LW-CovidNet: Automatic covid-19 lung infection detection from chest X-ray images.

Coronavirus Disease 2019 (Covid-19) overtook the worldwide in early 2020, placing the world's health in threat. Automated lung infection detection using Chest X-ray images has a ton of potential for enhancing the traditional covid-19 treatment strategy. However, there are several challenges to detect infected regions from Chest X-ray images, including significant variance in infected features similar spatial characteristics, multi-scale variations in texture shapes and sizes of infected regions. Moreover, high parameters with transfer learning are also a constraints to deploy deep convolutional neural network(CNN) models in real time environment. A novel covid-19 lightweight CNN(LW-CovidNet) method is proposed to automatically detect covid-19 infected regions from Chest X-ray images to address these challenges. In our proposed hybrid method of integrating Standard and Depth-wise Separable convolutions are used to aggregate the high level features and also compensate the information loss by increasing the Receptive Field of the model. The detection boundaries of disease regions representations are then enhanced via an Edge-Attention method by applying heatmaps for accurate detection of disease regions. Extensive experiments indicate that the proposed LW-CovidNet surpasses most cutting-edge detection methods and also contributes to the advancement of state-of-the-art performance. It is envisaged that with reliable accuracy, this method can be introduced for clinical practices in the future.

Efficacy and safety of auto-cross-linked hyaluronic gel to prevent intrauterine adhesion after hysteroscopic electrosurgical resection: a multi-center randomized controlled trial.

Background: The electrothermal effect of hysteroscopic bipolar electrosurgical resection may cause damage to the endometrium, leading to intrauterine adhesion (IUA). Although some studies have demonstrated the efficacy and feasibility of auto-cross-linked hyaluronic (ACP) gel in preventing IUAs, controversy over its use continues. In this randomized controlled multi-center 2-arm parallel trial, we aimed to examine the efficacy and safety of ACP gel in preventing IUA after hysteroscopic electrosurgical resection and facilitate pregnancy in patients. Methods: Patients from 4 centers in China were randomly assigned (1:1) to receive an intrauterine infusion of ACP gel or nothing after hysteroscopic electrosurgical resection. The randomization assignment was generated by computer and kept in a sealed envelope. A second-look hysteroscopy was performed within 3 months of the surgery. Results: From June 2018 to May 2021, 200 patients were recruited. Ultimately, 82 patients in both groups were included in the result analysis. The baseline characteristics were comparable. The outcomes were assessed by using per-protocol analysis. The incidence of IUA in the ACP gel group was lower than that in the control group [3.66% vs. 10.98%, risk ratio (RR) =0.333, 95% confidence interval (CI): 0.094-1.187, P=0.072], and the planned pregnancy rate was higher than that of the control group (60.98% vs. 40.54%, RR =1.504, 95% CI: 0.949-2.384, P=0.071), but the difference was not statistically significant. There was no significant difference in menstruation change. Menstrual volume remained unchanged in most cases (86.59% in ACP gel group vs. 89.02% in the control group, RR =0.877, 95% CI: 0.877-1.109, P=0.815). Menstrual volume decreased in 10 women in the ACP gel group and 8 in the control group (12.20% vs. 9.76%, RR =1.250, 95% CI: 0.520-3.007, P=0.617). No adverse effects were observed after the ACP administration. Conclusions: The present study showed that the use of ACP gel appeared to reduce both the tendency of IUA and American Fertility Society (AFS) scores and improve the subsequent pregnancy rate during hysteroscopic electrosurgical resection when treating polyps, fibroids, and uterine septum. ACP might be recommended to prevent IUA after such surgery. Further studies should be conducted with larger numbers of participants. Trial Registration: Chinese Clinical Trial Registry ChiCTR2100047165.

LW‐CovidNet: Automatic covid‐19 lung infection detection from chest X‐ray images

Coronavirus Disease 2019 (Covid‐19) overtook the worldwide in early 2020, placing the world's health in threat. Automated lung infection detection using Chest X‐ray images has a ton of potential for enhancing the traditional covid‐19 treatment strategy. However, there are several challenges to detect infected regions from Chest X‐ray images, including significant variance in infected features similar spatial characteristics, multi‐scale variations in texture shapes and sizes of infected regions. Moreover, high parameters with transfer learning are also a constraints to deploy deep convolutional neural network(CNN) models in real time environment. A novel covid‐19 lightweight CNN(LW‐CovidNet) method is proposed to automatically detect covid‐19 infected regions from Chest X‐ray images to address these challenges. In our proposed hybrid method of integrating Standard and Depth‐wise Separable convolutions are used to aggregate the high level features and also compensate the information loss by increasing the Receptive Field of the model. The detection boundaries of disease regions representations are then enhanced via an Edge‐Attention method by applying heatmaps for accurate detection of disease regions. Extensive experiments indicate that the proposed LW‐CovidNet surpasses most cutting‐edge detection methods and also contributes to the advancement of state‐of‐the‐art performance. It is envisaged that with reliable accuracy, this method can be introduced for clinical practices in the future.

