Miracle-dz/UniFAR-FTUs huggingface dataset:
An Economic Evaluation of a virtual Covid Ward in Leicester, Leicestershire, and Rutland

ObjectiveThe objective of this study was to demonstrate the impact of a virtual Covid--19 ward on NHS resource use. MethodsDifferent methods were used to derive comparators for the observational data on acute length of stay versus the actual lengths of stay of 310 patients on acute wards and differences estimated. The resource use associated with delivering care in the virtual ward were collected on an ongoing basis. ResultsThe virtual ward delivered estimated health care system savings of 1,103 bed days, {pound}529,719 in net financial savings across two key groups of patients; those who had been on oxygen and required weaning off it while within the virtual ward and those not requiring oxygen therapy with less severe acute Covid disease. The costs of the intervention were 9.7% of the estimated gross savings and the mean net saving per patient was {pound}1,709 in the base case without including the savings associated with a likely reduction in re-admissions. The 30-day re-admission rate was 2.9%, which was substantially beneath alternative comparative data. The mean cost of the intervention was {pound}184.38 per patient. ConclusionThe virtual ward delivered significant financial savings in both groups of patients, did so with a high degree of confidence, whilst doing so at a very low absolute and relative cost.
The Role of Mobile Technology in Tourism: Patents, Articles, News, and Mobile Tour App Reviews

The purpose of this research is to identify the status and role of mobile technology in achieving sustainable and smart tourism, and to suggest future research and strategy directions for academia and managers in practice. This research utilized multiple sources, such as patents, academic articles, and news, and selected methodologies optimized for the purpose of each study. Study 1 used Netminer, a social network analysis program, to analyze the relationships between patent’s International Patent Classification (IPC) codes. Study 2 used the T-LAB program for content analysis to analyze the texts of patents, journal articles, and news. Study 3 used the Leximancer program, which utilizes relative frequency to analyze mobile app consumer reviews. In study 1, we identified various forms of data related technologies and mobile technologies for smart city systems and maps. In study 2, we found the environment, sustainability, business, and market themes to be related to mobile technology. In study 3, we explored consumers’ attitudes and preferences for mobile travel app using their reviews. Advances in mobile technology are expected to create innovative experiences for consumers, foster a sustainable competitive advantage for tourism destinations and tourism-related suppliers, and create sustainable competencies for smart tourism.
Diagnostic accuracy and limit of detection of ten malaria parasite lactate dehydrogenase-based rapid tests for Plasmodium knowlesi and P. falciparum

Background Plasmodium knowlesi causes zoonotic malaria across Southeast Asia. First-line diagnostic microscopy cannot reliably differentiate P. knowlesi from other human malaria species. Rapid diagnostic tests (RDTs) designed for P. falciparum and P. vivax are used routinely in P. knowlesi co-endemic areas despite potential cross-reactivity for species-specific antibody targets. Methods Ten RDTs were evaluated: nine to detect clinical P. knowlesi infections from Malaysia, and nine assessing limit of detection (LoD) for P. knowlesi (PkA1-H.1) and P. falciparum (Pf3D7) cultures. Targets included Plasmodium-genus parasite lactate dehydrogenase (pan-pLDH) and P. vivax (Pv)-pLDH. Results Samples were collected prior to antimalarial treatment from 127 patients with microscopy-positive PCR-confirmed P. knowlesi mono-infections. Median parasitaemia was 788/µL (IQR 247-5,565/µL). Pan-pLDH sensitivities ranged from 50.6% (95% CI 39.6–61.5) (SD BIOLINE) to 87.0% (95% CI 75.1–94.6) (First Response® and CareStart™ PAN) compared to reference PCR. Pv-pLDH RDTs detected P. knowlesi with up to 92.0% (95% CI 84.3-96.7%) sensitivity (Biocredit™). For parasite counts ≥200/µL, pan-pLDH (Standard Q) and Pv-pLDH RDTs exceeded 95% sensitivity. Specificity of RDTs against 26 PCR-confirmed negative controls was 100%. Sensitivity of six highest performing RDTs were not significantly different when comparing samples taken before and after (median 3 hours) antimalarial treatment. Parasite ring stages were present in 30% of pre-treatment samples, with ring stage proportions (mean 1.9%) demonstrating inverse correlation with test positivity of Biocredit™ and two CareStart™ RDTs. For cultured P. knowlesi, CareStart™ PAN demonstrated the lowest LoD at 25 parasites/µL; LoDs of other pan-pLDH ranged from 98 to >2000 parasites/µL. Pv-pLDH LoD for P. knowlesi was 49 parasites/µL. No false-positive results were observed in either P. falciparum-pLDH or histidine-rich-protein-2 channels. Conclusion Selected RDTs demonstrate sufficient performance for detection of major human malaria species including P. knowlesi in co-endemic areas where microscopy is not available, particularly for higher parasite counts, although cannot reliably differentiate among non-falciparum malaria.
Sonographic Diaphragm Dysfunction is an Unexpectedly Frequent Feature of Long COVID with Non-Specific Dyspnea and Fatigue

