Deep Learning Approaches to Colorectal Cancer Diagnosis: A Review

Unprecedented breakthroughs in the development of graphical processing systems have led to great potential for deep learning (DL) algorithms in analyzing visual anatomy from high-resolution medical images. Recently, in digital pathology, the use of DL technologies has drawn a substantial amount of attention for use in the effective diagnosis of various cancer types, especially colorectal cancer (CRC), which is regarded as one of the dominant causes of cancer-related deaths worldwide. This review provides an in-depth perspective on recently published research articles on DL-based CRC diagnosis and prognosis. Overall, we provide a retrospective synopsis of simple image-processing-based and machine learning (ML)-based computer-aided diagnosis (CAD) systems, followed by a comprehensive appraisal of use cases with different types of state-of-the-art DL algorithms for detecting malignancies. We first list multiple standardized and publicly available CRC datasets from two imaging types: colonoscopy and histopathology. Secondly, we categorize the studies based on the different types of CRC detected (tumor tissue, microsatellite instability, and polyps), and we assess the data preprocessing steps and the adopted DL architectures before presenting the optimum diagnostic results. CRC diagnosis with DL algorithms is still in the preclinical phase, and therefore, we point out some open issues and provide some insights into the practicability and development of robust diagnostic systems in future health care and oncology.

Telehealth Training and Education

Despite the rapid expansion of telehealth services, education and training regarding the telehealth modality have lagged and yet to be validated. While clinical skills are traditionally taught in undergraduate and graduate training programs, few programs currently teach telehealth-specific skills. This is particularly challenging given that both novice and experienced clinicians require training and components of that training are program-specific. Training should include clinicians, patients, their carepartners, and telepresenters as the future health care team is rapidly evolving and will require a collaborative approach. This chapter outlines the various types of telehealth education, the groups of learners for whom training should be targeted, and various models of training.

COVID-19 and advance care planning: A unique opportunity.

32 Background: Advance Care Planning (ACP) is a process to document patient preferences for future health care. Conversations between healthcare providers, patients, and loved-ones are required to reflect a patient’s values, goals, and ultimately their choices for life-sustaining treatments (LST). The COVID-19 pandemic has highlighted the critical importance of these discussions and the need for improved patient engagement. Methods: As COVID-19 infections surged, the VA Northern California Health Care System (VA NCHCS) Hospice and Palliative Care Section (HPCS) partnered with Patient Aligned Care Teams to expand urgent outreach to high-risk patients needing LST documentation. High risk was defined as age > 80, COPD or asthma diagnosis, or Care Assessment Need Score > 80 (CAN Score models risk of hospitalization or death within 1 year). An experienced HPCS Nurse Practitioner (NP) contacted these identified patients to 1.) provide COVID-19 education, 2.) conduct a high-quality goals of care conversation, and 3.) complete LST documentation and other ACP needs. A representative cohort was then followed up to evaluate concordance of treatment with their documented preferences. Results: Between March 2020 and September 2020, 910 patients were identified as high risk. Of these patients, 294 agreed to participate in the telehealth visit and complete LST documentation. Importantly, 108 (37%) patients chose DNR and other LST limitations. In addition, 142 (48%) patients created POLST documentation and 128 (43%) completed Advance Directives. Over 70% of patients who were hospitalized in the VA received care concordant with the newly documented LST preferences. A follow up survey of 29 participants found the outreach impactful and their preferences documented correctly. Conclusions: Prior studies have demonstrated success at educating primary providers to conduct ACP discussions, but given the limitations imposed by COVID-19 restrictions, this novel and highly cost-effective process of coupling a highly trained HPCS NP with a primary care team to perform ACP was piloted with success. After only a single ACP discussion, patients were able to formalize their limits to treatment and subsequent care aligned with these preferences. Patients also found this focused ACP discussion meaningful. This pathway will be integrated within the VA NCHCS as a long-term approach to continued ACP outreach.

Socioeconomic and Demographic Factors Contributing to COVID-19–Related Delays and Reductions in Primary Retinal Detachment Repair in a US Hot Spot