Mental Health Research During the COVID-19 Pandemic: Focuses and Trends.

Background: The COVID-19 pandemic has profoundly influenced the world. In wave after wave, many countries suffered from the pandemic, which caused social instability, hindered global growth, and harmed mental health. Although research has been published on various mental health issues during the pandemic, some profound effects on mental health are difficult to observe and study thoroughly in the short term. The impact of the pandemic on mental health is still at a nascent stage of research. Based on the existing literature, we used bibliometric tools to conduct an overall analysis of mental health research during the COVID-19 pandemic. Method: Researchers from universities, hospitals, communities, and medical institutions around the world used questionnaire surveys, telephone-based surveys, online surveys, cross-sectional surveys, systematic reviews and meta-analyses, and systematic umbrella reviews as their research methods. Papers from the three academic databases, Web of Science (WOS), ProQuest Academic Database (ProQuest), and China National Knowledge Infrastructure (CNKI), were included. Their previous research results were systematically collected, sorted, and translated and CiteSpace 5.1 and VOSviewers 1.6.13 were used to conduct a bibliometric analysis of them. Result: Authors with papers in this field are generally from the USA, the People's Republic of China, the UK, South Korea, Singapore, and Australia. Huazhong University of Science and Technology, Hong Kong Polytechnic University, and Shanghai Jiao Tong University are the top three institutions in terms of the production of research papers on the subject. The University of Toronto, Columbia University, and the University of Melbourne played an important role in the research of mental health problems during the COVID-19 pandemic. The numbers of related research papers in the USA and China are significantly larger than those in the other countries, while co-occurrence centrality indexes in Germany, Italy, England, and Canada may be higher. Conclusion: We found that the most mentioned keywords in the study of mental health research during the COVID-19 pandemic can be divided into three categories: keywords that represent specific groups of people, that describe influences and symptoms, and that are related to public health policies. The most-cited issues were about medical staff, isolation, psychological symptoms, telehealth, social media, and loneliness. Protection of the youth and health workers and telemedicine research are expected to gain importance in the future.

Changes of COVID-19 Knowledge, Attitudes, Practices and Vaccination Willingness Among Residents in Jinan, China.

Background: Vaccine hesitancy is responsible for low vaccine coverage and increased risk of epidemics. The purpose of this study was to assess whether public knowledge, attitudes, practices, and willingness to vaccinate against COVID-19 have changed over time and at different stages of vaccination. Methods: Two consecutive surveys were conducted among residents of the Leshan Community in Jinan from May to June, 2021 (n = 423) (basic dose vaccination phase) and from December, 2021 to January, 2022 (n = 470) (booster vaccination phase). Randomly sampling was used in residents to complete an anonymous questionnaire. Chi-square test was used to compare the changes in knowledge, attitudes and practices of the subjects in different survey stages. Multivariable logistic regression analysis was used to explore factors related to vaccination hesitancy. Results: In the booster vaccination phase, protective behaviors (89.9%) of residents increased significantly compared with the basic vaccination phase (74.5%). Residents were more hesitant to receive booster doses than basal doses of COVID-19 vaccine (OR: 18.334, 95% CI: 9.021-37.262). Residents with other marital statuses (OR: 2.719, 95% CI: 1.632-4.528), negative attitudes toward government measures were more hesitant to get vaccinated (OR: 2.576, 95% CI: 1.612-4.118). People who thought their physical condition was very good or good were more likely to be vaccinated than those who thought they were in fair or poor health (OR: 0.516, 95% CI: 0.288-0.925; OR: 0.513, 95% CI: 0.295-0.893). Young people inclined to use new media (such as WeChat and microblog) to obtain information, while the elderly inclined to use traditional methods (such as television). Government propaganda, residents' perception of the importance of vaccines and the risk of disease were the main reasons for accelerating residents to vaccinate. The main reasons affecting residents' lack of vaccination were contraindications to the vaccine or inconvenient time for vaccination. Conclusions: Vaccine hesitancy increased significantly with change in vaccination stage. Strategies should be adopted to increase vaccination coverage such as improving the convenience of vaccination, promoting through multiple channels.

Neuroradiological Basis of COVID-19 Olfactory Dysfunction: A Systematic Review and Meta-Analysis.