Introduction/AimsThe primary aim of this study is to define the sonographic diaphragm phenotype of Long COVID patients with non-specific dyspnea and fatigue. We analyzed patients referred from a pulmonary medicine COVID clinic without any intrinsic cardiopulmonary explanation for their new symptoms. Additionally, we report the functional outcomes of patients who completed an outpatient cardiopulmonary physical therapy program. MethodsThis was a retrospective cohort study (n = 37) of consecutive patients referred for neuromuscular assessment centered on B-mode ultrasound of the diaphragm muscle. Patients were recruited from a single academic hospital between February 25, 2021 and October 7, 2021. ResultsSonographic abnormalities were identified in 65% (24/37) of patients, and in the vast majority of cases (23/24) was defined by low diaphragm muscle thickness. Thinner diaphragm muscles positively correlated with lower serum creatinine and creatine kinase values, but there was no association with markers of systemic inflammation. Eighteen patients participated in outpatient cardiopulmonary physical therapy that included respiratory muscle training, and 77.8% (n=14) had documented improvement. DiscussionIn the outpatient rehabilitation setting, patients with Long COVID frequently display low diaphragm muscle thickness, but intact muscle contractility on sonographic studies. We speculate this represents a form of disuse atrophy, which has a good response rate to cardiopulmonary physical therapy.
Impact of daily octenidine skin washing on antiseptic tolerance of coagulase-negative staphylococci in two neonatal intensive care units with different bathing practices.

BackgroundCoagulase Negative Staphylococci (CoNS) are responsible for 80-90 % of catheter related sepsis in neonates which can cause life threatening and damaging effects. NICUs within the UK use various practices to decolonise neonates to prevent infection ranging from regular full body bathing to localised skin decontamination before insertion of indwelling devices. There is a disparity in bathing practices for infants admitted onto neonatal units, with some choosing to regularly bathe infants and others not, and some routinely washing with skin antiseptics, and others not. AimTo compare the abundance of CoNS within two UK NICUs with different approaches to skin bathing and to test their tolerances to antiseptics. MethodsA collection of CoNS from two UK based NICUs with differing bathing routines for neonates were collated and tested for susceptibility to the antiseptics in use, octenidine and chlorhexidine. FindingsRegular bathing of neonates in octenidine did not decrease the abundance of organisms on neonatal skin. Isolates from the unit where octenidine was in frequent use did not show any increased antiseptic tolerance. Isolates from the unit where regular bathing was not routine practice were less susceptible to both antiseptics. ConclusionFrequent whole-body skin washing with octenidine does not appear to result in a lasting reduction in numbers of organisms found on the skin but also does not appear to select for antiseptic tolerant CoNS.
Patients with affective disorders profit most from telemedical treatment: Evidence from a naturalistic patient cohort during the COVID-19 pandemic

