CoRe study: COVID-19 and remdesivir: An insight into the current health planning and policy.

Introduction: The ongoing coronavirus disease-2019 (COVID-19) pandemic has witnessed rampant use of the repurposed drug, remdesivir, despite its conflicting evidence and rapidly changing guidelines. Methods: A cross-sectional, country-wide, questionnaire-based, electronic survey was conducted among the healthcare professionals involved in COVID-19 management from April 18 to May 18, 2021. Results: Out of 231 responses, 185 were included. Significantly, greater knowledge of trials was reported by the frontline healthcare professionals compared to those who are not involved in COVID-19 care. Medicine practitioners and pulmonologists expressed greater willingness to continue remdesivir (Odds ratio (OR) 5.329, 95% Confidence interval (CI) 2.31-12.291 and 5.063, 95% CI 1.414-18.129, respectively). The rationale attributed was personal experience, current guidelines, non-availability of any alternate antiviral drug, expert recommendations, and local hospital policy either alone (20%, 8.1%, 5.9%, 2.7%, and 2.2%, respectively) or in combination (46.5%, 39.5%, 29.2%, 21.1%, and 15.7%, respectively). Awareness of evidence and knowledge of landmark studies made no statistically significant impact on clinical decision-making. Improved clinical outcomes were reported by 10/22 (45.4%) practitioners who used remdesivir for unconventional indications. Conclusion: The study throws critical insights into the current perspectives of doctors on remdesivir in clinical management and its potential impact on current health planning strategies.

Detection of the power lines in UAV remote sensed images using spectral-spatial methods.

In this paper, detection of the power lines on images acquired by Unmanned Aerial Vehicle (UAV) based remote sensing is carried out using spectral-spatial methods. Spectral clustering was performed using Kmeans and Expectation Maximization (EM) algorithm to classify the pixels into the power lines and non-power lines. The spectral clustering methods used in this study are parametric in nature, to automate the number of clusters Davies-Bouldin index (DBI) is used. The UAV remote sensed image is clustered into the number of clusters determined by DBI. The k clustered image is merged into 2 clusters (power lines and non-power lines). Further, spatial segmentation was performed using morphological and geometric operations, to eliminate the non-power line regions. In this study, UAV images acquired at different altitudes and angles were analyzed to validate the robustness of the proposed method. It was observed that the EM with spatial segmentation (EM-Seg) performed better than the Kmeans with spatial segmentation (Kmeans-Seg) on most of the UAV images.

Maternal passive smoking and its effect on maternal, neonatal and placental parameters.

A study was undertaken to 1) determine the effects of tobacco smoke exposure on maternal and neonatal weight and body mass index (BMI) and placental weight, volume and surface area and 2) establish any correlations between the placental surface area, volume and weight with maternal and neonatal body weight and BMI in mothers exposed to cigarette smoke. A total of 154 full-term placentae, 65 from mothers exposed to tobacco smoke and 89 from non-exposed mothers were collected from Kuala Lumpur Maternity Hospital. The placental surface area was determined using a stereological grid, the volume by Scherle's method and the weight by using an electronic weighing machine. In general there were no differences in maternal, placental and neonatal parameters between the exposed and non-exposed groups. However, there were significant correlations between placental weight with maternal weight and maternal BMI in both exposed (r = 0.315; p = 0.013) and (r = 0.265; p = 0.038), and non-exposed (r = 0.224; p = 0.035) and (r = 0.241; p = 0.023) mothers. It was also found that the maternal weight on admission correlated significantly with placental weight in both Malay (r = 0.405; p = 0.020) and Indian (r = 0.553; p = 0.050) passive smokers. Correcting the placental parameters for the maternal weight had no effect on the results.

Weight, volume and surface area of placenta of normal pregnant women and their relation to maternal and neonatal parameters in Malay, Chinese and Indian ethnic groups.

This study was conducted to determine the effect of ethnicity on maternal, placental and neonatal parameters. Maternal, placental, and the newborn parameters were corrected for gestational age. The male:female sex ratio was 1:1.03. One hundred and forty-four freshly delivered placentae from 55 Malaysian, 51 Chinese, and 38 Indian normal healthy patients were collected and standard stereological methods used to estimate the placental parameters. Pearson's correlation, Spearman's correlation and 1-way ANOVA were used to test significance of differences. Placental surface area, placental weight and placental volume of Indians were lower than Malays (P< 0.05). Placental weight correlated significantly with neonatal length (r=0.527), birthweight (r=0.665), head circumference (r=0.371) and booking weight (r=0.193) while placental volume correlated with neonatal length (r=0.588), birthweight (r=0.688), head circumference (r=0.384), parity (r=0.202) and booking weight (r=0.219) at P< 0.05. Indian babies weight and length were less than Chinese and Malay babies (P< 0.05) while booking weight of Indian mothers was less than those of Chinese mothers (P< 0.05). Even after being corrected for booking weight, placental parameters of Indian patients were still significantly less than Malays and Chinese (P< 0.05).