OBJECTIVE: Olfactory dysfunction (OD) is a common presenting symptom of COVID-19 infection. Radiological imaging of the olfactory structures in patients with COVID-19 and OD can potentially shed light on its pathogenesis, and guide clinicians in prognostication and intervention. METHODS: PubMed, Embase, Cochrane, SCOPUS were searched from inception to August 1, 2021. Three reviewers selected observational studies, case series, and case reports reporting radiological changes in the olfactory structures, detected on magnetic resonance imaging, computed tomography, or other imaging modalities, in patients aged ≥18 years with COVID-19 infection and OD, following preferred reporting items for systematic reviews and meta-analyses guidelines and a PROSPERO-registered protocol (CRD42021275211). We described the proportion of radiological outcomes, and used random-effects meta-analyses to pool the prevalence of olfactory cleft opacification, olfactory bulb signal abnormalities, and olfactory mucosa abnormalities in patients with and without COVID-19-associated OD. RESULTS: We included 7 case-control studies (N = 353), 11 case series (N = 154), and 12 case reports (N = 12). The pooled prevalence of olfactory cleft opacification in patients with COVID-19 infection and OD (63%, 95% CI = 0.38-0.82) was significantly higher than that in controls (4%, 95% CI = 0.01-0.13). Conversely, similar proportions of cases and controls demonstrated olfactory bulb signal abnormalities (88% and 94%) and olfactory mucosa abnormalities (2% and 0%). Descriptive analysis found that 55.6% and 43.5% of patients with COVID-19 infection and OD had morphological abnormalities of the olfactory bulb and olfactory nerve, respectively, while 60.0% had abnormal olfactory bulb volumes. CONCLUSION: Our findings implicate a conductive mechanism of OD, localized to the olfactory cleft, in approximately half of the affected COVID-19 patients. Laryngoscope, 132:1260-1274, 2022.

Dynamic Changes in the Immune Response Correlate with Disease Severity and Outcomes During Infection with SARS-CoV-2.

INTRODUCTION: The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread throughout China and worldwide. Little is known about the dynamic changes in the patient immune responses to SARS-CoV-2 and how different responses are correlated with disease severity and outcomes. METHODS: Seventy-four patients with confirmed COVID-19 were enrolled in this prospective research. The demographic information, medical history, symptoms, signs and laboratory results were analyzed and compared between severe and non-severe patients. The leukocytes, lymphocyte subsets and inflammatory cytokines were longitudinally collected. RESULTS: Of the 74 patients included, 17 suffered from severe disease. The severe patients tended be older (65.29 ± 12.33 years vs. 45.37 ± 18.66 years) and had a greater degree of underlying disease (41.18% vs. 24.56%), lower baseline lymphocyte counts [0.64 (0.46-0.95) × 109 vs. 1.27 (0.95-1.70) × 109], higher neutrophil-lymphocyte ratios [NLRs; 3.76 (3.15-5.51) vs. 2.07 (1.48-2.93)] and lower baseline eosinophil counts [0 (0-0.01) × 109 vs. 0.03 (0.01-0.06) × 109] than those in non-severe patients. The baseline helper T (Th) cells (335.47 vs. 666.46/µl), suppressor T(Ts) cells (158 vs. 334/µl), B cells (95 vs. 210/µl) and natural killer (NK) cells (52 vs. 122/µl) were significantly decreased in severe cases compared to that in non-severe cases. In addition, the baseline neutrophils were positively correlated with the severity of COVID-19, and the baseline lymphocytes were negatively correlated with the severity of COVID-19. The dynamic change of T cells, Th cells and IFN-γ in the severe cases were parallel to the amelioration of the disease. CONCLUSIONS: Collectively, our study provides novel information on the kinetics of the immune responses in a cohort of COVID-19 patients with different disease severities. Furthermore, our study indicates that both innate and adaptive immune responses correlate with better clinical outcomes.

Pandemic programming: How COVID-19 affects software developers and how their organizations can help.

CONTEXT: As a novel coronavirus swept the world in early 2020, thousands of software developers began working from home. Many did so on short notice, under difficult and stressful conditions. OBJECTIVE: This study investigates the effects of the pandemic on developers' wellbeing and productivity. METHOD: A questionnaire survey was created mainly from existing, validated scales and translated into 12 languages. The data was analyzed using non-parametric inferential statistics and structural equation modeling. RESULTS: The questionnaire received 2225 usable responses from 53 countries. Factor analysis supported the validity of the scales and the structural model achieved a good fit (CFI = 0.961, RMSEA = 0.051, SRMR = 0.067). Confirmatory results include: (1) the pandemic has had a negative effect on developers' wellbeing and productivity; (2) productivity and wellbeing are closely related; (3) disaster preparedness, fear related to the pandemic and home office ergonomics all affect wellbeing or productivity. Exploratory analysis suggests that: (1) women, parents and people with disabilities may be disproportionately affected; (2) different people need different kinds of support. CONCLUSIONS: To improve employee productivity, software companies should focus on maximizing employee wellbeing and improving the ergonomics of employees' home offices. Women, parents and disabled persons may require extra support.

