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COVID-19 or 2019-nCoV is no longer pandemic but rather endemic, with more than 651,247 people around world having lost their lives after contracting the disease. Currently, there is no specific treatment or cure for COVID-19, and thus living with the disease and its symptoms is inevitable. This reality has placed a massive burden on limited healthcare systems worldwide especially in the developing nations. Although neither an effective, clinically proven antiviral agents' strategy nor an approved vaccine exist to eradicate the COVID-19 pandemic, there are alternatives that may reduce the huge burden on not only limited healthcare systems but also the economic sector; the most promising include harnessing non-clinical techniques such as machine learning, data mining, deep learning and other artificial intelligence. These alternatives would facilitate diagnosis and prognosis for 2019-nCoV pandemic patients. Supervised machine learning models for COVID-19 infection were developed in this work with learning algorithms which include logistic regression, decision tree, support vector machine, naive Bayes, and artificial neutral network using epidemiology labeled dataset for positive and negative COVID-19 cases of Mexico. The correlation coefficient analysis between various dependent and independent features was carried out to determine a strength relationship between each dependent feature and independent feature of the dataset prior to developing the models. The 80% of the training dataset were used for training the models while the remaining 20% were used for testing the models. The result of the performance evaluation of the models showed that decision tree model has the highest accuracy of 94.99% while the Support Vector Machine Model has the highest sensitivity of 93.34% and Naïve Bayes Model has the highest specificity of 94.30%.
We aimed to establish the short- and long-term efficacy of corticosteroid injection for coccydynia, and to determine if betamethasone or triamcinolone has the best effect.
During 2009 to 2016, we treated 277 patients with chronic coccydynia with either one 6 mg betamethasone or one 20 mg triamcinolone cortisone injection. A susequent injection was given to 62 (26%) of the patients. All were reviewed three to four months after injection, and 241 replied to a questionnaire a mean of 36 months (12 to 88) after the last injection. No pain at the early review was considered early success. When the patient had not been subsequently operated on, and indicated on the questionnaire that they were either well or much better, it was considered a long-term success.
At the three- to four-month review, 22 (9%) reported that they had no pain. The long-term success of one injection was 15% and rose to 29% after a second injection. Logistic regression tests showed that both early success (odds ratio (OR) 5.5, 95% confidselected.Cite this article Bone Joint Open 2020;1-11709-714.
There are reports of a marked increase in perioperative mortality in patients admitted to hospital with a fractured hip during the COVID-19 pandemic in the UK, USA, Spain, and Italy. Our study aims to describe the risk of mortality among patients with a fractured neck of femur in England during the early stages of the COVID-19 pandemic.
We completed a multicentre cohort study across ten hospitals in England. Data were collected from 1 March 2020 to 6 April 2020, during which period the World Health Organization (WHO) declared COVID-19 to be a pandemic. Patients ≥ 60 years of age admitted with hip fracture and a minimum follow-up of 30 days were included for analysis. Primary outcome of interest was mortality at 30 days post-surgery or postadmission in nonoperative patients. Secondary outcomes included length of hospital stay and discharge destination.
In total, 404 patients were included for final analysis with a COVID-19 diagnosis being made in 114 (28.2%) patients. Overall, 30-day mortality stood at 1tly higher risk of mortality than would be normally expected.Cite this article Bone Joint Open 2020;1-11697-705.
Due to the overwhelming demand for trauma services, resulting from increasing emergency department attendances over the past decade, virtual fracture clinics (VFCs) have become the fashion to keep up with the demand and help comply with the BOA Standards for Trauma and Orthopaedics (BOAST) guidelines. In this article, we perform a systematic review asking, "How useful are VFCs?", and what injuries and conditions can be treated safely and effectively, to help decrease patient face to face consultations. Our primary outcomes were patient satisfaction, clinical efficiency and cost analysis, and clinical outcomes.
We performed a systematic literature search of all papers pertaining to VFCs, using the search engines PubMed, MEDLINE, and the Cochrane Database, according to the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) checklist. Searches were carried out and screened by two authors, with final study eligibility confirmed by the senior author.
In total, 21 records were relevant to our research question. Six orthopaedic injuries were identified as suitable for VFC review, with a further four discussed in detail. A reduction of face to face appointments of up to 50% was reported with greater compliance to BOAST guidelines (46.4%) and cost saving (up to £212,000).
This systematic review demonstrates that the VFC model can help deliver a safe, more cost-effective, and more efficient arm of the trauma service to patients.Cite this article
2020;1-11683-690.
This systematic review demonstrates that the VFC model can help deliver a safe, more cost-effective, and more efficient arm of the trauma service to patients.Cite this article Bone Joint Open 2020;1-11683-690.
The COVID-19 pandemic has had a significant impact on the provision of orthopaedic care across the UK. During the pandemic orthopaedic specialist registrars were redeployed to "frontline" specialties occupying non-surgical roles. The impact of the COVID-19 pandemic on orthopaedic training in the UK is unknown. This paper sought to examine the role of orthopaedic trainees during the COVID-19 and the impact of COVID-19 pandemic on postgraduate orthopaedic education.
A 42-point questionnaire was designed, validated, and disseminated via e-mail and an instant-messaging platform.
A total of 101 orthopaedic trainees, representing the four nations (Wales, England, Scotland, and Northern Ireland), completed the questionnaire. Overall, 23.1% (23/101) of trainees were redeployed to non-surgical roles. selleck compound Of these, 73% (17/23) were redeployed to intensive treatment units (ITUs), 13% (3/23) to A/E, and 13%(3/23%) to general medicine. Of the trainees redeployed to ITU 100%, (17/17) received formal induction. Non-deployed or returning trainees had a significant reduction in sessions.
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