A Novel Framework to Forecast COVID-19 Incidence Based on Google Trends Search Data

The global outbreak of coronavirus disease 2019 (COVID-19) has spread to more than 200 countries worldwide, leading to severe health and socioeconomic consequences. As such, the topic of monitoring and predicting epidemics has been attracting a lot of interest. Previous work reported search volumes from Google Trends are beneficial in decoding influenza dynamics, implying its potential for COVID-19 prediction. Therefore, a predictive model using the Wiener methods was built based on epidemic-related search queries from Google Trends, along with climate variables, aiming to forecast the dynamics of the weekly COVID-19 incidence in Washington, DC, USA. The Wiener model, which shares the merits of interpretability, low computation costs, and adaptation to nonlinear fluctuations, was used in this study. Models with multiple sets of features were constructed and further optimized by the highest weight selecting strategy. Furthermore, comparisons to the other two commonly used prediction models based on the autoregressive integrated moving average (ARIMA) and long short-term memory (LSTM) were also performed. Our results showed the predicted COVID-19 trends significantly correlated with the actual (rho <inline-formula> <tex-math notation="LaTeX">$=$</tex-math> </inline-formula> 0.88, <inline-formula> <tex-math notation="LaTeX">$p $</tex-math> </inline-formula> <inline-formula> <tex-math notation="LaTeX">$<$</tex-math> </inline-formula> 0.0001), outperforming those with ARIMA and LSTM approaches, indicating Google Trends data as a useful tool in terms of COVID-19 prediction. Also, the model using 20 search queries with the highest weighting outperformed all other models, supporting the highest weight feature selection as a feasible criterion. Google Trends search query data can be used to forecast the outbreak of COVID-19, which might assist health policymakers to allocate health care resources and taking preventive strategies. IEEE

Psychological Impacts of COVID-19 Pandemic

Thousands of millions of people faced devastating impacts around the world during COVID-19 pandemic. Not only anxiety or fear of COVID-19 dominated the negative psychological impacts, mental disorders such as depression, posttraumatic stress disorder, and sleep disturbance increasingly appeared during or after the pandemic. Apart from the confirmed patients, survivors of the viral infection, close family members, elders, children and adolescents, people quarantined, people with preexisting psychiatric conditions, frontline police, emergency medical services, and health-care workers, mental distress specific to the vulnerable groups should be recognized. Preventive strategies including self-regulations, leadership, and teamwork were highlighted. Specific evaluations for at-risk population and efficacious treatment such as cognitive behavioral treatment could be considered. This article delineated directions for mental health workers during pandemic.Copyright © 2023 Wolters Kluwer Medknow Publications. All rights reserved.

Recycling Test Methods to Improve Test Capacity and Increase Chip Shipments

In this research, we quantified semiconductor fabrication capability parameters and test capability parameters and used a digital integrated circuit test model (DITM) to discuss the impact of the test guardband (TGB) on test yield. Furthermore, the DITM can be used to estimate the yield distribution trend of future semiconductor products using data from the IEEE International Roadmap for Devices and Systems (IRDS) 2021 Table. With the COVID-19 pandemic, the global semiconductor industry is facing chip and material shortages. Furthermore, test technology lags behind semiconductor manufacturing technology, and the test yield of production capacity is deteriorating, seriously affecting the entire semiconductor supply chain. Therefore, we proposed the recycling test method, extending the test time, moving TGB, and repeatedly looking for reliable products. These parameters were calculated using the estimated product parameters released by the IRDS 2021. We proved that the proposed recycling test method could improve the high-yield target of semiconductor testing. As long as test methods are used properly, not only can high-yield shipments be made, but also companies’overall profit will be significantly improved, and the problem of chip shortages will be solved. IEEE

Temporal changes in coagulation, endothelial dysfunction and fibrinolysis biomarkers are associated with illness severity in patients with COVID-19: Canadian COVID-19 Prospective Cohort Study (CanCOV)

