ABSTRACT
It is now only in the wake of coronavirus disease 2019 (COVID-19) that we are beginning to understand many of the extra-respiratory manifestations of the condition. There is now growing evidence that erectile dysfunction (ED) is closely linked with the disease. We carry out one of the first literature reviews to consolidate the current evidence of the causal link between COVID-19 and ED and explore the proposed mechanisms that underpin this phenomenon. We carried out a literature search of the databases;PubMed (MEDLINE), Scopus, Web of Science and the Cochrane library. Search time frame was between December 2019 and March 2022. Only studies deemed of acceptable quality were included. Five studies were found highlighting the link between COVID-19 and ED. A further Nineteen studies were utilized to illustrate the proposed biological mechanisms underpinning COVID-19 related ED. Clear evidence has been documented through multiple studies internationally recognizing reduction in erectile scores and reduced sexual activity. It appears there is likely indirect and direct cytopathic effects on endothelial cells, in addition to hormonal and psychosocial factors. The associated ED is likely a result of a multitude of mechanisms including direct and indirect endothelial dysfunction, vasoactive cytokines, endocrine dysregulation, and psychosocial factors. This is the first literature review to delve into the likely underpinning mechanisms of the virus that drive ED.Copyright ©2023 The Author(s). Published by MRE Press.
ABSTRACT
The unprecedented long-term online learning caused by COVID-19 has increased stress symptoms among students. The e-learning system reduces communications between teachers and students, making it difficult to observe student's mental issues and learning performance. This study aims to develop a non-intrusive method that can simultaneously monitor stress states and cognitive performance of student in the scenario of online education. Forty-three participants were recruited to perform a computer-based reading task under stressful and non-stressful conditions, and their eye-movement data were recorded. A tree ensemble machine learning model, named LightGBM (Light Gradient Boosting Machine), was utilized to predict stress states and reading performance of students with an accuracy of 0.825 and 0.793, respectively. An interpretable model, SHAP (SHapley Additive exPlanation), was used to identify the most important eye-movement indicators and their effects on stress and reading performance. The proposed model can serve as a foundation for further development of user-centred services in e-learning system. © 2022 The authors and IOS Press.
ABSTRACT
Introduction &Objective: The impact of COVID-19 in the United States has adversely impacted physicians. Fears of contracting SARS-CoV-2 has led to institutions requiring preoperative COVID screening in patients undergoing surgery. We present the results at a single institution with regard to the effectiveness of a screening program in patients scheduled for minimally invasive surgery. Method(s): Since April 2020, all patients that were scheduled for elective minimally invasive surgery by a single surgeon underwent COVID testing between 48 and 72 hours prior to surgery. Patients were advised to self-quarantine between the testing date and surgery date. In patients that tested positive for SARS-CoV-2, the surgery was postponed. The surgeon also underwent routine COVID testing between 1-4 times per month during this time period. Result(s): A total of 631 surgeries were scheduled between April 2020 and February 2022. Of these, 221 were performed in 2020, 352 in 2021, and 58 in 2022 YTD. Nine asymptomatic patients (1.4%) tested positive for SARS-CoV-2 and had surgery postponed for a minimum of 2 weeks. Eight patients rescheduled surgery after a repeat negative test result. The surgeon tested negative for SARS-CoV-2 based on rapid and PCR testing. Conclusion(s): At a time when the physician burnout rate is high, the added stress of the COVID-19 pandemic has had a deleterious effect on the quality of life of physicians. The institution of mandatory COVID screening in patients prior to surgery is not only effective in protecting the physical health of surgeons, but it can also have a positive impact on mental wellbeing.
ABSTRACT
Background: To evaluate the feasibility, baseline characteristics, and satisfaction of patients receiving telemedicine care during the coronavirus 2019 (COVID-19) pandemic in Taiwan. Methods: We retrospectively analyzed patients during the COVID-19 pandemic between May 2021 and December 2021 in a tertiary medical center in northern Taiwan. Information on the distribution of physician divisions, patients' clinical characteristics, and patterns of prescription use in telemedicine care was analyzed. Data were extracted from both the ordinary outpatient department (OPD) and nursing home systems. Results: A total of 6587 patients (55.8% female, mean age: 57.3 +/- 25.8 years) included in our telemedicine care conducted during the pandemic COVID-19 epidemic. Those who were older, female, and patients of Internal Medicine and Family Medicine utilized telemedicine more frequently than ordinary OPD, with a high refill prescription rate (82.6%) and low mail-back prescription use (35.9%). Patients of Family Medicine comprised the majority (40.3%) of nursing home telemedicine, with lower refill pre-scription use (37.3%). Overall satisfaction was high regarding telemedicine care, physicians profession-alism, and medical problem solving (98.3% and 97.7%, respectively). Conclusion: Older age, female sex, and potentially more health conditions were associated with higher willingness to access telemedicine. We identified medical divisional and disease-based differences in prescription patterns. Copyright (c) 2022, Taiwan Society of Geriatric Emergency & Critical Care Medicine.
ABSTRACT
Objective: To demonstrate the benefits of teleneurology visits for a vulnerable epilepsy population served at the epilepsy clinic in Los Angeles County Medical Center servicing the greater Los Angeles metropolitan area Background: We are a large safety-net hospital in Los Angeles county, providing Level 4 epilepsy care to patients who are uninsured/under-insured. Most are drug-resistant and have physical, social, and/or economic factors that limit their ability to receive healthcare, including epilepsy care. One main factor is that none can drive, and many have difficulties arriving to their in-person appointments due to limited transportation means (i.e. walking, public transportation). The current COVID-19 pandemic further limits their access to healthcare with reduced public services. However, the recent expanded access to teleneurology has been a significant change for this population by improving their access to healthcare and follow up. Regular follow up infers improved compliance leading to better quality of care. We readily and aggressively implemented teleneurology services for our patients. Teleneurology appointments (including phone and video) for our patients began March 20, 2020 with all appointments prior to this date being in-person appointments only. Design/Methods: We compared the rates of no-show appointments 12 months before (no teleneurology) and 12 months after (with teleneurology) March 20, 2020 by assessing significance using a z-test. Results: The rate of no-show appointments significantly falls from 33.7% (of 1711 patients) before to 15.3% (of 1684 patients) after the implementation of teleneurology (p<0.05). Conclusions: Teleneurology is a critical and effective clinical tool for improving patient compliance with clinic visits and continuing therapy. Teleneurology ensures justice in distribution of medical care even for an underserved population of patients with epilepsy in Los Angeles County.