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As the COVID-19 pandemic approaches its second year, wellness of healthcare workers has become increasingly important as we acknowledge the chronicity of the current situation. It has become essential as staff shortages fostered by burnout play a key role in dealing with the overwhelmed healthcare system. It is increasingly recognized that the finite collective mental health reserves of our providers is as important as the physical challenges such as hospital beds and ventilators in dealing with the pandemic. Physicians with preexisting burnout were suddenly exposed to a sudden surge of rapidly deteriorating patients compounded by a lack of capacity and supplies. This chapter explores those stressors and efforts to mitigate them. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
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COVID-19 is a novel virus infecting the upper respiratory tract and lungs. On a scale of the global pandemic, the number of cases and deaths had been increasing each day. Chest X-ray (CXR) images proved effective in monitoring a variety of lung illnesses, including the COVID-19 disease. In recent years, deep learning (DL) has become one of the most significant topics in the computing world and has been extensively applied in several medical applications. In terms of automatic diagnosis of COVID-19, those approaches had proven to be very effective. In this research, a DL technology based on convolution neural networks (CNN) models had been implemented with less number of layers with tuning parameters that will take less time for training for binary classification of COVID-19 based on CXR images. Experimental results had shown that the proposed model for training had achieved an accuracy of 96.68%, Recall of 94.12%, Precision of 93.49%, Specificity of 97.61%, and F1 Score of 93.8%. Those results had shown the high value of utilizing DL for early COVID-19 diagnosis, which can be utilized as a useful tool for COVID-19 screening. © 2023 IEEE.
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The outbreak of the new coronavirus (COVID-19) had resulted in the creation of a disaster all over the world and it had become a highly acute and severe illness. The prevalence of this disease is increasing rapidly worldwide. The technology of deep learning (DL) became one of the hot topics in the computing context and it is widely implemented in a variety of the medical applications. Those techniques proved to be sufficient tools for the clinicians in automatic COVID-19 diagnosis. In the present study, a DL technology that is based on convolution neural networks (CNN) models had been suggested for the binary COVID-19 classification. In the initial step of the suggested model, COVID-19 data-set of chest X-ray (CXR) images have been obtained then preprocessed. Whereas in the second stage, a new CNN model has been built and trained for diagnosing COVID-19 data-set as (positive) infection or (negative) normal cases. The suggested architecture had a success in classifying COVID-19 with the training model accuracy that had reached 96.57% for the training data-set and 92.29% for validating data-set and could reach the target point with a minimal learning rate for training this model with promising results. © 2023, Institute of Advanced Engineering and Science. All rights reserved.
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Background: Published studies have reported that acute kidney injury (AKI) and other kidney related manifestations are associated with COVID-19 and linked with poor outcome. This study aimed to determine the incidence, risk factors and outcomes of AKI in hospitalized COVID-19 patients.
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SESSION TITLE: Unique Inflammatory and Autoimmune Complications of COVID-19 Infections SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/19/2022 12:45 pm - 1:45 pm INTRODUCTION: We present a patient with left-sided eye pain and headache developing 3 weeks after hospitalization for COVID-19. MRI showed inflammation of the left optic nerve and other demyelinating lesions in the brain and cervical spinal cord consistent with multiple sclerosis. CASE PRESENTATION: Our patient is a 36-year-old female with a history of migraines who presented to the emergency department (ED) with complaints of right-sided eye pain and throbbing intractable headache for the past week. The pain was worse on eye movement and the patient reported color changes in her vision. She had been hospitalized for coronavirus disease 2019 (COVID-19) 3 weeks previously. Her workup in the ED revealed white matter changes in the right frontal lobe on computer tomography (CT) scan of the head. She subsequently had a Magnetic resonance imaging (MRI) scan of her brain, cervical