Smart healthcare system for severity prediction and critical tasks management of COVID-19 patients in IoT-fog computing environments

COVID-19 has depleted healthcare systems around the world. Extreme conditions must be defined as soon as possible so that services and treatment can be deployed and intensified. Many biomarkers are being investigated in order to track the patient's condition. Unfortunately, this may interfere with the symptoms of other diseases, making it more difficult for a specialist to diagnose or predict the severity level of the case. This research develops a Smart Healthcare System for Severity Prediction and Critical Tasks Management (SHSSP-CTM) for COVID-19 patients. On the one hand, a machine learning (ML) model is projected to predict the severity of COVID-19 disease. On the other hand, a multi-agent system is proposed to prioritize patients according to the seriousness of the COVID-19 condition and then provide complete network management from the edge to the cloud. Clinical data, including Internet of Medical Things (IoMT) sensors and Electronic Health Record (EHR) data of 78 patients from one hospital in the Wasit Governorate, Iraq, were used in this study. Different data sources are fused to generate new feature pattern. Also, data mining techniques such as normalization and feature selection are applied. Two models, specifically logistic regression (LR) and random forest (RF), are used as baseline severity predictive models. A multi-agent algorithm (MAA), consisting of a personal agent (PA) and fog node agent (FNA), is used to control the prioritization process of COVID-19 patients. The highest prediction result is achieved based on data fusion and selected features, where all examined classifiers observe a significant increase in accuracy. Furthermore, compared with state-of-the-art methods, the RF model showed a high and balanced prediction performance with 86% accuracy, 85.7% F-score, 87.2% precision, and 86% recall. In addition, as compared to the cloud, the MAA showed very significant performance where the resource usage was 66% in the proposed model and 34% in the traditional cloud, the delay was 19% in the proposed model and 81% in the cloud, and the consumed energy was 31% in proposed model and 69% in the cloud. The findings of this study will allow for the early detection of three severity cases, lowering mortality rates.Web of Science2022art. no. 501296

Effects of home confinement on mental health and lifestyle behaviours during the COVID-19 outbreak:insights from the ECLB-COVID19 multicentre study

Although recognised as effective measures to curb the spread of the COVID-19 outbreak, social distancing and self-isolation have been suggested to generate a burden throughout the population. To provide scientific data to help identify risk factors for the psychosocial strain during the COVID-19 outbreak, an international cross-disciplinary online survey was circulated in April 2020. This report outlines the mental, emotional and behavioural consequences of COVID-19 home confinement. The ECLB-COVID19 electronic survey was designed by a steering group of multidisciplinary scientists, following a structured review of the literature. The survey was uploaded and shared on the Google online survey platform and was promoted by thirty-five research organizations from Europe, North Africa, Western Asia and the Americas. Questions were presented in a differential format with questions related to responses “before” and “during” the confinement period. 1047 replies (54% women) from Western Asia (36%), North Africa (40%), Europe (21%) and other continents (3%) were analysed. The COVID-19 home confinement evoked a negative effect on mental wellbeing and emotional status (P < 0.001; 0.43 ≤ d ≤ 0.65) with a greater proportion of individuals experiencing psychosocial and emotional disorders (+10% to +16.5%). These psychosocial tolls were associated with unhealthy lifestyle behaviours with a greater proportion of individuals experiencing (i) physical (+15.2%) and social (+71.2%) inactivity, (ii) poor sleep quality (+12.8%), (iii) unhealthy diet behaviours (+10%), and (iv) unemployment (6%). Conversely, participants demonstrated a greater use (+15%) of technology during the confinement period. These findings elucidate the risk of psychosocial strain during the COVID-19 home confinement period and provide a clear remit for the urgent implementation of technology-based intervention to foster an Active and Healthy Confinement Lifestyle AHCL)

Globally altered sleep patterns and physical activity levels by confinement in 5056 individuals:ECLB COVID-19 international online survey

