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1.
Nat Rev Endocrinol ; 2022.
Article in English | PubMed | ID: covidwho-2028679

ABSTRACT

Two important maternal cardiometabolic disorders (CMDs), hypertensive disorders in pregnancy (HDP) (including pre-eclampsia) and gestational diabetes mellitus (GDM), result in a large disease burden for pregnant individuals worldwide. A global consensus has not been reached about the diagnostic criteria for HDP and GDM, making it challenging to assess differences in their disease burden between countries and areas. However, both diseases show an unevenly distributed disease burden for regions with a low income or middle income, or low-income and middle-income countries (LMICs), or regions with lower sociodemographic and human development indexes. In addition to many common clinical, demographic and behavioural risk factors, the development and clinical consequences of maternal CMDs are substantially influenced by the social determinants of health, such as systemic marginalization. Although progress has been occurring in the early screening and management of HDP and GDM, the accuracy and long-term effects of such screening and management programmes are still under investigation. In addition to pharmacological therapies and lifestyle modifications at the individual level, a multilevel approach in conjunction with multisector partnership should be adopted to tackle the public health issues and health inequity resulting from maternal CMDs. The current COVID-19 pandemic has disrupted health service delivery, with women with maternal CMDs being particularly vulnerable to this public health crisis.

3.
28th ACM SIGKDD Conference on Knowledge Discovery and Data Mining, KDD 2022 ; : 4684-4694, 2022.
Article in English | Scopus | ID: covidwho-2020405

ABSTRACT

In the fight against the COVID-19 pandemic, vaccines are the most critical resource but are still in short supply around the world. Therefore, efficient vaccine allocation strategies are urgently called for, especially in large-scale metropolis where uneven health risk is manifested in nearby neighborhoods. However, there exist several key challenges in solving this problem: (1) great complexity in the large scale scenario adds to the difficulty in experts' vaccine allocation decision making;(2) heterogeneous information from all aspects in the metropolis' contact network makes information utilization difficult in decision making;(3) when utilizing the strong decision-making ability of reinforcement learning (RL) to solve the problem, poor explainability limits the credibility of the RL strategies. In this paper, we propose a reinforcement learning enhanced experts method. We deal with the great complexity via a specially designed algorithm aggregating blocks in the metropolis into communities and we hierarchically integrate RL among the communities and experts solution within each community. We design a self-supervised contact network representation algorithm to fuse the heterogeneous information for efficient vaccine allocation decision making. We conduct extensive experiments in three metropolis with real-world data and prove that our method outperforms the best baseline, reducing 9.01% infections and 12.27% deaths.We further demonstrate the explainability of the RL model, adding to its credibility and also enlightening the experts in turn. © 2022 Owner/Author.

4.
Nat Hum Behav ; 2022.
Article in English | Web of Science | ID: covidwho-2016716

ABSTRACT

Balancing social utility and equity in distributing limited vaccines is a critical policy concern for protecting against the prolonged COVID-19 pandemic and future health emergencies. What is the nature of the trade-off between maximizing collective welfare and minimizing disparities between more and less privileged communities? To evaluate vaccination strategies, we propose an epidemic model that explicitly accounts for both demographic and mobility differences among communities and their associations with heterogeneous COVID-19 risks, then calibrate it with large-scale data. Using this model, we find that social utility and equity can be simultaneously improved when vaccine access is prioritized for the most disadvantaged communities, which holds even when such communities manifest considerable vaccine reluctance. Nevertheless, equity among distinct demographic features may conflict;for example, low-income neighbourhoods might have fewer elder citizens. We design two behaviour-and-demography-aware indices, community risk and societal risk, which capture the risks communities face and those they impose on society from not being vaccinated, to inform the design of comprehensive vaccine distribution strategies. Our study provides a framework for uniting utility and equity-based considerations in vaccine distribution and sheds light on how to balance multiple ethical values in complex settings for epidemic control.

