Finding the needle in a haystack: Extraction of Informative COVID-19 Danish Tweets

Finding informative COVID-19 posts in a stream of tweets is very useful to monitor health-related updates. Prior work focused on a balanced data setup and on English, but informative tweets are rare, and English is only one of the many languages spoken in the world. In this work, we introduce a new dataset of 5,000 tweets for finding informative COVID-19 tweets for Danish. In contrast to prior work, which balances the label distribution, we model the problem by keeping its natural distribution. We examine how well a simple probabilistic model and a convolutional neural network (CNN) perform on this task. We find a weighted CNN to work well but it is sensitive to embedding and hyperparameter choices. We hope the contributed dataset is a starting point for further work in this direction. © 2021 Association for Computational Linguistics.

Retrograde cerebral air embolism in a patient on venovenous ECMO

INTRODUCTION: Retrograde cerebral air embolism (CAE) is rarely described in literature that may be associated with manipulation of central or peripheral venous catheters. During a literature review, there were no described occurrences of CAE in patients on veno-venous (V-V) ECMO. DESCRIPTION: A 42-year-old male with ARDS secondary to COVID-19 pneumonitis was cannulated for V-V ECMO outside our facility and transferred to our cardiovascular intensive care unit. Upon arrival, he was noted to have a right femoral drainage cannula and right internal jugular (RIJ) venous antegrade cannula. On day 10 of his hospital stay he was converted to a RIJ Protek duo cannula and the right femoral drainage cannula was removed. This cannula was repositioned multiple times after placement due to flow issues. Due to poor oxygenator membrane function, it became necessary to exchange the oxygenator on day 25. During the exchange, the patient experienced sudden-onset bradycardia that progressed to several seconds of asystole. He regained spontaneous cardiac activity after a bolus dose of IV glycopyrrolate. Following this, he had several episodes of bradycardia and eventually asystole that resolved after one round of ACLS and IV atropine. The bradycardic episodes continued after this event and were associated with hypertension. On day 25, the patient suffered a decline in neurologic status from a GCS of 11T to 3T. The patient was sent emergently for non-contrast CT head. This scan revealed pneumocephalus with diffuse foci of air emboli in the subarachnoid and intraventricular spaces, the choroid plexus, and dural venous sinuses. After a family discussion, care was withdrawn from the patient on day 27. DISCUSSION: This patient suffered a massive retrograde CAE peri-ECMO circuit oxygenator exchange. It is our understanding that this a novel clinical situation for this phenomenon and not previously described in literature. This emphasizes that manipulation of any vascular cannula may result in the entrainment of air in a retrograde venous fashion into the cerebral vasculature.

Increasing left anterior descending artery size is associated with worsening myocardial function in the setting of multisystem inflammatory syndrome in children

Background: Multisystem inflammatory syndrome in children (MIS-C) is a hyperinflammatory syndrome after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Cardiovascular complications include left ventricular dysfunction and coronary artery abnormalities (CAA). Little is known, however, about the interaction between LV function and CAA. We aimed to assess the hypothesis that increased coronary artery size is inversely correlated with LV function utilizing left ventricular ejection fraction (LVEF) and indices of myocardial work. Methods: Two-dimensional and speckle-tracking echocardiograms were performed in 34 MIS-C patients at admission. Biplane LVEF and coronary artery Z scores were measured, and pressurestrain loops were used to calculate indices of myocardial work: global work index (GWI), global work efficiency (GWE), global wasted work (GWW), global constructive work (GCW), and global longitudinal strain (GS). Treating coronary artery Z-scores as a continuous variable, correlation analysis was performed. Results: LVEF and left anterior descending artery (LAD) Z-scores were inversely correlated (Spearman coefficient of -0.47;P=0.005). Both GWI and GCW demonstrated an inverse relationship with increasing LAD Z-scores, but both were not statistically significant (Spearman coefficient -0.21;P=0.239 and Spearman coefficient -0.21;P=0.235). GS also exhibited a trend of worsening (less negative scores) with increasing LAD Z-scores but was not statistically significant (Spearman coefficient 0.29;P=0.095). GWE and GWW did not correlate with any coronary artery Z-scores and left main coronary or right coronary artery Z-scores did not correlate with any markers of function. Conclusion: Increasing LAD Z-score showed a statistically significant association with decreased LVEF. Additionally, while not statistically significant, GWI, GCW, and GS all demonstrated a trend of decreased indices of myocardial work as LAD Z-score increases. In conclusion, this data suggests that patients with higher coronary artery Z-scores at admission are at increased risk of myocardial dysfunction.