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1.
Journal of Clinical Oncology ; JOUR(16):E18647-E18647, 40.
Article in English | Web of Science | ID: covidwho-2092897
2.
International Journal of Technology Enhanced Learning ; 14(4):420-444, 2022.
Article in English | Web of Science | ID: covidwho-2070795

ABSTRACT

The experience of remote learning during the pandemic COVID-19 significantly accelerated the process of digitalisation of the higher education in Russia and intensified preparations for the transition to a model of the Digital University. However, even those educational institutions that successfully applied remote technologies in the educational process faced the problem of effectively managing the entire remote learning system. The aim of the study is to identify the management potential of remote learning at universities in Russia from the point of view of the methodology of active management systems. Models of the remote learning system in institutions of higher education relevant for different stages of development have been created;recommendations are made to integrate the proposed models into the Digital University model. Research results contribute to the development of the theory and practice of active management systems in terms of modelling remote learning in institutions of higher education.

6.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2009601

ABSTRACT

Background: Patients with comorbidities especially those with oncological diseases could have severe COVID-19 outcomes. OBJECTIVE: The aim of this study was to evaluate the role of prolonged positivity of SARS-Cov2 in evolution of patients with various neoplasia. Methods: We analysed clinical and laboratory (hematological parameters and inflammatory markers: interleukin-6 and ferritin) data of COVID-19 patients admitted in intensive care unit (ICU) Department of our hospital, during 2020-2021 and presented in medical history solid tumors or haematological neoplasia . The cohort of patients included 78 patients with severe and critical form of COVID-19, 31 patients with solid tumors and 47 patients with hematologic malignancies. We consider long COVID-19 all cases with SARS Cov2 positivity more than 14 days. Results: The frequency of long COVID-19 was quite equal between patients groups with solid tumors and hematologic malignancies, incidence rate 1:2, the incidence rate differences was 1:18, p = 0.75. Long COVID-19 was observed in 60% cases with favourable evolution, Chi-squared 5.35%, p = 0.02, these patients had moderate form and was admitted in hospital in 1 or more days after the onset, median value 3 (min 1, max 55) compared with patients with normal duration of positivity of SARS-Cov2 test-median value 2 (min 1, max 8), p = 0.01. The Kaplan Meyer survival analyses indicated long COVID-19 as predictive factor for unfavourable evolution, Chi-squared 17.97, p < 0.0001. Although we have not obtain significant differences, we observed more severe lymphopenia in patient without long COVID-19, probably because a part of these patients group died in the first 14 days of COVID-19 (0.765 (min 0.04, max 297.64) vs. 1.01 (min 0.09, max 254.35), p = 0.09). The rest of hematological and biochemistry parameters was not significant different between groups. Infectious and thrombotic complication was most frequent in patients with long COVID-19, Chi squared 8.6, p = 0.003. Conclusions: Long Covid-19 is predictable for unfavourable evolution and is associated with sepsis and thrombotic complication. This diagnosis is frequent in patients who was admitted in hospital after the onset of COVID-19 symptoms, early treatment of COVID-19 in oncological patients being very important for favourable evolution.

7.
Her Russ Acad Sci ; 92(4): 488-490, 2022.
Article in English | MEDLINE | ID: covidwho-2008786

ABSTRACT

The results of a comprehensive study are presented on the development and creation of an original small PDSTP molecule, able to prevent the SARS-CoV-2 coronavirus infection from binding to the host cell. The PDSTP molecule was designed to electrostatically interact with heparan sulfate proteoglycans on the cell surface, and coronaviruses, particularly SARS-CoV-2, use this mechanism as the first stage of interaction with the cell. By blocking this process, it is possible to stop the life cycle of the virus, thus leading to its death. The drug candidate PDSTP, with its unique mechanism of action, is characterized by a very low toxicity and a high safety profile and demonstrates good efficacy in animal experiments.