5.
Annals of the Rheumatic Diseases ; 81:959, 2022.
Article in English | EMBASE | ID: covidwho-2009047

ABSTRACT

Background: Several studies have demonstrated immunogenicity after COVID-19 vaccination in patients with autoimmune rheumatic diseases (AIRD) [1], but the differences between mRNA-based and vector vaccines and the cellular responses to COVID-19 vaccines according to distinct immunogenicity in AIRD patients are still unclear. Objectives: To investigate the differences in efficacy and safety between the vector vaccine ChAdOx1 nCoV-19/AZD1222 (Oxford-AstraZeneca) and mRNA-based vaccine mRNA-1273 (Moderna) in patients with AIRD, and to explore the cell-cell interactions between high and low anti-SARS-CoV-2 IgG levels in patients with rheumatic arthritis (RA) by single-cell RNA sequencing (scRNA-seq). Methods: From September 16 to November 15, 2021, we consecutively enrolled 243 participants aged ≥20 years with AIRD who received COVID-19 vaccination, of whom 113 were immunized with AZD1222 and 130 with mRNA-1273. The level of serum IgG antibodies to the SARS-CoV-2 receptor-binding domain on the spike protein S1 subunit was quantifed by electrochemiluminescence immuno-assay at 4-6 weeks after vaccination. Moreover, peripheral blood mononuclear cells were isolated from two RA patient with high anti-SARS-CoV-2 IgG level and four RA patients with low level for scRNA-seq and cell-cell communication signal was analyzed by CellChat. Results: The anti-SARS-CoV-2 IgG seropositivity rate was 78.8% (89/113) for AZD1222 and 83.1% (108/130) for mRNA-1273. The level of anti-SARS-CoV-2 IgG was higher in patients who received mRNA-1273 than in those who received AZD1222 (β: 30.15, 95% CI: 11.67-48.63, p=0.002) (Table 1). Prednisolone-equivalent dose >5 mg/day and methotrexate (MTX) use in AIRD patients, and non-anti-tumor necrosis factor (TNF)-α biologics and Janus kinase (JAK) inhibitor use in RA patients were associated with inferior immunogenicity. ScRNA-seq revealed CD16-monocytes were predominant in RA patients with high anti-SARS-CoV2-IgG antibody level, and enriched pathways related to antigen presentation via major histocompatibility complex class II (MHC class II) were found (Figure 1). HLA-DRA and CD4 interaction was vigorous among all identifed MHC-II pathway and was enhanced in high anti-SARS-CoV2-IgG antibody group. Conclusion: mRNA-1273 and AZD1222 vaccines exhibited differential immunogenicity in patients with AIRD. Enriched pathways related to antigen presentation via MHC class II in CD16-monocytes might be associated with higher anti-SARS-CoV2-IgG level in RA patients and further study is warranted.

6.
Biointerface Research in Applied Chemistry ; 13(3), 2023.
Article in English | Scopus | ID: covidwho-1965107

ABSTRACT

Based on the information suggested by World Health Organization (WHO) and Hong Kong Special Administrative Region (HKSAR) government, wearing a mask and sterilizing hands with alcohol-based hand disinfectants are effective ways to maintain good personal hygiene to prevent viral infections. This study focused on the real-time concentrations of alcohol vapor in the air associated with five alcohol-based hand disinfectants. The results indicated that the alcohol concentrations increased dramatically (max. ~46,000 ppb/g sample) in the hand-rubbing process. Hong Kong residents' survey on habits of using such disinfectants showed that 65% of people use them daily and 34% of people use them ≥ 5 times per day, indicating a high frequency of usage. About 79% of respondents claimed to have skin problems, and 18% got eyes discomfort when using these disinfectants. Despite the potential health risks of using alcohol disinfectants remaining unclear, such a large amount and frequent usage should be aware of potential health problems in the long term. © 2022 by the authors.