Background: The mechanisms by which COVID-19 results in severe illness in some individuals remains poorly defined. Identification of biomarkers associated with disease severity could be useful in defining the mechanisms of COVID-19 pathology and predicting disease course. Aim(s): Identify trajectories of biomarkers of coagulation, endothelial dysfunction, and fibrinolysis that are associated with COVID-19 severity. Method(s): Longitudinal plasma samples were collected from 99 patients in the Canadian COVID-19 Prospective Cohort Study (CanCOV) (23 outpatients, 31 ward patients, and 45 intensive care unit (ICU) patients). Plasma was quantified using 1) ELISAs for plasminogen, soluble thrombomodulin (sTM), plasminogen activator inhibitor-1 (PAI-1), alpha2-antiplasmin, D-dimer, thrombin-activatable fibrinolysis inhibitor (TAFI), and fibrinogen, and 2) in-house functional assays for clot lysis times and activated TAFI (TAFIa) levels. Biomarker values were log-transformed and linear mixed effects models were used to compare trajectories in ICU and ward patients compared to outpatients from date of symptom onset. Result(s): Among the 45 ICU patients, 24 (53%) died. There were no deaths in the other patient groups. D-dimer (Fig 1A) and sTM (Fig 1B) were significantly elevated for both hospitalized and ICU cohorts when compared with outpatients. PAI-1 (Fig 1C) was significantly elevated only in the ICU group between days 1 and 40. Plasminogen (Fig 1D) significantly decreased only in the ICU group from day 25 onwards. TAFIa (Fig 1E) increased over time only in the ICU cohort, with the levels being significant from day 35. Fibrinogen (Fig 1F) displayed similar trends as plasminogen whereby only the ICU was significantly decreased from day 25. alpha2-antiplasmin, TAFI, and clot lysis times were not significantly different compared to COVID-19 outpatients Conclusion(s): D-dimer and sTM showed the strongest associations with moderate and severe COVID-19 compared to mild disease. PAI-1, plasminogen, TAFIa, and fibrinogen may additionally be useful in identifying patients who become critically ill.

The COVID-19 pandemic through the lens of four tech workers Walk a Mile in Their Shoes

ON MARCH 11, 2020, the World Health Organization officially declared COVID-19 a global pandemic. What followed was one of the most tumultuous times in recent history, filled with uncertainties about almost every aspect of daily life-including the workplace. Specifically, major tech companies shifted their operations from an office-based model to work from home (WFH) within a matter of weeks. Twitter mandated work from home on March 3, Microsoft and Facebook made similar announcements on March 4 and 6, respectively, and much of the world followed soon after. At the time, most people expected about a two-week outbreak. A few weeks turned into months, and at the time of this writing, 20 months after the initial WFH directive hit tech workers, we are still writing this article from our basements. Tech workers were at an advantage working from home since much of their job happens on computers, and collaboration can often be done over the Internet. That said, this was still a major change for software development companies, and it took time

