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1.
Medical Journal of Dr. D.Y. Patil Vidyapeeth ; 15(7):S65-S71, 2022.
Article in English | Scopus | ID: covidwho-2024830

ABSTRACT

Background: A high incidence of air leak syndromes (ALSs) has been reported in critically ill coronavirus disease 2019 (COVID-19) patients, which affects disease outcome. Objective: To evaluate the incidence, outcome, and risk factors associated with ALSs in critically ill COVID-19 patients receiving invasive or non-invasive positive pressure ventilation. Result: Out of 79 patients, 16 (20.2%) patients had ALS. The mean age of the ALS group was 48.6 ± 13.1 years as compared to 52.8 ± 13.1 (p = 0.260) years in the non-ALS group. The study group had a lower median body mass index (25.9 kg/m 2 vs 27.6 kg/m 2, P = 0.096), a higher D-dimer value (1179.5 vs 762.0, P = 0.024), lower saturation (74% vs 88%, P = 0.006), and a lower PF ratio (134 vs 189, P = 0.028) at presentation as compared to the non-ALS group. Patients with ALS had received a higher median positive end-expiratory pressure (PEEP) (10 cm vs 8 cm of water, P = 0.005). The pressure support, highest driving pressure, and peak airway pressure were not significantly different in the two groups. The ALS group had a significantly longer duration of hospital stay (17.5 vs 9 days, P = 0.003). Multiple logistic regression analyses indicated that patients who received inj. dexamethasone were less likely to develop ALS (OR: 12.6 (95% CI 1.6-95.4), P = 0.015). Conclusion: A high incidence of ALS is present in critically ill COVID-19 patients. High inflammatory parameters, severe hypoxia at presentation, and use of high PEEP are significant risk factors associated with ALS. The risk of developing ALS was lower in patients who received inj. dexamethasone. © Medical Journal of Dr. D.Y. Patil Vidyapeeth 2022.

2.
IEEE Journal on Selected Topics in Signal Processing ; 16(2):159-163, 2022.
Article in English | Scopus | ID: covidwho-1861134

ABSTRACT

COVID-19 infection-s recent outbreak triggered by the SARS-CoV-2 Corona virus had already led to more than two million reported infected individuals when we first addressed the community by our call - by now, the number sadly rose to roughly half a billion cases worldwide. The outbreak of COIVD-19 has also re-shaped and accelerated the scientific publication landscape in no time. One can observe a massive uprise in interest in work related to the topic of highly contagious virus diseases and potential contributions of digital health including intelligent signal processing. In addition, most publishers have reacted in one or the other way to the crises such as by opening up to pre-prints, waiving publication fees for COVID-19-related research, providing search functions and tools for COVID-19 research, and many more. Here, we gathered 13 carefully selected novel contributions across signal types such as audio, speech, image, video, or symbolic information, as well as their multimodal combination for application in the risk assessment, diagnosis, and monitoring of contagious virus diseases. © 2007-2012 IEEE.

3.
European Journal of Surgical Oncology ; 48(5):e212, 2022.
Article in English | EMBASE | ID: covidwho-1859511

ABSTRACT

Introduction: Breast conserving surgery (BCS) has comparable or superior oncological safety when compared to mastectomy and is associated with improved cosmetic and psychological outcome. Previously patients with larger tumour to breast ratios were not suitable for BCS due to poor aesthetic outcomes and hence underwent total mastectomy with or without reconstruction. With the introduction of chest wall perforator flaps (CWPF), a significant proportion of these women who would have otherwise undergone mastectomy, can now qualify for BCS along with volume replacement. The objective of our study was to find out the impact of CWPFs on mastectomy and reconstruction. Methods: All patients who underwent surgery for breast cancer from January 2016 to December 2019 were included in the study to know the impact of CWPF on rates of mastectomy and other procedures. We excluded 2020-21 due to alterations in breast cancer treatment due to COVID-19 pandemic. The study was registered and approved by the local Clinical Governance department at the University Hospitals of North Midlands NHS Trust (CA12119). Results: Following the introduction of CWPF reconstruction, the mastectomy rate (including reconstruction) dropped by 10.69% (from 215 mastectomies in 2016 to 192 in 2019) and the mastectomy with reconstruction rate dropped by 23.29% (from 73 in 2016 to 56 in 2019). This change can be attributed to the use of CWPFs (from 1 in 2016 to 51 in 2019). Conclusion: CWPF reconstruction has reduced the rates of mastectomy +/- reconstruction and can potentially improve overall patient outcome.