Purpose: This work evaluates demographic and socioeconomic predictors of delayed care for rhegmatogenous retinal detachments (RRDs) during the spring 2020 COVID-19 shutdown in a US hot spot. Methods: This multicenter, retrospective, case-control study took place in 3 academic vitreoretinal practices in metropolitan Boston. Consecutive patients treated for RRD during the COVID-19 state of emergency were compared with patients treated during the same period in 2018 and 2019. The primary outcome was macula status for RRD. Secondary outcomes included visual acuity, symptom duration, proportion with proliferative vitreoretinopathy, time to procedure, method of repair, and patient demographics. Results: The total number of acute RRD decreased by 13.7% from 2018 to 2020 and 17.2% from 2019 to 2020. Symptom duration was significantly longer in 2020 than 2018 and 2019 (median, 7 vs 4 days) with a higher proportion of macula-off detachments (80 of 125 [64%] in 2020 vs 75 of 145 [51.7%] in 2018 and 78 of 151 [51.6%] in 2019). The 2020 cohort included significantly fewer patients in the racial and/or ethnic minority group than in 2019 ( P = .02), and use of low-income, government-sponsored health insurance was a predictor of macula-off status during the pandemic ( P = .04). Conclusions: RRDs during the spring 2020 COVID-19 lockdown were more likely to be macula-off at presentation. Because sociodemographic factors including race, ethnicity, and income level were associated with deferral of care, ophthalmologists should consider measures targeting vulnerable populations to avoid preventable vision loss as the pandemic continues or in future health care emergencies.

Paediatric admissions to a hospital in the United Arab Emirates

A prospective study was designed to assess the types of illness which resulted in hospital admission in Al-Ain, United Arab Emirates, and the background to the admission. The majority of children were admitted for the management of a respiratory condition, particularly asthma. Infections were the next major cause of hospital care. Management of the complications of thalassaemia was also an important reason for admission. The recognition of the importance of this disorder is necessary for future health care planning in the United Arab Emirates. The majority of children were regarded as having a disorder of medium severity at the time of their admission. The results are discussed in light of a similar United Kingdom study

Artificial Intelligence the Itinerary of Sustainable Health Care

The Global Strategy for health for all by the year 2020 was launched by WHO in the year 1979 but still the goal has not been achieved; crisis of health care personnel is a major reason behind it. To achieve a more stable future, health care sector needs Artificial Intelligence (AI) will be a curtain raiser towards sustainability in the field of health care. Sustainable health care can be achieved by fulfilling the targets set out by Sustainable Development Goals, AI can provide promising alternatives to match the goals and aim the sustainable health care for the generations to come. The current paper would like to propose AI as a solution to these issues. AI is already in the front line for diagnosis and medical imaging but there is still lot of scopefor utilization.

Measuring reopening readiness: a universal COVID-19 index for US states

PurposeWhile United States is among countries with the world’s highest coronavirus infections, its approaches and policies to reopen the economy vary by state. A lack of objective criteria and monitoring toward satisfying the criteria can lead to another COVID-19 outbreak and business closures. Considering the pressing need to return to normalcy without a rebound of COVID-19 infections and deaths, an index that provides a data-driven and objective insight is urgently needed. Hence, a method was devised to assess the severity of the COVID-19 pandemic and determine the degree of progress any state has made in containing the spread of COVID-19.Design/methodology/approachUsing measures such as the weekly averages of daily new deaths, ICU bed occupancy rates, positive cases and test positivity rates, two indexes were developed: COVID-19 reopening readiness and severity.FindingsA clear difference in the pandemic severity trends can be observed between states, which is possibly due to the disparity in the state’s response to coronavirus. A sharp upward trend in index values requires caution prior to moving to the next phase of reopening.Originality/valueThe composite indexes advanced in this study will provide a universal, standardized and unbiased view of each state’s readiness to reopen and allow comparisons between states. This in turn can help governments and health-care agencies take counter measures if needed as to the anticipated demand for future health-care services and minimize adverse consequences of opening.

Orthopaedic Research and Education Foundation India, Pandemic and Orthopaedic Education

The covid pandemic has changed life for all of us in the past 1 ½ years. There are many challenges in our day-to-day working life. However, there are also many opportunities and one such opportunity has been to reach out to the experts through webinars and virtual learning classes. We are physically locked out, but not for our mental challenges and our academic pursuits. The Problem-during the Pandemic Providing quality orthopedic care is a real challenge during the current pandemic. The period of implemented government lockdown taught us many lessons. There was plenty of ups and downs during the surge. Many orthopedic residents put on COVID duty instead of ward work and lost contact with their subject. When one is not able to concentrate due to apprehension, anxiety and even fear of death, they find it difficult to understand the ABCs of orthopedics. Thus, the teaching program in all the departments was greatly hampered. This was not the story for a few days but for months together. With this crisis on our hands, the Orthopedic Research and Education Foundation (OREF) is really had to hard to fulfill its responsibility of the academic need for the orthopedic residents which could help a large number of orthopedic surgeons and improve future health care. What was OREF is Looking for: Searching for Solutions to Compromised Academics and Compromised Healthcare? Most of them are trying to serve patients by reducing the health risks by implementing various uses of the Internet, many revolutionized digital technologies, artificial intelligence, robotics, 3D printing, etc. We also learned to serve patients in remote areas through telemedicine. We are now moving forward in the quest to deliver and receive surgical care of the patient in other parts of the world through wireless technology. We also felt the need to do something for our academic needs as face-to-face educational activities, are hampered significantly. Exploring the revolution in digital technologies in ort