8.
Gastroenterology ; 162(7):S-685, 2022.
Article in English | EMBASE | ID: covidwho-1967364

ABSTRACT

Background With the COVID-19 pandemic there was an acute drop in procedural volume for trainees, highlighting the need and potential of simulation-based training (SBT). Prior to the pandemic, the uptake of simulation was poorly categorized and inconsistent across programs despite the variety of endoscopic simulators available. We aimed to evaluate the current state of endoscopy training internationally in the wake of the pandemic as perceived by trainees. Methods This cross-sectional study utilized a survey composed of 21 questions eliciting demographic data, COVID-19-related training experiences, and experience with SBT. This survey was distributed internationally (USA, Canada, EU, Philippines, Singapore) to gastroenterology trainees between August 2021 to October 2021. Results The questionnaire was completed by 182 fellows, with 55 (30.2%) from the USA and 127 (69.8%) from other countries. Of the respondents, 79.1% were fellows during the first year of the pandemic. A majority (69.2%) found endoscopy training in general to be negatively impacted. Of those who reported a negative impact from the pandemic, 75.0% attributed it to a decline in endoscopic volume, 40.0% to institutional/regional guidelines, 25.0% to a shortage of personal protective equipment. Overall, 47.2% of respondents believed COVID-19 will negatively affect their endoscopic proficiency upon fellowship completion. A total of 71 respondents (39.0%) had experienced SBT before or during fellowship, with 27 from the USA (49.1% of respondents from USA) and 44 from other countries (34.6% of respondents from other countries). In the USA, 63.0% had used virtual reality (VR), 37.0% mechanical models, and 37.0% animal models compared to 47.7% VR, 68.2% mechanical models, and 27.3% animal models in other countries. Respondents agreed that SBT was most helpful with developing technical skills such as ergonomic handling, torque steering, and fine tip control. A majority (52.1%) found SBT appropriate to their level of training. Respondents believed increased access to SBT (43.7%) and mentored training (54.9%) would improve the experience. Conclusion While current data supports the use of SBT early in training, the cumulative uptake of SBT across programs before and during the COVID-19 pandemic remained low. In the USA and abroad, fellows perceive a negative impact of COVID-19 on their training and proficiency upon graduation. Compared to other countries, the USA had higher utilization of VR and lower utilization of mechanical models. Decrease in endoscopic volume was reported as the main factor negatively impacting endoscopic training. This survey highlights the potential benefit of SBT with low case volumes and further prospective evaluation of SBT in achieving endoscopic competence. (Table Presented)

9.
Naukovyi Visnyk Natsionalnoho Hirnychoho Universytetu ; - (2):67-72, 2022.
Article in English | ProQuest Central | ID: covidwho-1836537

ABSTRACT

Мета. Урахування фактору випадковосл сощальних процесш при прогнозуванш попиту на електричну енерпю для зменшення похибки. Методика. Апарат математично! статистики, методш лшшного програмування, теорп нечггких множин i методiв експертного оцшювання, теорй' шкал, Байесовський п1дх1д до моделей прогнозування, комп'ютерне моделювання. Результаты. Проаналiзована динамiка споживання електрично! енергп за рiзнi перiоди часу, встановлено вплив фактору пандемп на процес формування попиту на електричну енерпю. Розроблена вербально-числова шкала для комплексного оцшювання впливу на попит на електричну енерпю такого складного сощального явища, як пандемш. Сформована модель прогнозування попиту на електричну енерпю з використанням Байесовського подходу та ощнки експерта, що дозволила використати ретроспективш данi споживання електрично! енергп та врахувати невизначенiсть соцiального фактору впливу пандемп. Наукова новизна. Набула подальшого розвитку модель прогнозування попиту на електричну енерпю, яка, на вщмшу в1д iнших, ураховуе фактор випадковостi соцiальних процеив i вербально-числову шкалу, що дозволяе зменшити похибку прогнозування споживання електрично! енергп. Практична значимтсть. Результата дослщження кориснi для пщприемств, що спецiалiзуються на генерацй', передачi й розподшу електрично! енергп споживачам. Представленi результата надають можливють зменшити похибку прогнозування попиту на електричну енерпю при врахуванш фактору випадковосл сощальних процешв.Alternate :Purpose. Taking into account the factor of randomness of social processes when forecasting the demand for electric energy to reduce the error. Methodology. Apparatus of mathematical statistics, linear programming methods, fuzzy set theory and expert assessment methods, scale theory, Bayesian approach to forecasting models, computer modeling. Findings. The dynamics of consumption of electric energy for different periods of time is analyzed, the influence of the pandemic factor on the process of formation of demand for electric energy is established. A verbal-numerical scale has been developed for a comprehensive assessment of the impact on the demand for electric energy of such a complex social phenomenon as a pandemic. A model for forecasting the demand for electrical energy was formed using the Bayesian approach and an expert's assessment, which made it possible to use retrospective data on electrical energy consumption and take into account the uncertainty of the social factor influencing the pandemic. Originality. The model for forecasting the demand for electrical energy has been further developed, which, unlike others, takes into account the factor of randomness of social processes and a verbal-numerical scale, which makes it possible to reduce the error in predicting the consumption of electrical energy. Practic l value. The research results are useful for enterprises specializing in the generation, transmission and distribution of electrical energy to consumers. The presented results make it possible to reduce the error in forecasting the demand for electric energy, taking into account the factor of randomness of social processes.

