Face Mask Detector for Raspberry Pi Based on Computer Vision and Edge Computing

The pandemic of the coronavirus disease 2019 has shown weakness and threats in various fields of human activity. In turn, the World Health Organization has recommended different preventive measures to decrease the spreading of coronavirus. Nonetheless, the world community ought to be ready for worldwide pandemics in the closest future. One of the most productive approaches to prevent spreading the virus is still using a face mask. This case has required staff who would verify visitors in public areas to wear masks. The aim of this paper was to identify persons remotely who wore masks or not, and also inform the personnel about the status through the message queuing telemetry transport as soon as possible using the edge computing paradigm. To solve this problem, we proposed to use the Raspberry Pi with a camera as an edge device, as well as the TensorFlow framework for pre-processing data at the edge. The offered system is developed as a system that could be introduced into the entrance of public areas. Experimental results have shown that the proposed approach was able to optimize network traffic and detect persons without masks. This study can be applied to various closed and public areas for monitoring situations. © 2022 Copyright for this paper by its authors. Use permitted under Creative Commons License Attribution 4.0 International (CC BY 4.0).

VentConnect: telemetry system that enables remote live transmission of ventilator screen: qualitative study of clinicians' expectations and experience

Introduction: To maximise the input of intensivists onto the management of ventilated patients during the COVID pandemic, we have developed and implemented telemetry system VentConnect [1]. The aim of this study is to identify stakeholder's expectations and experience from this technology. Method(s): The telemetry device VentConnect (scheme at Fig. 1) enabled transmission of HDMI signal from mechanical ventilators to a password protected interface on any web browser. We implemented it between December 2020 and March 2021 on a total of 31 beds where patients were treated during COVID Pandemic. Afterwards, we performed Structured User Interviews with ICU doctors. Questionnaire responses we clustered and calculated. Result(s): Eight doctors were interviewed, 4 fully qualified intensivists, and 4 in training. By far the most demanded was the ability to see flow curve or flow pattern (100%), followed by inspiratory pressures (75%) and check tidal volume (63%). Other parameters were mentioned less frequently such as driving pressure (25%) and interferences (38%). With regards users experience, answers were overwhelmingly positive, highlighting mostly the ability to continuously monitor the progress of patients without the need to donning personal protective equipment. In some, however, curiosity was the only motivator for use. Three juniors expressed apprehension that their supervisors might criticise their ventilator setting which would otherwise had gone unnoticed. Two participants thought that the temptation to check patient 24/7 would impair their ability to rest and relax during their off time. Conclusion(s): Telemetry system that enabled clinicians to remotely check ventilator screen met the expectation of clinicians, who mainly demanded to check flow patterns, tidal volumes and pressures. Concerns were mainly about psychological impact of using this technology. These need to be addressed.

Complications Of A Severe Case Of Multisystem Inflammatory Syndrome In Children

Case Presentation: A 10 year old male with prior COVID-19 exposure presented with 7 days of fever, rash, cough, vomiting, and hypotension. Laboratory evaluation was notable for SARS-CoV2 antibodies, elevated cardiac enzymes, BNP, and inflammatory markers. Initial echocardiogram showed normal cardiac function and a small LAD coronary aneurysm. He was diagnosed with Multisystemic Inflammatory Syndrome in Children (MIS-C) and given methylprednisolone and IVIG. Within 24 hours, he developed severe LV dysfunction and progressive cardiorespiratory failure requiring VA-ECMO cannulation and anticoagulation with bivalirudin. Cardiac biopsy demonstrated lymphocytic infiltration consistent with myocarditis. On VA-ECMO, he had transient periods of complete AV block. With immunomodulator treatment (anakinra, infliximab) and 5 days of plasmapheresis, inflammatory symptoms and cardiac function improved. He weaned off ECMO, and anticoagulation was transitioned to enoxaparin. He had left sided weakness 5 days later, and brain MRI revealed an MCA infarct. Ten days later, he had focal right sided weakness and repeat MRI showed multiple hemorrhagic cortical lesions, thought to be thromboembolic with hemorrhagic conversion secondary to an exaggerated inflammatory response to an MSSA bacteremia in the setting of MIS-C. Enoxaparin was discontinued. After continued recovery and a slow anakinra and steroid wean, he has normal coronary arteries, cardiac function, and baseline ECG but requires ongoing neurorehabilitation. Discussion(s): COVID-19 infection in children is often mild, but MIS-C is an evolving entity that can present with a wide range of features and severity. This case highlights two concepts. While first degree AV block is often reported in MIS-C, there is potential for progression to advanced AV block. Close telemetry monitoring is critical, especially if there is evidence of myocarditis. MIS-C shares features with Kawasaki disease, with a notable difference being a higher likelihood of shock and cardiac dysfunction in MIS-C. In MIS-C patients with cardiovascular collapse requiring ECMO, there is a risk for stroke. There should be a low threshold for neuroimaging and multidisciplinary effort to guide anticoagulation in these complex cases.

