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Background: Since COVID-19 the number of girls referred to pediatric endocrinologist for suspected precocious puberty (PP) and early puberty (EP) has increased. The aim of the study was to evaluate the incidence, the anthropometric, biochemical and radiological characteristics of PP during the COVID-19 pandemic, compared to previous years. Method(s): We retrospectively evaluated medical records of 464 females (F) referred to academic pediatric endocrinology center for suspected PP/EP from January 2016 to June 2021 (Group1: January 2016-March 2020, n=295;Group2: March 2020-June 2021, n=169). At first visit (V1) 289F had Idiopathic CPP (Group1 n=175;Group2 n=114) of which n=89 met the Rapidly Progressive Idiopathic CPP criteria (RP-ICPP;Group1 n=45;Group2 n=44) and n=200 for Slowly Progressive Idiopathic CPP (SP-ICPP;Group1 n=130;Group2 n=70). Additional n=44 of the SP-ICPP met the RP-ICPP criteria (Group1 n=27;Group2 n=17) at a second assessment (V2). Girls were classified by age at diagnosis (<6;6-6.99;7-7.99;>8 years). The total number of RP-ICPP was 133 (n=27 no-caucasians). Result(s): We found a higher incidence of RP-ICPP in Group 2 compared to Group1 (36% vs 24%, p<0.05, respectively);comparing the annual RP-ICPP incidences, 2021 showed the highest (p<0.05). RP-ICPP in Group1 and Group2 differed in age at diagnosis (7.96+/-0.71 vs 7.61+/-0.94;p<0.05) and in the time interval between thelarche and diagnosis (0.93+/-0.75 vs 0.74+/-0.64 yrs, p=0.05). We found a progressive increase in the number of girls Group2 in each age group<8 years (<6 years n=4 vs n=2;6-6,99 years n=7 vs n=4;7-7,99 years n=34 vs n=20), and a significant inverted proportion in girls >8 years (n=41 Group1 vs n=21 Group2, p<0.05). There were no differences between Group1 and Group2 for any anthropometric, biochemical and radiological parameters analyzed, except for blood glucose and cholesterol HDL levels (both highest in Group2 (p<0.05)). These data were confirmed in the total group and only in caucasian girls. By regression analyses we found that age at diagnosis was anticipated in Group2, regardless of BMI SDS. Analyzing the subgroup of patients with V2, BMI SDS V2-V1 was not different (-0.12+/-0.5 in Group1 vs 0.11+/-0.44 in Group2, p=0.17). Conclusion(s): During the Covid-19 pandemic the number of girls with suspected PP/EP resulted 1.79 fold increased, with a 1.5 time higher incidence of RC-ICPP. BMI doesn't seem to play a role, but further studies are needed to understand the etiology and primarily the role of metabolic parameters.
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BACKGROUND: Although sociodemographic factors have been linked with SARS-CoV-2 infection and hospitalizations in adults, there are little data on the association between sociodemographic characteristics and SARS-CoV-2-related hospitalization in children. OBJECTIVE(S): The objective of this study was to determine the association between area-level material deprivation and incidence of hospitalization with SARS-CoV-2 among children. DESIGN/METHODS: We conducted a retrospective cohort study of all children (0-17 years of age) with a PCR-confirmed SARS-CoV-2 infection between March 1, 2020, and May 31, 2021, at a tertiary care pediatric hospital. Data were collected through chart review and included age, sex, and postal code. Postal codes were then assigned a dissemination area-level material deprivation score, measured via the Pampalon Material Deprivation Index (PMDI) quintiles. The Pampalon Material Deprivation Index (PMDI) uses postal codes to describe factors related to material deprivation obtained from the Canadian census, which are proxies for individual data in a geographic area. Specifically, the PMDI integrates data regarding (i) the proportion of persons without a high school diploma;(ii) the employment-to-population ratio;(iii) average personal income which is aggregated at the dissemination area level. We examined the association between PMDI quintiles and hospitalization using Poisson regression. RESULT(S): During the study period, 964 children had a positive PCRconfirmed SARS-CoV-2 test and 124 were hospitalized due to SARSCoV- 2 infection. Children from the most deprived PMDI quintile represented 31.6% of positive cases and 40.7% of hospitalizations (Figure 1 and 2). Both in bivariate and multivariable regression analyses, there was evidence of greater proportion of positive test results in the most deprived PMDI quintile (Quintile 5) compared to the least deprived quintile (Quintile 1) (rate ratio 1.77, 95%CI: 1.36;2.62) (Table 1). The incidence of hospitalization due to SARS-CoV-2 infection was 2.42 times greater in the most deprived quintile compared to the least deprived quintile (95%CI: 1.33;4.41) (table 1). In a post-hoc analysis, the risk for severe disease appeared higher for children living in Q5 areas relative to other areas but the difference did not reach statistical significance. CONCLUSION(S): In conclusion, in this study we found evidence that Canadian children living in neighbourhoods with high material deprivation had a higher incidence of infection and hospitalizations related to SARS-Cov-2 compared to children living in neighbourhoods with less material deprivation. Public health authorities should take these disparities into account when devising public health policy and interventions especially at this crucial point in the pandemic. Special efforts should be deployed to protect children from these more disadvantaged areas, especially as vaccination is not yet available to a majority of children.
