bluuebunny/crossref_metadata_2025 huggingface dataset:
Three-dimensional episodic model of star formation in galaxies in the presence of dissipation
Authors: Das Sukanta , Chattopadhyay Tanuka , Mukherjee Sailajananda
Published: March 2020

The oscillatory model of star formation in giant and dwarf galaxies have been studied through a dynamical open system. In addition to various dynamical processes involving fractional masses of hot, warm, and cold gases, the system is subjected to dissipative processes e.g. outflow from the gaseous component caused by supernovae explosion and subsequent ram pressure stripping within the oscillation period. This is more realistic than a previous model which was considered conservative. The present episodic model has been found to be unimodal in general contrary to discrete episodes of star formation of decreasing amplitudes as found for closed systems. The duty cycles under various parametric conditions derived, vary in the range (2.0–40.0) × 107 yr for giant galaxies contrary to longer time, for example 9.0 × 107–1.0 × 109 yr for dwarf galaxies. This might be due to the low production rate of supernova in dwarf galaxies which reduces the evaporation rate of cold gas into hot gas making cold gas available for continuing the cycle for a longer time. The duty cycles have increased in both cases compared to the previous model by an order of one for giant galaxies and order of two for dwarf galaxies depending on the degree of dissipation. This might be due to the unimodal pattern of star formation which prevails for longer time in the late phase of galaxy evolution. Under very special parametric conditions limit cycles may occur i.e. star formation in discrete episodes, may occur involving one or more stable attractors especially in early-type dwarf and giant galaxies. Tendency of formation of multiple attractors are more likely in early-type giant spiral galaxies when the rate of dissipation is very slow.
Chemodynamics of green pea galaxies – I. Outflows and turbulence driving the escape of ionizing photons and chemical enrichment
Authors: Hogarth L , Amorín R , Vílchez J M , Hägele G F , Cardaci M , Pérez-Montero E , Firpo V , Jaskot A , Chávez R
Published: March 2020

We investigate the ionized gas kinematics, physical properties, and chemical abundances of Sloan Digital Sky Survey J142947, a Green Pea galaxy at redshift z∼ 0.17 with strong, double-peak Ly α emission and indirect evidence of Lyman continuum (LyC) leakage. Using high-dispersion spectroscopy, we perform a multicomponent analysis of emission-line profiles. Our model consistently fits all lines as a narrow component with intrinsic velocity dispersion σ ∼ 40 km s−1, and two broader blue-shifted components with σ ∼ 90 and ∼ 250 km s−1. We find electron densities and temperatures, ionization conditions, and direct O/H and N/O abundances for each component. A highly ionized, metal-poor, young and compact starburst dominates narrow emission, showing evidence of hard radiation fields and elevated N/O. The blue-shifted broader components are consistent with highly turbulent, possibly clumpy ionized gas at the base of a strong photoionized outflow, which accounts for ≳50 per cent of the integrated emission-line fluxes. The outflow is dense and metal-enriched compared to the H ii regions, with expansion velocities larger than those obtained from UV interstellar absorption lines under standard assumptions. Some of these metals may be able to escape, with outflows loading factors comparable to those found in high-z galaxies of similar SFR/Area. Our findings depict a two-stage starburst picture; hard radiation fields from young star clusters illuminate a turbulent and clumpy ISM that has been eroded by SNe feedback. Whilst UV data suggest an extended Ly α halo with high average H i column density, LyC photons could only escape from SDSS J142947 through low H i density channels or filaments in the ISM approaching density-bounded conditions, traced by outflowing gas.
Potassium bromate as positive assay control for the Fpg-modified comet assay
Authors: Møller Peter , Muruzabal Damian , Bakuradze Tamara , Richling Elke , Bankoglu Ezgi Eyluel , Stopper Helga , Langie Sabine A S , Azqueta Amaya , Jensen Annie , Scavone Francesca , Giovannelli Lisa , Wojewódzka Maria , Kruszewski Marcin , Valdiglesias Vanessa , Laffon Blanca , Costa Carla , Costa Solange , Teixeira João Paulo , Marino Mirko , Del Bo’ Cristian , Riso Patrizia , Shaposhnikov Sergey , Collins Andrew
Published: March 2020

