ABSTRACT
Background/study objective: The effect of the COVID-19 pandemic affected health care delivery, as it led to variable outcomes in different disease states including cardiovascular diseases. In this study, we evaluated the impact of coexisting COVID-19 on Acute Myocardial Infarction (AMI). Design/setting: We analyzed discharge records of AMI patients from the National Inpatient Sample (NIS) in the year 2020. Main outcome measures: Using propensity score matching, we assessed the impact of COVID-19 infection on the in-hospital outcomes of patients presenting with AMI. Results: There were 1154 patients with concomitant COVID-19 infection and AMI who were matched with 109,990 patients with AMI and without COVID-19. We found that patients with COVID-19 who had AMI were less likely to have dyslipidemia (64.6 % vs. 70.4 %, p < 0.001), peripheral vascular disease (2.4 % vs. 3.8 % p = 0.0017), smoking history (23.5 % vs. 28.2 % p < 0.0001) and hypertension (37.1 % vs. 40.1 % p = 0.004).COVID-19 was associated with higher hospital mortality rates (Adjusted odds ratio aOR: 2.72, CI: 2.23-3.30, p < 0.001), cardiac arrest (aOR: 1.65, 95 % CI: 1.26-2.15, p < 0.001), cardiogenic shock (aOR:1.36,95 % CI: 1.10-1.68, p = 0.004) and respiratory failure (aOR:1.81, 95 % CI: 1.55-2.11 p < 0.001) compared to AMI patients without COVID-19. There was also a significant association between coexisting COVID-19 and longer duration of hospital stay (Adjusted mean differences:1.40, 95 % CI: 1.31-1.59 p < 0.0001) in AMI patients. Conclusion: COVID-19 infection is associated with worse in-hospital mortality and cardiorespiratory complications in patients with AMI.
ABSTRACT
AR games such as Pokemon Go, Jurassic world Alive and other games encourage us to venture out in the real open world to also see the beauty of it. However, tourism has come almost to a virtual stop during the first year of the COVID-19 pandemic and recovery is slow. We present a tile-based experience-sharing PixoMap, which incorporates some aspects of smart tourism. For user requirements gathering, we first compare factors that make popular games such as Pokemon Go, Minecraft, and the Sims popular. Findings indicate that people enjoy collecting objects, such as monsters or cards, freedom and creativity, escape and sometimes nostalgia. Our PixoMap game allows players to virtually browse an area in the map, and choose a tile. Each tile contains memories (Memors)/experiences/stories. Users can read others' experiences and share their own experiences, play a minigame to earn in-game currency, to change his/her 2D avatar or change the tile's color or optionally, to own the tile. Alpha user feedback confirms and refines our design. Heuristic evaluation and user experience feedback at the end of the study, are positive and encouraging.
ABSTRACT
Introduction: Although there are several reports of COVID-19 in patients on peritoneal dialysis (PD), all of them were retrospective and mono-national-state designs, and none reported vaccination profiles. Method(s): The incidence of COVID-19 infection among PD patients and vaccination profiles of COVID-19 from 1 January 2020 to 30 September 2021 were retrieved from the survey of PD leaders in the ASEAN countries. Countries were excluded if their infection rates (IR) in PD populations were smaller than the lower limit value of 95% confidence interval (CI) of the overall pooled prevalence of 1.25 reported in kidney failure patients with COVID-19 infection globally, considering the possibility of under-reporting and if the number of PD population is less than 50 cases. Thus, Burma (45 cases, unknown IR), Cambodia (1 case, IR 0%), Indonesia (2,692 cases, unknown IR), Laos PDR (3 cases, IR 33%), and Vietnam (PD 1,500 cases, IR <1%) were excluded. Result(s): Figure 1 demonstrates the incidence of COVID-19 infection in PD populations in selected ASEAN members. The cumulative incidence of COVID-19 has gradually increased in all reported countries. The cumulative incidence rate of Singapore reached a plateau in the second quarter of 2020 but has since seen a surge in the third quarter of 2021 with an average incidence of 0.5-1.5 cases per 100 population. Overall IR ranged from 0.1% in Singapore to 23.8% in the Philippines with an average ASEAN IR of 2.6%. The majority of ASEAN had less than half of their populations fully vaccinated, ranging from only 13% in Vietnam to 46% in Brunei. Despite Laos being a low-income country, it was the first ASEAN to vaccinate its population. Singapore had the highest vaccination rates, with 83% and 81% of its population partially and completely vaccinated, respectively. Brunei, albeit being a high-income country, is the last country to roll out vaccination with a tardy vaccination rate, possibly due to the under-preparedness of the government and a false sense of security as Brunei had 15 months of zero cases before the latest wave. The incidence of ASEAN PD patients with COVID-19 infection surged during the second and third quartiles of 2021 despite the vaccine roll-out (Table 1). [Formula presented] Abbreviations: Ad26, Ad26.COV2.S;BBIBP, BBIBP-CorV;BNT, BNT162b2;Covishield, ChAdOx1 nCoV-19 (Covishield);Gam, Gam-COVID-Vac;mRNA, mRNA-1273;Vaxzeria, ChAdOx1 nCoV-19 (Vaxzeria) Remarks: Yellow, Conventional inactivated vaccines (BBIBP-CorV [Sinopharm], CoronaVac [Sinovac]);Green, RNA vaccines (BNT162b2 [Pfizer-BioNTech], mRNA-1273 [Moderna]);Pink, Viral vector vaccines (Gam-COVID-Vac [Sputnik], ChAdOx1 nCoV-19 [Covishield], ChAdOx1 nCoV-19 [Vaxzeria] and Ad26.COV2.S [Johnson & Johnson]) [Formula presented] Figure 1. Cumulative incidence of COVID-19 infected PD patients in selected ASEAN Conclusion(s): Overall IR of the ASEAN PD population varied widely among countries. However, the rollout rate of vaccination lagged behind that of western countries. This should increase efforts to educate their population on the benefits of timely vaccination. There remain a lot of uncertainties regarding COVID-19, and hence there is an urgent need for large prospective studies with international collaboration, to address these questions. No conflict of interestCopyright © 2023
