bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Study in Sexual Function between Male Renal Transplant Recipient and ESRD Patients on Hemodialysis
Authors: Shoaab M S , Yassen M M , Elsalakawy A S A
Published: May 2020

Background

erectile function is greatly affected in patients with chronic renal failure which manifest itself with various grades of erectile dysfunction which is reflected on physical and psychosocial health of the patients which has a significant impact on quality of life (QOL).

Purpose

to evaluate erectile function in CRF patients on regular hemodialysis versus post renal transplant patients.

Patients and Methods

the study included 50 patients recruited from urology and nephrology outpatient clinic in El Zaitoon and Naser Institute Hospitals during a period of 6 months. The 50 patients were divided into two groups: chronic kidney disease group (DIALYSIS) and renal transplant group (TRANSPLANT).

Results

the domains concerning the sexual performance of IIEF-5 showed that in our study erection function domain showed better results in renal transplantation group (p < 0.003) with median(IQR) in the CKD and renal transplant patients 10(40%) and 15(60%) respectively.

Conclusion

successful kidney transplantation can significantly improve ED in CKD patients, especially in individuals with a shorter time on dialysis. Changes in sex hormone levels may contribute to this improvement in ED.
Role of Balloon Assisted Maturation Technique in the Rate of AVF Maturation in Chronic Renal Failure Patients
Authors: Khatab M S , Essam S M , Aboelfotoh H
Published: May 2020

Background

the current recommendations from the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKFDOQI) favors the use of arteriovenous fistulas (AVF) over grafts and central catheters, in an effort to decrease cost, increase long term patency, reduce interventions and decrease patient morbidity.

Purpose

this study was designed to determine the rate of AVF maturation using the (BAM) technique; the primary and secondary patency rate and to evaluate the feasibility and safety of the (BAM) technique for the immature or failed AVF.

Patients and Methods

30 chronic renal failure patients were selected for the purpose of this study from patients presented to vascular surgery clinic, Ain Shams University Hospital and Nasr City Hospital.

Results

this study included 30 arteriovenous fistula, belonging to 30 chronic renal failure patient. Their mean age was 57.6 years (±14.6). The demographic characteristics and risk factor distribution are shown below.

Conclusion

endovascular techniques have an important role to play in helping the dialysis community meet the goals of the Fistula First Initiative. To meet these goals, the previously mentioned techniques need to be used in varying degrees to salvage > 95% of the nearly 60% of AVFs that fail to mature. When prolonged catheter time is taken into account, it is imperative to have a systematic method for salvaging these failing accesses before catheter-related complications are encountered.
The optimized preparation of HA/L-TiO2/D-TiO2 composite coating on porous titanium and its effect on the behavior osteoblasts
Authors: Fu Xi , Zhou Xingyu , Liu Pin , Chen Hewei , Xiao Zhanwen , Yuan Bo , Yang Xiao , Zhu Xiangdong , Zhang Kai , Zhang Xingdong
Published: May 2020

Various surface bioactivation technology has been confirmed to improve the osteogenic ability of porous titanium (pTi) implants effectively. In this study, a three-layered composite coating, i.e. outer layer of hydroxyapatite (HA), middle layer of loose titanium dioxide (L-TiO2) and inner layer of dense TiO2 (D-TiO2), was fabricated on pTi by a combined processing procedure of pickling, alkali heat (AH), anodic oxidation (AO), electrochemical deposition (ED) and hydrothermal treatment (HT). After soaking in simulated body fluid for 48 h, the surface of the AHAOEDHT-treated pTi was completely covered by a homogeneous apatite layer. Using MC3T3-E1 pro-osteoblasts as cell model, the cell culture revealed that both the pTi without surface treatment and the AHAOEDHT sample could support the attachment, growth and proliferation of the cells. Compared to the pTi sample, the AHAOEDHT one induced higher expressions of osteogenesis-related genes in the cells, including alkaline phosphatase, Type I collagen, osteopontin, osteoclast inhibitor, osteocalcin and zinc finger structure transcription factor. As thus, besides the good corrosion resistance, the HA/L-TiO2/D-TiO2-coated pTi had good osteogenic activity, showing good potential in practical application for bone defect repair.
A register of public-sector research organizations as a tool for research policy studies and evaluation
Authors: Lepori Benedetto
Published: May 2020

This article presents the conceptual and methodological design of a register of public-sector organizations, as well as a preliminary delineation of such organizations in Europe. Conceptual and methodological issues are discussed, as well as the potential usage of the register for interlining datasets and analysis. The significance of the register for research policy and evaluation studies is also discussed, as related with changes associated with New Public Management reforms.
The Implementation of the Soviet Healthcare Model in ‘People’s Democracy’ Countries—the Case of Post-war Poland (1944–1953)
Authors: Kozłowska Urszula , Sikorski Tomasz
Published: May 2020

This article aims at presenting a Soviet model of public health service, the so-called Siemaszko model, and its implementation in the People’s Republic of Poland (1944/45–1953). Based on the Marx’s and Lenin’s interpretations, the Soviet model assumed a universal nature of health service, financing healthcare from the public purse, full state (party) control over public health, full access to medical services for all, entire staff put on the public payroll and state education for medical personnel. After the Second World War a modified version of that model was implemented in the so-called people’s democracies (i.e. communist countries). In the post-war years, a two-stage implementation of this socialist model was rolled out in the People’s Republic of Poland. The first stage, in 1944–48, was based on the so-called multisector approach. The second began in 1948 and assumed a full and planned unification and nationalisation of the healthcare system.
Early-Life Access to a Basic Health Care Program and Adult Outcomes in Indonesia
Authors: Ahsan Md Nazmul , Banerjee Rakesh , Maharaj Riddhi
Published: May 2020