Background During the COVID-19 pandemic telemedicine became essential in maintaining diagnostic procedures and treatment in psychiatry. However, it is still an open question if telemedicine is a feasible treatment option for all groups of psychiatric patients alike. This prospective monocentric observational trial was conducted to assess the general applicability of telemedical treatment in a naturalistic psychiatric outpatient cohort and to identify groups of disorders and clusters of psychopathology that respond particularly well to telemedical treatment considering sociodemographic characteristics and patients' perspectives. Methods Patients were recruited April 2020–April 2021 and asked to fill out the WHO-5 and the SCL-90R at baseline, after 4–6 and 8–12 weeks and a feedback-survey. Additionally, medical records, psychopathology, psychosocial functioning, and socio-demographic data were analyzed. Primary outcomes were well-being, psychopathology and functioning during treatment. Secondly, diagnostic groups and psychopathology linked to a superior treatment-response were determined with respect to patients' subjective experiences. Results Out of 1.385 patients, 254—mostly with hyperkinetic (35.3%) and depressive disorders (24.6%)—took part. Well-being and SCL-90R total scores improved substantially (both p < 0.001). CGI and GAF scores were worse in depressed subjects (both p < 0.05). Improvement was mainly seen in depressed patients; chronic disorders experienced a decline in well-being. Sociodemographic characteristics could not explain this difference. Particularly female (r = 0.413) patients found telepsychiatry equivalent to conventional treatment. The more virtual sessions participants attended the more likely they were to find telepsychiatry equal to conventional treatment (r = 0.231). Conclusion Telemedicine is an effective treatment for patients with depression under naturalistic conditions. Telemedical consultations are a simple and reliable way of monitoring symptom severity and directing treatment choices during the treatment of depressive disorders. Patients with depression benefited more from telemedical treatment compared to participants with chronic non-episodic psychiatric disorders. Future research needs to concentrate on improving telemedical treatment options suited for the latter conditions. Psychiatric telemedicine yielded overall high degrees of satisfaction among users.
Clinical advancement of patients infected with SARS-CoV-2 Omicron variant in Shanghai, China

Background Studies on the Omicron variant infection have generally been restricted to descriptions of its initial clinical and epidemiological characteristics, we investigated the timeline-related advancement in individuals with Omicron variant. Methods We conducted a retrospective, single centered study including 226 laboratory confirmed cases with Omicron variant between April 6th and May 11th, 2022 in Shanghai, China. Final date of follow-up was May 30, 2022. Results Among 226 enrolled patients, the median age was 52 years old, and 118 (52.2%) were female. The duration from onset of symptoms to hospitalization was 3 (IQR, 2-4) days for symptomatic patients. Cough occurred in 168 patients (74.3% ). The median interval to negative reverse-transcriptase PCR tests of nasopharynx swab was 10 days (interquartile range [IQR]: 8-13 days). No radiographic progressions were found in 196 patients on the 7th day after onset of symptoms. The median duration of fever in all participants was 5 days (IQR: 4-6 days). The median PCR conversion time of Paxlovid-treated patients was 8 days (IQR: 7-10 days) compared with that of Lianhuaqingwen (10 days, IQR: 8-13 days) (p=0.00056). Booster vaccination can significantly decrease the severity of Omicron infection when compared with unvaccinated, partially or fully vaccinated patients (p=0.009). The median time of PCR conversion in individuals aged under 14 recovered significantly faster than older patients (median 8 days versus 11 days, P < 0.0001). In multivariate logistic analysis, erythrocyte sedimentation rate (ESR) (OR=1.05) was independently related to the severity of the infection. Conclusions The majority clinical symptoms of Omicron infection were not severe. Early and aggressive administration of Paxlovid can significantly reduce the PCR conversion time. Booster vaccination should also be highly recommended in population over 14 years old.
Predicting Confrontation Naming in the Logopenic Variant of Primary Progressive Aphasia