The comet assay is a popular assay in biomonitoring studies. DNA strand breaks (or unspecific DNA lesions) are measured using the standard comet assay. Oxidative stress-generated DNA lesions can be measured by employing DNA repair enzymes to recognise oxidatively damaged DNA. Unfortunately, there has been a tendency to fail to report results from assay controls (or maybe even not to employ assay controls). We believe this might have been due to uncertainty as to what really constitutes a positive control. It should go without saying that a biomonitoring study cannot have a positive control group as it is unethical to expose healthy humans to DNA damaging (and thus potentially carcinogenic) agents. However, it is possible to include assay controls in the analysis (here meant as a cryopreserved sample of cells i.e. included in each experiment as a reference sample). In the present report we tested potassium bromate (KBrO3) as a positive comet assay control for the formamidopyrimidine DNA glycosylase (Fpg)-modified comet assay. Ten laboratories used the same procedure for treatment of monocytic THP-1 cells with KBrO3 (0.5, 1.5 and 4.5 mM for 1 h at 37°C) and subsequent cryopreservation. Results from one laboratory were excluded in the statistical analysis because of technical issues in the Fpg-modified comet assay. All other laboratories found a concentration–response relationship in cryopreserved samples (regression coefficients from 0.80 to 0.98), although with different slopes ranging from 1.25 to 11.9 Fpg-sensitive sites (%DNA in tail) per 1 mM KBrO3. Our results demonstrate that KBrO3 is a suitable positive comet assay control.
A call for harmonization of European kidney care: dialysis reimbursement and distribution of kidney replacement therapies
Authors: van der Tol Arjan , Stel Vianda S , Jager Kitty J , Lameire Norbert , Morton Rachael L , Van Biesen Wim , Vanholder Raymond
Published: March 2020

Background

We compare reimbursement for haemodialysis (HD) and peritoneal dialysis (PD) in European countries to assess the impact on government healthcare budgets. We discuss strategies to reduce costs by promoting sustainable dialysis and kidney transplantation.

Methods

This was a cross-sectional survey among nephrologists conducted online July–December 2016. European countries were categorized by tertiles of gross domestic product per capita (GDP). Reimbursement data were matched to kidney replacement therapy (KRT) data.

Results

The prevalence per million population of patients being treated with long-term dialysis was not significantly different across tertiles of GDP (P = 0.22). The percentage of PD increased with GDP across tertiles (4.9, 8.2, 13.4%; P < 0.001). The HD-to-PD reimbursement ratio was higher in countries with the highest tertile of GDP (0.7, 1.0 versus 1.7; P = 0.007). Home HD was mainly reimbursed in countries with the highest tertile of GDP (15, 15 versus 69%; P = 0.005). The percentage of public health expenditure for reimbursement of dialysis decreased across tertiles of GDP (3.3, 1.5, 0.7%; P < 0.001). Transplantation as a proportion of all KRT increased across tertiles of GDP (18.5, 39.5, 56.0%; P < 0.001).

Conclusions

In Europe, dialysis has a disproportionately high impact on public health expenditure, especially in countries with a lower GDP. In these countries, the cost difference between PD and HD is smaller, and home dialysis and transplantation are less frequently provided than in countries with a higher GDP. In-depth evaluation and analysis of influential economic and political measures are needed to steer optimized reimbursement strategies for KRT.
Idiopathic retroperitoneal fibrosis: an update for nephrologists
Authors: Raglianti Valentina , Rossi Giovanni M. , Vaglio Augusto
Published: March 2020

Idiopathic retroperitoneal fibrosis (IRF) is a rare condition characterized by the development of a peri-aortic and peri-iliac tissue showing chronic inflammatory infiltrates and pronounced fibrosis. Ureteral entrapment with consequent obstructive uropathy is one of the most common complications of IRF, which can lead to acute renal failure and, in the long term, to varying degrees of chronic kidney disease. IRF may be isolated or develop in association with autoimmune diseases (e.g. Hashimoto’s thyroiditis and psoriasis) and other fibro-inflammatory disorders (often within the spectrum of immunoglobulin G4-related disease), which suggests that it should be considered as a potentially systemic condition. IRF is an immune-mediated disease: genetic variants (e.g. human leukocyte antigen (HLA)-DRB1*03) and environmental agents (mainly exposure to asbestos and smoking) are strongly associated with an increased risk of developing the disease, while a complex network of chemokines (e.g. CXCL12 and C-C moti chemokine 11 (CCL11)) and cytokines [e.g. interleukin (IL)-6, IL-12 and IL-13] is likely to orchestrate the inflammatory response and simultaneously promote fibrosis. Glucocorticoids, alone or in combination with traditional immunosuppressants such as methotrexate and mycophenolate mofetil, are usually efficacious and promptly induce disease remission; however, up to 50% of patients relapse, thus requiring repeat immunosuppressive courses. Biologic drugs, namely rituximab, are being explored for the treatment of IRF. In addition to medical therapies, interventional procedures (mainly ureteral stenting) are required to relieve ureteral obstruction, whereas surgical ureterolysis is generally reserved to refractory cases. If appropriately treated, then the overall and renal prognosis of IRF are good, with <5% patients developing end-stage renal disease.
3New Materialisms
Authors: Diener Samuel
Published: March 2020

