from baseline in RNA titer over time across all clades represented including 20A through 20E and 20G to 20I. No participants at the time of the study presented with 20F, 20J, or 21A. Conclusion. Distribution of clades in participants in MOVe-In and MOVe-Out was representative of those circulating globally at the time of collection (Oct 2020 -Jan 2021). Both in vitro and clinical data suggest that spike protein substitutions do not impact antiviral activity of MOV and suggest its potential use for the treatment of SARS-CoV-2 variants.

14.
European Journal of Educational Research ; 10(4):1683-1695, 2021.
Article in English | Scopus | ID: covidwho-1468819

ABSTRACT

The article mentions the impact of the Coronavirus disease (COVID-19) pandemic on online learning in Vietnamese higher education in 2020. This is a qualitative case study, by using in-depth interviews to explore the changes in the perception, methods, and orientation of online learning of students and lecturers at a key pedagogical university when experiencing the three COVID-19 outbreaks in Vietnam. The findings show that the COVID-19 pandemic has a positive impact on the developmental orientation of online learning at the Vietnamese higher education level. Even though at the time of an outbreak, opposition and dissatisfaction with online learning occurred;but through the three outbreaks, together with the efforts of lecturers and students, online learning in Vietnam has recorded remarkable achievements. This is a prerequisite for the development of online education and the innovation of digital technology in education. © 2021 The Author(s). Open Access - This article is under the CC BY license (https://creativecommons.org/licenses/by/4.0/).

15.
PLoS ONE ; 16(2), 2021.
Article in English | CAB Abstracts | ID: covidwho-1410733

ABSTRACT

Background: A high proportion of COVID-19 patients were reported to have cardiac involvements. Data pertaining to cardiac sequalae is of urgent importance to define subsequent cardiac surveillance.

17.
FAccT - Proc. ACM Conf. Fairness, Account., Transpar. ; : 173-184, 2021.
Article in English | Scopus | ID: covidwho-1145374

ABSTRACT

Anonymized smartphone-based mobility data has been widely adopted in devising and evaluating COVID-19 response strategies such as the targeting of public health resources. Yet little attention has been paid to measurement validity and demographic bias, due in part to the lack of documentation about which users are represented as well as the challenge of obtaining ground truth data on unique visits and demographics. We illustrate how linking large-scale administrative data can enable auditing mobility data for bias in the absence of demographic information and ground truth labels. More precisely, we show that linking voter roll data - -containing individual-level voter turnout for specific voting locations along with race and age - -can facilitate the construction of rigorous bias and reliability tests. Using data from North Carolina's 2018 general election, these tests illuminate a sampling bias that is particularly noteworthy in the pandemic context: older and non-white voters are less likely to be captured by mobility data. We show that allocating public health resources based on such mobility data could disproportionately harm high-risk elderly and minority groups. © 2021 Owner/Author.

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