4.
Cerebrovascular Diseases ; 50(SUPPL 1):1, 2021.
Article in English | Web of Science | ID: covidwho-1576496
5.
British Journal of Surgery ; 108:1, 2021.
Article in English | Web of Science | ID: covidwho-1539299
7.
IEEE International Conference on Acoustics, Speech and Signal Processing (ICASSP) ; : 8348-8352, 2021.
Article in English | Web of Science | ID: covidwho-1532691

ABSTRACT

Hospital workers are known to work long hours in a highly stressful environment. The COVID-19 pandemic has increased this burden multi-fold. Pre-COVID statistics already showed that one in every three nurses reported burnout, thus affecting patient satisfaction and the quality of their provided service. Real-time monitoring of burnout, and other underlying factors, such as stress, could provide feedback not only to the clinical staff, but also to hospital administrators, thus allowing for supportive measures to be taken early. In this paper, we present a context-aware speech-based system for stress detection. We consider data from 144 hospital workers who were monitored during their daily shifts over a 10-week period;subjective stress readings were collected daily. Wearable devices measured speech features and physiological readings, such as heart rate. Environment sensors, in turn, were used to track staff movement within the hospital. Here, we show the importance of context-awareness for stress level detection based on a bidirectional LSTM deep neural network. In particular, we show the importance of hospital location and circadian rhythm based contextual cues for stress prediction. Overall, we show improvements as high as 14% in F1 scores once context is incorporated, relative to using the speech features alone.

8.
Tissue Barriers ; 10(3): 2000300, 2022 Jul 03.
Article in English | MEDLINE | ID: covidwho-1500942

ABSTRACT

Cell junctions maintain the blood-tissue barriers to preserve vascular and tissue integrity. Viral infections reportedly modulate cell-cell junctions to facilitate their invasion. However, information on the effect of COVID-19 infection on the gene expression of cell junction and cytoskeletal proteins is limited. Using the Gene Expression Omnibus and Reactome databases, we analyzed the data on human lung A549, NHBE, and Calu-3 cells for the expression changes in cell junction and cytoskeletal proteins by SARS-CoV-2 (CoV-2) infection. The analysis revealed changes in 3,660 genes in A549, 100 genes in NHBE, and 592 genes in Calu-3 cells with CoV-2 infection. Interestingly, EGOT (9.8-, 3- and 8.3-fold; p < .05) and CSF3 (4.3-, 33- and 56.3-fold; p < .05) were the only two genes significantly elevated in all three cell lines (A549, NHBE and Calu-3, respectively). On the other hand, 39 genes related to cell junctions and cytoskeleton were modulated in lung cells, with DLL1 demonstrating alterations in all cells. Alterations were also seen in several miRNAs associated with the cell junction and cytoskeleton genes modulated in the analysis. Further, matrix metalloproteinases involved in disease pathologies, including MMP-3, -9, and -12 demonstrated elevated expression on CoV-2 infection (p < .05). The study findings emphasize the integral role of cell junction and cytoskeletal genes in COVID-19, suggesting their therapeutic potential. Our analysis also identified a distinct EGOT gene that has not been previously implicated in COVID-19. Further studies on these newly identified genes and miRNAs could lead to advances in the pathogenesis and therapeutics of COVID-19.