and thoracic spine showing left optic peri-neuritis, and scattered foci in the periventricular white matter, corpus callosum, and cervical spine. She was diagnosed with multiple sclerosis (MS) and treatment started with high-dose corticosteroids. The patient had a good response, with a resolution of her symptoms, and was discharged, on a tapering course of steroids, to follow up with neurology in the clinic. DISCUSSION: There is a well-known association between MS and viral infections capable of causing a neuroinflammatory response. COVID-19 includes several neurological manifestations both in the acute and chronic phase (Long COVID). It seems possible that an immune mechanism induced by COVID-19, which can activate lymphocytes and an inflammatory response, can induce the clinical onset of the disease. Other authors have reported an association between recent COVID and MS symptoms onset as well as exacerbations in MS symptoms in patients with established disease. CONCLUSIONS: In patients presenting with neurological symptoms after a recent COVID 19 infection, we should consider demyelinating disease as a possible diagnosis. Reference #1: Palao, M., Fernández-Díaz, E., Gracia-Gil, J., Romero-Sánchez, C. M., Díaz-Maroto, I., & Segura, T. (2020). Multiple sclerosis following SARS-CoV-2 infection. Multiple sclerosis and related disorders, 45, 102377. Reference #2: Bellucci, G., Rinaldi, V., Buscarinu, M. C., Reniè, R., Bigi, R., Pellicciari, G., … & Ristori, G. (2021). Multiple Sclerosis and SARS-CoV-2: Has the Interplay Started?. Frontiers in Immunology, 3850. Reference #3: Garjani A, Middleton RM, Hunter R, Tuite-Dalton KA, Coles A, Dobson R, Duddy M, Hughes S, Pearson OR, Rog D, Tallantyre EC, das Nair R, Nicholas R, Evangelou N. COVID-19 is associated with new symptoms of multiple sclerosis that are prevented by disease modifying therapies. Mult Scler Relat Disord. 2021 Jul;52:102939. doi: 10.1016/j.msard.2021.102939. Epub 2021 May 5. PMID: 34010764. DISCLOSURES: No relevant relationships by Adrian Estepa No relevant relationships by Neelima Manda No relevant relationships by Rehan Saeed
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SESSION TITLE: Pulmonary Manifestations of Systemic Disease Case Posters SESSION TYPE: Case Report Posters PRESENTED ON: 10/19/2022 12:45 pm - 01:45 pm INTRODUCTION: Granulomatous polyangiitis (GPA), previously known as Wegener's granulomatosis, is a rare syndrome characterized by inflammation of small and medium sized vessels. The clinical presentation can be very heterogenous and differentiation from an infectious disease can be challenging initially. Here, we present a case of a young male presenting with respiratory symptoms during the pandemic, presumed to have coronavirus disease 2019 (COVID-19) though after extensive workup was later diagnosed with GPA. CASE PRESENTATION: A 19-year-old male presented to the emergency department (ED) with complaints of low-grade fever and dry cough for one week. He reported having abdominal pain, fatigue, loss of appetite and polyarthralgia. An outpatient upper gastrointestinal endoscopy revealed gastritis and duodenitis. In the ED, his vitals included a temperature of 101.8°F, blood pressure of 115/65mmHg, heart rate of 99/min, respiratory rate of 18/minute and oxygen saturation of 99% on room air. COVID-19 testing was negative. A computerized tomography of the chest revealed extensive ground glass opacities. He was presumptively diagnosed with COVID-19 and started on dexamethasone therapy along with azithromycin for atypical pneumonia. However multiple tests for SARS-CoV-2 were negative. Another consideration was COVID-19 induced multisystem inflammatory syndrome given the patients young age. Infectious workup included negative testing for human immunodeficiency virus, Legionella, tick borne diseases and mycoplasma. As febrile episodes continued, he developed microcytic anemia, microscopic hematuria, and petechial rash on his ankles. Antinuclear antigen screen was negative, but C-antineutrophil cytoplasmic and anti-proteinase-3 antibodies were positive. Renal biopsy revealed GPA. He was prescribed pulse dose steroids and transitioned to immunotherapy. DISCUSSION: GPA is a challenging diagnosis given multiple system involvement, though early identification and initiation of treatment are important to prevent long term sequalae. In our case, acute onset febrile illness and pulmonary ground glass opacities led to repeated COVID-19 testing potentially delaying the diagnosis. Ultimately, the correct diagnosis was made and confirmed on renal biopsy. We believe our case highlight the importance of keeping a broad differential and considering vasculitis in these situations for prompt diagnosis. CONCLUSIONS: GPA can often mimic respiratory infectious processes, a high index of suspicion is necessary for timely diagnosis. Reference #1: Selvaraj V, Moustafa A, Dapaah-Afriyie K, et alCOVID-19-induced granulomatosis with polyangiitis. BMJ Case Reports CP 2021;14:e242142 Reference #2: Qurratulain, Q., Ahmed, A., & Jones, Q. (2021). Lesson of the month: Severe granulomatosis with polyangiitis (GPA): a diagnostic challenge during the COVID-19 pandemic. Clinical Medicine, 21(1), 79. DISCLOSURES: No relevant relationships by Aamna Khan No relevant relationships by Usama Sadiq No relevant relationships by Rehan Saeed