10.
Journal of Language and Education ; 7(4):139-155, 2021.
Article in English | Web of Science | ID: covidwho-1614383

ABSTRACT

This study conducted in an EFL setting investigates students' perception of the thesis proposal presentation in an online format due to safety concerns during the Covid-19 pandemic. Fifty-five students aged 20-22 years old, level B2-C1 in English, in their fourth year of a Business Informatics Bachelor's programme at HSE University, Moscow, were surveyed regarding their end-of-course assessment experience, which involved a Skype online presentation, rather than the usual face-to-face presentation. Data were collected using a researcher-made questionnaire consisted of 3 sections and 12 items. A mixed-method approach using quantitative and qualitative data was employed. The findings indicate that emergency transition to the new format did not affect students' satisfaction or results of the presentation. Overall, students were more than satisfied with the online format, and the results were similar, if not better, than in previous years. To minimise the disadvantages of this format, recommendations for teachers and students were offered. This study might offer new insight on the most appropriate and beneficial oral testing system for students and staff.

11.
American Journal of Gastroenterology ; 116(SUPPL):S1092-S1093, 2021.
Article in English | EMBASE | ID: covidwho-1534815

ABSTRACT

Introduction: To date, there have been over 32 million cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the United States alone. Remdesivir is the only drug approved by the US Food and Drug Administration for the treatment of SARS-CoV-2. Although safety data is limited, hepatotoxicity has been reported in 5-37% with most cases being mild. We present a case of acute liver failure (ALF) from remdesivir, successfully treated with N-acetylcysteine (NAC) infusion. Case Description/Methods: An 83-year-old obese male with chronic kidney and cardiac disease presented with cough and diarrhea for one week and was diagnosed with SARS-CoV-2. Due to hypoxemia, he was started on remdesivir and dexamethasone on hospital day 1. Compared to normal transaminases on admission, on hospital day 6, the patient had an acute elevation of his aspartate aminotransferase (AST) to 3539, alanine aminotransferase (ALT) to 2246, international normalized ratio (INR) to 4.77 and mild elevations in alkaline phosphatase (ALP) to 207 and total bilirubin to 2.9. This was consistent with a hepatocellular pattern of injury. He concurrently developed altered mental status with no asterixis. Acute viral hepatitis serologies and autoimmune markers were negative and liver ultrasound demonstrated a patent portal vein and normal biliary ducts. Remdesivir and dexamethasone were discontinued. Intravenous vitamin K was administered to reverse his coagulopathy and a 5-day course of NAC was completed. The patient had significant improvement in his mental status, AST, ALT, and INR within 24 hours of NAC initiation, with continued improvement over the next two weeks of hospitalization (Figure 1a,b). Discussion: Transaminase elevation is a known side effect of remdesivir, and close monitoring of liver tests is recommended. However, ALF is a rare complication with only two other published cases and with no approved therapy. In our case of an elderly gentleman with SARS-CoV-2 who developed ALF with grade 1 encephalopathy 6 days after initiation of remdesivir, the discontinuation of the drug along with NAC treatment was successful in reversing the ALF. Furthermore, this patient's obesity may have increased his risk of Remdesivir hepatotoxicity through impaired cytochrome P450 metabolism. While seemingly rare, more research on the mechanism and risk profile of remdesivir hepatotoxicity is needed as this drug becomes more commonly used in the treatment of SARS-CoV-2. (Figure Presented).