7.
LANCET ; 399(10342):2212-2225, 2022.
Article in English | Web of Science | ID: covidwho-1935221

ABSTRACT

Background Vaccination of children and young people against SARS-CoV-2 is recommended in some countries. Scarce data have been published on immune responses induced by COVID-19 vaccines in people younger than 18 years compared with the same data that are available in adults. Methods COV006 is a phase 2, single-blind, randomised, controlled trial of ChAdOx1 nCoV-19 (AZD1222) in children and adolescents at four trial sites in the UK. Healthy participants aged 6-17 years, who did not have a history of chronic respiratory conditions, laboratory-confirmed COVID-19, or previously received capsular group B meningococcal vaccine (the control), were randomly assigned to four groups (4:1:4:1) to receive two intramuscular doses of 5 x 10(1)degrees viral particles of ChAdOx1 nCoV-19 or control, 28 days or 84 days apart. Participants, clinical investigators, and the laboratory team were masked to treatment allocation. Study groups were stratified by age, and participants aged 12-17 years were enrolled before those aged 6-11 years. Due to the restrictions in the use of ChAdOx1 nCoV-19 in people younger than 30 years that were introduced during the study, only participants aged 12-17 years who were randomly assigned to the 28-day interval group had received their vaccinations at the intended interval (day 28). The remaining participants received their second dose at day 112. The primary outcome was assessment of safety and tolerability in the safety population, which included all participants who received at least one dose of the study drug. The secondary outcome was immunogenicity, which was assessed in participants who were seronegative to the nucleocapsid protein at baseline and received both prime and boost vaccine. This study is registered with ISRCTN (15638344). Findings Between Feb 15 and April 2, 2021, 262 participants (150 [57%] participants aged 12-17 years and 112 [43%] aged 6-11 years;due to the change in the UK vaccination policy, the study terminated recruitment of the younger age group before the planned number of participants had been enrolled) were randomly assigned to receive vaccination with two doses of either ChAdOx1 nCoV-19 (n=211 [n=105 at day 28 and n=106 at day 84]) or control (n=51 [n=26 at day 28 and n=25 at day 84]). One participant in the ChAdOx1 nCoV-19 day 28 group in the younger age bracket withdrew their consent before receiving a first dose. Of the participants who received ChAdOx1 nCoV-19, 169 (80%) of 210 participants reported at least one solicited local or systemic adverse event up to 7 days following the first dose, and 146 (76%) of 193 participants following the second dose. No serious adverse events related to ChAdOx1 nCoV-19 administration were recorded by the data cutoff date on Oct 28, 2021. Of the participants who received at least one dose of ChAdOx1 nCoV-19, there were 128 unsolicited adverse events up to 28 days after vaccination reported by 83 (40%) of 210 participants. One participant aged 6-11 years receiving ChAdOx1 nCoV-19 reported a grade 4 fever of 40.2 degrees C on day 1 following first vaccination, which resolved within 24 h. Pain and tenderness were the most common local solicited adverse events for all the ChAdOx1 nCoV-19 and capsular group B meningococcal groups following both doses. Of the 242 participants with available serostatus data, 14 (6%) were seropositive at baseline. Serostatus data were not available for 20 (8%) of 262 participants. Among seronegative participants who received ChAdOx1 nCoV-19, anti-SARS-CoV-2 IgG and pseudoneutralising antibody titres at day 28 after the second dose were higher in participants aged 12-17 years with a longer interval between doses (geometric means of 73 371 arbitrary units [AU]/mL [95% CI 58 685-91 733] and 299 half-maximal inhibitory concentration [IC 50;95% CI 230-390]) compared with those aged 12-17 years who received their vaccines 28 days apart (43 280 AU/mL [95% CI 35 852-52 246] and 150 IC 50 [95% CI 116-194]). Humoral responses were higher in those aged 6-11 years than in those aged 12-17 years receiving their second dose at the same 112-day interval (geometric mean ratios 1.48 [95% CI 1.07-2.07] for anti-SARS-CoV-2 IgG and 2.96 [1.89-4.62] for pseudoneutralising antibody titres). Cellular responses peaked after a first dose of ChAdOx1 nCoV-19 across all age and interval groups and remained above baseline after a second vaccination. Interpretation ChAdOx1 nCoV-19 is well tolerated and immunogenic in children aged 6-17 years, inducing concentrations of antibody that are similar to those associated with high efficacy in phase 3 studies in adults. No safety concerns were raised in this trial. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.