This review considers work in the field of new materialisms, bearing in mind the wide range of approaches that make up the broader ‘material turn’ in critical and cultural theory but focusing in particular on the feminist new materialist conversation that draws on the work of Jane Bennett, Karen Barad, Samantha Frost, Rosi Braidotti, and others. It notes the new materialisms’ continued heterogeneity and describes a turn to method in the field, one that enables a vibrant dialogue between applied and theoretical scholarship. The pieces reviewed share an engagement with that trend. They also illustrate two important problems that the field has engaged with in 2019. The first question concerns the new materialisms’ politics of citation, and the need for a decolonial practice that engages with indigenous and non-western thought. The second is the question of a new materialist ontology: how to reconcile the tension between ‘flat’ and differentiated, subject-oriented accounts of agency, significance, and value. The new materialists this review follows seek a middle ground, one that allows them to emphasize the political stakes of human and more-than-human relations. Following the introduction, sections are: 1. New Materialist Practice, Feminist Ends; 2. Indigeneity and the New Materialisms; 3. Sensation in a Material World; 4. A Cartography of the New Materialisms; 5. Reading's Situation; 6. Exclusion and Activist New Materialism; and 7. The Things We Imagine.
First case report of Schistosoma japonicum in Nepal
Authors: Bajracharya Dipendra , Pandit Sanjeet , Bhandari Durga
Published: March 2020

Background. Schistosomiasis, globally, is significant public as well as veterinary health problem as it is associated with a wide range of clinical conditions in humans and animals. Schistosomiasis is mostly caused by the following species of genus Schistosoma: Schistosoma japonicum, Schistosoma haematobium, Schistosoma mekongi, Schistosoma intercalatum Schistosoma guineensis, Schistosoma malayensis and Schistosoma mansoni. S. japonicum might be considered as the most pathogenic among these species as the clinical disease caused by this parasite ranges from mild diarrhea, nausea, Katayama fever, portal hypertension, splenomegaly and ascites to liver cirrhosis and fibrosis. S. japonicum has been commonly encountered in China, the Philippines and Indonesia. According to WHO, at least 220.8 million people required preventive treatment for schistosomiasis in 2017 but only 102.3 million people were reported to have been treated. To our knowledge, there are no cases reported from Nepal. Hence, this is the first reported case of S. japonicum in Nepal.

Case presentation. A case of acute schistosomiasis due to S. japonicum was identified in CIWEC Hospital and Travel Medicine Center, Kathmandu, Nepal. The patient arrived with gastrointestinal symptoms without any pre-existing chronic illness with no evidence of travel outside of Spain since last August, but had travelled to many other countries 2 years ago. Timely diagnosis by stool routine and microscopic examination and formal-ether concentration technique led to successful treatment of the disease.

Conclusion. As the parasite has not been reported to date in Nepal, many people are unaware of its mode of infection and pathogenesis. Many laboratory workers are heedless with the egg of the parasite due to which this parasite might be misdiagnosed or undiagnosed. This case report might help laboratory workers to be sentient about the parasite and further diagnosis in future.
Global profiling of SARS-CoV-2 specific IgG/ IgM responses of convalescents using a proteome microarray
Authors: Jiang He-wei , Li Yang , Zhang Hai-nan , Wang Wei , Men Dong , Yang Xiao , Qi Huan , Zhou Jie , Tao Sheng-ce
Published: March 2020

COVID-19 is caused by SARS-CoV-2, and has become a global pandemic. There is no highly effective medicine or vaccine, most of the patients were recovered by their own immune response, especially the virus specific IgG and IgM responses. However, the IgG/ IgM responses is barely known. To enable the global understanding of SARS-CoV-2 specific IgG/ IgM responses, a SARS-CoV-2 proteome microarray with 18 out of the 28 predicted proteins was constructed. The microarray was applied to profile the IgG/ IgM responses with 29 convalescent sera. The results suggest that at the convalescent phase 100% of patients had IgG/ IgM responses to SARS-CoV-2, especially to protein N, S1 but not S2. S1 purified from mammalian cell demonstrated the highest performance to differentiate COVID-19 patients from controls. Besides protein N and S1, significant antibody responses to ORF9b and NSP5 were also identified. In-depth analysis showed that the level of S1 IgG positively correlate to age and the level of LDH (lactate dehydrogenase), especially for women, while the level of S1 IgG negatively correlate to Ly% (Lymphocyte percentage). This study presents the first whole picture of the SARS-CoV-2 specific IgG/ IgM responses, and provides insights to develop precise immuno-diagnostics, effective treatment and vaccine.

Highlights

A SARS-CoV-2 proteome microarray contains 18 of the 28 predicted proteins

The 1stglobal picture of the SARS-CoV-2 specific IgG/ IgM response reveals that at the convalescent phase, 100% of patients have IgG/ IgM responses to protein N and S1

Significant antibody responses against ORF9b and NSP5 were identified

Protein S1 specific IgG positively correlates to age and LDH, while negatively to Ly%
Factors associated with prolonged viral shedding and impact of Lopinavir/Ritonavir treatment in patients with SARS-CoV-2 infection
Authors: Yan Dan , Liu Xiao-Yan , Zhu Ya-nan , Huang Li , Dan Bi-tang , Zhang Guo-jun , Gao Yong-hua
Published: March 2020

Background

The duration of viral shedding is central to guide decisions around isolation precautions and antiviral treatment. However, studies about risk factors associated with prolonged SARS-CoV-2 shedding and the potential impact of Lopinavir/Ritonavir (LPV/r) treatment remain scarce.