12.
American Journal of Gastroenterology ; 116(SUPPL):S521-S522, 2021.
Article in English | EMBASE | ID: covidwho-1534719

ABSTRACT

Introduction: Digestive laboratory abnormalities related to COVID-19 have been previously described, but most reports came from single centers and findings have been conflicting. We conducted a multi-center study using data from three large urban VA centers (New York Harbor VA, New Orleans VA and Detroit VA) to examine the association between demographics and digestive laboratory values with mortality on index hospitalization among individuals diagnosed with COVID-19. Methods: We manually extracted data on individuals hospitalized for COVID-19 between December 2019 and June 2020 at the three facilities. For this analysis, data on demographics and seven digestive laboratory values (highest AST, ALT, alkaline phosphatase, total bilirubin, and INR during admission, as well as lowest hemoglobin and platelets) were analyzed in relation to index hospitalization mortality. We performed descriptive statistics and conducted a multivariable logistic regression model. Results: Out of a total of 390 individuals who were hospitalized with COVID-19, 168 (43%) died and 222 survived. The median age of patients who died was higher than those who survived (75 vs. 69 years). The vast majority (94%) of patients were male. Black patients accounted for a higher proportion of those who died than those who survived (61% vs. 55%), whereas the opposite was true for Whites (26% vs. 31%) and Hispanics (9% vs. 12%). In the multivariable model (Table), mortality was associated with older age (OR 1.07, 95% CI 1.03-1.10), higher BMI (OR 1.05, 95% CI 1.01-1.10), higher AST (OR 1.01, 95% CI 1.004-1.02), lower ALT (OR 0.99, 95% CI 0.98-0.996), higher alkaline phosphatase (OR 1.02, 95% CI 1.01-1.02), and lower hemoglobin (OR 0.83, 95% CI 0.72-0.97). Conclusion: In this multicenter VA study of patients hospitalized with COVID-19 during the first half of 2020, overall mortality was 43%. For mortality during index hospitalization, we observed a positive association with age, BMI, AST, and alkaline phosphatase, and an inverse association with ALT and hemoglobin. Every 1 unit increase in hemoglobin was associated with 17% decreased odds of death. These findings suggest that commonly used digestive laboratory tests have prognostic significance for COVID-related survival.

13.
Research and Practice in Thrombosis and Haemostasis ; 5(SUPPL 2), 2021.
Article in English | EMBASE | ID: covidwho-1509096

ABSTRACT

Background : COVID-19 frequently associated thrombotic complication that could determine severe evolution. Inflammation was proved as important pathogenic mechanism of thrombosis. Aims : The main objective was to evaluate the role of inflammation in increased risk of thrombosis in COVID 19 patients. Methods : Our study was prospective and included all patients diagnosed with COVID 19 between April-September 2020 in Hematology, Pneumology and Intensive Care Unit from Colentina Clinical Hospital (285 patients). The diagnosis was established using molecular test for SARS-Cov2. Results : Thrombotic complication was presented in 56 COVID-19 patients (19, 65%), The higher incidence of thrombosis was observed in severe form of COVID-19: stage 3 (66%) and stage 2 (26.3%), Comorbidities: diabetes mellitus, obesity and arterial hypertension were presented in majority of COVID 19 patients with thrombosis. Acute thrombosis (stroke, myocardial infarction or pulmonary embolism) was diagnosed in 14 patients;all of them were admitted in Intensive care unit due severe form of COVID-19. Inflammatory markers including C reactive protein (CRP), procalcitonin, ferritin are significantly increased in COVID-19 group with acute thrombosis compared with COVID -19 patients with thrombosis in medical history CRP 148.86 mg/L (2.96-386.5) vs. 58.24 mg/L (min 0.25, max 212.98) P = 0.005;procalcitonin 0.93 ng/ml (0.04-784) vs 0.18 (min 0.02, max 14.1) P = 0.02;ferritin 702 ng/ml (min 102, max 4070) vs. 1195 ng/ml (min 358, max 12800) P = 0.03. There is no significant difference between haematological parameters in COVID-19 patients with acute thrombosis or in their medical history. D Dimers are significant increased in patients with acute thrombosis 4.79 ug/ml (0.51-20) vs patients with medical history of thrombosis 2.12 (0.31-20), P = 0.02. The level of protein C, protein S and antitrombine III, antiphospholipid antibodies are not significant modified in the both groups. Conclusions : The assessment of inflammation parameters are very important in COVID-19 patients especially those with a history of thrombosis or who have significant comorbidities (diabetes mellitus, arterial hypertension or obesity).