Effect of Exercise Therapy on Stress Response Evaluated by IoMT Monitoring System.

The Internet of Medical Things (IoMT) system plays a role in various areas of social activity, including healthcare. Telemetry of cardiovascular function, such as blood pressure and pulse, in daily life is useful in the treatment of cardiovascular disease and stress management. However, until now, brain function monitoring technology has not been installed in the IoMT system.In this study, we used near-infrared spectroscopy (NIRS) installed in the IoMT system to evaluate whether consumers who are not medical experts can measure their own brain function correctly. In addition, the IoMT system was used to assess the long-term effects of physical exercise on physical and mental health.We studied a total of 119 healthy adults recruited from a fitness gym in Koriyama, Japan. After receiving instruction in the usage of the IoMT monitoring system including NIRS, the subjects monitored their physical and mental conditions by themselves when they visited the gym. We evaluated the relations between blood pressure (BP), pulse rate (PR), body weight (BW) and age. In addition, we evaluated the left/right asymmetry of the prefrontal cortex (PFC) at rest and BP. We calculated the laterality index at rest (LIR) for assessment of left/right asymmetry of PFC activity; a positive LIR (>0) indicates right-dominant PFC activity associated with higher stress responses, while a negative LIR (<0) indicates left-dominant PFC activity associated with lower stress responses. We studied 47 out of 119 cases who monitored their physiological conditions before and after physical exercise for 6 months for this study.The results showed that the systolic blood pressure and mean blood pressure (p < 0.05) were significantly reduced after the physical exercise for 6 months; body weight did not change significantly (p > 0.05). In addition, NIRS demonstrated that LIR changed to plus values from minus values after exercise (p < 0.01).These results show that (1) consumers who are not-medical experts can measure their own brain function correctly using NIRS; (2) after long-term physical exercise, systemic blood pressure decreased, associated with modulation of PFC activity (i.e., from right-dominant PFC activity to left-dominant activity), indicating that long-term physical exercises caused relaxation in the brain and the autonomic nervous system.

Idiopathic anomalous congenital band causing small intestinal obstruction in a 5-month-old dog

A 5-month-old, intact male, yellow Labrador retriever was presented with a 24-hour history of anorexia and vomiting. Abdominal imaging revealed the presence of a mechanical obstruction in the jejunum and peritoneal effusion. Cytologic evaluation and culture of the effusion prior to surgery identified a suppurative exudate with bacteria consistent with septic peritonitis and suspected to be related to the intestinal lesion. An exploratory laparotomy was performed, and a segment of jejunum was circumferentially severely constricted by an off-white, fibrous band of tissue. Resection and anastomosis of the strangulated segment of jejunum and excision of the constricting band provided resolution of the clinical signs. The dog made a complete recovery. Histologic evaluation revealed the band to be composed of fibrovascular and smooth muscle tissue, consistent with an idiopathic anomalous congenital band. No other gastrointestinal lesions were observed, either grossly at surgery or histologically in the resected segment of intestine. To our knowledge, a similar structure has not been reported in the veterinary literature.Copyright © 2022 Canadian Veterinary Medical Association. All rights reserved.