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ICT is one of the most gadgets that plays a pivotal role in transferring information to all and sundry in the modern era. It is an undisputable fact that modern du'at have deployed this avenue in propagating their da'wah activities. The recent outbreak of the pandemic made the ICT to become a more resourceful platform where da'wah activities are being displayed by du'at in preaching Islam and this had denied listeners from seeing the person preaching vividly. The study employed triangulate research methodology. The usage of ICT during COVID-19 pandemic had helped in spreading da'wah activities on different platforms like WhatsApp, Facebook, Twitter, Zoom meeting, Google Meet, YouTube, and imo among others across the globe in no distance time. Our findings reveal that COVID-19 pandemic gave room for e-da'wah or electronic da'wah to be advanced in point of the fact that du'at are being invited to deliver lectures, online classes, and Friday sermons via electronic media by strictly adhering to the social distancing measure to curb its rapid spread. It was also revealed that ICT has both positive and negative impacts on da'wah activities during COVID-19 pandemic. This chapter concludes that the exquisite use of the ICT would help in spreading da'wah world within the twinkle of an eye. © 2022 Elsevier Inc. All rights reserved.
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The outbreak of the new coronavirus (COVID-19) has created a disaster worldwide and it became a very severe and acute disease. COVID-19 prevalence is rapidly increasing around the world. Deep learning (DL) technology had become a hot topic in the context of computing and is widely applied in various medical applications. These techniques have proven to be one of the effective tools for clinicians in the automatic diagnoses of COVID- 19. The goal of the present paper is to provide an overview of recently developed systems based on DL techniques that use various medical imaging modalities such as Computer Tomography (CT) and Chest X-Rays (CXR). This review focuses on systems that had been developed for the diagnosis of COVID-19 with the use of the DL methods, as well as the well-known datasets that are utilized for the training of those networks. Finally, the researcher reviewed 58 research papers based on different medical images. Overall, this article aims to assist experts (medical or otherwise) and technicians to understand how the DL approaches are utilized in this context and the way that they can potentially be expanded to combat COVID-19 outbreaks. © 2022 International Information and Engineering Technology Association. All rights reserved.
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In this paper, is to strongly analyze the Coronavirus Diseases (Covid-19) via utilizing the machine learning depended on classification as well as clustering method. Researchers' prediction will not only allow detection and pipeline to predict how much money their detection method for COVID-19 will make, but it will also allow them to justify their characteristics, such as type of infection and choice of vaccine to reach a certain detection using machine learning based model. In this way, it overcomes the challenge of new COVID-19 forecasting: the lack of historical data. With the machine learning algorithm, researchers provide prediction at 15 to 20 different methods with an accuracy above 80% after training. The training is performed on 80% of data while the testing is done on remaining 20% of data. Such prediction will also allow other interested third parties to predict the success of a COVID-19 detection before it is released on open-source community. In the process of prediction, some researchers found the variables most associated with COVID-19 detection, and to see how the various prediction models are affected by them. Nevertheless, those machines learning based methods can greatly benefit from modern artificial intelligence techniques for this purpose that can handle complex features and give out great prediction results. Therefore, employing historical COVID-19 data and using them in machine learning algorithms to predict disease could save companies millions of dollars on rather unsuccessful detection. © 2022 IEEE.