Subject(s)
COVID-19 , MicroRNAs , Computational Biology , Cytoskeletal Proteins/metabolism , Epithelial Cells/metabolism , Humans , Intercellular Junctions , Lung/metabolism , MicroRNAs/genetics , MicroRNAs/metabolism , SARS-CoV-2
9.
United European Gastroenterology Journal ; 9(SUPPL 8):874, 2021.
Article in English | EMBASE | ID: covidwho-1490956

ABSTRACT

Introduction: Colorectal Cancer is the third commonest cancer and ranks second in cancer-related deaths worldwide1. It is imperative to diagnose the condition in the initial stages for early treatment and improved outcomes. Colonoscopy is a gold standard investigation, but it is an invasive procedure and has failure and incompletion rates with risk of aerosol-generation2,3. Computed Tomographic Colonography, the second investigation, is limited by radiation exposure and aerosol generation3. Colon Capsule endoscopy is a novel technique without gas insufflation, therefore avoiding discomfort and aerosol generation. Current evidence favoured the CCE use, but the literature behind this is still in the infancy stages. Aims & Methods: This review aims to compare the yield of the CCE with CTC in CRC and polyps in patients with positive stool tests or diagnosed colorectal lesions. Review followed PRISMA standards. The electronic database searched for RCTs and observational studies. MedCalc Statistical Software version 17.2.1 used for the synthesis of results4. Primary (Per-Lesion and Per-Patient sensitivity analysis) and secondary (Other lesion and completion rate sensitivity analysis) outcomes measured using a random-effect model. Results: We found one RCT and three prospective observational studies (Fig 1), enrolling a total of 237 patients. Per-Lesion Sensitivity Analysis of CCE versus CTC showed overall effect of 1.903 (0.990- 1.937), p-value-0.057 (Fig 2). Per-Patient Sensitivity Analysis showed overall effect of 1.928 (0.995-1.892), p-value-0.054 (Fig 3). Other lesions Sensitivity Analysis showed overall effect of 0.810 (0.121-161.995), p-value-0.418. Completion Rate Sensitivity Analysis showed overall effect of -0.419 (0.526-1.516), p-value-0.676. None of the primary and secondary outcomes showed significant results between CCE and CTC. Conclusion: CCE had a better detection rate for colorectal cancer and polyp than the CTC, but this was not statistically significant. Therefore, this study failed to prove CCE's superiority over CTC. Considerable variability noted in the included studies with the inadequate quality and lacunae in the data. Initial studies revealed promising results of CCE, but they had a low level of evidence. A careful decision must be taken in the current COVID-19 pandemic since its advantage of zero aerosolisation. Researchers should focus on innovation in techniques and simultaneous high-quality studies to evaluate them.

10.
24th International Conference on Medical Image Computing and Computer Assisted Intervention, MICCAI 2021 ; 12905 LNCS:592-602, 2021.
Article in English | Scopus | ID: covidwho-1469656

ABSTRACT

The emergence of novel pathogens and zoonotic diseases like the SARS-CoV-2 have underlined the need for developing novel diagnosis and intervention pipelines that can learn rapidly from small amounts of labeled data. Combined with technological advances in next-generation sequencing, metagenome-based diagnostic tools hold much promise to revolutionize rapid point-of-care diagnosis. However, there are significant challenges in developing such an approach, the chief among which is to learn self-supervised representations that can help detect novel pathogen signatures with very low amounts of labeled data. This is particularly a difficult task given that closely related pathogens can share more than 90 % of their genome structure. In this work, we address these challenges by proposing MG-Net, a self-supervised representation learning framework that leverages multi-modal context using pseudo-imaging data derived from clinical metagenome sequences. We show that the proposed framework can learn robust representations from unlabeled data that can be used for downstream tasks such as metagenome sequence classification with limited access to labeled data. Extensive experiments show that the learned features outperform current baseline metagenome representations, given only 1000 samples per class. © 2021, Springer Nature Switzerland AG.

