Non-emergency Services Research Articles

Cessation and resumption of elective neurointerventional procedures during the coronavirus disease 2019 pandemic and future pandemics.

At the time of this writing, the coronavirus disease 2019 pandemic continues to be a global threat, disrupting usual processes, and protocols for delivering health care around the globe. There have been significant regional and national differences in the scope and timing of these disruptions. Many hospitals were forced to temporarily halt elective neurointerventional procedures with the first wave of the pandemic in the spring of 2020, in order to prioritize allocation of resources for acutely ill patients and also to minimize coronavirus disease 2019 transmission risks to non-acute patients, their families, and health care workers. This temporary moratorium on elective neurointerventional procedures is generally credited with helping to “flatten the curve” and direct scarce resources to more acutely ill patients; however, there have been reports of some delaying seeking medical care when it was in fact urgent, and other reports of patients having elective treatment delayed with the result of morbidity and mortality. Many regions have resumed elective neurointerventional procedures, only to now watch coronavirus disease 2019 positivity rates again climbing as winter of 2020 approaches. A new wave is now forecast which may have larger volumes of hospitalized coronavirus disease 2019 patients than the earlier wave(s) and may also coincide with a wave of patients hospitalized with seasonal influenza. This paper discusses relevant and practical elements of cessation and safe resumption of nonemergent neurointerventional services in the setting of a pandemic.

Noise complaints and transportation inequality assessment

As a self-reporting data source, the 311 non-emergency service reflects the residents’ concerns on various environmental complaints, including noise. This study explores the nexus between noise complaints extracted from this data source and the transportation-related inequality that reflects a wide range of socio-demographic cohorts associated with it in Dallas, Texas. Noise constitutes an inevitable fact of life—especially in denser urban areas, that as this paper reports, reflects social injustice. Drawing from multiple socio-demographic and transportation indicators, this study conducts multiple statistical and spatial analyses in the selected case studies. The findings further identify the explanatory variables relative to noise complaints and their inequality implications. The results confirm that transportation-related factors affect inequality while also operating within specific socio-demographic patterns. The study gleans lessons for transportation and urban planners, policymakers, and local authorities.

Impact of preoperative COVID infection on the outcomes of planned curative-intent cancer surgeries in the second wave of the pandemic from a tertiary care center in India.

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic was an unforeseen calamity. Sudden disruption of nonemergency services led to disruption of treatment across all specialties. Oncology revolves around the tenet of timely detection and treatment. Disruption of any sort will jeopardize cure rates. The time interval between coronavirus infection and cancer surgery is variable and needs to be tailored to avoid the progression of the disease.MethodsWe analyzed the impact of preoperative coronavirus disease 2019 (COVID‐19) infection on the planned cancer surgery, delay, disease progression, and change of intent of treatment from April 1 to May 31, 2021 at a tertiary care center. All preoperative positive patients were retested after 2 weeks and were considered for surgery if the repeat test was negative and asymptomatic.FindingsOur study included 432 preoperative patients of which 91 (21%) were COVID‐19 positive. Amongst this cohort, 76% were operated and the morbidity and mortality were comparable to the COVID‐19 negative cohort. Around 10% of the COVID‐19 positive were lost to follow up and 10% had disease progression and were deemed palliativeInterpretationSARS‐CoV‐2 infection has adversely impacted cancer care and a 2‐week waiting period postinfection seems to be a safe interval in asymptomatic individuals to consider radical cancer surgery.

Home-Based Peanut Oral Immunotherapy for Low-Risk Peanut-Allergic Preschoolers During the COVID-19 Pandemic and Beyond.