Methods

In this retrospective study, data were collected from all SARS-CoV-2 infected patients who were admitted to isolation wards and had RT-PCR conversion at the NO.3 People’s hospital of Hubei province between 31 January and 09 March 2020. We compared clinical features and SARS-CoV-2 RNA shedding between patients with LPV/r treatment and those without. Logistic regression analysis was employed to evaluate risk factors associated with prolonged viral shedding.

Results

Of 120 patients, the median age was 52 years, 54 (45%) were male and 78 (65%) received LPV/r treatment. The median duration of SARS-CoV-2 RNA detection from symptom onset was 23 days (IQR, 18-32 days). Older age (odd ratio [OR] 1.03, 95% confidence interval [CI] 1.00-1.05, p=0.03) and lack of LPV/r treatment (OR 2.42, 95% CI 1.10-5.36, p=0.029) were independent risk factors for prolonged SARS-CoV-2 RNA shedding in multivariate logistic regression analysis. The median duration of viral shedding was shorter in the LPV/r treatment group (n=78) than that in no LPV/r treatment group (n=42) (median, 22 days vs. 28.5 days, p=0.02). Only earlier administration of LPV/r treatment (≤10 days from symptom onset) could shorten the duration of viral shedding.

Conclusions

Older age and lack of LPV/r treatment were independently associated with prolonged SARS-CoV-2 RNA shedding in patients with COVID-19. Earlier administration of LPV/r treatment could shorten viral shedding.

Take home message

Risk factors for prolonged SARS-CoV-2 shedding included older age and lack of Lopinavir/Ritonavir treatment. Earlier administration of Lopinavir/Ritonavir treatment could shorten the duration of SARS-CoV-2 RNA shedding.
An alarming high prevalence of resistance associated mutations to macrolides and fluoroquinolones in Mycoplasma genitalium in Belgium: Results from samples collected between 2015-2018
Authors: De Baetselier I. , Kenyon C. , Berghe W. Vanden , Smet H. , Wouters K. , Van den Bossche D. , Vuylsteke B. , Crucitti T.
Published: March 2020

Objectives

The number of reported cases of multi-resistant Mycoplasma genitalium (Mg) is increasing globally. The aim of this study was to estimate the prevalence of macrolide and possible fluoroquinolone resistance associated mutations (RAMs) of Mg in Belgium.

Methods

The study was performed retrospectively on two sets of Mg positive samples collected in Belgium between 2015-2018. The first set of samples originated from routine surveillance activities and the second set came from a cohort of men who have sex with men (MSM) using pre-exposure prophylaxis to prevent HIV transmission. Detection of RAMs to macrolides and fluoroquinolones was performed on all samples using DNA sequencing of the 23S ribosomal RNA gene, the gyrA gene and the parC gene.

Results

Seventy-six percent of the Mg samples contained a mutation conferring resistance to macrolides or fluoroquinolones (parC position 83/87). RAMs were more frequently found among men compared to women for fluoroquinolones (28.7% vs 9.1%) and macrolides (82.9% vs 27.3%). More than 90% of the Mg infections among MSM possessed a RAM to macrolides (90.7%). In addition, 23.4% of the samples harboured both macrolides and fluoroquinolone RAMs; 3.0% in women and 30.7% in MSM. Being MSM was associated with macrolide RAMs (Odds ratio: 15.1), fluoroquinolone RAMs (Odds ratio: 3.4) and having a possible multi-resistant Mg infection (Odds ratio: 8.2).

Conclusion

The study shows an alarmingly high prevalence of Mg with RAMs to macrolides and fluoroquinolones in Belgium. These results highlight the need to improve antimicrobial stewardship in Belgium in order to avoid the emergence of untreatable Mg.

KEY MESSAGES

Our study reports an alarmingly high prevalence of Mycoplasma genitalium antimicrobial resistance to either macrolides or fluoroquinolones in Belgium (76.6%).

Multi-resistant Mg was found in almost 25% of cases, however, the prevalence of multi-resistant Mg was remarkably higher in men (27.1% vs 3.0%).

The number of Mg resistant cases was much higher in men who have sex with men compared to heterosexual men and women.

These results highlight the need to improve antimicrobial stewardship in Belgium.
COVID-19 attack rate increases with city size
Authors: Stier Andrew J. , Berman Marc G. , Bettencourt Luis M. A.
Published: March 2020

The current outbreak of novel coronavirus disease 2019 (COVID-19) poses an unprecedented global health and economic threat to interconnected human societies. Until a vaccine is developed, strategies for controlling the outbreak rely on aggressive social distancing. These measures largely disconnect the social network fabric of human societies, especially in urban areas. Here, we estimate the growth rates and reproductive numbers of COVID-19 in US cities from March 14th through March 19th to reveal a power-law scaling relationship to city population size. This means that COVID-19 is spreading faster on average in larger cities with the additional implication that, in an uncontrolled outbreak, larger fractions of the population are expected to become infected in more populous urban areas. We discuss the implications of these observations for controlling the COVID-19 outbreak, emphasizing the need to implement more aggressive distancing policies in larger cities while also preserving socioeconomic activity.
Exponential damping: The key to successful containment of COVID-19
Authors: Zhang Feng , Zhang Jinmei , Cao Menglan , Zhang Yong , Hui Cang
Published: March 2020