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Introduction: COVID-19 is a respiratory disease associated with an overproduction of proinflammatory cytokines such as interleukins, leading to cardiovascular collapse, multi-organ dysfunction, and death. Tocilizumab, a monoclonal antibody against interleukin-6, has shown to reduce risk of death for hospitalized patients with severe COVID- 19. At the height of the COVID-19 surge, the supply of tocilizumab was limited and many healthcare systems were forced to reserve the medication for the most severe patients. Research Question or Hypothesis: Does tocilizumab lead to reduced mortality and/or length of stay (LOS) in hospitalized COVID-19 patients without increasing risk of secondary infection or hepatotoxicity? Study Design: Retrospective, observational, single-center cohort study of COVID-19 hospitalized adult patients. Method(s): Baseline demographics were collected using hospital electronic medical records including comorbidities, oxygen requirements, labs, and concomitant COVID-19 medications from March 2020 to January 2022. Data analysis was performed to determine the odds ratio of mortality, LOS, risk of secondary infection, hepatotoxicity, comorbidity and co-intervention drugs. Chi-square and Student t-test were used for descriptive statistics. Binary logistic regression, MANOVA, and MANCOVA were performed to obtain the odds ratio for efficacy and safety of tocilizumab. Result(s): 164 patients were included in the study, 68 (41%) in the tocilizumab group and 96 (59%) in the control group. Baseline data showed significant differences in diabetes, oxygen requirement, lab, and concomitant COVID-19 medications. The odds ratio for mortality was 1.39 (95%CI 1.14-5, p=0.021). Subgroup analysis based on ICU admission was not significant: 0.17 (p=0.758) for ICU and 0.43 (p=0.613) for non-ICU. LOS was prolonged in the tocilizumab group at 13.6 days (p=<0.001). There was no significant risk of secondary infection or hepatotoxicity. Coronary artery disease and piperacillin-tazobactam concomitant use were significant contributing mortality factors. Conclusion(s): Among hospitalized patients with COVID-19, receiving tocilizumab did not reduce mortality or LOS. Tocilizumab did not increase risk of secondary infection or hepatotoxicity.
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Aims: Flexor tendon injuries are debilitating with rupture of repair leading to significant morbidity. The SARS-CoV-2 pandemic has led to a shift to out-of-theatre operating, with many flexor tendon repairs being performed on The same day as initial assessment in our outpatient Department (OpD) procedure room. We aimed to compare The rupture rates before and after The start of The pandemic to assess The safety of this change in practice. Method(s): Patients who underwent repair of one or more flexor tendons were included from two six-month periods: July to December 2019 and April to September 2020. Patient records were reviewed to identify operation location, number of flexor tendons repaired per patient and rupture incidence. In The second period, patients whose operation was performed in theatre were excluded. Result(s): 28 patients were included for The initial period with a total of 49 flexor tendons injured. All repairs were performed in theatre and 3 ruptures were recorded (6%). 17 patients underwent flexor tendon repair during The second period. 11 patients were operated on in The OpD with a total of 16 flexor tendons injured. 1 rupture was recorded (6%). Conclusion(s): The rupture rate of OpD operating is comparable to that of The traditional theatre pathway. OpD operating also allowed us to circumvent theatre waiting lists and thus avoid costly delays to patient care. This project demonstrates maintained safety for patients and of fers a platform for further Research to confirm OpD operating as a viable and sustainable alternative for future practice.
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With the worldwide spread of COVID-19, people are trying different ways to prevent the spread of the virus. One of the most useful and popular ways is wearing a face mask. Most people wear a face mask when they go out, which makes facial expression recognition become harder. Thus, how to improve the performance of the facial expression recognition model on masked faces is becoming an important issue. However, there is no public dataset that includes facial expressions with masks. Thus, we built two datasets which are a real-world masked facial expression database (VIP-DB) and a man-made masked facial expression database (M-RAF-DB). To reduce the influence of masks, we utilize contrastive representation learning and propose a two-branches network. We study the influence of contrastive learning on our two datasets. Results show that using contrastive representation learning improves the performance of expression recognition from masked face images. © 2022 ACM.
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The COVID-19 pandemic has severely affected the tourism industry, with national lockdowns aimed at curbing the spread of the virus mandating travel restrictions and prohibiting events and gatherings. The shift to online video conferencing tools, which offer limited interactivity, has spurred the need to integrate augmented reality (AR) in various contexts, such as meetings, exhibitions, museums, and travel. This quantitative study examines visitors' perspectives on AR-based apps in tourism. It investigates the influence of three kinds of quality determinants, such as information quality, system quality, and service quality, on visitors' perspectives on AR apps. Their impact on visitor satisfaction ultimately triggers visitors to reuse AR-based mobile apps. The research makes a theoretical contribution to the literature on AR and the quality dimensions of mobile apps. We expect demand for AR-based apps to rapidly increase, as people continue to follow preventive measures even after COVID-19.
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The outbreak of the COVID-19 pandemic has changed the whole world scenario and made researchers innovate on the corona virus. Researchers are working on information that includes symptoms, Infection spreading, preventive measures, health and travel advisories, and help lines for further assistance. During this pandemic scenario, the health assistant Chatbot is a very useful conversation tool for COVID-19, which provides preliminary medical advice and preventive measure suggestions. The paper proposes an Artificial Intelligence-based Re-Co Chatbot to provide information about the corona virus and also assist with customer queries. The goal is to build a 24/7 COVID Chatbot capable of answering user questions and to emphasize and stress the concept of contextual semantic search and Knowledge Graph to serve as the FAQ for Corona information. Natural Language Processing (NLP) is used to process the user question and the SpaCy library is used for text processing. Once the question is processed, entities (the subject of question) and relations (predicate of the question) are recognized and extracted. The Chatbot is designed for about 100 question-answers pairs in the CSV file and will create about 575 relationships in the Knowledge Graph. © 2021, Springer Nature Switzerland AG.