Access to primary care during early life can have substantial benefits in developing countries. This study evaluates the long-run impact of the Village Midwife Program in Indonesia. It utilizes the rollout variation of the program and links individual background and community characteristics in early childhood to adult outcomes in the Indonesian Family Life Survey. It finds that the presence of a midwife in a community in utero leads to an improvement in overall health, cognition, and economic outcomes among men, but not women. Greater receipt of antenatal care and skilled birth attendance could, in part, drive these results.
Genome communication in plants mediated by organelle–n­ucleus-located proteins
Authors: Krupinska Karin , Blanco Nicolás E. , Oetke Svenja , Zottini Michela
Published: May 2020

An increasing number of eukaryotic proteins have been shown to have a dual localization in the DNA-containing organelles, mitochondria and plastids, and/or the nucleus. Regulation of dual targeting and relocation of proteins from organelles to the nucleus offer the most direct means for communication between organelles as well as organelles and nucleus. Most of the mitochondrial proteins of animals have functions in DNA repair and gene expression by modelling of nucleoid architecture and/or chromatin. In plants, such proteins can affect replication and early development. Most plastid proteins with a confirmed or predicted second location in the nucleus are associated with the prokaryotic core RNA polymerase and are required for chloroplast development and light responses. Few plastid–nucleus-located proteins are involved in pathogen defence and cell cycle control. For three proteins, it has been clearly shown that they are first targeted to the organelle and then relocated to the nucleus, i.e. the nucleoid-associated proteins HEMERA and Whirly1 and the stroma-located defence protein NRIP1. Relocation to the nucleus can be experimentally demonstrated by plastid transformation leading to the synthesis of proteins with a tag that enables their detection in the nucleus or by fusions with fluoroproteins in different experimental set-ups.

This article is part of the theme issue ‘Retrograde signalling from endosymbiotic organelles’.
Red and blue light differentially impact retrograde signalling and photoprotection in rice
Authors: Duan Liu , Ruiz-Sola M. Águila , Couso Ana , Veciana Nil , Monte Elena
Published: May 2020

Chloroplast-to-nucleus retrograde signalling (RS) is known to impact plant growth and development. InArabidopsis, we and others have shown that RS affects seedling establishment by inhibiting deetiolation. In the presence of lincomycin, a chloroplast protein synthesis inhibitor that triggers RS,Arabidopsislight-grown seedlings display partial skotomorphogenesis with undeveloped plastids and closed cotyledons. By contrast, RS in monocotyledonous has been much less studied. Here, we show that emerging rice seedlings exposed to lincomycin do not accumulate chlorophyll but otherwise remain remarkably unaffected. However, by using high red (R) and blue (B) monochromatic lights in combination with lincomycin, we have uncovered a RS inhibition of length and a reduction in the B light-induced declination of the second leaf. Furthermore, we present data showing that seedlings grown in high B and R light display different non-photochemical quenching capacity. Our findings support the view that excess B and R light impact seedling photomorphogenesis differently to photoprotect and optimize the response to high-light stress.

This article is part of the theme issue ‘Retrograde signalling from endosymbiotic organelles'.
Joint inhibition of mitochondrial complex IV and alternative oxidase by genetic or chemical means represses chloroplast transcription in
Arabidopsis
Authors: Adamowicz-Skrzypkowska Aleksandra , Kwasniak-Owczarek Malgorzata , Van Aken Olivier , Kazmierczak Urszula , Janska Hanna
Published: May 2020

Changes in the functional state of mitochondria have profound effects on other cellular compartments. Genome-wide expression analysis of
Arabidopsis
rps10
mutants with an RNAi-silenced expression of mitoribosomal S10 protein has revealed extensive transcriptional reprogramming. A meta-analysis comparing expression datasets of 25 mitochondrial perturbations showed a high similarity of the
aox1a:rpoTmp
mutant
,
which is defective in the alternative oxidase (AOX1a) and dual-targeted mitochondrial and plastid RNA polymerase (RPOTmp), to
rps10
. Both
rps10
and
aox1a:rpoTmp
showed a significantly decreased electron flux through both the cytochrome and the alternative respiratory pathways, and a markedly decreased the expression of nuclear-encoded components of the chloroplast transcription machinery. In line with this, a decreased level of plastid transcripts was observed in
rps10
and
aox1a:rpoTmp
, which was reflected in a reduced rate of chloroplast transcription. Chemical treatment of wild-type seedlings with respiratory inhibitors showed that only simultaneous and direct inhibition of complex IV and AOX activity decreased the level of plastid transcripts. Taken together, both chemical and genetic studies show that the limitation of the activity of two mitochondrial terminal oxidases, complex IV and AOX, negatively impacts chloroplast transcription. Salicylic acid and oxygen are discussed as putative mediators of the signalling pathway between mitochondria, nucleus and chloroplasts.