8.
Journal of the Neurological Sciences ; 434:1, 2022.
Article in English | Web of Science | ID: covidwho-1859920
9.
Journal of the Neurological Sciences ; 434:1, 2022.
Article in English | Web of Science | ID: covidwho-1859919
10.
MEDLINE; 2020.
Preprint in English | MEDLINE | ID: ppcovidwho-329976

ABSTRACT

COVID-19 pandemic is the third zoonotic coronavirus (CoV) outbreak of the century after severe acute respiratory syndrome (SARS) in 2003 and Middle East respiratory syndrome (MERS) since 2012. Treatment options for CoVs are largely lacking. Here, we show that clofazimine, an anti-leprosy drug with a favorable safety and pharmacokinetics profile, possesses pan-coronaviral inhibitory activity, and can antagonize SARS-CoV-2 replication in multiple in vitro systems, including the human embryonic stem cell-derived cardiomyocytes and ex vivo lung cultures. The FDA-approved molecule was found to inhibit multiple steps of viral replication, suggesting multiple underlying antiviral mechanisms. In a hamster model of SARS-CoV-2 pathogenesis, prophylactic or therapeutic administration of clofazimine significantly reduced viral load in the lung and fecal viral shedding, and also prevented cytokine storm associated with viral infection. Additionally, clofazimine exhibited synergy when administered with remdesivir. Since clofazimine is orally bioavailable and has a comparatively low manufacturing cost, it is an attractive clinical candidate for outpatient treatment and remdesivir-based combinatorial therapy for hospitalized COVID-19 patients, particularly in developing countries. Taken together, our data provide evidence that clofazimine may have a role in the control of the current pandemic SARS-CoV-2, endemic MERS-CoV in the Middle East, and, possibly most importantly, emerging CoVs of the future.

11.
Proceedings of the Institution of Civil Engineers: Civil Engineering ; 2021.
Article in English | Scopus | ID: covidwho-1538292

ABSTRACT

Fully functioning hospitals are the backbone of society. The current design of hospitals in the UK and elsewhere tends to over-emphasise empirical knowledge and experimental research, but limits their ability to cope with new infectious diseases and increasing global connectedness. For example, around one-fifth of UK Covid-19 cases, including the majority of infected hospital healthcare workers, were infected in hospitals. This paper discusses a new agent-based modelling approach to developing more flexible and efficient hospital layouts that are better able to control the spread of infectious disease. © 2021 ICE Publishing. All rights reserved.

12.
8th ACM SIGCHI Annual Symposium on Computer-Human Interaction in Play, CHI PLAY 2021 ; : 371-375, 2021.
Article in English | Scopus | ID: covidwho-1511513

ABSTRACT

Dino-Store is a persuasive game that was designed to use gamification way to communicate with people and raise awareness on COVID-19. The game's setting is grocery shopping and the mechanic indicates that how different protection strategies, such as wearing mask, keeping social distance can affect people's infection chances in the COVID-19 pandemic. This paper will break down how the game designed by merging concepts from persuasive game models and uncomfortable interaction theory to create an engaging, but stressful experience for the user. © 2021 Owner/Author.