11.
Colorectal Disease ; 23(SUPPL 1):96, 2021.
Article in English | EMBASE | ID: covidwho-1457829

ABSTRACT

Introduction: Early diagnosis and treatment of Colorectal Cancer can improve outcomes. Polypectomy with colonoscopy has failure and incompletion rates with risk of aerosol-generation (Uraoka, Hosoe and Yahagi, 2015). Computed Tomographic Colonography, second investigation, is limited by radiation exposure and aerosol generation. Colon Capsule endoscopy is a novel technique without gas insufflation, therefore avoiding the discomfort and aerosol-generation. Objective: To compare the yield of the CCE with CTC in CRC and polyps in patients with positive stool tests or diagnosed colorectal lesions. Method: Review followed PRISMA standards. Electronic database searched for RCTs and observational studies. MedCalc Statistical Software used for the synthesis of results. Primary (Per-Lesion and Per-Patient sensitivity analysis) and secondary (Other lesion and completion rate sensitivity analysis) outcomes measured using a random-effect model. Results: We found one RCT and three observational studies. Per-Lesion Sensitivity Analysis of CCE versus CTC showed overall effect of 1.903 (0.990-1.937), p-value- 0.057. Per-Patient Sensitivity Analysis of showed overall effect of 1.928 (0.995-1.892), p-value- 0.054. Other lesions Sensitivity Analysis showed overall effect of 0.810 (0.121-161.995), p-value- 0.418. Completion Rate Sensitivity Analysis showed overall effect of -0.419 (0.526-1.516), p-value- 0.676. Conclusions: CCE had a better detection rate for colorectal cancer and polyp than the CTC, but this was not statistically significant. Therefore, this study failed to prove CCE's superiority over CTC. A careful decision can be made in current COVID-19 pandemic since its advantage of zero aerosolisation. Researchers should focus on innovation in techniques and simultaneous high-quality studies to evaluate them.

12.
Advances in Systems Science and Applications ; 21(2):42-57, 2021.
Article in English | Scopus | ID: covidwho-1332522

ABSTRACT

The COVID-19 pandemic situation keeps on ruining and affecting the wellbeing and prosperity of the worldwide population and due to this situation, the doctors around the world are working restlessly, as the coronavirus is increasing exponentially and the situation for testing has become quite a problematic and with restricted testing units, it’s impossible for every patient to be tested with available facilities. Effective screening of infected patients through chest X-ray images is a critical step in combating COVID-19. With the help of deep learning techniques, it is possible to train various radiology images and detect COVID-19. The dataset used in our research work is gathered from different sources and a specific new dataset is generated. The proposed methodology implemented is beneficial to the medical practitioner for the diagnosis of coronavirus infected patients where predictions can be done automated using deep learning. The deep learning algorithms that are used to predict the COVID with the help of chest X-ray images are evaluated for their prediction based on performance metrics such as accuracy, precision, Recall, and F1-score. In this work, the proposed model has used deep learning techniques for COVID-19 prediction and the results have shown superior performance in prediction of COVID-19. © 2021, International Institute for General Systems Studies. All rights reserved.

13.
Asian Economic Papers ; 20(2):33-37, 2021.
Article in English | Web of Science | ID: covidwho-1304339
14.
Contemp Clin Trials Commun ; 22: 100788, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1240268

ABSTRACT

OBJECTIVES: The COVID-19 pandemic has been a significant stressor worldwide and reports of psychological distress, depression, sedentary lifestyles, and overall decreased wellbeing are increasing. Yoga practices have been found to improve mental and physical health. The purpose of this randomized controlled trial is to compare Isha yoga practitioners to controls on perceived stress, resilience, wellbeing, and protection and recovery from COVID-19. Trial Design. In this prospective randomized control trial, the effects of yoga practices are being compared between seasoned yoga practitioners with two controls who are age (±3 years), gender matched, and living in the same neighborhood. METHODS: Participants will be asked to complete a series of web-based surveys at baseline, six weeks, and 12 weeks. These surveys include validated scales and objective questions on COVID-19 infection and medical history. The validated questionnaires assess stress, mood states, resilience, and overall wellbeing. Questionnaires, weekly activity diaries, and medical history, will be collected using REDCap. RESULTS: We hypothesize that routine yoga practice during the COVID-19 pandemic will reduce stress, enhance well-being, and provide protective effects against COVID-19. CONCLUSION: With the growing concern about the physical and mental impacts of COVID-19 and increased interest in alternative practices such as yogic practices, this study will contribute to the growing body of evidence about the safety and efficacy of yoga for emotional, mental, and physical health conditions.