Naming difficulties are prominent and pervasive in the logopenic variant of primary progressive aphasia (lvPPA) and are related to its underlying deficits in phonological processing. Importantly, some words appear to be more vulnerable to deterioration than others. We hypothesize that these differences can be explained, in part, by words unique psycholinguistic properties. Our study investigated the role of psycholinguistic properties of words, along with their underlying psycholinguistic factors, on confrontation naming performance in individuals with lvPPA. Naming accuracy data were collected from 10 individuals with lvPPA using the Boston Naming Test (BNT). For each test item, values were extracted for frequency, contextual diversity, age of acquisition (AoA), word length, phonological neighborhood density (PND), concreteness, semantic neighborhood density (SND), familiarity, arousal, and valence. We examined the effects of these psycholinguistic properties on naming accuracy using logistic regression analyses at the individual level and multiple linear regression analysis at the group level. Age of acquisition emerged as the strongest psycholinguistic predictor of naming accuracy in lvPPA at both the individual and group levels. Given that AoA and frequency are highly correlated, mediation analyses were performed to identify the relationships between AoA, frequency, and naming accuracy. The influence of AoA on naming accuracy was only partially mediated by frequency. Principal component analysis was performed to extract fundamental factors of the psycholinguistic properties. Four principal psycholinguistic factors were extracted. These were interpreted as "lexical-semantic usage", "phonological simplicity", "semantic disembodiment", and "semantic pleasantness". These factor scores were entered into multiple linear and logistic regression analyses to investigate their relative contribution to naming accuracy in lvPPA. Results indicated that "lexical-semantic usage", "semantic disembodiment", and "semantic pleasantness" predicted naming performance at the group level. Additionally, "lexical-semantic usage" and "semantic disembodiment" emerged as significant predictors at the individual level. The effects of the psycholinguistic properties and their factors and their theoretical implications are discussed in the context of phonological deficits in lvPPA and models of word naming. Highlights- Age of acquisition (AoA) predicts naming in lvPPA - The effect of AoA on naming corresponds with lvPPAs phonological impairment - The effect of AoA on naming is mostly direct and partially mediated by frequency - PCA-extracted psycholinguistic factors independently predict naming in lvPPA - Factors related to lexical semantics, semantics, and emotionality affect naming
Legionella pneumophila occurrence in reduced-occupancy buildings in 11 cities during the COVID-19 pandemic

In spring 2020, reduced water demand was an unintended consequence of COVID-19 pandemic-related building closures. Concerns arose that contaminants associated with water stagnation, such as Legionella pneumophila, could become prevalent. To investigate this potential public health risk, samples from 26 reduced-occupancy buildings across 11 cities in the United States, Canada, and Switzerland were analyzed for L. pneumophila using liquid culture (Legiolert, n=258) and DNA-based methods (qPCR/ddPCR, n=138). L. pneumophila culture-positivity was largely associated with just five buildings, each of which had specific design or operational deficiencies commonly associated with L. pneumophila occurrence. Samples from free chlorine buildings had higher culture-positivity (37%) than chloramine buildings (1%), and 78% of culture-positive samples occurred when the residual was [≤]0.1 mg/L Cl2. Although overall sample positivities using culture- and DNA-based methods were equivalent (34% vs. 35%), there was disagreement between the methods in 13% of paired samples. Few buildings reported any water management activities, and L. pneumophila concentrations in flushed samples were occasionally greater than in first-draw samples. This study provides insight into how building plumbing characteristics and management practices contribute to L. pneumophila occurrence during low water use periods and can inform targeted prevention and mitigation efforts. Synopsis StatementLegionella pneumophila occurrence was evaluated in reduced-occupancy buildings during the COVID-19 pandemic across multiple cities. Graphic for Table of Contents (TOC) O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=108 SRC="FIGDIR/small/22277022v1_ufig1. gif" ALT="Figure 1"> View larger version (35K): org.highwire. dtl.DTLVardef@814c84org.highwire. dtl.DTLVardef@c679a7org.highwire. dtl.DTLVardef@5cc45dorg.highwire. dtl.DTLVardef@5fd086_HPS_FORMAT_FIGEXP M_FIG C_FIG
Automatic bolus tracking in abdominal CT scans with convolutional neural networks