13.
Hepatology ; 74(SUPPL 1):1018A-1019A, 2021.
Article in English | EMBASE | ID: covidwho-1508756

ABSTRACT

Background: Non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease worldwide. The mainstay of treatment involves lifestyle modifications such as weight loss, exercise, and dietary changes to prevent the progression of liver disease. Since the emergence of the coronavirus disease 2019 (COVID-19), research efforts have focused on the influence of liver disease on COVID-19 and the impact of COVID-19 on those living with liver disease. The aim of this study was to assess the metabolic impact of COVID-19 on lifestyle behaviors of patients with NAFLD. Methods: We investigated the impact of the COVID-19 pandemic on dietary and lifestyle habits in patients with NAFLD using an online questionnaire. The questionnaire was distributed to patients identified to have a diagnosis of NAFLD or non-alcoholic steatohepatitis (NASH) through a search of the hospital electronic medical records system. Demographic information, anthropometric data, and dietary and lifestyle habits before and during the pandemic were inquired. The survey was conducted from December 2020 to March 2021. Results: A total of 360 out of 2,800 individuals responded to the survey. Incomplete surveys were excluded. Among the 312 respondents included, 84.6% identified ethnically as Caucasian, 60.6% were female, and 77.4% described themselves as overweight or obese. The mean age was 60.7 years. Of the respondents, 39.6% (p=0.002) and 51.4% (p<0.001) felt that their dietary habits and lifestyle habits significantly worsened, respectively. Consumption of fruits, vegetables, and water increased while the consumption of salty snacks, frozen desserts, and sugary beverages decreased during COVID-19 (Table 1). Moreover, there was a marked decrease in fast food consumption and increase in homecooked meals (Table 1). There was a decrease in physical activity and an increase in screen time on working and non-working days primarily due to entertainment and boredom. Conclusion: Patients with NAFLD felt that their dietary and lifestyle habits were negatively impacted by the COVID-19 pandemic. Healthy dietary modifications were made in food and beverage consumption patterns before and during the pandemic. However, there was an increase in sedentary behaviors reflected by decreased physical activity and increased screen time. Our findings signify the importance of recognizing the impact of a global pandemic on healthy lifestyle and its downstream effects on patients with NAFLD.

14.
4th International Conference on Pattern Recognition and Artificial Intelligence, PRAI 2021 ; : 331-335, 2021.
Article in English | Scopus | ID: covidwho-1501330

ABSTRACT

COVID-19 is a new type of infectious disease that has been massively outbroken in December 2019. So far, with the development and promotion of the vaccines against COVID-19, the epidemic throughout the world appears to be contained. In this paper, we propose a multi-layer prediction method with a SEIRD model which is improved from a classical Susceptible-Exposed-Infected-Recovered (SEIR) model. We expand the classical model by taking the effect of vaccines into account. Furthermore, we use epidemic data accessed from the U.S. government to fit the model and visualize the results, a conclusion that the U.S. will be able to contain its epidemic effectively by practicing the development and injection of vaccines can be inferred. © 2021 IEEE.

15.
Public Health ; 198: 96-101, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1356415

ABSTRACT

OBJECTIVES: The transmission of COVID-19 has sent Malaysia into cycles of tightening and relaxation of movement control, which are still continuing currently in line with local fluctuations of new COVID-19 cases. During movement control, measures comprising physical distancing, hand cleaning or sanitizing, and sanitization of premises are consistently implemented while self-isolation and travel restrictions are adaptively enforced. This study aims to examine if the control of COVID-19 transmission has an effect on the national influenza occurrences as some measures for COVID-19 control are similar to those for influenza. STUDY DESIGN: For this study, data of weekly new cases of influenza and COVID-19 were obtained from official platforms for non-parametric statistical analysis. METHODS: This study compared the influenza occurrences before and after the onset of COVID-19 using the Mann-Whitney U-test and explored Spearman's correlations between COVID-19 and influenza incidences after the onset of COVID-19. RESULTS: It shows that influenza incidences before and after the onset of COVID-19 were significantly different and that influenza cases have significantly reduced after the onset of COVID-19. The weekly cases of influenza and COVID-19 were significantly and negatively correlated. CONCLUSIONS: This study underscores the co-benefits of COVID-19 control measures and alleviates the concern for the risk of COVID-19 and influenza co-infection.