Challenges in small cetacean telemetry: an attempt at developing a remotely deployed attachment device for single-pin dorsal fin satellite transmitters.

Satellite telemetry is critical for collecting fine-scale temporal and spatial data on individual animals that has broad-scale applicability at population and species levels. There have been significant advances in the remote deployment of satellite telemetry devices on large cetacean species. However, the development of comparable remote attachment methodologies for small cetaceans is still limited. Currently, satellite tag attachment for small cetaceans requires manual capture that increases the risk to the target animal, can be logistically challenging, and cost prohibitive. The goal of this project was to develop a novel tool to remotely attach single-pin satellite telemetry devices to the dorsal fin of individual small cetaceans. Three different spring-loaded designs and one pneumatic version of the remote attachment device were built in an iterative process to identify a successful deployment methodology. Ultimately, as a result of logistical challenges associated with a Category 5 hurricane, the COVID-19 pandemic, and engineering complexities related to dorsal fin morphology and small cetacean behavior, the objective of this project was not met. However, lessons learned from these attempts to develop this new sampling tool have applicability for future researchers in the successful completion of a safe and effective methodology for remote attachment of satellite tags to small cetacean dorsal fins.

Tocilizumab- a Treatment Option for Torsades De Pointes in Covid-19 Patients

Background The incidence of ventricular arrhythmias (VA) in Coronavirus disease 2019 (COVID-19) patients ranges from 1.6 to 5.9%. COVID-19 can trigger a systemic inflammatory response, which may unmask arrhythmias. Here we discuss a challenging case of COVID-19 that manifested as recurrent Torsades de Pointes (TdP). Case A 39-year-old female with no known past medical history presented with a complaint of multiple syncopal episodes in the last two days. Initial electrocardiograms (EKG) showed a heart rate of 62 with frequent premature ventricular contractions (PVCs) and a prolonged corrected QT(QTc) interval of 520ms. Frequent PVCs soon converted to TdP with loss of consciousness which was managed with successful direct current cardioversion (DCCV). However, the patient relapsed into TdP, warranting another successful DCCV. COVID-19 workup came back positive. Electrolytes were within normal limits;however, C-reactive protein (CRP) and troponin T levels were elevated. Decision-making The patient was started on intravenous (IV) magnesium for 24 hours. Following another episode of self-limiting TdP, IV isoproterenol was started, and tocilizumab was given. An echocardiogram showed no evidence of structural heart disease. During the hospital course, telemetry showed PVCs that decreased in frequency paralleled with a decrease in CRP and troponins. Repeat EKGs showed normalization of QTc interval. The patient declined implantable device placement or procedures and was eventually discharged with a heart monitor and a beta blocker. On follow-up, the patient denied any symptoms since the discharge, QTc remained normal, and the heart monitor did not show any VA. Conclusion Management of TdP generally involves magnesium, IV isoproterenol, and transvenous pacing. However, as described in this case, tocilizumab can cause QT interval shortening and a reduction in CRP and cytokine levels and may be beneficial for use in COVID-19 patients with QT prolongation and VA, including TdP. There are no strict guidelines for arrhythmias in COVID-19 patients. Accordingly, more studies need to be done to follow this patient population managed with tocilizumab for their eventual outcomes.Copyright © 2023 American College of Cardiology Foundation

Indications for Inpatient Glucose Telemetry

Objective: The primary objective was to explore indications for inpatient glucose telemetry. Method(s): The inpatient glucose telemetry (IGT) has been instituted at the peak of COVID cases at an urban academic medical center. Besides remote glucose monitoring due to infection isolation, feasibility, reliability and indications for IGT were investigated in hospitalized patients. Result(s): IGT was used in n=75 patients in critical and non-critical care inpatient settings. In addition to remote glucose monitoring due to infection isolation, feasibility, reliability and indications for IGT were investigated in cases requiring hypoglycemia prevention, multimorbidity, fingertip bruising, transplant, cancer, intensive insulin management, brain/psychiatric disease/injury, and inpatient rehabilitation.IGT was used in patients hospitalized with personal home continuous glucose monitoring system and patients with recurrent diabetes hospitalizations. Conclusion(s): Inpatient glucose telemetry indications must be expanded beyond hypoglycemia prevention.