Anesthetic Considerations for Chiari I Malformation in a BMI 62 Patient

Patients with Chiari I malformations present with tonsillar herniation below the foramen magnum causing abnormal spinal anatomy. Anesthesia challenges in this population include difficult airway management, monitoring intraoperative autonomic dysfunction, avoiding increased intracranial pressure, and accommodating sensitivity to neuromuscular blockade. We present a case with an additional airway management challenge due to morbid obesity with a BMI of 62. A 23 year old female with a history of Covid pneumonia and morbid obesity who presented with syringomyelia and Chiari I malformation. She initially presented with bilateral numbness, tingling, weakness, and pain in her hands. Imaging with MRI at the time showed downward displacement of the cerebellar tonsils with the tips reaching the lower portion of C1 and overall 10-12 mm displacement below the level of the foramen magnum. Syrinx was also visualized from the level of C1-C2 extending down to the level of T5-T6. Repeat MRI a year later showed no significant changes. However, she has worsening symptoms of pain in her right arm preventing her from working. She is agreeable to surgical decompression of the posterior fossa through a suboccipital craniotomy with resection of the posterior arch of C1 with duraplasty. Significant findings on the physical exam include Mallampati III, shorter thyromental distance, and limited range of motion of her cervical spine due to pain in her arms. We chose awake fiberoptic intubation due to difficult airway from morbid obesity and limited cervical spine range of motion and the consideration of hypercapnia induced from brief apnea the patient may not tolerate. She was premedicated with versed, glycopyrrolate, and dexmedetomidine, and given a 5% lidocaine paste lollipop to topicalize oropharynx. She was also started on a low dose remifentanil infusion for sedation during the awake fiberoptic approach. Blood pressure, heart rate, respiratory rate with continuous end-tidal capnography, and pulse oximetry were monitored during the awake fiberoptic intubation. A 7.0 endotracheal tube was lubricated with viscous lidocaine and placed over a fiberoptic scope. Once there was visualization of the vocal cords, additional 2% lidocaine was administered directly at the vocal cords. She was intubated smoothly on the first attempt. She was then immediately induced to general anesthesia with propofol and non-depolarizing muscle relaxant to avoid using succinylcholine due to the possible hypersensitivity caused by denervation. Intraoperatively, a conventional air warmer was used to prevent hypothermia. Invasive arterial blood pressure monitoring was applied. Normotensive blood pressure and normocapnia were maintained throughout the surgery. Muscular blockade was reversed with sugammadex at the end of surgery to ensure adequate ventilation especially with the patient's body habitus. Upon extubation, the patient had acute hypertension which was managed by nicardipine infusion and hydralazine boluses. Patient was taken to a neurosurgical intensive unit and monitored for two days. She was discharged home without any complication. In conclusion, anesthetic considerations for patients with Chiari I malformation include airway management, monitoring for autonomic dysfunction, avoiding increase in ICP, and optimizing postoperative neurological status with balanced anesthetic management.

Should COVID-Positive Pregnant Patients with Thrombocytosis get Prophylactic Anticoagulation for Stroke in Labor?

Clinical manifestation of coronavirus (COVID-19) is known to be associated with a hypercoagulable state and has a correlation of stroke as observed during the COVID pandemic. Pregnancy augments physiologic estrogenic effects on coagulation, making pregnant patients hypercoagulable. Management of hypercoagulability includes anticoagulation, which poses a contraindication to neuraxial anesthesia based on current guidelines. Management of primary labor anesthesia modality in patients with thrombocytosis can be challenging, particularly when presented with concurrent COVID infection. There is no guideline on the administration of anti-coagulation in this populace. The risk-benefit stratification of neuraxial anesthesia versus general anesthesia needs to be reviewed in such a patient population. We present a case of a parturient in labor who had thrombocytosis with a platelet of 576, COVID infection, and received therapeutic anticoagulation based on an automatic EMR best practices protocol. In this report, we examine literature surrounding the intersection of COVID, pregnancy, thrombocytosis and neuraxial anesthesia with respect to coagulation status to better guide anesthetic management in patients.

Telemedicine utilization and patient satisfaction in an ambulatory movement disorders clinic during COVID-19

Objective: To compare patient satisfaction parameters with telehealth vs. in-person visits and trend telehealth utilization during the COVID-19 pandemic in the setting of an outpatient movement disorders clinic. Background: Preliminary studies suggest that patients are satisfied with telehealth in ambulatory settings during COVID-19. However, existing adult tele-neurology satisfaction data are limited by small sample size and exclusion of new patient encounters. Design/Methods: In this prospective observational cohort study, patients ≥18 years who completed an appointment at Northwestern's movement disorders clinic were invited to complete a post-encounter Medallia survey. The primary outcomes of the survey were likelihood to recommend (LTR) provider, LTR location, and 'spent enough time,' on a 0-10 scale. Responses were categorized into in-person vs. telehealth groups. Results: 621 patients responded to the Medallia survey (response rate = 30%), of which 365 had in-person encounters and 256 had telehealth. The two groups did not differ significantly in age and gender, however the percentage of new patient encounters was significantly higher with in-person visits compared to telehealth visits (25.2% vs. 4.7%;p-value < 0.001). No significant primary outcome differences were observed between in-person and telehealth encounters in LTR provider (p=0.892), LTR location (p=0.659), and time spent (p=0.395). Additional subgroup multivariable analysis did not support differences among age or gender. There was minimal utilization of telehealth prior to COVID-19 (0.3% vs. 39.5%, p-value < 0.001). Conclusions: With its large sample size, our study demonstrates that the utilization of telemedicine has increased dramatically in our movement disorders clinic during the coronavirus pandemic and patients report similar degrees of satisfaction with telehealth encounters compared to in-person encounters. Although limited by volunteer bias, our study supports the utility of telehealth in an ambulatory movement disorder setting. Further research is needed to compare the effectiveness of telehealth versus in-person encounters in other ambulatory neurology settings and using objective outcome measures.

