Articles: pandemics.
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Psychological and behavioral stress has increased enormously during Coronavirus Disease 2019 (COVID-19) pandemic. However, early prediction and intervention to address psychological distress and suicidal behaviors are crucial to prevent suicide-related deaths. This study aimed to develop a machine algorithm to predict suicidal behaviors and identify essential predictors of suicidal behaviors among university students in Bangladesh during the COVID-19 pandemic. ⋯ The performance evaluation and comparison of the MLM showed that all models behaved consistently and were comparable in predicting suicidal risk. However, the Support Vector Machine was the best and most consistent performing model among all MLMs in terms of accuracy (79%), Kappa (0.59), receiver operating characteristic (0.89), sensitivity (0.81), and specificity (0.81). Support Vector Machine is the best-performing model for predicting suicidal risks among university students in Bangladesh and can help in designing appropriate and timely suicide prevention interventions.
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Multicenter Study Observational Study
Delayed intubation associated with in-hospital mortality in patients with COVID-19 respiratory failure who fail heated and humified high flow nasal canula.
Advanced respiratory support modalities such as non-invasive positive pressure ventilation (NiPPV) and heated and humidified high flow nasal canula (HFNC) served as useful alternatives to invasive mechanical ventilatory support for acute respiratory failure (ARF) during the peak of the SARS-CoV-2/COVID-19 pandemic. Unlike NiPPV, HFNC is a newer modality and its role in the treatment of patients with severe ARF is not yet clearly defined. Furthermore, the characteristics of responders versus non-responders to HFNC have not been determined. Although recent evidence indicates that many patients with ARF treated with HFNC survive without needing intubation, those who fail and are subsequently intubated have worse outcomes. Given that prolonged use of HFNC in patients with ARF might exacerbate patient self-inflicted lung injury, we hypothesized that among those patients with ARF due to COVID-19 pneumonia, prolonged HFNC beyond 24 h before intubation would be associated with increased in-hospital mortality. ⋯ Among patients with ARF due to COVID-19 pneumonia who fail HFNC, delay of intubation beyond 24 h is associated with increased mortality.