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Introduction: The COVID-19 could be a dangerous widespread that has influenced each angle of life including education. The educational institutes have been closed to avoid the spread of the infection, and they have changed over their system into distance education. Completing the semester there's a have to be address the risky issues within the modern framework to create it for future usage Objectives: 1-To explore the effects of Covid-19 on life style 2- To know the perceptions and suggestions regarding online education in pandemic Material and Methods Study design: Qualitative Settings: Rawalpindi Medical University Duration: Six months i.e. 1st January 2021 to 30th June 2021 Data Collection procedure: It was focus group discussion conducted via Zoom link. There were 15 medical students were selected from all five classes of MBBS randomly after taking informed consent. A variety of issues that were obtained from the discussion were identified. Results: The findings have uncovered that most of the members were influenced by the widespread period contrarily Anxiety, hope less, and fatigue. It is clear from the findings that education process has had its shortcomings instead of its advantages such as need of interaction, and communication which lead the students to segregation, issues about exams, conventional instructive habits, the load of assignments, and time administration. On the other side the advantages regarding flexibility of place and time to learn and comfort in assessment Conclusion: It is evident that the COVID-19 widespread process has influenced the students' lives adversely. These negative sentiments have not been overcome by the instruction they uncovered all through the period. While, in conventional campus life they would be at the side their companions and teachers and they would overcome the issues together through socializing. Distance education system tried to facilitating teaching. The COVID-19 widespread period ought to be regarded as an opportunity for teachers to consider how to push the distance education framework forward. Within the light of the findings, it would be awesome to create the current distance education practices which we may well are beyond any doubt that long-term executions get a solid premise.
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Coronavirus disease 2019 (COVID-19) has been labeled a global pandemic with the first reported case of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurring in Wuhan, China in December 2019. To combat the alarming, increasing rate of those affected by the virus, vaccine development ensued. As mass vaccination initiatives against COVID-19 ensued, adverse reactions began emerging. This non-consecutive, population-based case series focuses on four vaccine-associated neurological adverse events across the central and peripheral nervous system detailing the diagnosis, treatment and subsequent follow-up management. These four patients presented to public and private hospitals in Trinidad and Tobago with new-onset neurological diseases soon after their first doses of a COVID-19 vaccine: two after the Pfizer-BioNTech vaccine (one case of new-onset seizures and one case of longitudinally extensive transverse myelitis) and two after the ChAdOx1 nCoV-19 vaccine (one case of Guillain-Barre syndrome and one case of meningitis-retention syndrome). The background incidence rates of neurological conditions in the population and the large numbers of persons being vaccinated means that some of these conditions will appear in the post-vaccination window by chance. Hence, establishing causal links is difficult. The close temporal relationship between vaccination and the presenting symptoms, the biological plausibility, and the extensive diagnostic workup to exclude other causes fulfill criteria provided by the World Health Organization for causality assessment of an adverse event following immunization on an individual level. On this basis, it was determined that these adverse events were likely due to the vaccines. However, establishing causal links on a population level requires large epidemiological studies and cannot be done on individual case reports alone. While physicians should be cognizant of even these rare adverse events of vaccines, it should be reiterated that the overall safety profile of vaccines is well established.
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This paper proposes a new cross-layer communication system for the provision of Internet services and applications to mitigate the negative impacts of COVID-19, due to which the massive online demands are affecting the current communication systems' infrastructures and capabilities. The system requirements and model are investigated where it utilizes high-altitude platform (HAP) for fast and efficient connectivity provision to bridge the communication infrastructure gap in the current pandemic. The HAP is linked to the main server or gateway station located on ground and can provide communication narrow beams towards isolated areas which suffer from poor terrestrial radio coverage or lack of communication infrastructure. The vital e-learning applications using Internet services provision from the proposed HAP system are described and modelled including system adaptation parameters such as the application and physical layers to control the data rates of different e-learning applications and the overall cell data rate. On the other hand, the provision of high-speed Internet services from the proposed system is supported by using adaptive antenna arrays onboard HAP which provides high-gain beams to achieve the required high-quality transmission data rates at the student premises and provides the capability of coverage cell area adaptation for load balancing. The concentric circular antenna arrays with tapered feeding are proposed in this adaptive antenna system to control the cell mainlobe gain and reduce the out-of-coverage radiation as well. In addition, the system feasibility has been proved in two coverage scenarios including single-beam and multibeam HAP communications.