MQTT equipped Intrusion detection system for IoT devices based Machine Learning Algorithms

In the era of COVID19, the world has shifted to an online presence and is now forced to embrace the usage of digital technology in their daily lives. With the meteoric rise of internet-based devices, there is a requirement for a protocol for secure communication between these devices. Message Queueing Telemetry Transport (MQTT) is the standard protocol for IoT devices. The MQTT implementation with IDS have very prominent usability and has huge potential for increasing efficiency. Therefore, in this paper, an IDS has been proposed with MQTT as a protocol for IoT devices, using machine learning to improve the pattern recognition of the IDS. The proposed system has been tested with three machine learning algorithms, namely, and the results show that they are adequate for the MQTT protocol © 2022 IEEE.

A Case of Sick Sinus Syndrome With Prolonged Asystole Masquerading as a Transient Ischemic Attack.

Sick sinus syndrome (SSS) is a term used to describe dysfunction of the sinoatrial (SA) node that can lead to various cardiac arrhythmias that predominately manifest in the elderly. Commonly implicated arrhythmias vary from inappropriate bradycardia, tachycardia, sinus pauses, and rarely sinus arrest. Despite being a common reason for permanent pacemaker implantation, little is known regarding the incidence of SSS and there is even less reporting on SSS complicated by prolonged asystole. We present a case highlighting an infrequently observed manifestation of SSS with recurrent, prolonged ventricular asystolic episodes that were causing previously unexplained episodes of confusion and agonal breathing. Our patient was a 75-year-old male with a past medical history of hypertension, dyslipidemia, and prior transient ischemic attacks (TIAs) that presented after an acute mental status change. The initial leading differential diagnosis was believed to be a TIA and he was admitted to neurology service for further evaluation. The patient had recurring episodes of confusion associated with agonal breathing that upon closer review of the cardiac telemetry revealed sinus bradycardia to the 40s interrupted by several prolonged episodes of asystole, the longest lasting 20 seconds. Due to his symptoms and to avoid potential deterioration resulting in hemodynamic instability, the electrophysiology service urgently placed a temporary transvenous pacemaker and then later implanted a leadless pacemaker. On outpatient follow-up, he no longer had episodes of confusion, and no further asystolic episodes were noted on his device check.

A Framework for Infectious Disease Monitoring With Automated Contact Tracing-A Case Study of COVID-19

Throughout human history, deadly infectious diseases emerged occasionally. Even with the present-day advanced healthcare systems, the COVID-19 has caused more than six million deaths worldwide (as of 27 July 2022). Currently, researchers are working to develop tools for better and effective management of the pandemic. "Contact tracing " is one such tool to monitor and control the spread of the disease. However, manual contact tracing is labor-intensive and time-consuming. Therefore, manually tracking all potentially infected individuals is a great challenge, especially for an infectious disease like COVID-19. To date, many digital contact tracing applications were developed and used globally to restrain the spread of COVID-19. In this work, we perform a detailed review of the current digital contact tracing technologies. We mention some of their key limitations and propose a fully integrated system for contact tracing of infectious diseases using COVID-19 as a case study. Our system has four main modules-1) case maps;2) exposure detection;3) screening;and 4) health indicators that take multiple inputs like users' self-reported information, measurement of physiological parameters, and information of the confirmed cases from the public health, and keeps a record of contact histories using Bluetooth technology. The system can potentially evaluate the users' risk of getting infected and generate notifications to alert them about the exposure events, risk of infection, or abnormal health indicators. The system further integrates the Web-based information on confirmed COVID-19 cases and screening tools, which potentially increases the adoption rate of the system.

Successful implementation of round-the-clock care in a virtual ward during the COVID-19 pandemic.