This article is part of the theme issue ‘Retrograde signalling from endosymbiotic organelles’.
Mitochondrial retrograde signalling in neurological disease
Authors: Granat Lucy , Hunt Rachel J. , Bateman Joseph M.
Published: May 2020

Neuronal mitochondrial dysfunction causes primary mitochondrial diseases and likely contributes to neurodegenerative diseases including Parkinson's and Alzheimer's disease. Mitochondrial dysfunction has also been documented in neurodevelopmental disorders such as tuberous sclerosis complex and autism spectrum disorder. Only symptomatic treatments exist for neurodevelopmental disorders, while neurodegenerative diseases are largely untreatable. Altered mitochondrial function activates mitochondrial retrograde signalling pathways, which enable signalling to the nucleus to reprogramme nuclear gene expression. In this review, we discuss the role of mitochondrial retrograde signalling in neurological diseases. We summarize how mitochondrial dysfunction contributes to neurodegenerative disease and neurodevelopmental disorders. Mitochondrial signalling mechanisms that have relevance to neurological disease are discussed. We then describe studies documenting retrograde signalling pathways in neurons and glia, and in animal models of neuronal mitochondrial dysfunction and neurological disease. Finally, we suggest how specific retrograde signalling pathways can be targeted to develop novel treatments for neurological diseases.

This article is part of the theme issue ‘Retrograde signalling from endosymbiotic organelles’.
Proteomic analysis of haem-binding protein from
Arabidopsis thaliana
and
Cyanidioschyzon merolae
Authors: Shimizu Takayuki , Yasuda Rintaro , Mukai Yui , Tanoue Ryo , Shimada Tomohiro , Imamura Sousuke , Tanaka Kan , Watanabe Satoru , Masuda Tatsuru
Published: May 2020

Chloroplast biogenesis involves the coordinated expression of the plastid and nuclear genomes, requiring information to be sent from the nucleus to the developing chloroplasts and vice versa. Although it is well known how the nucleus controls chloroplast development, it is still poorly understood how the plastid communicates with the nucleus. Currently, haem is proposed as a plastid-to-nucleus (retrograde) signal that is involved in various physiological regulations, such as photosynthesis-associated nuclear genes expression and cell cycle in plants and algae. However, components that transduce haem-dependent signalling are still unidentified. In this study, by using haem-immobilized high-performance affinity beads, we performed proteomic analysis of haem-binding proteins from
Arabidopsis thaliana
and
Cyanidioschyzon merolae
. Most of the identified proteins were non-canonical haemoproteins localized in various organelles. Interestingly, half of the identified proteins were nucleus proteins, some of them have a similar function or localization in either or both organisms. Following biochemical analysis of selective proteins demonstrated haem binding. This study firstly demonstrates that nucleus proteins in plant and algae show haem-binding properties.

This article is part of the theme issue ‘Retrograde signalling from endosymbiotic organelles’.
Anomalous atmospheric circulation favored the spread of COVID-19 in Europe
Authors: Sanchez-Lorenzo Arturo , Vaquero-Martínez Javier , Calbó Josep , Wild Martin , Santurtún Ana , Lopez-Bustins Joan-A. , Vaquero Jose-M. , Folini Doris , Antón Manuel
Published: May 2020

The current pandemic caused by the coronavirus SARS-CoV-2 is having negative health, social and economic consequences worldwide. In Europe, the pandemic started to develop strongly at the end of February and beginning of March 2020. It has subsequently spread over the continent, with special virulence in northern Italy and inland Spain. In this study we show that an unusual persistent anticyclonic situation prevailing in southwestern Europe during February 2020 (i.e. anomalously strong positive phase of the North Atlantic and Arctic Oscillations) could have resulted in favorable conditions, in terms of air temperature and humidity, in Italy and Spain for a quicker spread of the virus compared with the rest of the European countries. It seems plausible that the strong atmospheric stability and associated dry conditions that dominated in these regions may have favored the virus’s propagation, by short-range droplet transmission as well as likely by long-range aerosol (airborne) transmission.
Better Strategies for Containing COVID-19 Epidemics–A Study of 25 Countries via an Extended SEIR Model
Authors: Gu Jia , Yan Han , Huang Yaxuan , Zhu Yuru , Sun Haoxuan , Zhang Xinyu , Wang Yuqing , Qiu Yumou , Chen Song Xi
Published: May 2020

We evaluate the effectiveness of COVID-19 control strategies of 25 countries which have endured more than four weeks of community infections. With an extended SEIR model that allows infections in both the exposed and infected states, the key epidemic parameters are estimated from each country’s data, which facilitate the evaluation and cross-country comparison. It is found quicker control measures significantly reduce the average reproduction numbers and shorten the time length to infection peaks. If the swift control measures of Korea and China were implemented, average reductions of 88% in the confirmed cases and 80% in deaths would had been attained for the other 23 countries from start to April 10. Effects of earlier or delayed interventions in the US and the UK are experimented which show at least 75% (29%) less infections and deaths can be attained for the US (the UK) under a Five-Day Earlier experiment. The impacts of two removal regimes (Korea and Italy) on the total infection and death tolls on the other countries are compared with the natural forecast ones, which suggest there are still ample opportunity for countries to reduce the final death numbers by improving the removal process.
Predictive value of sudden olfactory loss in the diagnosis of COVID-19
Authors: Haehner Antje , Draf Julia , Dräger Sarah , With Katja de , Hummel Thomas
Published: May 2020

Introduction

Recent reports suggest that sudden smell loss might be a symptom of SARS-CoV-2 infection. The aim of this study was to investigate the frequency of olfactory loss in an out-patient population who presented to a coronavirus testing center during a 2-week period and to evaluate the diagnostic value of the symptom “sudden smell loss” for screening procedures.

