Sleep Disturbances in Healthcare Professionals During the Covid-19 Pandemic

Objectives: To determine the incidence of sleep disturbances, including insomnia in healthcare professionals dealing with COVID-19 patients. Methodology: A cross-sectional study was conducted at inpatient infectious disease units, emergency department and ICU (for COVID-19 patients), at the Pakistan Institute of Medical Sciences (PIMS) from February 2022 to April 2022. All the individuals participating in the study were healthcare professionals. Insomnia Severity Index was used for the questionnaire. The scores of the surveyed subjects were calculated and the characteristic demographics of the subjects were analyzed. Results: An upward trend in the incidence of poor sleep quality was noted among the healthcare professionals who participated in this study. Out of 160 healthcare professionals, 93(58.1%) of the population was females, while 67(41.9%) were males. The majority of participants (p<0.05) were between the ages of 20 and 30 years, followed by 31 to 40 years and 41 to 50 years. A significant proportion of the population (p<0.05) belonged to the unmarried group, followed by the married, separated, and divorced with a percentage of 60.6, 36.2, 2.5 and 0.6%, respectively. Moreover, 84.4% (135/160) of healthcare professionals (p<0.05) had a previous history of sleep disorders. Insomnia Severity Index (ISI) score system was used to analyze the intensity of sleep disorders and insomnia in the affected persons and it was found that most of the participants were diagnosed with subthreshold insomnia (38.8%). Conclusion: The study elucidated that there was a significantly higher incidence of sleep disturbances and insomnia, in healthcare professionals working in Covid-19 care units

A Novel Deep Learning Method for Recognition and Classification of Brain Tumors from MRI images

A brain tumor is an abnormal growth in brain cells that causes damage to various blood vessels and nerves in the human body. An earlier and accurate diagnosis of the brain tumor is of foremost important to avoid future complications. Precise segmentation of brain tumors provides a basis for surgical planning and treatment to doctors. Manual detection using MRI images is computationally complex in cases where the survival of the patient is dependent on timely treatment, and the performance relies on domain expertise. Therefore, computerized detection of tumors is still a challenging task due to significant variations in their location and structure, i.e., irregular shapes and ambiguous boundaries. In this study, we propose a custom Mask Region-based Convolution neural network (Mask RCNN) with a densenet-41 backbone architecture that is trained via transfer learning for precise classification and segmentation of brain tumors. Our method is evaluated on two different benchmark datasets using various quantitative measures. Comparative results show that the custom Mask-RCNN can more precisely detect tumor locations using bounding boxes and return segmentation masks to provide exact tumor regions. Our proposed model achieved an accuracy of 96.3% and 98.34% for segmentation and classification respectively, demonstrating enhanced robustness compared to state-of-the-art approaches

Robust estimation based nonlinear higher order sliding mode control strategies for PMSG-WECS

The wind energy conversion systems (WECS) suffer from an intermittent nature of source (wind) and the resulting disparity between power generation and electricity demand. Thus, WECS are required to be operated at maximum power point (MPP). This research paper addresses a sophisticated MPP tracking (MPPT) strategy to ensure optimum (maximum) power out of the WECS despite environmental (wind) variations. This study considers a WECS (fixed pitch, 3KW, variable speed) coupled with a permanent magnet synchronous generator (PMSG) and proposes three sliding mode control (SMC) based MPPT schemes, a conventional first order SMC (FOSMC), an integral back-stepping-based SMC (IBSMC) and a super-twisting reachability-based SMC, for maximizing the power output. However, the efficacy of MPPT/control schemes rely on availability of system parameters especially, uncertain/nonlinear dynamics and aerodynamic terms, which are not commonly accessible in practice. As a remedy, an off-line artificial function-fitting neural network (ANN) based on Levenberg-Marquardt algorithm is employed to enhance the performance and robustness of MPPT/control scheme by effectively imitating the uncertain/nonlinear drift terms in the control input pathways. Furthermore, the speed and missing derivative of a generator shaft are determined using a high-gain observer (HGO). Finally, a comparison is made among the stated strategies subjected to stochastic and deterministic wind speed profiles. Extensive MATLAB/Simulink simulations assess the effectiveness of the suggested approaches