15.
Cancer Research ; 81(4 SUPPL), 2021.
Article in English | EMBASE | ID: covidwho-1186389

ABSTRACT

Introduction: The COVID-19 pandemic has disrupted routine cancer care and training globally. Breast units adopted modified national guidelines in the UK, and significant changes were implemented to ensure the safety of patients and staff. The national breast screening services were temporarily suspended from March 2020. Patients underwent surgery in COVID-19 free zones. Complex oncoplastic procedures and immediate reconstructions were not offered. Adjuvant treatments were modified to reduce the risk of complications and hospital readmission. The objective of our study is to assess the impact of COVID-19 on breast cancer management and surgical training. Methods: The resource reallocation was implemented for 100 days, commencing from the 16th of March,2020. Patients diagnosed with breast cancer during this period were identified from the cancer database, and a comparison was made with patients diagnosed last year within the same time frame. We assessed the time taken from the decision to treatment and modifications made to cancer management due to the pandemic. The impact on resident training was evaluated by comparing the number of cases performed or assisted during this period. Results: During the pandemic period, out of 1064 patients seen in the Breast one-stop clinic, 64 patients (6.0%) were diagnosed with breast cancer. During the same time frame in 2019, out of 1881 new symptomatic patients, 90 (4.8%) were diagnosed with cancer. In 2019, sixty-three patients were treated for screen-detected cancer, whereas only 23 patients entered the screening pathway before the services were suspended. Majority of patients underwent surgery in 2019 as compared to 2020 (80% versus 36%). Fifty-six percent of patients received endocrine treatmentas primary or bridging therapy;whereas, in 2019, only 12% received primary endocrine therapy. In 2020, time fromdecision to surgical treatment has decreased by half as compared to 2019 (8.6 versus 19.1 days). One patient whounderwent surgery developed COVID-19 infection after two weeks, and no postoperative mortality was reported. Onaverage, each trainee was involved in 35 procedures during 2020;whereas in 2019, 54 procedures were assisted orperformed by a trainee. Conclusion: Our study shows that COVID-19 has made a significant impact on patients'management and surgical training. Majority of the patients were commenced on neoadjuvant endocrine therapyinstead of surgery. The conversion rate to cancers in one-stop clinic improved possibly due to a smaller number of benign referrals during the pandemic. The impact on surgical training is due to the reduction in the number of patients operated during this period, and constraints of performing complex oncoplastic procedures and breastreconstruction.

16.
J Cell Physiol ; 236(9): 6597-6606, 2021 09.
Article in English | MEDLINE | ID: covidwho-1098899

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 that causes coronavirus disease 2019 (COVID-19) binds to the angiotensin-converting enzyme 2 (ACE2) to gain cellular entry. Akt inhibitor triciribine (TCBN) has demonstrated promising results in promoting recovery from advanced-stage acute lung injury in preclinical studies. In the current study, we tested the direct effect of TCBN on ACE2 expression in human bronchial (H441) and lung alveolar (A549) epithelial cells. Treatment with TCBN resulted in the downregulation of both messenger RNA and protein levels of ACE2 in A549 cells. Since HMGB1 plays a vital role in the inflammatory response in COVID-19, and because hyperglycemia has been linked to increased COVID-19 infections, we determined if HMGB1 and hyperglycemia have any effect on ACE2 expression in lung epithelial cells and whether TCBN has any effect on reversing HMGB1- and hyperglycemia-induced ACE2 expression. We observed increased ACE2 expression with both HMGB1 and hyperglycemia treatment in A549 as well as H441 cells, which were blunted by TCBN treatment. Our findings from this study, combined with our previous reports on the potential benefits of TCBN in the treatment of acute lung injury, generate reasonable optimism on the potential utility of TCBN in the therapeutic management of patients with COVID-19.