Methods

In this cross-sectional controlled cohort study, 500 patients who presented with symptoms of a common cold to a corona testing center and fulfilled corona testing criteria, completed a standardized diagnostic questionnaire which included the patients’ main symptoms, time course and an additional self-assessment of the patients’ current smell, taste function and nasal breathing compared to the level before onset of symptoms.

Results

Out of the 500 patients, 69 presented with olfactory loss. Twenty-two of them subsequently tested positive for SARS-CoV-2. Only twelve out of the patients without olfactory loss tested positive, resulting in a frequency of 64.7% for the symptom “sudden smell loss” in COVID-19 patients. Compared to COVID-19 patients without smell loss, they were significantly younger and less severely affected. Changes in nasal airflow were significantly more pronounced in SARS-CoV-2 negative patients with olfactory complaints compared to the patients with smell loss who were tested positive for SARS-CoV-2. By excluding patients with a blocked nose, the symptom “sudden smell loss” can be attested a high specificity (97%) and a sensitivity of 65% with a PPV of 63% and NPV of 97% for COVID-19.

Conclusion

Considering the high frequency of smell loss in non-hospitalized COVID-19 patients, acute olfactory impairment should be included in the WHO symptoms list and should be recognized as an early symptom of the disease. In contrast to other acute viral smell impairment, COVID-19 associated smell loss seems to be only rarely accompanied by a severely blocked nose.
Is this the beginning or the end of COVID-19 outbreak in India? A data driven mathematical model-based analysis
Authors: Singh Anupam , Dey Jhilik , Bhardwaj Shivam
Published: May 2020

India has experienced an early and harshest lockdown from 25th March 2020 in response to the outbreak. However, an accurate estimation of the progression of the spread of infection and the level of preparedness to combat this disease are urgently needed. Using a data-based mathematical model, our study has made predictions on the number of cases that are expected to rise in India till 14th June 2020. The epidemiological data of daily cases have been utilized from 25th March (i.e., the first day of lockdown) to 23rd April 2020. In the study, we have stimulated two possible scenarios (optimistic and pessimistic) for the prediction. As per the optimistic approach of modelling, COVID-19 may end in the first week of June 2020 with a total of 77,900 infected cases including 2,442 fatalities. However, the results under the pessimistic scenario are a bit scary as it shows that a total of 283,300 infected cases with 10,180 fatalities till 14th June. To win the battle, 10 weeks of complete lockdown is much needed at least in the infected states and the union territories of India. Alternatively, the isolation of clusters (hotspot regions) is required if India wants a resume of some essential activities.
Using the Mercy Method to Estimate Ideal Body Weight in Children – A Description and Validation of a New Methodology
Authors: Wells Mike , Goldstein Lara Nicole
Published: May 2020

Background

In obese children, lipophilic medications should be dosed to total body weight (TBW) and hydrophilic medications to ideal body weight (IBW). During emergencies these weights need to be estimated to ensure that urgent drug therapy is accurate and safe. The Mercy method is a well-established weight estimation system that has recently been adapted to provide estimations of body length in children. It was therefore conceivable that this could be further modified to provide estimations of IBW.

Methods

A model was developed a priori using the Mercy method’s humeral length segments to predict IBW. The accuracy of this model was then tested in a sample of 13134 children from the National Health and Nutrition Examination Survey (NHANES) datasets. The accuracy of IBW estimation was determined from the percentage of estimations falling within 10% (p10) and 20% (p20) of true IBW. The model was also tested to see the accuracy of detection of obesity in the study sample.

Results

From the sample of 13134 children, a subset of 1318 obese children were identified. In this subset, the new Mercy method model achieved an IBW estimation accuracy p10 of 66.9% and a p20 of 95.1%. For the detection of the obese child, the model had a sensitivity of 88.6% and a specificity of 75.8%.

Conclusions

This study established that the Mercy method can be modified to provide a reasonably accurate estimation of IBW in obese children, with very few critical errors. The ability to the model to identify the obese child was also reasonably accurate, on a par with other such predictive methods. While other accurate methods of estimating both TBW and IBW exist, such as the PAWPER XL tape, the modified Mercy method is an acceptable alternative if such other devices are not available.
Incidence of COVID-19 and Connections with Air Pollution Exposure: Evidence from the Netherlands
Authors: Andrée Bo Pieter Johannes
Published: May 2020

The fast spread of severe acute respiratory syndrome coronavirus 2 has resulted in the emergence of several hot-spots around the world. Several of these are located in areas associated with high levels of air pollution. This study investigates the relationship between exposure to particulate matter and COVID-19 incidence in 355 municipalities in the Netherlands. The results show that atmospheric particulate matter with diameter less than 2.5 is a highly significant predictor of the number of confirmed COVID-19 cases and related hospital admissions. The estimates suggest that expected COVID-19 cases increase by nearly 100 percent when pollution concentrations increase by 20 percent. The association between air pollution and case incidence is robust in the presence of data on health-related preconditions, proxies for symptom severity, and demographic control variables. The results are obtained with ground-measurements and satellite-derived measures of atmospheric particulate matter as well as COVID-19 data from alternative dates. The findings call for further investigation into the association between air pollution and SARS-CoV-2 infection risk. If particulate matter plays a significant role in COVID-19 incidence, it has strong implications for the mitigation strategies required to prevent spreading.

Highlights

Background

Research on viral respiratory infections has found that infection risks increase following exposure to high concentrations of particulate matter. Several hot-spots of Severe Acute Respiratory Syndrome Coronavirus 2 infections are in areas associated with high levels of air pollution.