Development of Ultrapure and Potent Tannic Acids as a Pan-coronal Antiviral Therapeutic

The rampageous transmission of SARS-CoV-2 has been devastatingly impacting human life and public health since late 2019. The waves of pandemic events caused by distinct coronaviruses at present and over the past decades have prompted the need to develop broad-spectrum antiviral drugs against them. In this study, our Pentarlandir ultrapure and potent tannic acids (UPPTA) showed activities against two coronaviral strains, SARSCoV-2 and HCoV-OC43, the earliest-known coronaviruses. The mode of inhibition of Pentarlandir UPPTA is likely to act on 3-chymotrypsin-like protease (3CLpro) to prevent viral replication, as supported by results of biochemical analysis, a 3CLpro assay, and a "gain-of-function" 3CLpro overexpressed cell-based method. Even in the 3CLpro overexpressed environment, Pentarlandir UPPTA remained its antiviral characteristic. Utilizing cell-based virucidal and cytotoxicity assays, the 50% effective concentrations (EC50) and 50% cytotoxicity concentration (CC50) of Pentarlandir UPPTA were determined to be similar to 0.5 and 52.5 mu M against SARS-CoV-2, while they were 1.3 and 205.9 mu M against HCoV-OC43, respectively. In the pharmacokinetic studies, Pentarlandir UPPTA was distributable at a high level to the lung tissue with no accumulation in the body, although the distribution was affected by the food effect. With further investigation in toxicology, Pentarlandir UPPTA demonstrated an overall safe toxicology profile. Taking these findings together, Pentarlandir UPPTA is considered to be a safe and efficacious pancoronal antiviral drug candidate that has been advanced to clinical development.

A Collaborative Framework for Customized E-Learning Services by Analytic Hierarchy Processing

Thanks to the drastic proliferation of the Internet, e-learning has been recognized as an effective medium for various kinds of aggressive learners. However, due to the deficiencies of tutoring and guiding functionalities in current learning platforms, casual learners may deviate from the original course direction with frustration, when confronting inflexible course materials and fixed learning models. In the post-COVID-19 era, we believe that the most important functionality for a personal learning environment (PLE) to offer is a course recommendation process which adaptively provides a versatile course combination scheme for different learners from different perspectives. In this paper, we propose a flexible framework for users to customize their e-learning environment based on a two-stage Analytical Hierarchical Processing (AHP) structure for building adaptive course portfolios, which adaptively provides a versatile course scheme for different learners. The main objective of our framework is to transform a learner from a role of passively accepting the course content organized by instructors, into another role of proactively selecting the courses and contributing their knowledge to continuously improve the learning platform. We believe the approach proposed is a versatile way for supporting various challenges for the next generation of personal e-learning environment. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

The COVID-19 Pandemic and Emerging Cultural Assets

In an attempt to name challenges and envision possibilities facing educators during the COVID-19 pandemic, this article asks, what are examples of culturally relevant pedagogy emergent from forced distance-learning that promote and foster students' cultural assets? The authors present a model for identifying cultural assets and reflect upon and share three examples from their teaching at the onset of the pandemic: (1) The Corona Chronicles, a showcase of personal editorials created by fourth graders, (2) QuaranTeen, a podcast created by eleventh graders to explore and learn from one another amidst distance learning, and (3) Ecological Asset-Mapping, a pedagogical tool for pre-service teachers to reflect upon their own-and learn from their K-12 students'-cultural assets. These pedagogical examples are portrayed and discussed in ways to foster student, family, and community cultural assets as foundations of meaningful learning.