The coronavirus disease 2019 (COVID-19) pandemic has led to the deprioritization of non-emergency services, such as oral food challenges and the initiation of oral immunotherapy (OIT) for food-allergic children. Recent studies have suggested that home-based peanut OIT could be a safe and effective option for low-risk peanut-allergic children. In the period between September 1, 2020, and January 31, 2021, nine preschoolers with a history of mild allergic reactions to peanut underwent home-based peanut OIT. Eight of them (88.9%) completed the build-up phase at home in 11–28 weeks, tolerating a daily maintenance dose of 320 mg peanut protein. During the build-up, six patients (75.0%) reported urticaria, three (33.3%) reported gastrointestinal tract symptoms, and one (14.3%) reported oral pruritis. None of the patients developed anaphylaxis, required epinephrine, or attended emergency services related to OIT. One or two virtual follow-up visits were completed per patient during the build-up phase. Our case series shows that home-based OIT could be offered to the low-risk preschoolers during the COVID-19 pandemic when non-emergency services are limited and could be considered beyond the pandemic, especially for the families living in the rural or remote areas that may otherwise be unable to access OIT.

Studying and Clustering Cities Based on Their Non-Emergency Service Requests

This study offers a new perspective in analyzing 311 service requests (SRs) across the country by representing cities based on the types of their SRs. This not only uncovers temporal patterns of SRs in each city over the years but also detects cities with the most or least similarity to other cities based on their SR types. The first challenge is to gather 311 SRs for different cities and standardize their types since they differ in various cities. Implementing our analyses on close to 42 million SR records in 20 cities from 2006 to 2019 is the second challenge. Representing clusters of cities and outliers effectively, and providing justifications for them, is the last challenge. Our attempt resulted in 79 standardized SR types. We applied the principal component analysis to depict cities on a two-dimensional canvas based on their standardized SR types. Among our main findings are the following: many cities are observing a fall in requests regarding the condition of roads and sidewalks but a rise in requests concerning transportation and traffic; requests regarding garbage, cleaning, rodents, and complaints have also been rising in some cities; new types of requests have emerged and soared in recent years, such as requests for information and regarding shared mobility devices; requests about parking meters, information, sidewalks, curbs, graffities, and missed garbage pick up have the highest variance in their rates across different cities, i.e., they have a large rate in some cities while a low rate in others; the most consistent outliers, in terms of SR types, are Washington DC, Baltimore, Las Vegas, Philadelphia, Chicago, and Baton Rouge.

COVID-19 Preparedness and Response Plans from 106 countries: a review from a health systems resilience perspective.

Coronavirus disease (COVID-19) has exposed long-standing fragmentation in health systems strengthening efforts for health security and universal health coverage while these objectives are largely interdependent and complementary. In this prevailing background, we reviewed countries’ COVID-19 Preparedness and Response Plans (CPRPs) to assess the extent of integration of non-COVID-19 essential health service continuity considerations alongside emergency response activities. We searched for COVID-19 planning documents from governments and ministries of health, World Health Organization (WHO) country offices and United Nations (UN) country teams. We developed document review protocols using global guidance from the WHO and UN and the health systems resilience literature. After screening, we analysed 154 CPRPs from 106 countries. The majority of plans had a high degree of alignment with pillars of emergency response such as surveillance (99%), laboratory systems (96%) and COVID-19-specific case management (97%). Less than half considered maintaining essential health services (47%); 41% designated a mechanism for health system–wide participation in emergency planning; 34% considered subnational service delivery; 95% contained infection prevention and control (IPC) activities and 29% considered quality of care; and 24% were budgeted for and 7% contained monitoring and evaluation of essential health services. To improve, ongoing and future emergency planning should proactively include proportionate activities, resources and monitoring for essential health services to reduce excess mortality and morbidity. Specifically, this entails strengthening subnational health services with local stakeholder engagement in planning; ensuring a dedicated focus in emergency operations structures to maintain health systems resilience for non-emergency health services; considering all domains of quality in health services along with IPC; and building resilient monitoring capacity for timely and reliable tracking of health systems functionality including service utilization and health outcomes. An integrated approach to planning should be pursued as health systems recover from COVID-19 disruptions and take actions to build back better.