14.
Revista Romana De Medicina De Laborator ; 29(4):377-385, 2021.
Article in English | Web of Science | ID: covidwho-1496908

ABSTRACT

Introduciton: COVID19 is one of the largest pandemics. Since December 2019 until now the coronavirus has infected over 131 million people. The mortality rate in the general population varies between 1 to 5%, with a potential of over 30% in patients with neoplasms. Methods: The main objective of the study was to identify some peculiarities of the evolution, complications and treatment of patients with acute leukaemia and COVID-19. The study was retrospective and included 50 patients with acute leukaemia and COVID-19. Results: Recent administration of chemotherapy was identified in 20 patients with acute myeloblastic leukaemia and 4 patients with acute lymphoblastic leukaemia. The newly diagnosed patients or those undergoing intensive chemotherapy, in particular elderly patients, had a severe form of COVID-19 and an unfavourable evolution, and these clinical situations were identified as predictive factors for adverse outcomes. Patients with acute lymphoblastic leukaemia had a shorter survival curve compared to patients with acute myeloblastic leukaemia. Pneumonia was present especially in patients with acute myeloblastic leukaemia, most patients having over 30% of lung fields affected (55.26%). Patients with an unfavourable outcome had significantly increased median values of C-reactive protein, procalcitonin and interleukin6. Conclusions: Patients with acute leukaemia, especially acute myeloblastic leukaemia who have been diagnosed with COVID-19 infection require special attention because they may associate complications and adverse outcomes of COVID-19. The results we obtained require evaluation in a larger group of patients and analysis in the follow-up period after COVID-19.

16.
HemaSphere ; 5(SUPPL 2):383, 2021.
Article in English | EMBASE | ID: covidwho-1393444

ABSTRACT

Background: The severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) was first reported in Wuhan, China in December2019 and represented the pathogen agent that induced COVID-19. The onset and evolution of COVID -19 is severe when is associated with another comorbidities. Patients with acute leukemia present high risk for severe form of COVID-19 Aims: The main objective was to evaluate the particularities of COVID-19 in patients with acute leukemia. Methods: Our study was prospective and included 49 patients with acute leukemia (27 male median age 64 and22 female median age 54,5) who also were SARS CoV2 positive between April2020- February2021 admitted in Hematology and Intensive Care Unit Departments of Colentina Clinical Hospital Bucharest. The diagnosis was established using molecular test for SARS-Cov2 Results: In the group was included 32 patients diagnosed with acute myeloid leukemia (AML), 9 patients with acute lymphoid leukemia (ALL), 6 patients with acut promyelocytic leukemia and2 patients with acute bifenotypic leukemia. Severe form of COVID-19 with ICU addmission was diagnosed in16 patients (32,17%), almost all of them (15 patients) had unfavourable evolution compared with non-ICU patients group with only1 deceased patient, p<0.0001. The recent chemotherapy followed by severe aplasia was the main negative factor that impacted patient evolution (rho=0.508, p=0.0002),13 patients admitted in ICU Department and12 patients in non-ICU. Severe pneumonia (more than 30% lung field) was diagnosed in17 patients with recent chemotherapy and 4 untreated patients. The type of leukemia or refractory status have not any impact of patient evolution. Antiviral therapy - Remdesivir rapidly introduced in patient's therapy was followed by favourable evolution. Summary/Conclusion: Patients with acute leukemia are negatively impacted by intensive chemotherapy during COVID-19 evolution. The key for good prognosis of these patients during COVID-19 are rapid diagnosis and antiviral therapy at the onset of the disease.