Lymphopenia predicted illness severity and recovery in patients with COVID-19: A single-center, retrospective study.

The outbreak of SARS-CoV-2 began in December 2019 and rapidly became a pandemic. The present study investigated the significance of lymphopenia on disease severity. A total of 115 patients with confirmed COVID-19 from a tertiary hospital in Changsha, China, were enrolled. Clinical, laboratory, treatment and outcome data were gathered and compared between patients with and without lymphopenia. The median age was 42 years (1-75). Fifty-four patients (47.0%) of the 115 patients had lymphopenia on admission. More patients in the lymphopenia group had hypertension (30.8% vs. 10.0%, P = 0.006) and coronary heart disease (3.6% vs. 0%, P = 0.029) than in the nonlymphopenia group, and more patients with leukopenia (48.1% vs 14.8%, P<0.001) and eosinopenia (92.6% vs 54.1%, P<0.001) were observed. Lymphopenia was also correlated with severity grades of pneumonia (P<0.001) and C-reactive protein (CRP) level (P = 0.0014). Lymphopenia was associated with a prolonged duration of hospitalization (17.0 days vs. 14.0 days, P = 0.002). Lymphocyte recovery appeared the earliest, prior to CRP and chest radiographs, in severe cases, which suggests its predictive value for disease improvement. Our results demonstrated the clinical significance of lymphopenia for predicting the severity of and recovery from COVID-19, which emphasizes the need to dynamically monitor lymphocyte count.

SARS-CoV-2 clearance in COVID-19 patients with Novaferon treatment: A randomized, open-label, parallel-group trial.

BACKGROUND: The antiviral effects of Novaferon, a potent antiviral protein drug, on COVID-19 was evaluated in the laboratory, and in a randomized, open-label, parallel-group trial. METHODS: In the laboratory, Novaferon's inhibition of viral replication in cells infected with SARS-CoV-2, and prevention of SARS-CoV-2 entry into healthy cells was determined. Antiviral effects of Novaferon in COVID-19 patients with treatment of Novaferon, Novaferon plus Lopinavir/Ritonavir, or Lopinavir/Ritonavir were evaluated. The primary endpoint was the SARS-CoV-2 clearance rates on day six of treatment, and the secondary endpoint was the time to SARS-CoV-2 clearance. RESULTS: Novaferon inhibited viral replication (EC50=1.02ng/ml), and prevented viral infection (EC50=0.10ng/ml). Results from the 89 enrolled COVID-19 patients showed that both Novaferon and Novaferon plus Lopinavir/Ritonavir groups had significantly higher viral clearance rates on day six than Lopinavir/Ritonavir group (50.0% vs. 24.1%, p=0.0400, and 60.0% vs. 24.1%, p=0.0053). The median time to viral clearance was six days, six days, and nine days for three groups, respectively, a 3-day reduction in both the Novaferon and Novaferon plus Lopinavir/Ritonavir groups compared with the Lopinavir/Ritonavir group. CONCLUSIONS: Novaferon exhibited anti-SARS-CoV-2 effects in vitro and in COVID-19 patients. These data justify further evaluation of Novaferon. TRIAL REGISTRATION NUMBER: Number ChiCTR2000029496 at the Chinese Clinical Trial Registry (http://www.chictr.org.cn/).

Novel coronavirus infection in children outside of Wuhan, China.

BACKGROUND: Since December 8, 2019, an epidemic of coronavirus disease 2019 (COVID-19) has spread rapidly, but information about children with COVID-19 is limited. METHODS: This retrospective and the single-center study were done at the Public Health Clinic Center of Changsha, Hunan, China. We identified all hospitalized children diagnosed with COVID-19 between January 8, 2019 and February 19, 2020, in Changsha. Epidemiological and clinical data of these children were collected and analyzed. Outcomes were followed until February 26th, 2020. RESULTS: By February 19, 2020, nine pediatric patients were identified as having 2019-nCoV infection in Changsha. Six children had a family exposure and could provide the exact dates of close contact with someone who was confirmed to have 2019-nCoV infection, among whom the median incubation period was 7.5 days. The initial symptoms of the nine children were mild, including fever (3/9), diarrhea (2/9), cough (1/9), and sore throat (1/9), two had no symptoms. Two of the enrolled patients showed small ground-glass opacity of chest computed tomography scan. As of February 26, six patients had a negative RT-PCR for 2019-nCoV and were discharged. The median time from exposure to a negative RT-PCR was 14 days. CONCLUSIONS: The clinical symptoms of the new coronavirus infection in children were not typical and showed a less aggressive clinical course than teenage and adult patients. Children who have a familial clustering or have a family member with a definite diagnosis should be reported to ensure a timely diagnosis.