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In the last century, we have passed two severe pandemics; the 1957 influenza (Asian flu) pandemic and the 1918 influenza (Spanish flu) pandemic with a high fatality rate. In the last few months, we have been again facing a new epidemic (COVID-19), which is a frighteningly high-risk disease and is globally threatening human lives. Among all attempts and presented solutions to tackle the COVID-19, a publicly available dataset of radiological imaging using chest radiography, also called chest X-ray (CXR) images, could efficiently accelerate the detection process of patients infected with COVID-19 through presented abnormalities in their chest radiography images. In this study, we have proposed a deep neural network (DNN), namely RAM-Net, a new combination of MobileNet with Dilated Depthwise Separable Convolution (DDSC), Residual blocks, and Attention augmented convolution. The network has been learned and validated using the COVIDx dataset, one of the most popular public datasets comprising the chest X-ray (CXR) images. Using this model, we could accurately identify the positive cases of COVID-19 viral infection while a new suspicious chest X-ray image is shown to the network. Our network’s overall accuracy on the COVIDx test dataset was 95.33%, with a sensitivity and precision of 92% and 99% for COVID-19 cases, respectively, which are the highest results on the COVIDx dataset to date, to the best of our knowledge. Finally, we performed an audit on RAM-Net based on the Grad-CAM’s interpretation to demonstrate that our proposed architecture detects SARS-CoV-2 (COVID-19) viral infection by focusing on vital factors rather than relying on irrelevant information.

ObjectiveTo evaluate the validity of COVID-19 International Classification of Diseases, 10th Revision (ICD-10) codes and their combinations.DesignRetrospective cohort study.SettingAcute care hospitals and emergency departments (EDs) in Alberta, Canada.ParticipantsPatients who were admitted to hospital or presented to an ED in Alberta, as captured by local administrative databases between 1 March 2020 and 28 February 2021, who had a positive COVID-19 test and/or a COVID-19-related ICD-10 code.Main outcome measuresThe sensitivity, positive predictive value (PPV) and 95% CIs for ICD-10 codes were computed. Stratified analysis on age group, sex, symptomatic status, mechanical ventilation, hospital type, patient intensive care unit (ICU) admission, discharge status and season of pandemic were conducted.ResultsTwo overlapping subsets of the study population were considered: those who had a positive COVID-19 test (cohort A, for estimating sensitivity) and those who had a COVID-19-related ICD-10 code (cohort B, for estimating PPV). Cohort A included 17 979 ED patients and 6477 inpatients while cohort B included 33 675 ED patients and 18 746 inpatients. Of inpatients, 9.5% in cohort A and 8.1% in cohort B received mechanical ventilation. Over 13% of inpatients were admitted to ICU. The length of hospital stay was 6 days (IQR: 3–14) for cohort A and 8 days (IQR: 3–19) for cohort B. In-hospital mortality was 15.9% and 38.8% for cohort A and B, respectively. The sensitivity for ICD-10 code U07.1 (COVID-19, virus identified) was 82.5% (81.8%–83.2%) with a PPV of 93.1% (92.6%–93.6%). The combination of U07.1 and U07.3 (multisystem inflammatory syndrome associated with COVID-19) had a sensitivity of 82.5% (81.9%–83.2%) and PPV of 92.9% (92.4%–93.4%).ConclusionsIn Alberta, ICD-10 COVID-19 codes (U07.1 and U07.3) were coded well with high validity. This indicates administrative data can be used for COVID-19 research and pandemic management purposes.

COVID-19 is truly an unprecedented event, forcing nearly four billion people into isolation, social distancing, and requiring people to rigorously follow public health measures such as frequent hand washing and indoor face-covering. People around the world have spent months staying home-bound, enduring significant financial, social, and emotional costs. They have been feeling anxious, irritable, afraid, and ambivalent in the wake of an invisible, pervasive, and potent pandemic. A strength focus can help us mitigate unwarranted or excessive negative emotions engendered by maintaining social distancing. This paper posits that by using our strengths, we can enhance our psychological immunity through pragmatic actions to enhance our daily wellbeing. More importantly, we can reframe and reappraise challenges to build perspective in dealing with global crises such as pandemics and disasters. Strengths expressed through pragmatic actions can boost our coping skills as well as enhance our wellbeing. Consistent with the zeitgeist of our times-equity, social justice, digital connections, the paper offers easily implemented, concrete actions using character strengths in adaptive ways to reduce the likelihood that social distancing will result in overwhelming anxiety, lack of structure or stimulation, and demoralization.

