The prompt spread of COVID-19 has emphasized the necessity for effective and precise diagnostic tools.In this article,a hybrid approach in terms of datasets as well as the methodology by utilizing a previously unexplo...The prompt spread of COVID-19 has emphasized the necessity for effective and precise diagnostic tools.In this article,a hybrid approach in terms of datasets as well as the methodology by utilizing a previously unexplored dataset obtained from a private hospital for detecting COVID-19,pneumonia,and normal conditions in chest X-ray images(CXIs)is proposed coupled with Explainable Artificial Intelligence(XAI).Our study leverages less preprocessing with pre-trained cutting-edge models like InceptionV3,VGG16,and VGG19 that excel in the task of feature extraction.The methodology is further enhanced by the inclusion of the t-SNE(t-Distributed Stochastic Neighbor Embedding)technique for visualizing the extracted image features and Contrast Limited Adaptive Histogram Equalization(CLAHE)to improve images before extraction of features.Additionally,an AttentionMechanism is utilized,which helps clarify how the modelmakes decisions,which builds trust in artificial intelligence(AI)systems.To evaluate the effectiveness of the proposed approach,both benchmark datasets and a private dataset obtained with permissions from Jinnah PostgraduateMedical Center(JPMC)in Karachi,Pakistan,are utilized.In 12 experiments,VGG19 showcased remarkable performance in the hybrid dataset approach,achieving 100%accuracy in COVID-19 vs.pneumonia classification and 97%in distinguishing normal cases.Overall,across all classes,the approach achieved 98%accuracy,demonstrating its efficiency in detecting COVID-19 and differentiating it fromother chest disorders(Pneumonia and healthy)while also providing insights into the decision-making process of the models.展开更多
Since the beginning of COVID-19 pandemics many countries were facing challenges with testing capacity recourse limitations. Throughout the waves of the pandemic countries were trying to address the existing constrains...Since the beginning of COVID-19 pandemics many countries were facing challenges with testing capacity recourse limitations. Throughout the waves of the pandemic countries were trying to address the existing constrains exploring solutions to increase the testing capacity with more cost-effective approaches. Pooled methodology was one of the methods which many have validated and used. It is evident that in case of pooled sample testing the sensitivity becomes lower, however the variation highly depends on the pool size as well as the incidence rate at the certain point. Armenia as well as many other countries has adopted regulations for mandatory COVID-19 PCR testing for all the travelers. Current study aimed to explore the efficiency of COVID-19 pooled PCR testing for nasopharyngeal swabs of individuals with no symptoms in a time period with good epidemiological state of the infection. Nasopharingeal swab samples from individuals were collected. The manual extraction of RNAs of samples was performed after pooling up to 5 samples. The pools with Cycle Threshold (CT) of < 37 were considered positive and were retested individually. In total 28,015 samples were grouped in 667 pools of which 57 were positive. The total number of positive samples was 65. The median difference (CT-pool–CT samples) was 2.4 (ranging from–3.0 to 8.9). The correlation of CT of pools and positive samples was positive. The correlation coefficient r = 0.84, P < 0.000, 95% CI range 0.7423 to 0.9243). The total economic saving when using pools compared to the individual testing was 72%. The minor difference between CT values of pools and samples can be explained by the dilution effect in the pool. However, the positive correlation between the values as well as the amount of cost saving demonstrate that pooling on nasopharyngeal samples for COVID-19 PCR testing can be a good method for efficient screening with significant resource saving. One of the most important advantages of the proposed method is the fact that samples are pooled prior extraction, which avoids the possibilities with misinterpretation of IC due to low yield of RNA in the extraction process.展开更多
BACKGROUND Osteonecrosis or avascular necrosis(AVN)of the hip was one of the dreaded complications of coronavirus disease 2019(COVID-19),which emerged in patients who received steroid therapy.Corticosteroids have been...BACKGROUND Osteonecrosis or avascular necrosis(AVN)of the hip was one of the dreaded complications of coronavirus disease 2019(COVID-19),which emerged in patients who received steroid therapy.Corticosteroids have been a mainstay in the treatment protocol of COVID-19 patients.Popular corticosteroid drugs used in patients suffering from COVID-19 were intravenous(IV)or oral dexamethasone,methylprednisolone or hydrocortisone.The use of such high doses of corticost-eroids has shown very positive results and has been lifesaving in many cases.Still,long-term consequences were drug-induced diabetes,osteoporosis,Cushing syndrome,muscle wasting,peripheral fat mobilization,AVN,hirsutism,sleep disturbances and poor wound healing.A significant number of young patients were admitted for bilateral total hip replacements(THR)secondary to AVN following steroid use for COVID-19 treatment.AIM To assess the efficacy of bilateral pericapsular end nerve group(PENG)blocks in patients posted for bilateral THR post-steroid therapy after COVID-19 infection and assess the time taken to first ambulate after surgery.METHODS This prospective observational study was conducted between January 2023 and August 2023 at Care Hospitals,Hyderabad,India.Twenty young patients 30-35 years of age who underwent bilateral THR were studied after due consent over 8 months.All the patients received spinal anaesthesia for surgery and bilateral PENG blocks for postoperative analgesia.RESULTS The duration of surgery was 2.5 h on average.Seventeen out of twenty patients(85%)had a Visual Analog Score(VAS)of less than 2 and did not require any supplementation.One patient was removed from the study,as he required re-exploration.The remaining two patients had a VAS of more than 8 and received IV morphine post-operatively as a rescue analgesic drug.Fifteen out of seventeen patients(88.2%)could be mobilized 12 h after the procedure.CONCLUSION Osteonecrosis or AVN of the hip was one of the dreaded complications of COVID-19,which surfaced in patients who received steroid therapy requiring surgical intervention.Bilateral PENG block is an effective technique to provide post-operative analgesia resulting in early mobilization and enhanced recovery after surgery.展开更多
基金the Deanship of Graduate Studies and Scientific Research at Qassim University for financial support(QU-APC-2024-9/1).