BackgroundBolus tracking can optimize the time delay between contrast injection and diagnostic scan initiation in contrast-enhanced computed tomography (CT), yet the procedure is time-consuming and subject to inter- and intra-operator variances which affect the enhancement levels in diagnostic scans. The objective of the current study is to use artificial intelligence algorithms to fully automate the bolus tracking procedure in contrast-enhanced abdominal CT exams for improved standardization and diagnostic accuracy while providing a simplified imaging workflow. MethodsThis retrospective study used abdominal CT exams collected under a dedicated IRB. Input data consisted of CT topograms and images with high heterogeneity in terms of anatomy, sex, cancer pathologies, and imaging artifacts acquired with four different CT scanner models. Our method consisted of two sequential steps: (i) automatic locator scan positioning on topograms, and (ii) automatic ROI positioning within the aorta on locator scans. The task of locator scan positioning is formulated as a regression problem, where the limited amount of annotated data is circumvented using transfer learning. The task of ROI positioning is formulated as a segmentation problem. ResultsOur locator scan positioning network offered improved positional consistency compared to a high degree of variance in manual slice positionings, verifying inter-operator variance as a significant source of error. When trained using expert-user ground truth labels, the locator scan positioning network achieved a sub-centimeter error (9.76 {+/-} 6.78 mm) on a test dataset. The ROI segmentation network achieved a sub-millimeter absolute error (0.99 {+/-} 0.66 mm) on a test dataset. ConclusionsLocator scan positioning networks offer improved positional consistency compared to manual slice positionings and verified inter-operator variance as an important source of error. By significantly reducing operator-related decisions, this method opens opportunities to standardize and simplify the workflow of bolus tracking procedures for contrast-enhanced CT.
Leveraging Serosurveillance and Postmortem Surveillance to Quantify the Impact of Coronavirus Disease 2019 in Africa

BackgroundThe COVID-19 pandemic has had a devastating impact on global health, the magnitude of which appears to differ intercontinentally: for example, reports suggest 271,900 per million people have been infected in Europe versus 8,800 per million people in Africa. While Africa is the second largest continent by population, its reported COVID-19 cases comprise <3% of global cases. Although social, environmental, and environmental explanations have been proposed to clarify this discrepancy, systematic infection underascertainment may be equally responsible. MethodsWe seek to quantify magnitude of underascertainment in COVID-19s cumulative incidence in Africa. Using serosurveillance and postmortem surveillance, we constructed multiplicative factors estimating ratios of true infections to reported cases in African nations since March 2020. ResultsMultiplicative factors derived from serology data - in a subset of 12 nations - suggested a range of COVID-19 reporting rates, from 1 in 630 infections reported in Kenya (May 2020) to 1 in 15 infections reported in South Africa (November 2021). The largest multiplicative factor, 3,795, corresponded to Malawi (June 2020), suggesting <0.05% of infections captured. A similar set of multiplicative factors for all nations derived from postmortem data points toward the same conclusion: reported COVID-19 cases are unrepresentative of true infections, suggesting a key reason for low case burden in many African nations is significant underdetection and underreporting. ConclusionsWhile estimating COVID-19s exact burden is challenging, the multiplicative factors we present provide incidence curves reflecting likely-to-worst-case ranges of infection. Our results stress the need for expansive surveillance to allocate resources in areas experiencing severe discrepancies between reported cases, projected infections, and deaths. SummaryHere we present a range of estimates quantifying the extent of underascertainment of COVID-19 cumulative incidence in Africa. These estimates, constructed from serology and mortality data, suggest that systematic underdetection and underreporting may be contributing to the seemingly low burden of COVID-19 reported in Africa.