17.
29th Interdisciplinary Information Management Talks - Pandemics: Impacts, Strategies and Responses, IDIMT 2021 ; : 483-490, 2021.
Article in English | Scopus | ID: covidwho-1366141

ABSTRACT

Traditional distance learning/education has been studied for decades, however, emergency remote teaching/ learning during pandemic or distance learning during coronavirus crisis requires careful analysis from teachers' and students' perspectives. The primary research with cross-country comparative analysis and multivariate technique aimed to identify the University students' learning experience during the Covid-19 pandemic: challengers students face this period, the perceptions of the convenience of emergency distance learning, and the motivation to distance learning in future education. It was conducted among the Czech and Russian students in December 2020 (total: 250 students of 5 universities). The study confirmed that students face several technical and nontechnical problems. About 26 % of all respondents feel not comfortable, notifying that the overall complexity of their study with the transition to emergency remote education increased. More than 63% of respondents state that they easily adapted to the conditions of distance learning during the pandemic. In general, students are satisfied with online/distance learning when: the teacher is adaptable to a new practice of e-teaching, good in digital skills and creativity to keep students engaged, and when the students are informed about education changes in time. Almost 60% of students would prefer blended learning, combining face-to-face and online education after the pandemic, and in the future of higher education. The findings of the research are of benefit to higher education policymakers and all educational actors: University managers, teachers, students. © 2021 IDIMT 2021 - Pandemics: Impacts, Strategies and Responses, 29th Interdisciplinary Information Management Talks All rights reserved.

18.
Annals of the Rheumatic Diseases ; 80(SUPPL 1):890-891, 2021.
Article in English | EMBASE | ID: covidwho-1358778

ABSTRACT

Background: Levilimab (LVL) is a novel anti-IL6Rmonoclonal antibody against IL6Rα. Cytokine release syndrome plays the key role in the pathogenesis of a range of life-threatening conditions including the acute respiratory distress syndrome in severely ill COVID-19 patients. Thus, the use of LVL could be considered as anti-cytokine therapy with a potency to prevent the complications and progression of respiratory failure in COVID-19. Objectives: We analyzed the changes in the serum concentrations of inflammatory markers (Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and IL-6) in patients treated with LVL or placebo as part of a phase III multicenter randomized double-blind placebo-controlled adaptive-design CORONA clinical study aimed to evaluate the efficacy and safety of LVL in subjects with severe COVID-19 (NCT04397562). Methods: A total of 217 patients were enrolled in the study, 206 patients were randomized, and 204 patients received the investigational product (IP, LVL or placebo). Study included men and non-pregnant women aged ≥18 years, hospitalized for severe COVID-19 pneumonia, receiving standard therapy according to the national guidelines. Patients with acute respiratory failure with the need in invasive respiratory support, septic shock, multiple organ failure or life expectancy less than 24 hours could not participate in the study. The use of other monoclonal antibodies and glucocorticoids for the treatment of COVID-19 were not allowed. Subjects were stratified according to the CRP level (CRP ≤ 7 mg/L;CRP ≥ 7 mg/L) and then randomized (1:1) into 2 groups to receive LVL 324 mg or placebo. LVL/ placebo were administered as a single subcutaneous injection, investigator and patients were unaware of the received therapy. Among secondary endpoints of the study changes from baseline in ESR, CRP and IL-6 concentrations were assessed. CRP level and ESR were measured before the IP administration and on Days 3, 5, 7, 14, 21, 29 and 30. Blood samples for the measurement of IL-6 concentration were obtained before the IP administration and then every day for 2 weeks after administration. Results: We observed the pronounced decrease of ESR in LVL group compared to Placebo group. The difference was statistically significant on Days 3 and 7: the median ESR change from baseline was -3 mm/h and +3 mm/h on Day 3, -11 mm/h and -3.1 mm/h on Day 7, in LVL and Placebo groups, respectively (p=0.0319 and p=0.0110, Days 3 and 7). The statistically significant difference in the change of CRP level was detected between the groups on Day 3: -26.6±41.9 mg/L and -19.2±58.2 mg/L in LVL and Placebo groups, respectively (p=0.0241). Numerically the same dynamics of ESR and CRP was observed over entire study period. The dynamics of IL-6 serum concentrations in LVL and Placebo groups was strikingly different. After LVL administration we detected the rapid significant increase in IL-6 concentration due to IL-6 receptors inhibition. Maximum change from baseline was observed on Day 3 (+91.9±117.7 pg/mL), on Day 14 the value was +31.9±62.7 pg/mL. In the Placebo group, the IL-6 concentration increased slightly until Day 4 (+5,1±76,5 pg/mL), and then decreased significantly (-39.2±55.1 pg/mL on Day 14) due to clinical improvement in this group. Conclusion: The significant differences in the dynamics of ESR, CRP and IL-6 after LVL administration compared to placebo confirmed the pharmacodynamic effect and its potency to prevent the excessive release of inflammatory substances in severely ill COVID-19 patients.