Approach

This study investigates the relationship between exposure to particulate matter and COVID-19 incidence in 355 municipalities in the Netherlands using data on confirmed cases and hospital admissions coded by residence, along with local PM2.5, PM10, population density, demographics and health-related pre-conditions. The analysis utilizes different regression specifications that allow for spatial dependence, nonlinearity, alternative error distributions and outlier treatment.

Results

PM2.5 is a highly significant predictor of the number of confirmed COVID-19 cases and related hospital admissions. Taking the WHO guideline of 10mcg/m3 as a baseline, the estimates suggest that expected COVID-19 cases increase by nearly 100% when pollution concentrations increase by 20%.

Conclusion

The findings call for further investigation into the association between air pollution on SARS-CoV-2 infection risk. If particulate matter plays a significant role in the incidence of COVID-19 disease, it has strong implications for the mitigation strategies required to prevent spreading, particularly in areas that have high levels of pollution.
Integrating Gut Microbiota and Host Immune Markers for Highly Accurate Diagnosis of Clostridioides difficile Infection
Authors: Ke Shanlin , Pollock Nira R. , Wang Xu-Wen , Chen Xinhua , Daugherty Kaitlyn , Lin Qianyun , Xu Hua , Garey Kevin W. , Gonzales-Luna Anne J. , Kelly Ciarán P. , Liu Yang-Yu
Published: May 2020

Exposure to Clostridioides difficile can result in asymptomatic carriage or infection with symptoms ranging from mild diarrhea to fulminant pseudomembranous colitis. A reliable diagnostic approach for C. difficile infection (CDI) remains controversial. Accurate diagnosis is paramount not only for patient management but also for epidemiology and disease research. Here, we characterized gut microbial compositions and a broad panel of innate and adaptive immunological markers in 243 well-characterized human subjects, who were divided into four phenotype groups: CDI, Asymptomatic Carriage, Non-CDI Diarrhea, and Control. We found that CDI is associated with alteration of many different aspects of the gut microbiota, including overall microbial diversity and microbial association networks. We demonstrated that incorporating both gut microbiome and host immune marker data into classification models can better distinguish CDI from other groups than can either type of data alone. Our classification models display robust diagnostic performance to differentiate CDI from Asymptomatic carriage (AUC~0.916), Non-CDI Diarrhea (AUC~0.917), or Non-CDI that combines all other three groups (AUC~0.929). Finally, we performed symbolic classification using selected features to derive simple mathematic formulas for highly accurate CDI diagnosis. Overall, this study provides evidence supporting important roles of gut microbiota and host immune markers in CDI diagnosis, which may also inform the design of future therapeutic strategies.

One Sentence Summary

Incorporating both gut microbiome and host immune marker data into classification models can better distinguish CDI from other groups than can either type of data alone.
Variation among states in rate of coronavirus spread
Authors: Condit Richard
Published: May 2020

The corona virus, COVID-19, has been spreading rapidly across the USA since early March, but at a decreasing rate, where the rate r is defined as the exponential increase. I modeled the way the rate of increase y = ln(er − 1) has declined through time in each of the 51 states with the goal of determining how quickly the rate has declined, whether the decline has changed, and whether states differ. A piecewise linear regression was used, with a single break point. This model can identify whether there was a change in the rate of decline, when the change happened, and which states have shown the greatest improvement in reducing the spread of COVID-19. The piecewise model identified a significant breakpoint on 24 Mar for all states combined, and all states had nearly the same breakpoint. Prior to 24 Mar, the average change in y was −0.013 d−1, meaning a reduction in the rate of spread from 23.5 pct. d−1 to 19.5 pct. d−1; after 24 Mar, the average change in y was −0.070 d−1, a reduction from 19.5 pct. d−1 to 7.5 pct. d−1. Prior to 24 Mar there was no significant variation among states in the decline in y, but after 24 Mar there was substantial variation. Montana, Idaho, and Vermont showed the greatest improvement, while Nebraska, South Dakota, and Iowa the least. The improvement as measured by the reduction after 24 Mar did not correlate with case density in a state, nor state population. The next question is whether it correlates with differences among states in the health measures taken to combat the spread.
Predicting community mortality risk due to CoVID-19 using machine learning and development of a prediction tool
Authors: Das Ashis Kumar , Mishra Shiba , Gopalan Saji Saraswathy
Published: May 2020

Background

The recent pandemic of CoVID-19 has emerged as a threat to global health security. There are a very few prognostic models on CoVID-19 using machine learning.

Objectives

To predict mortality among confirmed CoVID-19 patients in South Korea using machine learning and deploy the best performing algorithm as an open-source online prediction tool for decision-making.

Materials and methods

Mortality for confirmed CoVID-19 patients (n=3,022) between January 20, 2020 and April 07, 2020 was predicted using five machine learning algorithms (logistic regression, support vector machine, K nearest neighbor, random forest and gradient boosting). Performance of the algorithms was compared, and the best performing algorithm was deployed as an online prediction tool.

Results

The gradient boosting algorithm was the best performer in terms of discrimination (area under ROC curve=0.966), calibration (Matthews Correlation Coefficient=0.656; Brier Score=0.013) and predictive ability (accuracy=0.987). The best performer algorithm (gradient boosting) was deployed as the online CoVID-19 Community Mortality Risk Prediction tool named CoCoMoRP (https://ashis-das.shinyapps.io/CoCoMoRP/).