Detection of Diabetic Eye Disease from Retinal Images Using a Deep Learning Based CenterNet Model

Diabetic retinopathy (DR) is an eye disease that alters the blood vessels of a person suffering from diabetes. Diabetic macular edema (DME) occurs when DR affects the macula, which causes fluid accumulation in the macula. Efficient screening systems require experts to manually analyze images to recognize diseases. However, due to the challenging nature of the screening method and lack of trained human resources, devising effective screening-oriented treatment is an expensive task. Automated systems are trying to cope with these challenges; however, these methods do not generalize well to multiple diseases and real-world scenarios. To solve the aforementioned issues, we propose a new method comprising two main steps. The first involves dataset preparation and feature extraction and the other relates to improving a custom deep learning based CenterNet model trained for eye disease classification. Initially, we generate annotations for suspected samples to locate the precise region of interest, while the other part of the proposed solution trains the Center Net model over annotated images. Specifically, we use DenseNet-100 as a feature extraction method on which the one-stage detector, CenterNet, is employed to localize and classify the disease lesions. We evaluated our method over challenging datasets, namely, APTOS-2019 and IDRiD, and attained average accuracy of 97.93% and 98.10%, respectively. We also performed cross-dataset validation with benchmark EYEPACS and Diaretdb1 datasets. Both qualitative and quantitative results demonstrate that our proposed approach outperforms state-of-the-art methods due to more effective localization power of CenterNet, as it can easily recognize small lesions and deal with over-fitted training data. Our proposed framework is proficient in correctly locating and classifying disease lesions. In comparison to existing DR and DME classification approaches, our method can extract representative key points from low-intensity and noisy images and accurately classify them. Hence our approach can play an important role in automated detection and recognition of DR and DME lesions

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Can the genes communicate with each other after birth? An international cross‐sectional study

Abstract Background Various factors contribute to the pathogenesis of a disease. These include genetic factors, family history, and some idiopathic causes. Genetic makeup has an important role in the progression of disease. This is due to mutations in genetic material, that is, deoxyribonucleic acid (DNA). Methodology This is a cross‐sectional study that involved 5000 participants distributed across 250 countries. All the participants were randomly selected and asked to fill out the online survey. All the participants were fully informed about the study's purpose before providing their consent. Results The participants were distributed among 250 countries. Their age mean (standard deviation) is 46.7 (12.4). We discovered a significant difference between those who have genetic or congenital diseases and those who have a family history of the disease. Also, there is a statistically significant difference between the recurrence of the disease and the duration of the visits of close relatives who have the same disease. Conclusion The study suggests that there might be some ways, through gene waves or the environment, in which a gene changes the expression of other genes of similar sequence in different individuals when the required period of contact is provided. In the future, this theory might explain the idiopathic nature of some diseases

A Machine Learning Method for Prediction of Stock Market Using Real-Time Twitter Data

Finances represent one of the key requirements to perform any useful activity for humanity. Financial markets, e.g., stock markets, forex, and mercantile exchanges, etc., provide the opportunity to anyone to invest and generate finances. However, to reap maximum benefits from these financial markets, effective decision making is required to identify the trade directions, e.g., going long/short by analyzing all the influential factors, e.g., price action, economic policies, and supply/demand estimation, in a timely manner. In this regard, analysis of the financial news and Twitter posts plays a significant role to predict the future behavior of financial markets, public sentiment estimation, and systematic/idiosyncratic risk estimation. In this paper, our proposed work aims to analyze the Twitter posts and Google Finance data to predict the future behavior of the stock markets (one of the key financial markets) in a particular time frame, i.e., hourly, daily, weekly, etc., through a novel StockSentiWordNet (SSWN) model. The proposed SSWN model extends the standard opinion lexicon named SentiWordNet (SWN) through the terms specifically related to the stock markets to train extreme learning machine (ELM) and recurrent neural network (RNN) for stock price prediction. The experiments are performed on two datasets, i.e., Sentiment140 and Twitter datasets, and achieved the accuracy value of 86.06%. Findings show that our work outperforms the state-of-the-art approaches with respect to overall accuracy. In future, we plan to enhance the capability of our method by adding other popular social media, e.g., Facebook and Google News etc