What are the psychological consequences of the increasingly politicized nature of the COVID-19 pandemic in the United States relative to similar Western countries? In a two-wave study completed early (March) and later (December) in the pandemic, we found that polarization was greater in the United States ( N = 1,339) than in Canada ( N = 644) and the United Kingdom. ( N = 1,283). Political conservatism in the United States was strongly associated with engaging in weaker mitigation behaviors, lower COVID-19 risk perceptions, greater misperceptions, and stronger vaccination hesitancy. Although there was some evidence that cognitive sophistication was associated with increased polarization in the United States in December (but not March), cognitive sophistication was nonetheless consistently negatively correlated with misperceptions and vaccination hesitancy across time, countries, and party lines. Furthermore, COVID-19 skepticism in the United States was strongly correlated with distrust in liberal-leaning mainstream news outlets and trust in conservative-leaning news outlets, suggesting that polarization may be driven by differences in information environments.

Introduction Studies suggest that patients with cancer are more likely to experience severe outcomes from COVID-19. Therefore, cancer centers have undertaken efforts to care for patients with cancer in COVID-free units. Nevertheless, the frequency and relevance of nosocomial transmission of COVID-19 in patients with cancer remain unknown. The goal of this study was to determine the incidence and impact of hospital-acquired COVID-19 in this population and identify predictive factors for COVID-19 severity in patients with cancer. Methods Patients with cancer and a laboratory-confirmed diagnosis of COVID-19 were prospectively identified using provincial registries and hospital databases between March 3rd and May 23rd, 2020 in the provinces of Quebec and British Columbia in Canada. Patient’s baseline characteristics including age, sex, comorbidities, cancer type, and type of anti-cancer treatment were collected. The exposure of interest was incidence of hospital-acquired infection defined by diagnosis of SARS-CoV-2 ≥ 5 days after hospital admission for COVID-unrelated cause. Co-primary outcomes were death or composite outcomes of severe illness from COVID-19 such as hospitalization, supplemental oxygen, intensive-care unit (ICU) admission and/or mechanical ventilation. Results A total of 252 patients (N=249 adult, and N=3 pediatric) with COVID-19 and cancer were identified, and the majority were residents of Quebec (N=233). One-hundred-and-six patients (42.1%) received active anti-cancer treatment in the last 3 months prior to COVID-19 diagnosis. During a median follow-up of 25 days, 33 (13.1%) required admission to the ICU, and 71 (28.2%) died. Forty-seven (19.1%) had a diagnosis of hospital-acquired COVID-19. Median overall survival was shorter in those with hospital-acquired infection, compared to a contemporary community-acquired population (27 days vs unreached, HR 2.3, 95% CI 1.2-4.4, p=0.0006). Multivariate analysis demonstrated that hospital-acquired COVID-19, age, ECOG status, and advanced stage of cancer were independently associated with death. Interpretation Our study demonstrates a high rate of nosocomial transmission of COVID-19, associated with increased mortality in both univariate and multivariate analysis in the cancer population, reinforcing the importance of treating patients with cancer in COVID-free units. We also validated that age and advanced cancer were negative predictive factors for COVID-19 severity in patients with cancer. Highlights • We found a high rate of nosocomial transmission of COVID-19 in patients with cancer. • Nosocomial COVID-19 increased mortality compared to community-acquired infection. • Nosocomial COVID-19, age, ECOG, and stage were independently associated with death. • COVID-free units and infection control procedures are required to protect patients.

