Accuracy of the Traditional COVID-19 Phone Triaging System and Phone Triage-Driven Deep Learning Model.

OBJECTIVES: During the COVID-19 pandemic, a quick and reliable phone-triage system is critical for early care and efficient distribution of hospital resources. The study aimed to assess the accuracy of the traditional phone-triage system and phone triage-driven deep learning model in the prediction of positive COVID-19 patients. SETTING: This is a retrospective study conducted at the family medicine department, Cairo University. METHODS: The study included a dataset of 943 suspected COVID-19 patients from the phone triage during the first wave of the pandemic. The accuracy of the phone triaging system was assessed. PCR-dependent and phone triage-driven deep learning model for automated classifications of natural human responses was conducted. RESULTS: Based on the RT-PCR results, we found that myalgia, fever, and contact with a case with respiratory symptoms had the highest sensitivity among the symptoms/ risk factors that were asked during the phone calls (86.3%, 77.5%, and 75.1%, respectively). While immunodeficiency, smoking, and loss of smell or taste had the highest specificity (96.9%, 83.6%, and 74.0%, respectively). The positive predictive value (PPV) of phone triage was 48.4%. The classification accuracy achieved by the deep learning model was 66%, while the PPV was 70.5%. CONCLUSION: Phone triage and deep learning models are feasible and convenient tools for screening COVID-19 patients. Using the deep learning models for symptoms screening will help to provide the proper medical care as early as possible for those at a higher risk of developing severe illness paving the way for a more efficient allocation of the scanty health resources.

An Adapted Online Family Medicine Training for House Officers Amid Covid-19 Pandemic in Egypt.

INTRODUCTION: The COVID-19 pandemic is an unprecedented challenge to house officers training programs because of the safety measures. OBJECTIVE: This current study aimed to introduce the adaptation of family medicine training for house officers during COVID-19 pandemic and gauge their level of satisfaction with the training. METHODS: Unfortunately, more than one-fourth of the house officers attending the family medicine training turned out to be hospital-admitted or in obligatory home isolation. A time-sensitive plan was proposed to maintain a competent training guaranteeing safety and support of house officers and fulfilling the training objectives in a virtual setting. Three mentors were assigned to each 10 house officers to provide continuous support and monitoring. Tutor and house officer interaction and reflection were maintained through a virtual clinical training session via Zoom application and a daily online discussion of a clinical scenario. Peer interaction was provided through post-webinar and small-group online discussion sessions. RESULTS: The adapted training was applied on thirteen cohorts of house officers. The response rate was 70% (666 out of 950). Most of them were satisfied with the training (84.6%). Their satisfaction with each modality of the training was encouraging. CONCLUSIONS: During COVID-19 pandemic, successful adaptation of family medicine training has succeeded in fulfilling the training objectives and providing psychological support and engagement for house officers without burdening the hospital-admitted and home-isolated house officers.

Differentiation of Bone Marrow: Derived Mesenchymal Stem Cells into Hepatocyte-like Cells.

Cirrhosis is the end-stage liver fibrosis, whereby normal liver architecture is disrupted by fibrotic bands, parenchymal nodules and vascular distortion. Portal hypertension and hepatocyte dysfunction are the end results and give rise to major systemic complications and premature death. Mesenchymal stem cells (MSC) have the capacity of self-renew and to give rise to cells of various lineages, so MSC can be isolated from bone marrow (BM) and induced to differentiate into hepatocyte-like cells. MSC were induced to differentiate into hepatocyte-like cells by hepatotic growth factor (HGF) and fibroblast growth factor-4 (FGF-4). Differentiated cells were examined for the expression of hepatocyte-specific markers and hepatocyte functions. MSC were isolated. Flow cytometry analysis showed that they expressed the MSC-specific markers, reverse transcriptase-polymerase chain reaction (RT-PCR) demonstrated that MSC expressed the hepatocyte-specific marker cytokeratin 18 (CK-18) following hepatocyte induction. This study demonstrates that BM-derived-MSC can differentiate into functional hepatocyte-like cells following the induction of HGF and FGF-4. MSC can serve as a favorable cell source for tissue engineering in the treatment of liver disease.