ABSTRACT
AR games such as Pokemon Go, Jurassic World Alive and other games encourage us to venture out in the real open world to also see the beauty of it. However, tourism has come almost to a virtual stop during the first year of the COVID-19 pandemic and recovery is slow. We present a tile-based experience-sharing PixoMap, which incorporates some aspects of smart tourism. For user requirements gathering, we first compare factors that make popular games such as Pokemon Go, Minecraft, and the Sims popular. Findings indicate that people enjoy collecting objects, such as monsters or cards, freedom and creativity, escape and sometimes nostalgia. Our PixoMap game allows players to virtually browse an area in the map, and choose a tile. Each tile contains memories (Memors)/experiences/stories. Users can read others’ experiences and share their own experiences, play a minigame to earn in-game currency, to change his/her 2D avatar or change the tile’s color or optionally, to own the tile. Alpha user feedback confirms and refines our design. Heuristic evaluation and user experience feedback at the end of the study, are positive and encouraging. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
Aims: Survival of people with advanced colorectal cancer (CRC) can be prolonged through treatment pathways including cytoreductive surgery and hypothermic intraperitoneal chemotherapy (CRS-HIPEC), pelvic exenteration, liver resection, and palliative chemotherapy without surgery. Virtually no qualitative research has compared the experiences and needs of advanced CRC survivors who receive these treatments. This study aims to fill this gap. Methods : Adult survivors of CRC who have undergone the aforementioned treatments are being recruited 0.5-2 years post-surgery or, for palliative chemotherapy participants, 0.5-2 years post-diagnosis of advanced CRC. Recruitment will continue until approximately N = 40 or data saturation is reached. Quantitative data include: demographic and clinical data, Functional Assessment of Cancer Therapy - Colorectal (FACT-C), Distress Thermometer, and Comprehensive Score for Financial Toxicity (COST). Quantitative data will undergo descriptive analysis to characterise the sample. All participants will participate in a qualitative semi-structured telephone interview exploring quality of life, employment, finances, stigma, supportive care needs, social functioning, perceptions of survivorship, and impacts of COVID-19. Interviews are analysed via the framework approach of thematic analysis. Results : Preliminary analysis of 36 interviews (n = 10 CRS-HIPEC, n = 10 pelvic exenteration, n = 9 liver resection, n = 7 palliative chemotherapy) reveals some advanced CRC survivors report post-surgical complications and chemotherapy-induced peripheral neuropathy, which can limit physical activity. CRC impacted some participants' psychosocial well-being ability to work, and sense of identity. Participants reportedly manage these impacts through distraction, positive reframing, and contact with other CRC survivors. Most participants appeared satisfied with their cancer treatment teams. Some viewed GPs as important healthcare coordinators. COVID-19 made some participants more cautious when leaving the house. Telehealth was considered less personal, but convenient. Conclusions : The study's findings will help guide development of interventions to improve the survivorship experience of patients who receive treatment for advanced CRC. This may include an information booklet, patient-reported outcome measure, clinical pathway, or targeted intervention.
ABSTRACT
The critical need for surveillance of SARS-CoV-2 variants of concern has prompted the development of methods that can track variants in wastewater. Here, we develop and present an open-source method based on allele-specific RT-qPCR (AS RT-qPCR) that detects and quantifies the B.1.1.7 variant, targeting spike protein mutations at three independent genomic loci that are highly predictive of B.1.1.7 (HV69/70del, Y144del, and A570D). Our assays can reliably detect and quantify low levels of B.1.1.7 with low cross-reactivity, and at variant proportions down to 1% in a background of mixed SARS-CoV-2. Applying our method to wastewater samples from the United States, we track the occurrence of B.1.1.7 over time in 19 communities. AS RT-qPCR results align with clinical trends, and summation of B.1.1.7 and wild-type sequences quantified by our assays matches SARS-CoV-2 levels indicated by the U.S. CDC N1 and N2 assays. This work paves the way for AS RT-qPCR as a method for rapid inexpensive surveillance of SARS-CoV-2 variants in wastewater. © 2021 The Authors. Published by American Chemical Society.