A qualitative analysis of the impact of the opioid crisis on non-emergency frontline social service workers

ABSTRACT The opioid crisis in Canada has led to over 9,000 opioid-related deaths. The impact of this crisis on frontline workers is poorly understood. We spoke to 14 frontline workers to explore the impact of the opioid crisis on their work, examine perceptions of supports in the workplace, and identify recommendations to mitigate overdose-related stressors. Findings suggest that workers are experiencing significant increases in stress/burnout. Perceived stressors included new/increased job duties, fear of deaths, inadequate staffing/training, heightened vigilance, and fears for safety. Additional counseling, debriefing, staffing, training, and recreation were recommended. Public policies favoring harm reduction are also discussed.

Challenges and navigating conundrums in setting up an obstetrics and gynecology coronavirus disease facility in a pre-existing tertiary care hospital – An Indian perspective

India at present has 145,779 active coronavirus disease (COVID) cases and 8884 deaths. Being the largest tertiary care health facility under Delhi Government, our center was designated as a 2000 bedded dedicated COVID hospital. In addition to establishing areas for COVID management, COVID Obstetrics and Gynecology area requires a dedicated set up for delivering women, an operating room, and a neonatal care unit. A phased evacuation plan begins by curtailing non-emergency services and postponing elective surgeries, this process may take longer for obstetrics than other specialties on account of labor and postnatal care. The percentage reduction in the number of elective obstetric and gynecological surgeries was 73% and further fell by 98% (n = 4; category C, D) over a period of 1 month of the evacuation phase, whereas the reduction in emergency cases was only 15% (n = 200) in the beginning and fell to 89%. During the surge phase of COVID, we were able to increase the inpatient surge capacity by 8% (n = 100) as the bed occupancy increased exponentially from 30% to 88%. The start of evacuation of the facility until the endpoint of the surge marks the most dynamic phase of establishing a COVID facility during a pandemic. Pre-event planning for surge capacity at the inception of such pandemics should be based on the local and regional policies which depend on the competing demands of resources to maintain sustainability. These logistical demands are dynamic and vary as the pandemic progresses through its phases.

Racial disparities in use of non-emergency outpatient care by Medicaid-eligible adults after release from prison: Wisconsin, 2015–2017

BackgroundBlack individuals with substance use disorders (SUD) are less likely to receive effective treatment and more likely to be incarcerated compared to White individuals. Despite this, research documenting racial disparities in healthcare use among people with SUD releasing from prison is limited. ObjectivesThe goals of this study are to: 1) assess racial disparities in Medicaid enrollment among individuals released from prison with a history of substance use; and 2) characterize racial disparities in outpatient service use, emergency department (ED) use, and receipt of medication for opioid use disorder (MOUD) among those who do enroll in Medicaid. MethodsThis study included individuals with a history of substance use that were released from Wisconsin state correctional facilities from April 2015 through June 2017. Medicaid enrollment and claims data were analyzed to compare healthcare utilization 6 months post-release between individuals identifying as Black, White, or other races. The total sample included 15,621 prison releases among 14,400 unique persons with a history of substance abuse. ResultsAmong the 15,621 prison releases, 10,836 (69.4%) were enrolled in Medicaid in the month of release. The proportion of prison releases among individuals of other races who enrolled in Medicaid (506/934, 54.2%) was significantly lower than the proportion among Black individuals (3679/5306, 69.3%) and White individuals (6651/9381, 70.9%). Among the subset of 7685 releases enrolled in Medicaid for 6 months post-release, 5040 (65.6%) had an outpatient visit within 6 months; 73.9% of White, 51.3% of Black, and 66.9% of other individuals. Relative to White individuals, Black individuals were 0.324 times less likely (P < 0.001) and individuals of other races were 0.591 times less likely (P = 0.004) to have an outpatient visit. Of the 7685 releases, 1016 (13.2%) had an ED visit within 6 months; 12.0% of White, 13.8% of Black and 25.1% of other individuals. Relative to White individuals, Black individuals were 1.23 times more likely (P = 0.019) and individuals of other races were 2.64 times more likely (P < 0.001) to have an ED visit. Black individuals were 0.100 times less likely (P < 0.001) and individuals of other races were 0.435 times less likely (P = 0.016) to receive MOUD post-release compared to White individuals. ConclusionsBlack adults with a history of substance use are significantly less likely than White adults to use non-emergency outpatient services after release from incarceration. Improving equitable access to outpatient services is needed to reduce health disparities across racial groups.

