CAN SHOE SIZE CORRECTLY PREDICT THE SIZE OF COMPONENTS OF TOTAL KNEE REPLACEMENT PRE-OPERATIVELY

Objective: To ascertain the correlation between shoe size and sizes of femoral and tibial components of total knee replacement preoperatively in patients undergoing total knee arthroplasty. Study design: Prospective cohort study Study settings and duration: This study was conducted at department of orthopedic surgery, Shifa International Hospital, Islamabad from July 2020 – December 2020. Material and methods: Sample size was calculated using WHO calculator and it was 43 patients in total. Patients were approached through non-probability consecutive sampling. Shoe size of patients was measured using a Brannock device. During surgery, Implant model and sizes of the femoral and tibial components implanted during knee replacement were noted. Data was analyzed with the help of SPSS version 24. We applied Pearson’s correlation cofficeint. P value ≤ 0.05 was considered significant. Results: Out of 43, there were 9(20.9%) male and female 34(79.1%). Mean age of patients was 51.7±6.8 (SD). We found good positive correlation between shoe size and tibial component (p=<0.001). Positive co relation was found between femoral component and shoe size (p=0.001). Shoe size predict 72% of Tibial component and 65% femoral component. Conclusion: Shoe size is effective and safe predictors of total knee replacement components pre-operatively. This procedure is more accurate and less labor intensive. Accurate templating result in less surgical duration and provide several benefits to patients and health care providers.  

Fighting the COVID-19 Infodemic:Modeling the Perspective of Journalists, Fact-Checkers, Social Media Platforms, Policy Makers, and the Society

With the emergence of the COVID-19 pandemic, the political and the medical aspects of disinformation merged as the problem got elevated to a whole new level to become the first global infodemic. Fighting this infodemic has been declared one of the most important focus areas of the World Health Organization, with dangers ranging from promoting fake cures, rumors, and conspiracy theories to spreading xenophobia and panic. Addressing the issue requires solving a number of challenging problems such as identifying messages containing claims, determining their check-worthiness and factuality, and their potential to do harm as well as the nature of that harm, to mention just a few. To address this gap, we release a large dataset of 16K manually annotated tweets for fine-grained disinformation analysis that (i) focuses on COVID-19, (ii) combines the perspectives and the interests of journalists, fact-checkers, social media platforms, policy makers, and society, and (iii) covers Arabic, Bulgarian, Dutch, and English. Finally, we show strong evaluation results using pretrained Transformers, thus confirming the practical utility of the dataset in monolingual vs. multilingual, and single task vs. multitask settings

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

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

NatiQ: An End-to-end Text-to-Speech System for Arabic

NatiQ is end-to-end text-to-speech system for Arabic. Our speech synthesizer uses an encoder-decoder architecture with attention. We used both tacotron-based models (tacotron-1 and tacotron-2) and the faster transformer model for generating mel-spectrograms from characters. We concatenated Tacotron1 with the WaveRNN vocoder, Tacotron2 with the WaveGlow vocoder and ESPnet transformer with the parallel wavegan vocoder to synthesize waveforms from the spectrograms. We used in-house speech data for two voices: 1) neutral male "Hamza"- narrating general content and news, and 2) expressive female "Amina"- narrating children story books to train our models. Our best systems achieve an average Mean Opinion Score (MOS) of 4.21 and 4.40 for Amina and Hamza respectively. The objective evaluation of the systems using word and character error rate (WER and CER) as well as the response time measured by real-time factor favored the end-to-end architecture ESPnet. NatiQ demo is available on-line at https://tts.qcri.or

Fighting the COVID-19 Infodemic in Social Media: A Holistic Perspective and a Call to Arms

With the outbreak of the COVID-19 pandemic, people turned to social media to read and to share timely information including statistics, warnings, advice, and inspirational stories. Unfortunately, alongside all this useful information, there was also a new blending of medical and political misinformation and disinformation, which gave rise to the first global infodemic. While fighting this infodemic is typically thought of in terms of factuality, the problem is much broader as malicious content includes not only fake news, rumors, and conspiracy theories, but also promotion of fake cures, panic, racism, xenophobia, and mistrust in the authorities, among others. This is a complex problem that needs a holistic approach combining the perspectives of journalists, fact-checkers, policymakers, government entities, social media platforms, and society as a whole. With this in mind, we define an annotation schema and detailed annotation instructions that reflect these perspectives. We further deploy a multilingual annotation platform, and we issue a call to arms to the research community and beyond to join the fight by supporting our crowdsourcing annotation efforts. We perform initial annotations using the annotation schema, and our initial experiments demonstrated sizable improvements over the baselines