Due to its excessively high capacity for human-to-human transmission, the 2019 novel coronavirus disease (COVID-19), first reported in Wuhan in China, spread rapidly to the entire nation and beyond, and has now been declared a global public health emergency. Understanding the transmission pattern of the virus and the efficacy of transmission control measures is crucial to ensuring regional and global disease control. Here we propose a simple model based on exponential infectious growth, but with a time-varying, largely damping, transmission rate. This model provides an excellent fit to the existing data from the 102 countries and regions which have reported cases for more than 6 days, and, we think, has largely captured the transmission patterns of the COVID-19 outbreak under a variety of intervention and control measures. We found that the damping rate, defined as the rate of the exponential decline in transmission rate, ranged from -0.125 to 0.513 d-1 globally (a negative damping rate represents acceleration in spread). The estimated peak time (when the fastest spread occurs) and the final number of infections were found to be greatly affected by the damping rate. Successful control measures, such as those implemented in China and South Korea, have resulted in a clear pattern of exponential damping in the viral spread (also shown during the 2003 outbreak of Severe Acute Respiratory Syndrome, SARS). The damping rate, therefore, could be used as an indicator for the efficacy of implemented control measures. Our model suggests that the COVID-19 outbreak is currently accelerating worldwide, especially rapidly in certain countries (e.g. USA and Australia) where exponential damping is yet to emerge. Consistent with the message from the World Health Organisation (WHO), we thus strongly suggest all countries to take active measures to contain this global pandemic. Slight increments in the damping rate from additional control efforts, especially in countries showing weak or no exponential damping in COVID-19 transmission, could lead to a radically more positive outcome in the fight to contain the pandemic.
Deep Learning-Based Universal Expert-Level Recognizing Pathological Images of Hepatocellular Carcinoma and beyond
Authors: Chen Wei-Ming , Fu Min , Zhang Cheng-Ju , Xing Qing-Qing , Zhou Fei , Lin Meng-Jie , Dong Xuan , Zheng Qi-Zhong , Hong Mei-Zhu , Pan Jin-Shui
Published: March 2020

Purpose

Human-based medical-image interpretation always falls into the predicament between specialized practitioners and expanding medical imaging. We aim at developing a diagnostic tool for pathological-image classification by using transfer learning that can be applied to diverse tumor types.

Experimental Design

In this study, images were retrospectively collected and prospectively analyzed using machine learning. Microscopic images of liver tissue that show or do not show hepatocellular carcinoma were used to train and validate a classification framework based on convolutional neural network. To evaluate the universal classification performance of the artificial-intelligence (AI) framework, histological images from colorectal tissue and breast were also collected. Training and validation set of images were collected from Xiamen Hospital of Traditional Chinese Medicine whereas test set of images were collected from Zhongshan Hospital Xiamen University.

Results

Accuracy, sensitivity, and specificity were reported and compared to human image interpretation and other AI image classification systems such as AlexNet and GoogLeNet. For the test dataset, sensitivity, specificity, and area under the curve of the AI framework were 99.1%, 98.0%, and 0.960, respectively. In human-machine comparisons, the accuracy of the AI framework was 98.5%, while the accuracy of human experts fluctuated between 93.0% and 95.0%. Based on transfer learning, the AI framework accuracy for colorectal carcinoma, breast invasive ductal carcinoma, were 96.8%, and 96.0%, respectively.

Conclusions

The performance of the proposed AI framework in classifying histological images with hepatocellular carcinoma is comparable to the classification by human experts. With limited training, the proposed AI framework has potential universality in histological image classification.

Study Highlights

WHAT IS KNOWN

✓

Accurate recognition of medical images is the basis for clinical decision-making.

✓

Unresolved challenge exists between specialized practitioners and expanding medical imaging output.

WHAT IS NEW HERE

✓

Proposed AI framework has excellent performance in classifying hepatocellular carcinoma.

✓

The AI framework has universal feature in classifying other types of histological images.

✓

The AI framework may help to interpret emerging imaging technology.
Delaying the COVID-19 epidemic in Australia: Evaluating the effectiveness of international travel bans
Authors: Adekunle Adeshina I. , Meehan Michael , Rojas Dianna , Trauer James , McBryde Emma
Published: March 2020

Following the outbreak of novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) or COVID-19 in Wuhan, China late 2019, different countries have put in place interventions such as travel ban, proper hygiene, and social distancing to slow the spread of this novel virus. We evaluated the effects of travel bans in the Australia context and projected the epidemic until May 2020. Our modelling results closely align with observed cases in Australia indicating the need for maintaining or improving on the control measures to slow down the virus.
Gastrointestinal tract symptoms in coronavirus disease 2019: Analysis of clinical symptoms in adult patients
Authors: Zhang Yong , Lu Zuneng , Wang Bo , Cang Jinxing , Ma Yonggang
Published: March 2020

Objective

To investigate the clinical presentation of coronavirus disease 2019 (COVID-19), particularly the incidence of gastrointestinal tract symptoms.