The COVID-19 pandemic led to unprecedented demand on NHS infrastructure. Virtual wards (VW) were created in response, using technology to monitor patients remotely. Their implementation required new systems of staffing, escalation, risk management and information governance. The Norfolk and Norwich University Hospitals Foundation Trust offered an example of a highly successful VW. It cared for 852 patients in its first year of operation, providing 24/7 nursing cover, supported by pharmacists and junior doctors, daily consultant-led ward rounds and virtual visits. The remote care platform collected continuous vital sign observations and generated custom alarms. The care team triaged, then escalated to nurse-specialists or consultants as required. Patients reported increased confidence and relief at earlier discharge. Staff highlighted the benefits of working from home, even if isolating or shielding. Challenges included developing awareness of the new service, overcoming concerns around increased workload and transitioning from emergency to long-term funding. The ward subsequently expanded from COVID-19 to nine other use cases.

A CASE OF TRACHEOBRONCHIAL AMYLOIDOSIS PRESENTING AS SYNCOPE

SESSION TITLE: Systemic Diseases with Deceptive Pulmonary Manifestations SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/18/2022 12:25 pm - 01:25 pm INTRODUCTION: Amyloidosis of the respiratory tract is rare. We present a case of tracheobronchial amyloid presenting as multifactorial cough with syncope. CASE PRESENTATION: The patient is a 65-year-old man with history of hypertension, hyperlipidemia, and allergic rhinitis who presented to the ED after a syncopal event. Two weeks prior, he had a new-onset myalgias and severe persistent cough, not resolving with over-the-counter medications. During a coughing paroxysm, he experienced a brief loss of consciousness. On arrival, his vital signs and physical exam were within normal limits except for Mallampati II, BM of 38.8 kg/m2. Basic laboratory testing was also unremarkable except for troponin T of 251 nl/dL and NT-ProBNP of 1181 pg/mL. NP swab for Sars-CoV-19 (PCR), Influenza A and B were not detected. CT of the chest revealed an area of circumferential mural soft tissue thickening in the left lower lobe bronchi. Cardiac MRI showed an area of subepicardial delayed enhancement, suggestive of myocardial inflammation or edema. Flexible bronchoscopy confirmed that the left lower lobe bronchus and proximal subsegmental bronchi had an infiltrative process with a friable, erythematous irregular mucosal surface. Forceps biopsy sampling and staining with Congo red, sulfate Alcian blue and Trichome stain were positive for amyloid deposits. Immunostain revealed predominantly CD3 positive T-Cells. Mass spectometry showed AL (lamda)-type amyloid deposition. GMS and AFB stains were negative. Telemetry showed 2-3 second pauses, correlated with episodes of cough. DISCUSSION: Amyloidosis is a disorder caused by misfolding of proteins and fibril accumulation in the extracellular space. It can present as a diffuse or localized process to one organ system. Several patterns of lung involvement have been described: nodular pulmonary, diffuse alveolar-septal, cystic, pleural, and tracheobronchial amyloidosis. Tracheobronchial amyloidosis is usually limited and not associated with systemic disease or hematologic malignancy. It can be asymptomatic, or can present with cough, dyspnea or signs of obstruction, including postobstructive pneumonia. Congo Red stained samples reveal green birefringence under polarized light microscopy. Further analysis of proteins usually reveals localized immunoglobulin light chains (AL). Cough syncope is due to increased intrathoracic pressure, decreased venous return and cardiac output, stimulation of baroreceptors, decreased chronotropic response, arterial hypotension and decreased cerebral perfusion. Our patient presented with multifactorial cough (possible viral infection, upper airway cough syndrome, amyloidosis) causing sinus pauses and syncope, on underlying myocarditis. CONCLUSIONS: Amyloid infiltration of the respiratory system is rare, but it should be considered in the differential diagnosis of airway disorders, nodular or cystic lung diseases, and pleural processes. Reference #1: Milani P, Basset M, Russo F, et al. The lung in amyloidosis. Eur Respir Rev 2017;26: 170046 [https://doi.org/10.1183/16000617.0046-2017]. Reference #2: Utz JP, Swensen SJ, Gertz MA. Pulmonary amyloidosis. The Mayo Clinic experience from 1980 to 1993. Ann Intern Med. 1996 Feb 15;124(4):407-13. doi: 10.7326/0003-4819-124-4-199602150-00004 Reference #3: Dicpinigaitis PV, Lim L, Farmakidis C. Cough syncope. Respir Med. 2014 Feb;108(2):244-51. doi: 10.1016/j.rmed.2013.10.020. Epub 2013 Nov 5. PMID: 24238768. DISCLOSURES: No relevant relationships by Amarilys Alarcon-Calderon No relevant relationships by Ashokakumar Patel