Biomarkers of coagulation, endothelial function and fibrinolysis in criticallyill patients with COVID-19: A single centre prospective longitudinal study

Background: Immunothrombosis and coagulopathy in the lung microvasculature may lead to lung injury and disease progression in COVID-19. We aim to identify biomarkers of coagulation, endothelial function, and fibrinolysis that are associated with disease severity and may have prognostic potential. Aims: To identify biomarkers of coagulation, inflammation, and fibrinolysis that may predict clinical course and outcome of COVID-19 patients. Methods: We performed a single-center prospective study of 14 adult COVID-19(+) ICU patients who were age and sex-matched to 14 COVID-19(-) ICU patients, and healthy controls. Daily blood draws, clinical data, and patient characteristics were collected. Ten biomarkers of interest were subjected to linear discriminant analysis (LDA) to explore the discriminatory ability of biomarkers for COVID-19 status. Linear repeated measures mixed models were used to screen biomarkers for associations with mortality. Selected biomarkers were further explored and entered into an unsupervised longitudinal clustering machine learning algorithm to identify trends and targets that may be used for future predictive modelling efforts. Results: LDA identified high D-dimer as the strongest contributor in distinguishing COVID-19 status however D-dimer was not associated with survival. Variable selection identified clot lysis time, and antigen levels of soluble thrombomodulin (sTM), plasminogen activator inhibitor-1 (PAI-1), and plasminogen as biomarkers associated with death. Longitudinal multivariate k-means clustering on these biomarkers alone identified two clusters of COVID-19(+) patients -low (30%) and high (100%) mortality groups (Figure 1). Biomarker trajectories that characterized the high mortality cluster were higher clot lysis times (inhibited fibrinolysis), higher sTM and PAI-1 levels, and lower plasminogen levels. Conclusions: Longitudinal trajectories of clot lysis time, sTM, PAI-1, and plasminogen may have predictive ability for mortality in COVID-19.

Immunothrombosis biomarkers for distinguishing COVID-19 patients from non-COVID septic pneumonia patients andfor predicting ICU mortality

Background : COVID-19 infection is characterized by immunothrombosis that likely reflects hypercoagulation, endothelial dysfunction, and increased formation of neutrophil extracellular traps. Aims : In this study, we investigated the utility of immunothrombosis biomarkers to distinguish between COVID-19 patients and non-COVID septic pneumonia patients. We also investigated the prognostic utility of the biomarkers in predicting ICU mortality in the two patients groups. Methods : The participants in this study were ICU COVID-19 patients ( n = 14), ICU non-COVID septic pneumonia patients ( n = 19), and age-and sex-matched healthy controls ( n = 14). Blood samples were collected on Days 4, 7, 10, and/or 14. We measured plasma levels of the following biomarkers: thrombin-antithrombin (TAT) complexes, protein C, antithrombin, soluble TM, soluble EPCR, fibrinogen, D-dimer, cell-free DNA (cfDNA), and citrullinated histones (H3-Cit). Data analysis was based on binomial logit models and receiver operating characteristic curve analyses. Results : We identified 8 biomarkers that distinguish COVID-19 patients from healthy individuals: cfDNA, D-dimer, sEPCR, PC, sTM, fibrinogen, H3-Cit, and TAT complexes. In comparison, 4 biomarkers distinguish COVID-19 from non-COVID septic pneumonia patients: fibrinogen, sEPCR, antithrombin, and cfDNA. With respect to prognosis, the main predictors of ICU mortality differ between the two patient groups. In COVID-19 patients, non-survivors have higher sTM and H3-Cit compared with survivors. In septic pneumonia patients, non-survivor patients have lower levels of protein C and higher cfDNA levels compared with survivors. In addition, the most recent values of the biomarkers have stronger prognostic value compared to their Day 1 values. Conclusions : Our results suggest that fibrinogen, sEPCR, antithrombin, and cfDNA have utility for distinguishing COVID-19 patients from non-COVID septic pneumonia patients. Our data also suggest that the predictors of ICU mortality differ between the two patient groups: sTM and H3-Cit for COVID-19 patients, and protein C and cfDNA for non-COVID septic pneumonia patients. These findings suggests that there are pathophysiological differences between the two patients groups.