Changes in Oral Health Policies and Guidelines During the COVID-19 Pandemic.

The aim of this study was to describe the changes in oral health policies and guidelines in response to the Coronavirus disease 2019 (COVID-19) pandemic in different countries and regions around the world. Information on oral health policies and guidelines from 9 countries (Canada, China including Hong Kong, Egypt, India, Japan, New Zealand, Nigeria, Switzerland, and Thailand) were summarized, and sources of the information were mostly the national or regional health authorities and/or dental council/associations. The changes made to the oral health guidelines depended on the severity of the COVID-19 pandemic. This included suspension of non-emergency dental care services at the peak of the COVID-19 outbreak, and easing the restrictions on non-essential and elective dental care when the pandemic became under control. The COVID-19 risk mitigation strategies include strict adherence to infection control practices (use of hand sanitizers, facemask and maintaining social distancing), reducing the amount of aerosol production in the dental setting, and managing the quality of air in the dental treatment rooms by reducing the use of air conditioners and improving air exchange. The COVID-19 pandemic has shown a major impact on dental practice. Dental professionals are trying to adapt to the new norms, while the medium to long-term impact of COVID-19 on dentistry needs further investigation.

Treat and Release for Patients Requiring Emergency Medical Services

&#x0D; “Treat and release” and “treat and refer” protocols or practices refer to the onsite treatment of patients by responding emergency medical services personnel that does not involve transporting patients to health care facilities for additional assessment and treatment. The goal of these protocols is to allow patients to be released from care or to be referred directly to non-emergency services by emergency medical services personnel when appropriate, diverting patients from emergency departments.&#x0D; One health technology assessment that included a relevant randomized controlled trial and economic evaluation and 2 non-randomized studies were identified for inclusion. These studies examined treat and release or treat and refer protocols for treating hypoglycemia and exertional heat stroke, and for attending to older people following a fall.&#x0D; Overall, the clinical evidence summarized in this report suggests that treat and release protocols are as good as, or better than, usual care (i.e., onsite treatment of immediate medical care followed by transportation to health care facilities). Across most reported outcomes, there were no significant differences between patients who received care using treat and release or treat and refer protocols, and those who received usual care; however, there were some instances where the use of these protocols was associated with improvements in some clinical outcomes, such as patient satisfaction, risk for future falls or fractures, and some measures of repeat access to health care services.&#x0D; Findings related to the cost-effectiveness of treat and refer protocols were inconclusive because of the limited generalizability of the findings from the included economic evaluation. The economic evaluation estimated that implementing a treat and refer protocol for older patients who experienced a fall did not result in significant changes to health care resource utilization and did not generate improved health-related quality of life compared to usual care.&#x0D; No evidence-based guidelines regarding the use of treat and release protocols for patients requiring emergency medical services were identified.&#x0D;

331 Trends and outcomes in patients with malignant skin cancers during the COVID pandemic

The COVID-19 pandemic has forced healthcare organizations to reduce the provision of non-emergent services leading to delays in diagnoses and treatment. There is scant literature regarding the impact of COVID in malignant skin cancer (MSC) patients. A retrospective analysis was done from Apr-July 2020 using TriNetX, a national federated database of 63 million records. The incidence of new MSC-related codes was estimated during the pandemic period and compared to a corresponding pre-pandemic period.

The "COVID-19 Pandemic Gap" and Its Influence on Oncologic Outcomes of Bladder Cancer.