Design

We enrolled adult COVID-19 patients from a mobile cabin hospital in Wuhan with a definitive diagnosis by SARS-CoV-2 nucleic acid testing. Face-to-face interviews were conducted in which the patient selected COVID-19-related symptoms and report the time of onset and duration of symptoms.

Results

A total of 212 adults were enrolled in this study, of which 127 (59.9%) were females, mean age was 48.50 ±13.15 (range: 17-79) years, and mean disease course was 26.78±9.16 (3-60) days. Fever and cough were the most common and earliest clinical symptoms of COVID-19.

Diarrhoea occurred in 43.8% (93/212) of patients, of which 86.0% (80/93) had mushy stools. Nausea and vomiting were also common (20.7%). Diarrhoea lasted for 4.00(2.00-8.85) days and mostly occurred 5.00(0.25-11.00) days after the emergence of the first symptoms. Multiple logistic regression analysis found that diarrhoea was significantly correlated with fatigue [OR2.900,95%CI (1.629-5.164), p<0.0001].

Conclusions

Gastrointestinal tract symptoms are common in COVID-19 and most occur during the middle stage of the disease and lasts for a short period of time. Clinicians need to pay greater attention to gastrointestinal tract symptoms of COVID-19.
Impact of changing case definitions for COVID-19 on the epidemic curve and transmission parameters in mainland China
Authors: Tsang Tim K. , Wu Peng , Lin Yun , Lau Eric H. Y. , Leung Gabriel M. , Cowling Benjamin J.
Published: March 2020

Background

When a new infectious disease emerges, appropriate case definitions are important for clinical diagnosis and also for public health surveillance. Tracking case numbers over time allows us to determine speed of spread and the effectiveness of interventions. Changing case definitions during an epidemic can affect these inferences.

Methods

We examined changes in the case definition for COVID-19 in mainland China during the first epidemic wave. We used simple models assuming exponential growth and then exponential decay to estimate how changes in the case definitions affected the numbers of cases reported each day. We then inferred how the epidemic curve would have appeared if the same case definition had been used throughout the epidemic.

Findings

From January through to early March 2020, seven versions of the case definition for COVID-19 were issued by the National Health Commission in China. As of February 20, there were 55,508 confirmed cases reported in mainland China. We estimated that when the case definitions were changed from version 1 to 2, version 2 to 4 and version 4 to 5, the proportion of infections being detected as cases were increased by 7.1-fold (95% credible interval (CI): 4.8, 10.9), 2.8-fold (95% CI: 1.9, 4.2) and 4.2-fold (95% CI: 2.6, 7.3) respectively. If the fifth version of the case definition had been applied throughout the outbreak, we estimated that by February 20 there would have been 232,000 (95% CI: 161,000, 359,000) confirmed cases.

Interpretation

The case definition was initially narrow, but was gradually broadened to allow detection of more cases as knowledge increased, particularly milder cases and those without epidemiological links to Wuhan or other known cases. This should be taken into account when making inferences on epidemic growth rates and doubling times, and therefore on the reproductive number, to avoid bias.

Funding

Commissioned grant from the Health and Medical Research Fund, Food and Health Bureau, Government of the Hong Kong Special Administrative Region.
The role of the environment in overweight and eating behavior variability: Insights from a multivariate twin study
Authors: Herle Moritz , Madrid-Valero Juan J , Morosoli José J , Colodro-Conde Lucía , Ordoñana Juan
Published: March 2020

The health consequences of overweight and obesity remain one of the greatest global health challenges. Twin and molecular studies have confirmed the genetic basis of individual differences in BMI; however, genetics cannot explain the rapid rise of obesity rates over the past decades. Eating behaviors have been stipulated to be the behavioral expression of genetic risk in an obesogenic environment. Multivariate twin studies can inform future applied research by providing insights into the etiology of the relationship between behaviors and BMI. In this study, we aimed to decompose variation and covariation between three key eating behaviors and BMI in a sample from a population-based twin registry of adult women in the southeast of Spain, The Murcia Twin Registry (345 complete, 9 incomplete, same-sex female twin pairs, 175 MZ, 170 DZ). Phenotypes were emotional eating, uncontrolled eating, and cognitive restraint, as measured by the Three Factor Eating Questionnaire, as well as objectively measured BMI. Variation in eating behaviors was mostly driven by non-shared environmental factors (range: 56-65%), whereas shared environmental and genetic factors were secondary. All three eating behaviors were associated with BMI at a phenotypic level (range r=0.19–0.25). Etiological correlations implied that non-shared environmental factors underly the covariations of the phenotypes (Emotional eating – Uncontrolled eating: rE= 0.54, 95%CI: 0.43, 0.64; BMI – Cognitive restraint: rE= 0.15, 95%CI: 0.01, 0.28). Results indicate that in contrast to BMI, individual differences in eating behaviors are mostly explained by non-shared environmental factors, which also account for the phenotypic correlation between eating behaviors and BMI. These results support that eating behaviors are viable intervention targets to help individuals reach and maintain a healthy weight.
History of coronary heart disease increases the mortality rate of COVID-19 patients: a nested case-control study
Authors: Gu Tian , Chu Qiao , Yu Zhangsheng , Fa Botao , Li Anqi , Xu Lei , He Yaping , Wu Ruijun
Published: March 2020