文摘The prompt spread of COVID-19 has emphasized the necessity for effective and precise diagnostic tools.In this article,a hybrid approach in terms of datasets as well as the methodology by utilizing a previously unexplored dataset obtained from a private hospital for detecting COVID-19,pneumonia,and normal conditions in chest X-ray images(CXIs)is proposed coupled with Explainable Artificial Intelligence(XAI).Our study leverages less preprocessing with pre-trained cutting-edge models like InceptionV3,VGG16,and VGG19 that excel in the task of feature extraction.The methodology is further enhanced by the inclusion of the t-SNE(t-Distributed Stochastic Neighbor Embedding)technique for visualizing the extracted image features and Contrast Limited Adaptive Histogram Equalization(CLAHE)to improve images before extraction of features.Additionally,an AttentionMechanism is utilized,which helps clarify how the modelmakes decisions,which builds trust in artificial intelligence(AI)systems.To evaluate the effectiveness of the proposed approach,both benchmark datasets and a private dataset obtained with permissions from Jinnah PostgraduateMedical Center(JPMC)in Karachi,Pakistan,are utilized.In 12 experiments,VGG19 showcased remarkable performance in the hybrid dataset approach,achieving 100%accuracy in COVID-19 vs.pneumonia classification and 97%in distinguishing normal cases.Overall,across all classes,the approach achieved 98%accuracy,demonstrating its efficiency in detecting COVID-19 and differentiating it fromother chest disorders(Pneumonia and healthy)while also providing insights into the decision-making process of the models.
文摘Since the beginning of COVID-19 pandemics many countries were facing challenges with testing capacity recourse limitations. Throughout the waves of the pandemic countries were trying to address the existing constrains exploring solutions to increase the testing capacity with more cost-effective approaches. Pooled methodology was one of the methods which many have validated and used. It is evident that in case of pooled sample testing the sensitivity becomes lower, however the variation highly depends on the pool size as well as the incidence rate at the certain point. Armenia as well as many other countries has adopted regulations for mandatory COVID-19 PCR testing for all the travelers. Current study aimed to explore the efficiency of COVID-19 pooled PCR testing for nasopharyngeal swabs of individuals with no symptoms in a time period with good epidemiological state of the infection. Nasopharingeal swab samples from individuals were collected. The manual extraction of RNAs of samples was performed after pooling up to 5 samples. The pools with Cycle Threshold (CT) of < 37 were considered positive and were retested individually. In total 28,015 samples were grouped in 667 pools of which 57 were positive. The total number of positive samples was 65. The median difference (CT-pool–CT samples) was 2.4 (ranging from–3.0 to 8.9). The correlation of CT of pools and positive samples was positive. The correlation coefficient r = 0.84, P < 0.000, 95% CI range 0.7423 to 0.9243). The total economic saving when using pools compared to the individual testing was 72%. The minor difference between CT values of pools and samples can be explained by the dilution effect in the pool. However, the positive correlation between the values as well as the amount of cost saving demonstrate that pooling on nasopharyngeal samples for COVID-19 PCR testing can be a good method for efficient screening with significant resource saving. One of the most important advantages of the proposed method is the fact that samples are pooled prior extraction, which avoids the possibilities with misinterpretation of IC due to low yield of RNA in the extraction process.
文摘BACKGROUND Osteonecrosis or avascular necrosis(AVN)of the hip was one of the dreaded complications of coronavirus disease 2019(COVID-19),which emerged in patients who received steroid therapy.Corticosteroids have been a mainstay in the treatment protocol of COVID-19 patients.Popular corticosteroid drugs used in patients suffering from COVID-19 were intravenous(IV)or oral dexamethasone,methylprednisolone or hydrocortisone.The use of such high doses of corticost-eroids has shown very positive results and has been lifesaving in many cases.Still,long-term consequences were drug-induced diabetes,osteoporosis,Cushing syndrome,muscle wasting,peripheral fat mobilization,AVN,hirsutism,sleep disturbances and poor wound healing.A significant number of young patients were admitted for bilateral total hip replacements(THR)secondary to AVN following steroid use for COVID-19 treatment.AIM To assess the efficacy of bilateral pericapsular end nerve group(PENG)blocks in patients posted for bilateral THR post-steroid therapy after COVID-19 infection and assess the time taken to first ambulate after surgery.METHODS This prospective observational study was conducted between January 2023 and August 2023 at Care Hospitals,Hyderabad,India.Twenty young patients 30-35 years of age who underwent bilateral THR were studied after due consent over 8 months.All the patients received spinal anaesthesia for surgery and bilateral PENG blocks for postoperative analgesia.RESULTS The duration of surgery was 2.5 h on average.Seventeen out of twenty patients(85%)had a Visual Analog Score(VAS)of less than 2 and did not require any supplementation.One patient was removed from the study,as he required re-exploration.The remaining two patients had a VAS of more than 8 and received IV morphine post-operatively as a rescue analgesic drug.Fifteen out of seventeen patients(88.2%)could be mobilized 12 h after the procedure.CONCLUSION Osteonecrosis or AVN of the hip was one of the dreaded complications of COVID-19,which surfaced in patients who received steroid therapy requiring surgical intervention.Bilateral PENG block is an effective technique to provide post-operative analgesia resulting in early mobilization and enhanced recovery after surgery.
基金National Natural Science Foundation of China(No.62075177)the Open Research Fund of CAS Key Laboratory of Spectral Imaging Technology(No.LSIT202005W)+1 种基金the 111 Project(No.B17035)。