RESUSCITATION AIRWAY MANAGEMENT AT A TERTIARY CARE CENTER THAT ENCOURAGES FIRST-CHOICE SUPRAGLOTTIC AIRWAY USE

SESSION TITLE: Hot Topics in Critical Care SESSION TYPE: Original Investigations PRESENTED ON: 10/18/2022 02:45 pm - 03:45 pm PURPOSE: Recent data from the national American Heart Association Get with the Guidelines Resuscitation registry suggests substantial hospital-to-hospital variation in airway management during in-hospital cardiac arrest (IHCA), with most patients undergoing endotracheal intubation. Less than 5% of IHCA patients receive a supraglottic airway (SGA). Over the past several years, SGAs have been studied extensively in out-of-hospital cardiac arrests (OHCA) with promising results and are widely used in the OHCA setting. In this study, we describe factors and airway characteristics at a center encouraging either SGA or endotracheal intubation (ETI) for IHCA advanced airway management. METHODS: We performed a retrospective observational study examining all cardiac arrests occurring at a multi-campus academic medical center between August 3, 2020 to July 11, 2021. Locations studied included general medical wards, telemetry units, and intensive care units (both medical and specialty ICUs, such as surgical or cardiac). Patients were excluded if they possessed an invasive airway at time of arrest, suffered an arrest in the ED or procedural areas (e.g., operating room, catheterization lab), or were SARS-CoV-2 positive. Of note, SGAs were not specifically discouraged during the COVID-19 pandemic at this institution. We compared patient, arrest, and airway characteristics between the SGA and endotracheal intubation (ETI) groups using t-tests or Fisher’s exact tests where appropriate. Given risk for confounding by indication, we did not compare patient outcomes between groups. RESULTS: A total of 97 patients were included in the study, of whom 82 (84.5%) received an advanced airway during cardiopulmonary resuscitation. Of these the initial airway was ETI in 46 (56.1%) arrests and SGA in 36 (43.9%) arrests. As compared to SGA, patients receiving ETI were younger (66.1 [±2.0] vs. 71.2 [±2.1], p=0.08), more likely to be obese (11.0% vs. 5.6%), and more likely to have pre-existing lung conditions (19.6% vs 11.1%)—although no difference reached the a priori defined α<0.5 level of significance. Other hypothesized differences were not as extreme including for body mass index (28.3 [±1.4] vs. 28.4 [±1.6]) and respiratory cause of arrest (34.8% vs. 47.2%). First pass success rate was 84.8% for ETI. Complications of airway management were rare with one patient in each group suffering vomiting, one instance of oropharyngeal bleeding in the SGA group, and one pneumothorax in the ETI group. CONCLUSIONS: At a center using both SGA and ETI during IHCA response, patients who were younger, more obese, and more commonly had underlying lung disease tended to receive ETI—although these associations were not statistically significant. Complications of both advanced airway modalities were rare. CLINICAL IMPLICATIONS: DISCLOSURES: No relevant relationships by jonathan daich No relevant relationships by Alex Li No relevant relationships by Ari Moskowitz No relevant relationships by Aron Soleiman

COVID-19 and arrhythmia: The factors associated and the role of myocardial electrical impulse propagation. An observational study based on cardiac telemetric monitoring.

