Motion-compensated online object tracking for activity detection and crowd behavior analysis.

It is a nontrivial task to manage crowds in public places and recognize unacceptable behavior (such as violating social distancing norms during the COVID-19 pandemic). In such situations, people should avoid loitering (unnecessary moving out in public places without apparent purpose) and maintain a sufficient physical distance. In this study, a multi-object tracking algorithm has been introduced to improve short-term object occlusion, detection errors, and identity switches. The objects are tracked through bounding box detection and with linear velocity estimation of the object using the Kalman filter frame by frame. The predicted tracks are kept alive for some time, handling the missing detections and short-term object occlusion. ID switches (mainly due to crossing trajectories) are managed by explicitly considering the motion direction of the objects in real time. Furthermore, a novel approach to detect unusual behavior of loitering with a severity level is proposed based on the tracking information. An adaptive algorithm is also proposed to detect physical distance violation based on the object dimensions for the entire length of the track. At last, a mathematical approach to calculate actual physical distance is proposed by using the height of a human as a reference object which adheres more specific distancing norms. The proposed approach is evaluated in traffic and pedestrian movement scenarios. The experimental results demonstrate a significant improvement in the results.

A Leadership Perspective on the Plastic and Reconstructive Surgery Residency Application Cycle During the COVID-19 Pandemic.

Introduction: The purpose of this study was to identify leadership perspective on the impact of COVID-19 Plastic and Reconstructive Surgery (PRS) residency application cycle in 2020 and its future implications. Methods: A survey was sent to residency program leaders (RPL), consisting of program directors and division chiefs/chairs. The survey was sent weekly for 4 weeks and remained open for 28 days. Results: A total of 156 PRS RPL were emailed. Response rate was 24% (38/156). A total of 68% were division chiefs/chairs, and 42% were program directors. Ten percent were both division chiefs/chairs and program directors. Among them, 78% were male. Eighty-seven percent of RPLs reported changes in the number of away rotations, of which 91% reported less away rotations. Only 27% of programs provided virtual away rotations (VAR), and 88% of RPLs were not comfortable writing letters of recommendation after VARs. Hundred percent of cases reported that VARs influenced whether an applicant received an interview. A total of 24 RPLs (63%) reported no changes in how they viewed applications due to the pandemic. However, 5 (13%) reported USMLE scores were more important, 4 (11%) reported research was more important, and 4 (11%) reported LORs were more important. Sixty-six percent did not feel they relied heavily on home institution candidates. Seventy-six percent found virtual interviews to be effective in evaluating applicants, and 71% reported they would add virtual interviews in future interviews. Conclusions: During the 2020-2021 PRS residency application cycle, fewer away rotations were offered, and formerly in-person activities were moved to virtual platforms. Virtual activities caused difficulty assessing candidates for many residency programs.

Prevalence of cardiac pathology and relation to mortality in a multiethnic population hospitalised with COVID-19.

OBJECTIVE: To determine the prevalence of cardiac abnormalities and their relationship to markers of myocardial injury and mortality in patients admitted to hospital with COVID-19. METHODS: A retrospective and prospective observational study of inpatients referred for transthoracic echocardiography for suspected cardiac pathology due to COVID-19 within a London NHS Trust. Echocardiograms were performed to assess left ventricular (LV), right ventricular (RV) and pulmonary variables along with collection of patient demographics, comorbid conditions, blood biomarkers and outcomes. RESULT: In the predominant non-white (72%) population, RV dysfunction was the primary cardiac abnormality noted in 50% of patients, with RV fractional area change <35% being the most common marker of this RV dysfunction. By comparison, LV systolic dysfunction occurred in 18% of patients. RV dysfunction was associated with LV systolic dysfunction and the presence of a D-shaped LV throughout the cardiac cycle (marker of significant pulmonary artery hypertension). LV systolic dysfunction (p=0.002, HR 3.82, 95% CI 1.624 to 8.982), pulmonary valve acceleration time (p=0.024, HR 0.98, 95% CI 0.964 to 0.997)-marker of increased pulmonary vascular resistance, age (p=0.047, HR 1.027, 95% CI 1.000 to 1.055) and an episode of tachycardia measured from admission to time of echo (p=0.004, HR 6.183, 95% CI 1.772 to 21.575) were independently associated with mortality. CONCLUSIONS: In this predominantly non-white population hospitalised with COVID-19, the most common cardiac pathology was RV dysfunction which is associated with both LV systolic dysfunction and elevated pulmonary artery pressure. The latter two, not RV dysfunction, were associated with mortality.