Plastics are versatile, durable, and can be manipulated to match different needs. The COVID-19 pandemic has demonstrated the importance of reducing plastic waste and is believed to be responsible for increasing the generation of plastic waste by 54,000 tons/day which was reported in 2020. Another widely available waste is biomass waste. Agriculture and agroforestry, forest and wood processing, municipal waste, and the food industry are all considered major producers of biowaste. Co-gasification is considered one of the most promising methods of chemical recycling that targets the production of syngas (hydrogen and carbon monoxide) and light hydrocarbon gases. In this study, the gasification of pure birch sawdust wood (BSD) and pure rice husk (RH) was compared with mixtures where each BSD and RH was mixed with both LDPE and HDPE in the presence of three different bed materials, namely silica sand, olivine, and red mud. It was found that mixing the biomass with LDPE and HDPE increased hydrogen gas (H2) production. The Hydrogen gas concentration in the product gas increased slightly from 10% to 12% by volume when birch sawdust (BSD) was mixed with LDPE with a ratio of 1:1, while the hydrogen gas concentration increased to 15-16% by volume when birch sawdust was mixed with HDPE with a ratio of 1:1 and olivine has been used as bed material. The lower heating value of the produced gas, which has a direct relationship with the hydrogen and light hydrocarbons concentration, increased from 2.8 to 5.7 MJ/Nm3. Red mud increased the lower heating value of the produced gas when rice husk was premixed with HDPE from 3-4 MJ/Nm3 to 5.5-6 MJ/J/Nm3, however, the main drawback of using red mud as a bed material was the occurrence of attrition which requires a precautionary measure to control the dust produced and prevent air pollution. The produced gases from the gasification processes are commonly used in internal combustion engines applications, but due to the high content of hydrogen gas (H2/CO range 2-3) in the product, it can be considered a renewable source of hydrogen by further processing the gas mixture to obtain pure hydrogen gas that is utilized in various chemical industries.

Home dialysis therapies are flexible kidney replacement strategies with documented clinical benefits. While the incidence of end-stage kidney disease continues to increase globally, the use of home dialysis remains low in most developed countries. Multiple barriers to providing home dialysis have been noted in the published literature. Among known challenges, gaps in clinician knowledge are potentially addressable with a focused education strategy. Recent national surveys in the United States and Australia have highlighted the need for enhanced home dialysis knowledge especially among nephrologists who have recently completed training. Traditional in-person continuing professional educational programmes have had modest success in promoting home dialysis and are limited by scale and the present global COVID-19 pandemic. We hypothesize that the use of a ‘Hub and Spoke’ model of virtual home dialysis mentorship for nephrologists based on project ECHO would support home dialysis growth. We review the home dialysis literature, known educational gaps and plausible educational interventions to address current limitations in physician education Refereed/Peer-reviewed

The diagnosis of COVID-19 is based on clinical symptoms and a positive reverse-transcription polymerase chain reaction (RT-PCR) assay.[1][1] Chest radiography has been reported to have 25%–69% sensitivity, with limited data regarding specificity,[2][2],[3][3] compared with computed tomography (CT

AbstractAn 84 year old male with a previous history of immune thrombotic thrombocytopenic purpura (iTTP) received the first dose of COVID19 mRNA vaccine (Pfizer-Biontech). Seven days later he was diagnosed with iTTP relapse. He received in-patient treatment with therapeutic plasma exchange, high dose steroids and rituximab and subsequently recovered. This case report highlights the need to monitor patients with iTTP following vaccination.

The Vero cell line is considered the most used continuous cell line for the production of viral vectors and vaccines. Historically, it is the first cell line that was approved by the WHO for the production of human vaccines. Comprehensive experimental data on the production of many viruses using the Vero cell line can be found in the literature. However, the vast majority of these processes is relying on the microcarrier technology. While this system is established for the large-scale manufacturing of viral vaccine, it is still quite complex and labor intensive. Moreover, scale-up remains difficult and is limited by the surface area given by the carriers. To overcome these and other drawbacks and to establish more efficient manufacturing processes, it is a priority to further develop the Vero cell platform by applying novel bioprocess technologies. Especially in times like the current COVID-19 pandemic, advanced and scalable platform technologies could provide more efficient and cost-effective solutions to meet the global vaccine demand. Herein, we review the prevailing literature on Vero cell bioprocess development for the production of viral vectors and vaccines with the aim to assess the recent advances in bioprocess development. We critically underline the need for further research activities and describe bottlenecks to improve the Vero cell platform by taking advantage of recent developments in the cell culture engineering field.