Background

China has experienced an outbreak of a novel human coronavirus (SARS-CoV-2) since December 2019, which quickly became a worldwide pandemic in early 2020. There is limited evidence on the mortality risk effect of pre-existing comorbidities for coronavirus disease 2019 (COVID-19), which has important implications for early treatment.

Objective

Evaluate the risk of pre-existing comorbidities on COVID-19 mortality, and provide clinical suggestions accordingly.

Method

This study used a nested case-control design. A total of 94 publicly reported deaths in locations outside of Hubei Province, China, between December 18th, 2019 and March 8th, 2020 were included as cases. Each case was matched with up to three controls, based on gender and age ± 1 year old (94 cases and 181 controls). The inverse probability weighted Cox proportional hazard model was performed.

Results

History of comorbidities significantly increased the death risk of COVID-19: one additional pre-existing comorbidity led to an estimated 40% higher risk of death (p<0.001). The estimated mortality risk in patients with CHD was three times of those without CHD (p<0.001). The estimated 30-day survival probability for a profile patient with pre-existing CHD (65-year-old female with no other comorbidities) was 0.53 (95% CI [0.34-0.82]), while it was 0.85 (95% CI [0.79-0.91]) for those without CHD. Older age was also associated with increased death risk: every 5-year increase in age was associated with a 20% increased risk of mortality (p<0.001).

Conclusion

Extra care and early medical intervention are needed for patients with pre-existing comorbidities, especially CHD.
Modelling strategies to organize healthcare workforce during pandemics: application to COVID-19
Authors: Sánchez-Taltavull Daniel , Candinas Daniel , Roldán Édgar , Beldi Guido
Published: March 2020

Protection of healthcare workforce who are at increased risk to become infected is of paramount relevance for the care of patients in the setting of a pandemic such as coronavirus disease 2019 (COVID-19). The ideal organisational strategy to protect the workforce in a situation in which social distancing cannot be maintained remains to be determined. In this study, we have mathematically modelled strategies for the employment of hospital workforce with the goal to simulate health and productivity of the workers. The models were designed to determine if desynchronization of medical teams by dichotomizing the workers may protect the workforce. Our studies model workforce productivity depending on the infection rate, the presence of reinfection and the efficiency of home office and apply our theory to the case of COVID-19. The results reveal that a desynchronization strategy in which two medical teams work alternating for 7 days increases the available workforce.
Coincidence of COVID-19 epidemic and olfactory dysfunction outbreak
Authors: Bagheri Seyed Hamidreza , Asghari Alimohamad , Farhadi Mohammad , Shamshiri Ahmad Reza , Kabir Ali , Kamrava Seyed Kamran , Jalessi Maryam , Mohebbi Alireza , Alizadeh Rafieh , Honarmand Ali Asghar , Ghalehbaghi Babak , Salimi Alireza
Published: March 2020

Background

Recent surge of olfactory dysfunction in patients who were referred to ENT clinics and concurrent COVID-19epidemic in Iran motivated us to evaluate anosmic/hyposmic patients to find any relation between these two events.

Methods

This is a cross-sectional study with an online checklist on voluntary cases in all provinces of Iran between the 12th and 17th March, 2020. Cases was defined as self-reported anosmia/hyposmia in responders fewer than 4 weeks later (from start the of COVID-19 epidemic in Iran). Variables consist of clinical presentations, related past medical history, family history of recent respiratory tract infection and hospitalization.

Results

In this study 10069 participants aged 32.5±8.6 (7-78) years, 71.13% female and 81.68% non-smoker completed online checklist. They reported 10.55% a history of a trip out of home town and 1.1% hospitalization due to respiratory problems recently. From family members 12.17% had a history of severe respiratory disease in recent days and 48.23% had anosmia/hyposmia.

Correlation between the number of olfactory disorder and reported COVID-19 patients in all 31 provinces till 16th March 2020 was highly significant (Spearman correlation coefficient=0.87, p-Value<0.001). The onset of anosmia was sudden in 76.24% and till the time of filling the questionnaire in 60.90% of patients decreased sense of smell was constant. Also 83.38 of this patients had decreased taste sensation in association with anosmia.