Tackling rest facilities at a busy tertiary paediatric hospital

BackgroundThe well-being of trainees has become a high priority for Trusts, colleges and the wider NHS. Low morale, demanding rotas and inadequate staffing are some of the issues that contribute to burnout of doctors in training. Now more than ever given the current pandemic, the working environment needs to supportive and ensure the well being of our workforce is sustained.The NHS ‘8 High Impact actions to improve the working environment for Junior Doctors’ sets out key areas that need to be addressed by all Trusts, with action 2 ensuring rest breaks are promoted and encouraged.A survey to West Midlands trainees between December 2018 and March 2019 highlighted that many trusts in our region had inadequate or no rest facilities available for staff working overnight. Sleep deprivation leads to increased clinical errors whereas as rest breaks help to improve decision making and provide safer care to patients.ObjectivesOur aim was to tackle the lack the rest facilities within our Trust for our trainees working overnight at a busy tertiary hospital in the centre of Birmingham.MethodsWe created a working group with the postgraduate clinical tutor, the postgraduate team and doctors interested in supporting the well being of trainees to brainstorm ideas on location and necessary provisions.An appropriate space that was easily accessible and centrally located was high on our priority list. Our central education centre contains many rooms which remained unused overnight which provided an ideal space to create our ‘snooze’ rooms.We used funding from our postgraduate budget to purchase essential items to create rest rooms that promoted rest and relaxationResultsWe have created 2 identical ‘snooze’ rooms for our trainees working the hospital at night rota. Each room contains a single sofa which can be pulled out to a single bed and easily wipeable to comply with infection control standards. Linen is provided and replaced by our domestics team daily. To promote a relaxing and restful atmosphere we included plants, a bedside lamp, lavender essence, hot drink facilities, phone chargers, blackout blinds and ‘please do not disturb, doctor resting’ door displays.Our rest rooms have been launched since Wednesday 3rd March 2021, and we will be seeking feedback from the trainees to assess their experience and see if further improvements for their well being can be made.ConclusionsDespite the current COVID 19 pandemic, the well-being of our trainees remains paramount. Although space is limited, we have demonstrated that it is possible to adapt already used spaces to overnight rest facilities, even in a busy tertiary hospital. Using this model, we hope to work with our local Trainee Committee and School Board to develop rest facilities in each of our district general hospitals for our paediatric and neonatal departments.We also intend to appointment trainee well being representatives without our Trust to work on other well being projects like catering facilities and engagement with managers.

The impact of COVID-19 on communication in theatres

Gloucestershire Hospitals NHS Foundation trust comprises sites in Cheltenham and Gloucester (GRH). As part of the COVID-19 response, emergency services were temporarily reconfigured to GRH. This was rapidly implemented, to maximise patient safety whilst managing high patient volumes and potentially high levels of staff sickness.In theatres, communication is critical to safe working. Much has been done in our Trust to improve theatre briefings. We aimed to assess how communication in theatres was impacted by changes made to working patterns during COVID-19. A SurveyMonkeyTM collected demographics, and Likert scale responses assessing team working, communication, briefings, and staff well-being. The survey was distributed to all surgical specialties, anaesthetic, and theatre staff. A total of 100 responses were collected over 5 weeks.The survey confirmed that COVID-19 had a significant impact on working structures. 60% of respondents worked in different teams, and 44% felt outside of their comfort zone. 72% found communication more difficult, with 92% attributing this to PPE. The majority (72%) felt briefings covered specific C-19 related issues and they could raise concerns (77%). However, only 26% of respondents felt this was true for emergency briefings. This is the focus of our initial change.We plan to improve briefings whilst re-engaging those stakeholders who were less involved during the early phase of the initial pandemic. Our high volume of emergency work means that we can implement rapid PDSA cycles following focused discussion groups. Some simple changes have already been made, including introduction of a dedicated pager for the operating general surgeon, and allocation of a CEPOD co-ordinator to attend morning handover. We plan to repeat the survey in 6 weeks. We will also conduct interviews with staff which, in addition to evaluating service improvement, will give vital information to guide ongoing refinements.

Contrast echocardiography facilitates appropriate management of hospitalized patients with coronavirus disease 2019 (COVID-19) and suspected right ventricular masses: case series.