19.
Academic Emergency Medicine ; 28(SUPPL 1):S409, 2021.
Article in English | EMBASE | ID: covidwho-1255306

ABSTRACT

Intro/Background: Simulation enhances emergency medicine provider's competence, improving patient health outcomes. However, high fidelity simulation is costly, requires in-person training and is logistically challenging due to the COVID-19 pandemic. Screen-based simulation using virtual patients and augmented reality (AR) are exciting technologies, available on-demand, and can directly address these barriers. Furthermore, enhancing user experience by incorporating artificial intelligence and ambient intelligence (ability to integrate information across multiple platforms) will enrich clinician decision making in real-world context. Purpose/Objective: Primary Aim: (Efficacy): To develop a proof-of-concept, ambient, augmented, artificial intelligence (AAAIM) application and demonstrate its efficacy as an innovative cognitive aid to improve patient outcomes in pediatric resuscitation. Secondary Aims: (Acceptability): Evaluate the acceptability of AAAIM as a clinical decision support cognitive aid for pediatric resuscitation in simulated settings and utilize an iterative, rapid prototyping and design cycle to improve the user experience. Methods: We assembled a team of ED clinicians, educators, developers, designers, and a cognitive psychologist. Using web technology and communication protocols to share information across many devices and services simultaneously in real-time, we used open source software to develop an interactive PALS algorithm for cardiac arrest that was available concurrently on an AR headset, laptop and on the web, which provided prompts to the trainee as he/she underwent a simulated pediatric resuscitation scenario. Outcomes (if available): Primary: a) Time between residents' recognition of a patient in cardiac arrest to first treatment. Secondary: a) Frequencies of successful completion of each anticipated step of the PALS algorithm b) Stress and cognitive load (using objective and subjective measurements by Electrodermal Activity-EDA) c) Participants' acceptability and usefulness ratings of AAAIM as a cognitive aid (measured by a Modified Technology Acceptance Model survey) Summary: High fidelity, manikin-based simulation training effectively improves provider/trainee decision-making skills, procedural competency and patient outcomes. However, it is expensive and logistically challenging especially given the current COVID-19 pandemic. Currently available cognitive aids, such smartphones, VR/AR headsets, etc., cannot be integrated into clinical workflow (real-world), or have not been designed with the end-user in mind. We have used the tenets of ambient user experience (i.e., ability to display and interact with meaningful content simultaneously), augmented reality (i.e., ability to digitally enhance the real world with holographic images) and artificial intelligence (learn from and respond to the clinician) to create AAAIM-a web-based software application. The application is device and operating system agnostic, available for training (on demand) and clinical care (fully integrated within current workflows). Such a system allows the trainee to improve decision-making skills that can also be broadcast, thus allowing trainers and experts to connect remotely with the user in real-time for immediate feedback. As a proof-of-concept, we have developed a highly interactive PALS cardiac arrest algorithm that sequentially suggests next steps and provides tips for safety checks (calculates medication doses, times chest compressions, recommends a change of compressor at 2 minutes, etc.,). This interactive algorithm can be visualized using ambient technology across platforms (AR headset, smartphone, tablet etc.) and viewed by trainers in the simulated setting. Sessions can be recorded and trainees can assess performance and knowledge gaps. Furthermore, since this application can be used in a real-world context and broadcast, remote experts can connect with the user and interact to co-manage patients.

20.
Urol Case Rep ; 37: 101634, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1213231

ABSTRACT

According to statistics, the 5-year overall survival in metastatic prostate cancer is about 21 months. We present a case of a patient with castration-resistant prostate cancer with proven bone lesions 2 years after the onset of the disease and the current survival of over 9 years.

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