Background: The heart is commonly involved in COVID-19, and rhythm disorders have been largely reported. Objective: To evaluate the association of some non-cardiac and cardiac comorbidities and QT dispersion with arrhythmias and their impact on outcomes in hospitalized patients with COVID-19. Methods: Each patient underwent cardiac telemetry monitoring through the entire hospitalization period, laboratory analyses, 12-lead ECG, and lung imaging examination. Patients with arrhythmia were divided into three groups (bradyarrhythmias, tachyarrhythmias, and tachy- and bradyarrhythmias). Results: Two-hundred patients completed the study (males, 123; mean age, 70.1 years); of these, 80 patients (40%) exhibited rhythm disorders on telemetry. Patients with arrhythmia were older (p < 0.0001), had a greater number of comorbidities (p < 0.0001), higher values of creatinine (p = 0.007), B-type natriuretic peptide (p < 0.0001), troponin (p < 0.0001), C-reactive protein (p = 0.01), ferritin (p = 0.001), D-dimer (p < 0.0001), procalcitonin (p = 0.0008), QT interval (p = 0.002), QTc interval (p = 0.04), and QTc dispersion (p = 0.01), and lower values of sodium (p = 0.03), magnesium (p = 0.04), glomerular filtration rate (p < 0.0001), and hemoglobin (p = 0.008) as compared to patients without arrhythmia. By comparing the three subgroups of patients, no significant differences were found. At multivariate analysis, age [odds ratio (OR) = 1.14 (95% CI: 1.07-1.22); p = 0.0004], coronary artery disease [OR = 12.7 (95% CI: 2.38-68.01); p = 0.005], and circulating troponin [OR = 1.05 (95% CI: 1.003-1.10); p = 0.04] represented risk factors independently associated with arrhythmia. All-cause in-hospital mortality was ∼40-fold higher among patients with arrhythmia [OR = 39.66 (95% CI: 5.20-302.51); p = 0.0004]. Conclusion: Arrhythmias are associated with aging, coronary artery disease, subtle myocardial injury, hyperinflammatory status, coagulative unbalance, and prolonged QTc dispersion in patients with COVID-19, and confer a worse in-hospital prognosis. Given its usefulness, routinary use of cardiac telemetry should be encouraged in COVID wards.

Heart Rate Variability And Cardio-Renal Outcomes In Patients With Novel Covid 19 Infection

Studies have shown that SARS-CoV2 can infect the vagal nerve and its connections to the brain stem. This neuronal involvement is seen mostly in the delayed inflammatory phase. It is associated with autonomic nervous system dysfunction, resulting in decreased respiratory ventilation and impaired blood pressure as well as heart rate regulation. The dysautonomia seen in SARSCoV-2 infection can be measured, and heart rate variability (HRV) measurement is one method. Our study explores the relationship between autonomic dysfunction and mortality in patients with COVID- 19 using HRV measurement. In a prospective design, data of consecutive patients with SARS-CoV-2 positive infection admitted to Banner university of Arizona, Tucson, and whose telemetry information was available was collected between August 2020 to November 2021. We attempted to use the telemetry data to measure diurnal heart rate variation by obtaining mean average hourly heart rates, divided into 12-hour day/night periods. The primary outcome measure was mortality. The secondary outcome measured includes incidence of acute kidney injury, transfer to ICU, need for mechanical ventilation, and live discharge from hospital. 334 patients were included in the study. The baseline demographic characteristics, medical history, radiological data, laboratory data, details of medications, and hospital course were reported. Diseases associated with an autonomic dysfunction like diabetes mellitus, chronic renal failure, a history of alcohol abuse, clinical evidence of autonomic neuropathy, or a recent myocardial infarction, documented constrictive or hypertrophic cardiomyopathy, sustained non-sinus dysrhythmias, atrioventricular conduction defects will be excluded in the final analysis. Mortality was high in patients with lower heart rate variability. Compared with survivors, non-survivors were older, were less frequently women, had a higher prevalence of diabetes mellitus, longer stay in the hospital, received an organ transplant, smoking, and higher level of calcitonin. Lower heart rate variability was associated with a higher incidence of acute kidney injury, need for mechanical ventilation, and need for ECMO. This study suggests that analysis of the variability of heart rate may have prognostic implications in patients with COVID19.

Remdesivir-Induced Marked Sinus Bradycardia in COVID-19.