BACKGROUND: Coronavirus disease 2019 (COVID-19) infection is associated with a coagulopathy with high incidence of venous thrombo-embolism. However, bleeding risk is also significant, causing difficulty in initiating and adjusting anticoagulation therapy in case of suspected thrombi. Cardiac masses can be challenging to be identified properly in the context of this disease. The use of bedside contrast echocardiography (CE) can be of a great value in this situation decreasing procedure-related risk and allowing proper diagnosis and management of a cardiac mass. CASES SUMMARY: We present two cases who were admitted with severe COVID-19 infection. Both cases had additional risk factors for hypercoagulability. Un-enhanced echocardiography was performed and revealed right ventricular (RV) dysfunction with a suspected RV mass. The use of bedside CE could confirm a RV thrombus in the first case and exclude it in the second case. Hence, anticoagulation therapy could be adjusted accordingly in both patients. DISCUSSION: Coronavirus disease 2019 infection is associated with peripheral thrombo-embolism and cardiac thrombi. Given the critical condition of many patients affected by COVID-19, imaging for thrombo-embolic events is often restricted. With the use of bedside CE, cardiac masses may be correctly identified, aiding proper adjustment of anticoagulation therapy.

Virtual screening of curcumin and its analogs against the spike surface glycoprotein of SARS-CoV-2 and SARS-CoV.

COVID-19, a new pandemic caused by SARS-CoV-2, was first identified in 2019 in Wuhan, China. The novel corona virus SARS-CoV-2 and the 2002 SARS-CoV have 74% identity and use similar mechanisms to gain entry into the cell. Both the viruses enter the host cell by binding of the viral spike glycoprotein to the host receptor, angiotensin converting enzyme 2 (ACE2). Targeting entry of the virus has a better advantage than inhibiting the later stages of the viral life cycle. The crystal structure of the SARS-CoV (6CRV: full length S protein) and SARS-CoV-2 Spike proteins (6M0J: Receptor binding domain, RBD) was used to determine potential small molecule inhibitors. Curcumin, a naturally occurring phytochemical in Curcuma longa, is known to have broad pharmacological properties. In the present study, curcumin and its derivatives were docked, using Autodock 4.2, onto the 6CRV and 6M0J to study their capability to act as inhibitors of the spike protein and thereby, viral entry. The curcumin and its derivatives displayed binding energies, ΔG, ranging from -10.98 to -5.12 kcal/mol (6CRV) and -10.01 to -5.33 kcal/mol (6M0J). The least binding energy was seen in bis-demethoxycurcumin with: ΔG = -10.98 kcal/mol (6CRV) and -10.01 kcal/mol (6M0J). A good binding energy, drug likeness and efficient pharmacokinetic parameters suggest the potential of curcumin and few of its derivatives as SARS-CoV-2 spike protein inhibitors. However, further research is necessary to investigate the ability of these compounds as viral entry inhibitors.Communicated by Ramaswamy H. Sarma.

Review and Analysis of Massively Registered Clinical Trials of COVID-19 using the Text Mining Approach.

OBJECTIVE: Immediately after the outbreak of nCoV, many clinical trials are registered for COVID-19. The numbers of registrations are now raising inordinately. It is challenging to understand which research areas are explored in this massive pool of clinical studies. If such information can be compiled, then it is easy to explore new research studies for possible contributions in COVID-19 research. METHODS: In the present work, a text-mining technique of artificial intelligence is utilized to map the research domains explored through the clinical trials of COVID-19. With the help of the open-- source and graphical user interface-based tool, 3007 clinical trials are analyzed here. The dataset is acquired from the international clinical trial registry platform of WHO. With the help of hierarchical cluster analysis, the clinical trials were grouped according to their common research studies. These clusters are analyzed manually using their word clouds for understanding the scientific area of a particular cluster. The scientific fields of clinical studies are comprehensively reviewed and discussed based on this analysis. RESULTS: More than three-thousand clinical trials are grouped in 212 clusters by hierarchical cluster analysis. Manual intervention of these clusters using their individual word-cloud helped to identify various scientific areas which are explored in COVID19 related clinical studies. CONCLUSION: The text-mining is an easy and fastest way to explore many registered clinical trials. In our study, thirteen major clusters or research areas were identified in which the majority of clinical trials were registered. Many other uncategorized clinical studies were also identified as "miscellaneous studies". The clinical trials within the individual cluster were studied, and their research purposes are compiled comprehensively in the present work.