Symptoms of psychological distress and disorder have been widely reported in people under quarantine during the COVID-19 pandemic; in addition to severe disruption of peoples' daily activity and sleep patterns. This study investigates the association between physical-activity levels and sleep patterns in quarantined individuals. An international Google online survey was launched in April 6th, 2020 for 12-weeks. Forty-one research organizations from Europe, North-Africa, Western-Asia, and the Americas promoted the survey through their networks to the general society, which was made available in 14 languages. The survey was presented in a differential format with questions related to responses "before" and "during" the confinement period. Participants responded to the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the short form of the International Physical Activity Questionnaire. 5056 replies (59.4% female), from Europe (46.4%), Western-Asia (25.4%), America (14.8%) and North-Africa (13.3%) were analysed. The COVID-19 home confinement led to impaired sleep quality, as evidenced by the increase in the global PSQI score (4.37 +/- 2.71 before home confinement vs. 5.32 +/- 3.23 during home confinement) (p &lt; 0.001). The frequency of individuals experiencing a good sleep decreased from 61% (n = 3063) before home confinement to 48% (n = 2405) during home confinement with highly active individuals experienced better sleep quality (p &lt; 0.001) in both conditions. Time spent engaged in all physical-activity and the metabolic equivalent of task in each physical-activity category (i.e., vigorous, moderate, walking) decreased significantly during COVID-19 home confinement (p &lt; 0.001). The number of hours of daily-sitting increased by similar to 2 hours/days during home confinement (p &lt; 0.001). COVID-19 home confinement resulted in significantly negative alterations in sleep patterns and physical-activity levels. To maintain health during home confinement, physical-activity promotion and sleep hygiene education and support are strongly warranted.</p

Sleep Quality and Physical Activity as Predictors of Mental Wellbeing Variance in Older Adults during COVID-19 Lockdown:ECLB COVID-19 International Online Survey

Background. The COVID-19 lockdown could engender disruption to lifestyle behaviors, thus impairing mental wellbeing in the general population. This study investigated whether sociodemographic variables, changes in physical activity, and sleep quality from pre- to during lockdown were predictors of change in mental wellbeing in quarantined older adults. Methods. A 12-week international online survey was launched in 14 languages on 6 April 2020. Forty-one research institutions from Europe, Western-Asia, North-Africa, and the Americas, promoted the survey. The survey was presented in a differential format with questions related to responses "pre" and "during" the lockdown period. Participants responded to the Short Warwick-Edinburgh Mental Wellbeing Scale, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and the short form of the International Physical Activity Questionnaire. Results. Replies from older adults (aged &gt;55 years, n = 517), mainly from Europe (50.1%), Western-Asia (6.8%), America (30%), and North-Africa (9.3%) were analyzed. The COVID-19 lockdown led to significantly decreased mental wellbeing, sleep quality, and total physical activity energy expenditure levels (all p &lt; 0.001). Regression analysis showed that the change in total PSQI score and total physical activity energy expenditure (F-(2,F- 514) = 66.41 p &lt; 0.001) were significant predictors of the decrease in mental wellbeing from pre- to during lockdown (p &lt; 0.001, R-2: 0.20). Conclusion. COVID-19 lockdown deleteriously affected physical activity and sleep patterns. Furthermore, change in the total PSQI score and total physical activity energy expenditure were significant predictors for the decrease in mental wellbeing.</p

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Enhancing Concrete Properties Using Silica Fume: Optimized Mix Design

In the current work, concrete mixes containing (7.0-33.11) weight % silica fume as a partial replacement of cement with a water /cement ratio (0.42-0.48) were prepared according to an adopted two factorial central composite design. The samples were tested, optimized, and modeled for compressive strength and density. &nbsp;The estimated results confirmed that compressive strength and density increase with increasing silica fume content up to 11.9 wt.%. Response surface analysis results confirmed that silica fume concrete with developed compressive strength (53.42 MPa) could be prepared by incorporation of 11.9 wt. % silica fume as partial replacement of cement using 0.42 water/cement ratio. An increase in compressive strength and density (up to &nbsp;39.3% and &nbsp;2.6% ) respectively was recorded for silica fume concrete mixes compared to Portland cement concrete. Overall, the research findings revealed that silica fume concretes prepared with appropriate silica fume content and water/cement ratio exhibited superior strength and density characteristics candidate them to be used effectively in civil engineering applications

Factorial Mixture Design for Properties Optimization and Modeling of Concrete Composites Incorporated with Acetates as Admixtures