Remdesivir has been extensively employed during the coronavirus disease 2019 (COVID-19) pandemic as it has proven to be efficacious against the causative SARS-CoV-2. However, there is not much evidence on the cardiovascular adverse effect profile of remdesivir. In addition, limited data support the occurrence of sinus bradycardia associated with remdesivir. Herein we chronicle a clinical encounter of a patient suffering from COVID-19 whose clinical course was complicated by marked sinus bradycardia that began acutely after remdesivir initiation and resolved on cessation of the medication. The patient denied symptoms and completed a 5-day course with a resolution of bradycardia on completion of medication. We suggest that the physicians be cognizant of this rare side effect of remdesivir and suggest a continuation of this medication unless symptomatic bradycardia precludes management.

A Framework for Infectious Disease Monitoring with Automated Contact Tracing - A Case Study of COVID-19

Throughout human history, deadly infectious diseases emerged occasionally. Even with the present-day advanced healthcare systems, the COVID-19 has caused more than six million deaths worldwide (as of 27 July 2022). Currently, researchers are working to develop tools for better and effective management of the pandemic. ’Contact tracing’is one such tool to monitor and control the spread of the disease. However, manual contact tracing is labor-intensive and time-consuming. Therefore, manually tracking all potentially infected individuals is a great challenge, especially for an infectious disease like COIVD-19. To date, many digital contact tracing applications were developed and used globally to restrain the spread of COVID-19. In this work, we perform a detailed review of the current digital contact tracing technologies. We mention some of their key limitations and propose a fully integrated system for contact tracing of infectious diseases using COVID-19 as a case study. Our system has four main modules -Case Maps, Exposure Detection, Screening, and Health Indicators that takes multiple inputs like users’self-reported information, measurement of physiological parameters, and information of the confirmed cases from the public health, and keeps a record of contact histories using Bluetooth technology. The system can potentially evaluate the users’risk of getting infected and generate notifications to alert them about the exposure events, risk of infection, or abnormal health indicators. The system further integrates the web-based information on confirmed Covid-19 cases and screening tools, which potentially increases the adoption rate of the system. IEEE

Seasonal space use and habitat selection in magpie geese: implications for reducing human‐wildlife conflicts

Negative interactions between waterbirds and people are increasing. Waterbirds feeding on agricultural crops cause significant losses to farmers worldwide, but so far most research to address these conflicts has been conducted on migratory species in the temperate northern hemisphere. We investigated the space use and habitat selection of the magpie goose (Anseranas semipalmata), a taxonomically distinct waterbird endemic to Australia and southern Papua New Guinea. In tropical northern Australia, magpie geese are protected but are increasingly persecuted by farmers to protect crops during the late dry–early wet season (~Sep–Jan), a bottleneck of natural resources for waterbirds in the monsoonal tropics. Using satellite telemetry of 38 geese spread across 3 seasons (2016–2017, 2017–2018, 2018–2019), we evaluated daily and seasonal space use, individual site fidelity, and habitat selection to determine the extent of use of agricultural fields by geese, and the spatiotemporal scales at which management should be undertaken. Geese used relatively small daily areas (x̄ = 8.2 km2) consistently throughout the late dry–early wet season, and repeatedly used agricultural fields, forested bushlands, and local wetlands. Geese used comparatively large seasonal areas (x̄ = 219.5 km2) encompassing several agricultural areas, and had a low mean overlap between successive weekly core activity areas, indicating that site fidelity rapidly weakened over time. These results suggest that farm‐scale (<30 ha) management of geese is unlikely to be effective because hazed individuals are likely to be replaced soon afterwards. Instead, our findings suggest that goose management should be coordinated strategically at the local (~1,000 ha), or regional (~100,000 ha) scale. Farm‐level management would likely be more effective if implemented in conjunction with the creation of regional sanctuaries where geese could rest and potentially feed undisturbed away from farms. Our findings can be used by wildlife managers for optimizing the location of such sanctuaries and highlight the necessity for management to be adaptive given the opportunistic nature of the species. [ FROM AUTHOR] Copyright of Journal of Wildlife Management is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)