Simple SummaryThe COVID-19 pandemic has had a major impact on the entire healthcare system, resulting in severe restrictions of nonemergency clinical services, as well as in the clinical practice of uro-oncology. We performed a retrospective analysis to evaluate outcomes of the COVID-19 pandemic resulting from delayed diagnosis, staging, and treatment of bladder cancer. We showed that the COVID-19 pandemic led to a deferred oncological diagnosis and treatment of bladder cancer. More attention is required to avoid adverse outcomes, with increased rates of advanced and aggressive tumors in patients with primary bladder cancer. Moreover, timely treatment is compulsory in those patients.Coronavirus-19 (COVID-19)-induced effects on deferred diagnosis and treatment of bladder cancer (BC) patients are currently not clarified. The aim of this study was to evaluate outcomes of the COVID-19 pandemic by considering its effects on tumor stage and grade, and to create feasible clinical triage decisions. A retrospective single-center analysis of all patients who underwent diagnostic and surgical procedures due to BC, during January 2019 and December 2020, was performed. Due to COVID-19 lockdowns, significantly fewer (diagnostic and therapeutic) endoscopic procedures were performed in the first 6 months of 2020 compared to 2019 (p = 0.002). In patients with a primary diagnosis of BC, a significant increase of high-grade tumors (p < 0.001), as well as advanced tumor stages (p = 0.014), were noticed during 2020 in comparison to 2019. On the contrary, patients with recurrent BC undergoing risk-adapted surveillance, depending on previous tumor histology, showed no adverse outcomes regarding tumor stage and grade when comparing the pre COVID-19 era with 2020. Thus, more awareness in clinical urologic practice is mandatory to avoid adverse consequences, with increased rates of advanced and aggressive tumors in patients with primary BC. In recurrent BC, an individual risk stratification in order to avoid worse outcomes during the COVID-19 pandemic seems to be justified.

Changing trends in the outpatient dental visits during the COVID - 19 pandemic in a tertiary care hospital.

The coronavirus pandemic has caused a global public health crisis with an unprecedented shutdown of major establishments and non-emergency services. Disruptions across the country in dental hospitals led to challenges in addressing patient’s dental complaints. The present study aimed to analyse the difference in the pattern of the Outpatient dental visits during the pandemic period in comparison to that of the pre-pandemic period in a tertiary care hospital. This retrospective study was carried out by retrieving the patient data from the diagnostic register of the Department of Oral Medicine and Radiology for a period of one year. The data that was retrieved from 24th September 2019 to 23rd March 2020 was categorized under the pre-pandemic period and the data from 24th March 2020 to 24th September 2020 was grouped under the pandemic period. Patient data regarding the age, gender and clinical diagnosis was recorded and categorized under three main categories: “Emergency”, “urgent” and “elective”. 7550 patients during pre-pandemic period and 4035 patients during the pandemic period visited the dental hospital during the study period. Under the “emergency dental care” category, during the pre-pandemic period, majority of the cases reported of acute dental pain (71.0%) followed by cellulitis and space infection (20.1%) and maxillofacial trauma (8.7%). During the pandemic period, acute dental pain consisted of all emergency visits (n = 307). The proportion of emergency dental visits during the pandemic were significantly higher than the pre-pandemic period. Elective dental visits were significantly higher during pre-pandemic period in comparison to the pandemic period. (P < 0.001). There was a notable change in the outpatient trend of the dental visits during the COVID-19 pandemic in comparison to the pre-pandemic period. Emergency dental services were utilized at a higher rate during the pandemic period in comparison to the pre-pandemic counterpart.