Subject(s)
Angiotensin-Converting Enzyme 2/genetics , COVID-19/drug therapy , HMGB1 Protein/genetics , Proto-Oncogene Proteins c-akt/genetics , A549 Cells , Bronchi/metabolism , Bronchi/pathology , Bronchi/virology , COVID-19/genetics , COVID-19/pathology , Epithelial Cells/drug effects , Epithelial Cells/virology , Gene Expression Regulation/drug effects , Humans , Lung/drug effects , Lung/pathology , RNA, Viral/genetics , Ribonucleosides/administration & dosage , SARS-CoV-2/genetics , SARS-CoV-2/pathogenicity
17.
Journal of Investigative Medicine ; 69(1):115-116, 2021.
Article in English | Web of Science | ID: covidwho-1079089
18.
Review of Agrarian Studies ; 10(1):111-127, 2020.
Article in English | Web of Science | ID: covidwho-958800

ABSTRACT

This paper reviews the Indian state's response to the disruption in agri-food supply chains triggered by the lockdown as revealed in notifications pertaining to the agricultural sector. This paper contends that though many notifications and orders did not percolate to State and local-level administrative enforcement mechanisms, the greater problem was the absence of coordination between the Centre and States. Our analysis suggests that State Governments better managed the situation and in tackling many issues pertaining to agri-food supply chains, took action before the Centre did. The Centre's actions were not only a step behind but also largely uncoordinated with State initiatives. This disjunction was not addressed, and the ensuing chaos was therefore unsurprising. This experience highlights the importance of better Centre-State coordination and offers lessons for both future emergencies and structural reform in agriculture.

19.
Drug Discov Ther ; 14(5): 256-258, 2020 Nov 04.
Article in English | MEDLINE | ID: covidwho-895583

ABSTRACT

In the ongoing coronavirus diseases-2019 (COVID-19) crisis that caused immense suffering and deaths, the choice of therapy for the prevention and life-saving conditions must be based on sound scientific evidence. Uncertainty and apprehension are exacerbated in people using angiotensin-converting enzyme (ACE) inhibitors to control their comorbidities such as hypertension and diabetes. These drugs are reported to result in unfavorable outcome as they tend to increase the levels of ACE2 which mediates the entry of SARS-CoV-2. Amiloride, a prototypic inhibitor of epithelial sodium channels (ENaC) can be an ideal candidate for COVID-19 patients, given its ACE reducing and cytosolic pH increasing effects. Moreover, its potassium-sparing and anti-epileptic activities make it a promising alternative or a combinatorial agent.


Subject(s)
Amiloride/pharmacology , Antiviral Agents/pharmacology , Betacoronavirus/drug effects , Coronavirus Infections/drug therapy , Epithelial Sodium Channel Blockers/pharmacology , Pneumonia, Viral/drug therapy , Respiratory Mucosa/drug effects , Virus Internalization/drug effects , A549 Cells , Angiotensin-Converting Enzyme 2 , Betacoronavirus/pathogenicity , COVID-19 , Cardiovascular Diseases/drug therapy , Cardiovascular Diseases/enzymology , Coronavirus Infections/enzymology , Coronavirus Infections/virology , Down-Regulation , Host-Pathogen Interactions , Humans , Pandemics , Peptidyl-Dipeptidase A/metabolism , Pneumonia, Viral/enzymology , Pneumonia, Viral/virology , Receptors, Virus/metabolism , Respiratory Mucosa/enzymology , Respiratory Mucosa/virology , SARS-CoV-2
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