Conclusions

We describe the framework for the rapid development and deployment of an open-source machine learning tool to predict mortality risk among CoVID-19 confirmed patients using publicly available surveillance data. This tool can be utilized by potential stakeholders such as health providers and policy makers to triage patients at the community level in addition to other approaches.
COVID-19 Infections and Outcomes in a Live Registry of Heart Failure Patients Across an Integrated Health Care System
Authors: Caraballo Cesar , McCullough Megan , Fuery Michael A. , Chouairi Fouad , Keating Craig , Ravindra Neal , Miller P. Elliott , Malinis Maricar , Kashyap Nitu , Hsiao Allen , Wilson F. Perry , Curtis Jeptha P , Grant Matthew , Velazquez Eric J , Desai Nihar R , Ahmad Tariq
Published: May 2020

Background

Patients with comorbid conditions have a higher risk of mortality with SARS-CoV-2 (COVID-19) infection, but the impact on heart failure patients living near a disease hotspot is unknown. Therefore, we sought to characterize the prevalence and outcomes of COVID-19 in a live registry of heart failure patients across an integrated health care system in Connecticut.

Methods

In this retrospective analysis, the Yale Heart Failure Registry (NCT04237701) that includes 26,703 patients with heart failure across a 6-hospital integrated health care system in Connecticut was queried on April 16th, 2020 for all patients tested for COVID-19. Sociodemographic and geospatial data as well as, clinical management, respiratory failure, and patient mortality were obtained via the real-time registry. Data on COVID-19 specific care was extracted by retrospective chart review.

Results

COVID-19 testing was performed on 900 symptomatic patients, comprising 3.4% of the Yale Heart Failure Registry (N=26,703). Overall, 206 (23%) were COVID-19+. As compared to COVID-19-, these patients were more likely to be older, black, have hypertension, coronary artery disease, and were less likely to be on renin angiotensin blockers (P<0.05, all). COVID-19- patients tended to be more diffusely spread across the state whereas COVID-19+ were largely clustered around urban centers. 20% of COVID-19+ patients died, and age was associated with increased risk of death [OR 1.92 95% CI (1.33–2.78); P<0.001]. Among COVID-19+ patients who were ≥85 years of age rates of hospitalization were 87%, rates of death 36%, and continuing hospitalization 62% at time of manuscript preparation.

Conclusions

In this real-world snapshot of COVID-19 infection among a large cohort of heart failure patients, we found that a small proportion had undergone testing. Patients found to be COVID-19+ tended to be black with multiple comorbidities and clustered around lower socioeconomic status communities. Elderly COVID-19+ patients were very likely to be admitted to the hospital and experience high rates of mortality.
Cardiometabolic risk factors and preclinical target organ damage among adults in Ghana: Findings from a national study
Authors: Li Jie , Owusu Isaac Kofi , Geng Qingshan , Folson Aba Ankomaba , Zheng Zhichao , Adu-Boakye Yaw , Dong Xinran , Wu Wen-Chih , Agyekum Francis , Fei Hongwen , Ayetey Harold , Deng Mulan , Adomako-Boateng Fred , Jiang Zuxun , Abubakari Braimah Baba , Xian Zhao , Fokuoh Forster Nketiah , Appiah Lambert Tetteh , Liu Simin , Lin Chunying
Published: May 2020

Background

Sub-Saharan Africa (SSA) has the highest prevalence of cardiovascular diseases (CVD). Nevertheless, very few studies have directly examined the development of and risk factors for CVD among Africans.

Objective

To examine CVD risk factors and outcomes particularly in the early stage of CVD development among adults in Ghana.

Methods

Using a stratified multistage random sampling method, 1,106 participants were recruited as a nationally representative sample of the general population ≥18 years in Ghana from 2016 to 2017. For each participant, we measured CVD risk factors and preclinical target organ damage (TOD) for CVD development.

Results

The prevalence of CVD risk factors was 21.1% for obesity, 10.8% for diabetes, 55.4% for hypertension, 37.3% for dyslipidemia, 12.8% for hyperuricemia, and 39.3% for hsCRP>3 mg/L in the recruited population. The prevalence of preclinical TOD was 8.6% for peripheral artery disease (PAD), 14.7% for carotid thickening, 5.9% for left ventricular hypertrophy (LVH), and 4.4% for chronic kidney disease (CKD). Three CVD risk factors appeared to play most prominent roles in TOD development, including obesity for PAD (OR 1.88, 95% CI 1.13–3.09), hypertension for carotid thickening (OR 1.57, 95% CI 0.99–2.54) and LVH (OR 6.25, 95% CI 2.98–14.50), and hyperuricemia for CKD (OR 5.56, 95% CI 2.79–11.15).

Conclusions

The prevalence of CVD risk factors and early outcomes have reached epidemic proportions among Ghanaian adults. The distinct patterns of risk factors in the development of TOD presents important challenges and opportunities for interventions to improve cardiometabolic health among adults in Ghana.
Mental Health Status of the General Population during the COVID-19 Pandemic: A Cross-Sectional National Survey in Japan
Authors: Ueda Michiko , Stickley Andrew , Sueki Hajime , Matsubayashi Tetsuya
Published: May 2020