Maintaining therapeutic continuity in adolescent psychiatric day hospital programs during the COVID-19 lockdown

IntroductionThe COVID-19 social lockdown imposed important limitation to non-emergency health care services in Italy, between March and May 2020, with many difficulties in the mental health assistance of those chronic conditions needing a continuative therapeutic support.ObjectivesOur study aimed to describe how therapeutic activities have been carried on by remote services in two Adolescent Psychiatric Day Hospital Units (Rome and Turin) and the outcome of these assistance interventions in youths with subacute psychopathology.MethodsThe patient cohort includes 162 adolescents (12-19 years old; QI&gt;70) DH outpatients presenting a complete clinical and neuropsychiatric assessment before the lockdown. During the several phases of COVID-19 quarantine all patients were monitored and supported by telemedicine interventions. All data were recorded and standardized every 15 days: symptom severity was rated by global severity (CGI-S) and stress level by self-reported measures of stress (IES-R).ResultsAmong patients, CGI score remained stable, IES-R score declined over time: higher IES-R score was significantly associated with female gender and but no differences was observed related with the primary diagnosis. 5 patients presented a clinical acute state needing a hospitalization. The rate of hospitalization was not significantly different compared with the rate observed in the same period of 2019.ConclusionsIn youth with psychopathological conditions, remote assistance for psychiatric cares resulted effective and it was associated with a clinical stability with decreasing stress levels.DisclosureNo significant relationships.

The impact of the COVID-19 pandemic on health services utilization in China: Time-series analyses for 2016–2020

BackgroundThe aim of this study is to quantify the effects of the SARS-CoV-2 pandemic on health services utilization in China using over four years of routine health information system data. MethodsWe conducted a retrospective observational cohort study of health services utilization from health facilities at all levels in all provinces of mainland China. We analyzed monthly all-cause health facility visits and inpatient volume in health facilities before and during the SARS-CoV-2 outbreak using nationwide routine health information system data from January 2016 to June 2020. We used interrupted time series analyses and segmented negative binomial regression to examine changes in healthcare utilization attributable to the pandemic. Stratified analyses by facility type and by provincial Human Development Index (HDI) – an area-level measure of socioeconomic status – were conducted to assess potential heterogeneity in effects. FindingsIn the months before the SARS-CoV-2 outbreak, a positive secular trend in patterns of healthcare utilization was observed. After the SARS-CoV-2 outbreak, we noted statistically significant decreases in all indicators, with all indicators achieving their nadir in February 2020. The magnitude of decline in February ranged from 63% (95% CI 61–65%; p<0•0001) in all-cause visits at hospitals in regions with high HDI and 71% (95% CI 70–72%; p<0•0001) in all-cause visits at primary care clinics to 33% (95% CI 24–42%; p<0•0001) in inpatient volume and 10% (95% CI 3–17%; p = 0•0076) in all-cause visits at township health centers (THC) in regions with low HDI. The reduction in health facility visits was greater than that in the number of outpatients discharged (51% versus 48%; p<0•0079). The reductions in both health facility visits and inpatient volume were greater in hospitals than in primary health care facilities (p<0•0001) and greater in developed regions than in underdeveloped regions (p<0•0001). Following the nadir of health services utilization in February 2020, all indicators showed statistically significant increases. However, even by June 2020, nearly all indicators except outpatient and inpatient volume in regions with low HDI and inpatient volume in private hospitals had not achieved their pre-SARS-COV-2 forecasted levels. In total, we estimated cumulative losses of 1020.5 (95% CI 951.2- 1089.4; P<0.0001) million or 23.9% (95% CI 22.5–25.2%; P<0.0001) health facility visits, and 28.9 (95% CI 26.1–31.6; P<0.0001) million or 21.6% (95% CI 19.7–23.4%; P<0.0001) inpatients as of June 2020. InterpretationInpatient and outpatient health services utilization in China declined significantly after the SARS-CoV-2 outbreak, likely due to changes in patient and provider behaviors, suspension of health facilities or their non-emergency services, massive mobility restrictions, and the potential reduction in the risk of non-SARS-COV-2 diseases. All indicators rebounded beginning in March but most had not recovered to their pre-SARS-COV-2 levels as of June 2020. FundingThe National Natural Science Foundation of China (No. 72042014).

Prioritisation of outpatient appointments and elective surgery in gynaecology.