Nowadays, admixtures are used with the aim to provide strength and durability to concrete with less water use. New and low-cost admixtures gained a large amount of consideration to mitigate the problems associated with concrete’s durability and service life without upsetting its strength properties. The current work investigates the effect of three types of acetates on the workability, density, and compressive strength of concrete, which is used in structures of the Iraqi ports that suffer from corrosion damages and deterioration owing to the aggressive marine environments. Potassium acetate (KA), calcium acetate (CaA), and ethyl acetate (EA) are incorporated with different doses (1.38–5.6 wt.% of cement) in concrete mixtures using different water/cement ratios (0.48–0.54) based on an espoused central composite experimental design. The experimental results confirmed that the average workability increased with increasing the acetate dose, particularly with CaA. The density and compressive strength of 28 days of water-cured mixtures increased with increasing acetate dose following the order: Ca > K > Ethyl acetate and decreased with increasing w/c ratio. The high rise in compressive strength and workability linked to control mixtures was 30.8% and 77.3% as well as 15.7% and 64.3% for the mixtures incorporated with 5.6 wt.% CaA and KA, respectively. While it was 14.2% and 58.3% for the mixtures incorporated with 3.5 wt.% EA. RSM was employed to optimize and model the design and hardened properties of concrete mixtures. ANOVA results predicted the same trend, which was obtained from the experimental results. The mathematical models were valued with high-regression coefficients. The highest compressive strength of 42.68 MPa has been achieved for a concrete mixture of 0.48 w/c ratio by the incorporation of 5.1 wt.% CaA through a model with R2 96.97%. The relatively low-cost acetate admixtures, particularly CaA, seemed promising for the fabrication of concrete with outstanding properties

New concrete composites incorporated with calcium acetate as admixture: The Impact of Curing Age on Strength and the Effect of Temperature on Water Absorption

In previous work, concrete mixes incorporated with different types of acetates (inorganic and organic) were formulated, cured for 28 days in water, and then tested for compressive strength. The effect of the water-to-cement ratio and the acetate content was optimized using a central composited design based on the response surface methodology approach. The results confirmed that the optimum compressive strength was achieved for the mixes incorporated with calcium acetate (CaA) using of 0.48 water-to-cement ratio. In the current work, the effect of curing age on compressive strength and density was studied for the optimum mixes. Also, the water absorption of the mixes carried out by immersion test was assessed at different temperatures (25-55 °C). Microscopic observations were also noted. The results obtained confirmed that the compressive strength and density of the CaA-concrete mix increase with increasing the curing age. The thermodynamic study of water absorption assured the dependence of water absorption on temperature. The activation energies depicted from the Arrhenius relation and the decrease in the water absorption rate for the concrete incorporated with CaA are considered as an indicator of decreasing the porosity of the concrete mixes compared to the control mixes without CaA. The findings assured that the modified mixes with CaA are promising construction materials owing to their outstanding strength and lower water absorption rates compared to conventional concrete

A Survey of Neck Pain among Dentists of the Lebanese Community

Background and Objectives. In the area of dentistry, musculoskeletal disorders (MSDs), particularly neck discomfort, are significant occupational health hazards. The purpose of this study was to ascertain how neck pain affected the capacity and productivity of dental practices. Additionally, it examined the advantages of preventive measures in lessening pain intensity and rated the degree of dentists’ incapacity. Subjects and Methods. This study used a cross-sectional survey design to examine how neck pain affected dentists’ ability to work and their productivity between July 2022 and November 2022. The study included 342 dentists from all around Lebanon. An online validated survey was designed, and the data collection process was performed via direct calls and emails where the survey link was shared. Data included demographic characteristics, gender, type, and duration of the dental practice, which were presented by the toll of hours of work per week, general health status, exercise habits, and Neck Disability Index (NDI). The weight of the participants was not included in the study. The statistical analysis was performed using IBM SPSS version 25. Results. The majority of participants were between the ages of 25 and 35, and the gender distribution of the demographic distribution was comparable. The prevalence of pain was 86.8% (97/342 dentists). NDI analysis showed that 65.7% had mild disability, 12.8% have a moderate disability, and 1% had severe disability. Bivariate analysis showed that pain was affected by age (p=0.013), orthodontist practices (p=0.031), regular exercise (p<0.001), using vibrating instruments (p<0.001), cervical flexion for better vision while working (p<0.001), knowledge, and experience about ergonomic posture (p<0.005). Multivariate analysis showed four predictors for pain: age (p=0.017), performing stretching exercises after finishing clinical practice (p=0.022), orthodontist specialty (p=0.029), and performing cervical flexion for better vision while working (p=0.004). Conclusion. This study showed that through the application of some strategies such as stretching, exercising, and being careful in using vibrating instruments, the dentist may be able to relieve the pain