The ongoing COVID-19 pandemic may have detrimental mental health consequences. However, as yet, there is limited understanding of its impact on the mental health of the general population. The aim of this study is to examine the mental health of the Japanese general population by conducting the first systematic survey during the pandemic (N=1,000), with a particular focus on identifying the most vulnerable groups. Results from logistic regression analyses showed that the mental health of young and middle-aged individuals was significantly worse than that of older individuals during the pandemic. There was also some indication that individuals who were not currently working were significantly more likely to report a high level of anxiety and depressive symptoms. Part-time and temporary contract-based workers were also more likely to suffer from anxiety disorder. Our results highlight that monitoring the mental health of younger and economically vulnerable individuals may be especially important. In addition, they also indicate that population mental health might not only be affected by the direct health consequences of COVID-19, but also by the economic ramifications of the pandemic.
Clinical features and outcomes of inpatients with neurological disease and COVID-19
Authors: Benussi Alberto , Pilotto Andrea , Premi Enrico , Libri Ilenia , Giunta Marcello , Agosti Chiara , Alberici Antonella , Baldelli Enrico , Benini Matteo , Bonacina Sonia , Brambilla Laura , Caratozzolo Salvatore , Cortinovis Matteo , Costa Angelo , Piccinelli Stefano Cotti , Cottini Elisabetta , Cristillo Viviana , Delrio Ilenia , Filosto Massimiliano , Gamba Massimo , Gazzina Stefano , Gilberti Nicola , Gipponi Stefano , Imarisio Alberto , Invernizzi Paolo , Leggio Ugo , Leonardi Matilde , Liberini Paolo , Locatelli Martina , Masciocchi Stefano , Poli Loris , Rao Renata , Risi Barbara , Rozzini Luca , Scalvini Andrea , di Cola Francesca Schiano , Spezi Raffaella , Vergani Veronica , Volonghi Irene , Zoppi Nicola , Borroni Barbara , Magoni Mauro , Pezzini Alessandro , Padovani Alessandro
Published: May 2020

Objective

To report the clinical and laboratory characteristics, as well as treatment and clinical outcomes of patients admitted for neurological diseases with COVID-19 in a Neuro-COVID unit compared to patients without COVID-19.

Methods

In this retrospective, single centre cohort study, we included all adult inpatients with confirmed COVID-19, who had been discharged or died by April 5, 2020. Demographic, clinical, treatment, and laboratory data were extracted from medical records.

Results

173 patients were included in this study, of whom 56 resulted positive for COVID-19 and 117 resulted negative for COVID-19. Patients with COVID-19 were older, had a different distribution regarding admission diagnoses, including cerebrovascular disorders, and had a higher quick Sequential Organ Failure Assessment (qSOFA) score on admission (all p<0.05).

In-hospital mortality rates and incident delirium were significantly higher in the COVID-19 group (all p<0.05). COVID-19 and non-COVID patients with stroke had similar baseline characteristics but patients with COVID-19 had higher modified Rankin scale scores at discharge (p<0.0001), with a significantly lower number of patients with a good outcome (p<0.0001).

Multivariable regressions showed increasing odds of in-hospital death associated with higher qSOFA scores (odds ratio 4.47, 95% CI 1.21-16.5; p=0.025), lower platelet count (0.98, 0.97-0.99; p=0.005) and higher lactate dehydrogenase (1.01, 1.00-1.03; p=0.009) on admission.

Conclusions

COVID-19 patients admitted with neurological disease, including stroke, have a significantly higher in-hospital mortality, incident delirium and higher disability than patients without COVID-19.
The Chronic Kidney Disease and Acute Kidney Injury Involvement in COVID-19 Pandemic: A Systematic Review and Meta-analysis
Authors: Liu Ya-Fei , Zhang Zhe , Pan Xiao-Li , Xing Guo-Lan , Zhang Ying , Liu Zhang-Suo , Tu Sheng-Hao
Published: May 2020

Aim

The aim of this study was to uncover whether kidney diseases were involved in COVID-19 pandemic from a systematic review.

Methods

The studies reported the kidney outcomes in different severity of COVID-19 were included in this study. Standardized mean differences or odds ratios were calculated by employing Review Manager meta-analysis software.

Results

Thirty-six trials were included in this systematic review with a total of 6395 COVID-19 patients. The overall effects indicated that the comorbidity of chronic kidney disease (CKD) (OR = 3.28), complication of acute kidney injury (AKI) (OR = 11.02), serum creatinine (SMD = 0.68), abnormal serum creatinine (OR = 4.86), blood urea nitrogen (SMD = 1.95), abnormal blood urea nitrogen (OR = 6.53), received continuous renal replacement therapy (CRRT) (OR = 23.63) was significantly increased in severe group than that in nonsevere group. Additionally, the complication of AKI (OR = 13.92) and blood urea nitrogen (SMD = 1.18) were remarkably elevated in critical group than that in severe group.

Conclusion

CKD and AKI are susceptible to occur in patients with severe COVID-19. CRRT is applied frequently in severe COVID-19 patients than that in nonsevere COVID-19 patients. The risk of AKI is higher in critical group than that in severe group.
Excess mortality during COVID-19 in five European countries and a critique of mortality data analysis
Authors: Félix-Cardoso J. , Vasconcelos H. , Pereira Rodrigues P. , Cruz-Correia R.
Published: May 2020

INTRODUCTION

The COVID-19 pandemic is an ongoing event disrupting lives, health systems, and economies worldwide. Clear data about the pandemic’s impact is lacking, namely regarding mortality. This work aims to study the impact of COVID-19 through the analysis of all-cause mortality data made available by different European countries, and to critique their mortality surveillance data.