The coronavirus disease 2019 (COVID-19) pandemic continues to be a global public health concern. It has posed a multitude of challenges from managing the supply chain of personal protective equipment (PPE), reducing the spread of the virus through national restrictions, disrupting the routine delivery of healthcare services to now the race in developing novel treatments and vaccines. As the National Health Service (NHS) considers a phased restoration of non-emergency services, it is imperative to consider the high volume of patients awaiting specialist reviews and surgical procedures. Gynaecology services have to be prioritised according to the patients’ clinical needs rather than their individual waiting times. In this chapter, we look at the varying aspects of prioritising non-emergency gynaecology care, including outpatient appointments and elective surgery, how innovative pathways have evolved in response to necessity, what some of the barriers have been to implement these and how this has overall impacted on individual gynaecological specialties.

Coronavirus disease 2019 and its impact on psychosocial aspects amongst infertile couples: An overview

Following the outbreak of the coronavirus pandemic, there has been an unforeseen pressure and stress to the already burdened health-care systems. This necessitated an urgent need to reallocate the health-care resources and prompted immediate suspension and postponement of non-emergent health-care services including infertility treatments. This pandemic brought additional stress to the couples seeking infertility treatment and resulted in an indefinite time lag to their treatment thereby adding to the psychological distress among this vulnerable population. The coronavirus disease 2019 (COVID-19) has also predisposed them to various psychiatric disorders by affecting their mental, reproductive, and relationship status. These included emotional disorders ranging from frustration, depression, anxiety, hopelessness, and guilt, feelings of worthlessness in life to psychiatric disorders such as generalized anxiety disorder, major depressive disorder, and dysthymic disorder. The social isolation imposed grave psychological consequences and lead to an unpredicted change in attitudes and beliefs of such infertile couples. The implication of the loss of employment has further dwelled on their financial constraints and made this population even more labile. Thus, the current time has brought forth some unique and unexpected challenges and emotional turmoil that needs due recognition and prompt professional support. Furthermore, it is high time to review our health-care policies and hence restart infertility services striking a balance between the safety of both patient and health-care professionals amidst this pandemic while helping these unfortunate couples achieve parenthood. The resumption of infertility services post-COVID-19 has challenges of its own. The clinician and the paramedical staff had to undergo specific training to adapt to the new norms of workplace while minimizing in person interactions and exposure risk.

COVID-19 Pandemic and Infertility: Gynecological Dilemma from an Indian Perspective.

As the emaciated healthcare system is attempting to break the tide of the novel coronavirus pandemic across the globe, the highest cost of this fight is being borne by the third world countries. India is currently experiencing the peak incidence of COVID-19 cases. For the last 9 months, non-emergency services including OPDs have been suspended in majority of the hospitals to divert resources for combatting emergency medical care during this deadly pandemic. This temporary pause and containment could be detrimental to even patients suffering from malignancy. During this critical hour, commencement of infertility treatments including assisted reproductive technologies (ART) will add to additional burden upon the crippled medical fraternity. Fate of thousands of patients seems to hang by a fine thread now. In the resource-poor countries, it is our duty to divert maximum medical power to curtail this contagious pandemic rather than focusing on non-urgent treatment services.

Spatiotemporal Prediction of Theft Risk with Deep Inception-Residual Networks

Spatiotemporal prediction of crime is crucial for public safety and smart cities operation. As crime incidents are distributed sparsely across space and time, existing deep-learning methods constrained by coarse spatial scale offer only limited values in prediction of crime density. This paper proposes the use of deep inception-residual networks (DIRNet) to conduct fine-grained, theft-related crime prediction based on non-emergency service request data (311 events). Specifically, it outlines the employment of inception units comprising asymmetrical convolution layers to draw low-level spatiotemporal dependencies hidden in crime events and complaint records in the 311 dataset. Afterward, this paper details how residual units can be applied to capture high-level spatiotemporal features from low-level spatiotemporal dependencies for the final prediction. The effectiveness of the proposed DIRNet is evaluated based on theft-related crime data and 311 data in New York City from 2010 to 2015. The results confirm that the DIRNet obtains an average F1 of 71%, which is better than other prediction models.