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SESSION TITLE: Medical Student/Resident Disorders of the Mediastinum Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: Tracheoesophageal fistula (TEF) is a rare condition that can be congenital or acquired. Patients of the novel Corona Virus Disease 2019 (COVID-19) remain intubated for prolonged periods that can give rise to a multitude of complications. Here we present a case of a 53-year-old female who got intubated after developing COVID pneumonitis, complicated by acute respiratory distress syndrome (ARDS). She developed TEF at the end of the third week of intubation. CASE PRESENTATION: A 53-year-old female presented to the hospital with hypoxemic respiratory failure caused by COVID pneumonitis. She got intubated and her hospital course was complicated by ARDS. She got extubated by the end of the third week but reintubated for persistent hypoxemia two days later. She was on the pressure control mode of ventilation with positive end-expiratory pressure (PEEP) of 16, Inspiratory Pressure ( Pi) of 19 and peak pressure of 35. Suddenly, she developed hypoxemia and gastric distension on the same ventilator settings and her peak pressure dropped to 22. The X-ray of the abdomen was normal. Sudden dropping of peak pressure prompted the clinician to get computerized tomography (CT) scan of the neck which revealed trachea-esophageal fistula. (Figure 1,2,3). She was treated with tocilizumab, Flolan, and broad-spectrum antibiotics. The fistula was bypassed temporarily with a tracheostomy tube and a plan was made to follow up with the surgery team for possible surgical intervention. DISCUSSION: COVID-19 patients who develop severe respiratory disease remain on mechanical ventilation for a prolonged time period. In addition to the lack of specific guidelines to treat this disease, the severity of illness, heavy sedation, and significantly long time period of intubation add to poor outcomes in these patients. Complications of prolonged intubation include ventilator-dependent respiratory failure, ulceration, granulation tissue formation, tracheal or laryngeal stenosis, and rarely tracheoesophageal fistula to name a few. [1] The sudden deterioration of respiratory status, dropping peak pressures, and gastric distension are a few signs of fistulous opening in the trachea. The commonest site of TEF is at the bifurcation of the trachea. [2] These patients should be extubated as early as their respiratory status allows but should not be delayed for more than two weeks to avoid these complications. CONCLUSIONS: Patients with severe COVID-19 disease remained intubated for a prolonged period. Tracheostomy tube placement should not be delayed or they can develop multiple complications. If a patient develops sudden desaturation, gastric distension, or drops peak pressures without changing the baseline ventilator settings, TEF should always be in the differentials, and management should proceed with either immediate surgical intervention or supportive care temporarily and surgical intervention later in course Reference #1: Surgery and perioperative management for post-intubation tracheoesophageal fistula: case series analysis.Puma F, Vannucci J, Santoprete S, Urbani M, Cagini L, Andolfi M, Potenza R, Daddi NJ Thorac Dis. 2017 Feb;9(2):278-286. Reference #2: Moersch HJ, Tinney WS. A fistula between the esophagus and the tracheobronchial tree. Medical Clinics of North America. 1944 Jan 1;28(4):1001-7. DISCLOSURES: no disclosure on file for Asad Chohan;No relevant relationships by Soban Farooq, source=Web Response no disclosure on file for Rajesh Kumar;No relevant relationships by S Roomi, source=Web Response No relevant relationships by Rehan Saeed, source=Web Response no disclosure on file for Maryam Siddique;No relevant relationships by Usama Talib, source=Web Response
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Background: Coronavirus disease 2019 (COVID-19) emerged as a small outbreak in Wuhan rapidly progressing into the deadliest pandemic since the Spanish flu of 1918. The disease was deemed trivial in children, until the reporting, few days ago, of an emerging pediatric multi-inflammatory syndrome mimicking Kawasaki disease (KD). Main body: This report reveals that coronaviridae were implicated in induction of several post-infectious vasculitides, namely, KD, AHEI, and HSP. This occurs in genetically susceptible individuals to vascular inflammation. Shared genetic susceptibilities between KD and CoV include genes encoding for CD 40, HLAB-15:03, and ACE. This leads to augmented inflammation with hypersecretion of cytokines especially IL-6. Conclusion(s): The revealed relationships between KD and CoV can help to predict the risk of KD in COVID-19 patients through screening levels of upregulated cytokines. It might also signify that classic treatment of KD with IVIG might need to be replaced with anti-cytokine therapy in COVID-19 patients. Copyright © 2020, The Author(s).