METHODS

European countries that had publicly available data about the number of deaths per day/week were selected (England and Wales, France, Italy, Netherlands and Portugal). Two different methods were selected to estimate the excess mortality due to COVID19: (DEV) deviation from the expected value from homologue periods, and (RSTS) remainder after seasonal time series decomposition. We estimate total, age- and gender-specific excess mortality. Furthermore, we compare different policy responses to COVID-19.

RESULTS

Excess mortality was found in all 5 countries, ranging from 10.6% in Portugal (DEV) to 98.5% in Italy (DEV). Furthermore, excess mortality is higher than COVID-attributed deaths in all 5 countries.

DISCUSSION

The impact of COVID-19 on mortality appears to be larger than officially attributed deaths, in varying degrees in different countries. Comparisons between countries would be useful, but large disparities in mortality surveillance data could not be overcome. Unreliable data, and even a lack of cause-specific mortality data undermine the understanding of the impact of policy choices on both direct and indirect deaths during COVID-19. European countries should invest more on mortality surveillance systems to improve the publicly available data.
A Model of Workflow in the Hospital During a Pandemic to Assist Management
Authors: Garbey Marc , Joerger Guillaume , Furr Shannon , Fikfak Vid
Published: May 2020

We present a computational model of workflow in the hospital during a pandemic. The objective is to assist management in anticipating the load of each care unit, such as the ICU, or ordering supplies, such as personal protective equipment, but also to retrieve key parameters that measure the performance of the health system facing a new crisis. The model was fitted with good accuracy to France’s data set that gives information on hospitalized patients and is provided online by the French government. The goal of this work is both practical in offering hospital management a tool to deal with the present crisis of COVID-19 and offering a conceptual illustration of the benefit of computational science during a pandemic.
Systematic investigations of COVID-19 in 283 cancer patients
Authors: Wang Jie , Song Qibin , Chen Yuan , Wang Zhijie , Chu Qian , Gong Hongyun , Cai Shangli , Dong Xiaorong , Xu Bin , Hu Weidong , Wang Qun , Li Linjun , Yang Jiyuan , Xie Zhibin , Luo Zhiguo , Liu Jing , Luo Xiuli , Ren Jie , Rao Zhiguo , Xu Xinhua , Pan Dongfeng , Hu Zuowei , Feng Gang , Hu Chiding , Luo Liqiong , Lu Hongda , Ran Ruizhi , Jin Jun , Xu Yanhua , Yang Yong , Zhang Zhihong , Kuang Li , Wang Runkun , Dong Youhong , Sun Jianhai , Hu Wenbing , Yi Tienan , Wu Hanlin , Liu Mingyu , Xu Jiachen , Duan Jianchun , Zhao Zhengyi , Wang Guoqiang , Xu Yu , He Jie
Published: May 2020

Abstracts

Background

Cancer patients are considered to be highly susceptible to viral infections, however, the comprehensive features of COVID-19 in these patients remained largely unknown. The present study aimed to assess the clinical characteristics and outcomes of COVID-19 in a large cohort of cancer patients.

Design, Setting, and Participants

Data of consecutive cancer patients admitted to 33 designated hospitals for COVID-19 in Hubei province, China from December 17, 2019 to March 18, 2020 were retrospectively collected. The follow-up cutoff date was April 02, 2020. The clinical course and survival status of the cancer patients with COVID-19 were measured, and the potential risk factors of severe events and death were assessed through univariable and multivariable analyses.

Results

A total of 283 laboratory confirmed COVID-19 patients (50% male; median age, 63.0 years [IQR, 55.0 to 70.0]) with more than 20 cancer types were included. The overall mortality rate was 18% (50/283), and the median hospitalization stay for the survivors was 26 days. Amongst all, 76 (27%) were former cancer patients with curative resections for over five years without recurrence. The current cancer patients exhibited worse outcomes versus former cancer patients (overall survival, HR=2.45, 95%CI 1.10 to 5.44, log-rank p=0.02; mortality rate, 21% vs 9%). Of the 207 current cancer patients, 95 (46%) have received recent anti-tumor treatment, and the highest mortality rate was observed in the patients receiving recent chemotherapy (33%), followed by surgery (26%), other anti-tumor treatments (19%), and no anti-tumor treatment (15%). In addition, a higher mortality rate was observed in patients with lymphohematopoietic malignancies (LHM) (53%, 9/17), and all seven LHM patients with recent chemotherapy died. Multivariable analysis indicated that LHM (p=0.001) was one of the independent factors associating with critical illness or death.

Conclusions

This is the first systematic study comprehensively depicting COVID-19 in a large cancer cohort. Patients with tumors, especially LHM, may have poorer prognosis of COVID-19. Additional cares are warranted and non-emergency anti-tumor treatment should be cautiously used for these patients under the pandemic.
Simplified model of Covid-19 epidemic prognosis under quarantine and estimation of quarantine effectiveness
Authors: Džiugys Algis , Bieliūnas Martynas , Skarbalius Gediminas , Misiulis Edagaras , Navakas Robertas
Published: May 2020

A simplified model of Covid-19 epidemic dynamics under quarantine conditions and method to estimate quarantine effectiveness are developed. The model is based on the growth rate of new infections when total number of infections is significantly smaller than population size of infected country or region. The model is developed on the basis of collected epidemiological data of Covid19 pandemic, which shows that the growth rate of new infections has tendency to decrease linearly when the quarantine is imposed in a country (or a region) until it reaches a constant value, which corresponds to the effectiveness of quarantine measures taken in the country. The growth rate of new infections can be used as criteria to estimate quarantine effectiveness.