Subject(s)
COVID-19 , Influenza, Human , Humans , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Malaysia/epidemiology , SARS-CoV-2 , Travel
16.
6th IEEE International Conference on Intelligent Computing and Signal Processing, ICSP 2021 ; : 1031-1035, 2021.
Article in English | Scopus | ID: covidwho-1232283

ABSTRACT

Under the influence of COVID-19, more and more e-commerce companies are in urgent need to understand the causality and impact probability of B2B strategies, and formulate effective cooperative operation strategies. Although recently, few articles believe that B2B strategies are beneficial to improving enterprise profitability. In this paper, data from 362 takeout APP users were surveyed by questionnaire. Through machine learning, Bayesian Networks (BNs) algorithm was adopted to analyze the B2B strategy adopted by the takeout industry for the impact of COVID-19. Firstly, BNs analysis structure is designed according to prior knowledge and market information. Then the maximum likelihood estimation is used to calculate the conditional dependence probability. Finally, the effectiveness of BNs model is verified by training set and test set. The results show that the causal relationship between B2B strategies is highly concentrated in rider's daily health clock, and this strategy is also dependent on green passcode, highlighting the reliability of the windowing strategy. The contribution of this paper is to introduce BNs to B2B strategies and dependent probabilities, specifically providing a feasible way to find the causal relationship between strategies. © 2021 IEEE.

17.
Proc. - Int. Conf. Public Health Data Sci., ICPHDS ; : 333-337, 2020.
Article in English | Scopus | ID: covidwho-1142830

ABSTRACT

The new coronavirus is a highly infectious and lethal RNA coronavirus, which may have been from a bat parasitic virus through its infection and evolution in a mammalian intermediate host. The new coronavirus has caused a pandemic of more than 24 million infections and more than 800 thousand deaths in a short period of time without strict and standard physical insulation. It has severely affected human health and economic development, and it is still threatening people's lives today. Its typical characteristics are the refractory nature and high mortality of clinically severe diseases, which lead to excessive consumption and even collapse of medical resources. Therefore, the clinical severe cases in the literature were analyzed, the risk factors of severe COVID-19 were summarized and potential severe risk markers were explored to guide the prevention and treatment of COVID-19. Nineteen risk factors were highlighted that suggested severe illness of the new coronavirus from three aspects: individual characteristics, disease factors, and biomarkers. Overall, it is recommended that people with the above risk factors should be given prior protection during the prevention process, and relevant markers should be monitored in confirmed patients to reduce severe mortality and medical resource consumption. © 2020 IEEE.

18.
Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi ; 36(12):1145-1150, 2020.
Article in Chinese | PubMed | ID: covidwho-977924

ABSTRACT

It is a new challenge for medical students and teachers to set up basic study of Medical Immunology fully online during the outbreak of coronavirus disease 2019 (COVID-19). To achieve the same educational quality with that of offline teaching, the online education design should be reconstructed according to the online cognitive rules of the students. During teaching progress, a cutting-edge research paper on COVID-19 was utilized as the main line for education design to accomplish the immunology teaching. We also combined multiple sources in auxiliary classroom and improved the interaction between the students and teachers through internet which might be the privilege of online teaching. These attempts achieved the curriculum standard requirements and the expected effect of education, which might provide future reference regarding the online or online-offline combined teaching model of Medical Immunology.

19.
CHI PLAY - Ext. Abstr. Annu. Symp. Comput.-Hum, Interact. Play ; : 173-177, 2020.
Article in English | Scopus | ID: covidwho-955440

ABSTRACT

In order to understand a pandemic like the COVID-19 crisis of 2020, we have to keep in mind larger patterns (e.g., information visualizations such as charts), and individual perspectives (e.g., interviews). However, it is challenging to connect these larger patterns with lived experiences. In this work-in-progress paper, we argue that interactive digital experiences such as games have the potential to bridge this gap by allowing players to explore the pandemic at multiple levels of abstraction. We present Essential Workers: an online multiplayer game which situates players as one of four workers?Nurse, Grocery Worker, Office Worker, or Delivery Driver?who face difficult dilemmas as they live through three weeks of rising infection during the COVID-19 pandemic. Through a core cooperative game mechanic, Essential Workers seeks to tie the constraints and choices of the individual to the health of their communities, and to simulate some of the interdependencies that keep our communities functional during the pandemic. We aim to illustrate our approach to key challenges commonly faced by designers seeking to model the entanglements of the individual and society. © 2020 ACM.

20.
Annals Academy of Medicine Singapore ; 49(10):825-828, 2020.
Article in English | Web of Science | ID: covidwho-955163
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