Conclusions

It seems that we have a surge in outbreak of olfactory dysfunction happened in Iran during the COVID-19 epidemic. The exact mechanism of anosmia/hyposmia in COVID-19 patients’ needs further investigations.
Is a COVID19 Quarantine Justified in Chile or USA Right Now?
Authors: Gonzalez R. I. , Munoz F. , Moya P. S. , Kiwi M.
Published: March 2020

During the current COVID-19 pandemic it is imperative to give early warnings to reduce mortality. However, non-specialist such as authorities and the general population face several problems to understand the real thread of this pandemic, and under/overestimation of its risk are a commonplace in the press and social media. Here we define an index, which we call the COVID-19 Burden Index, that relates the capacities of the healthcare system of a given country to treat severe and critical cases. Its value is 0 if there is no extra strain in the healthcare system, and it reaches 1.0 when the collapse is imminent. As of 23 March 2020, we show that Chile, the USA, UK, among other countries, must reduce the rate of infections right now, otherwise, in less than 7 days they could be in a catastrophic situation such as Italy, Spain and Iran.
Structural basis of ethnic-specific variants of PAX4 associated with type 2 diabetes
Authors: Hosoe Jun , Suzuki Ken , Kato Takashi , Okada Yukinori , Horikoshi Momoko , Shojima Nobuhiro , Yamauchi Toshimasa , Kadowaki Takashi
Published: March 2020

Recently, we conducted genome-wide association studies of type 2 diabetes (T2D) in a Japanese population, which identified 20 novel T2D loci that were not associated with T2D in Europeans. Moreover, nine novel missense risk variants, such as those ofPAX4, were not rare in the Japanese population, but rare in Europeans. We reportin silicostructural analysis of ethnic-specific variants ofPAX4, which suggests the pathogenic effect of these variants.
Overlooked tertiary sulci serve as a meso-scale link between microstructural and functional properties of human lateral prefrontal cortex
Authors: Miller Jacob A. , Voorhies Willa I. , Lurie Daniel J. , D’Esposito Mark , Weiner Kevin S.
Published: March 2020

Understanding the relationship between neuroanatomy and function in portions of human cortex that are expanded compared to other mammals such as lateral prefrontal cortex (LPFC) is of major interest in systems and cognitive neuroscience. When considering neuroanatomical-functional relationships in LPFC, shallow indentations in cortex known as tertiary sulci have been largely ignored. Here, by implementing a multi-modal approach and manually defining 936 neuroanatomical structures in 72 hemispheres (males and females), we show that a subset of these overlooked tertiary sulci serve as a meso-scale link between microstructural (myelin content) and functional (network connectivity) properties of human LPFC in individuals. For example, theposterior middle frontal sulcus(pmfs) is a tertiary sulcus with three components that differ in their myelin content, resting state connectivity profiles, and engagement across meta-analyses of 83 cognitive tasks. Further, generating microstructural profiles of myelin content across cortical depths for eachpmfscomponent and the surrounding middle frontal gyrus (MFG) shows that both gyral and sulcal components of the MFG have greater myelin content in deeper compared to superficial layers and that the myelin content in superficial layers of the gyral components is greater than sulcal components. These findings support a classic, yet largely unconsidered theory that tertiary sulci may serve as landmarks in association cortices, as well as a modern cognitive neuroscience theory proposing a functional hierarchy in LPFC. As there is a growing need for computational tools that automatically define tertiary sulci throughout cortex, we sharepmfsprobabilistic sulcal maps with the field.

Significance statement

Lateral prefrontal cortex (LPFC) is critical for higher-order cognitive control and goal-directed behavior and is disproportionately expanded in the human brain. However, relationships between fine-scale neuroanatomical structures largely specific to hominoid cortex and functional properties of LPFC remain elusive. Here, we show that these structures, which have been largely neglected throughout history, surprisingly serve as markers for anatomical and functional organization in human LPFC. These findings have theoretical, methodological, developmental, and evolutionary implications for improved understanding of neuroanatomical-functional relationships not only in LPFC, but also in association cortices more broadly. Finally, these findings ignite new questions regarding how morphological features of these neglected neuroanatomical structures contribute to functions of association cortices that are critical for human-specific aspects of cognition.
Transmission dynamics of SARS-COV-2 in China: impact of public health interventions
Authors: Wang Wenbao , Chen Yiqin , Wang Qi , Cai Ping , He Ye , Hu Shanwen , Wu Yan , Huang Zuxiong , Wang Wenxiang
Published: March 2020

COVID-19 has become a global pandemic. However, the impact of the public health interventions in China needs to be evaluated. We established a SEIRD model to simulate the transmission trend of China. In addition, the reduction of the reproductive number was estimated under the current forty public health interventions policies. Furthermore, the infection curve, daily transmission replication curve, and the trend of cumulative confirmed cases were used to evaluate the effects of the public health interventions. Our results showed that the SEIRD curve model we established had a good fit and the basic reproductive number is 3.38 (95% CI, 3.25–3.48). The SEIRD curve show a small difference between the simulated number of cases and the actual number; the correlation index (H2) is 0.934, and the reproductive number (R) has been reduced from 3.38 to 0.5 under the current forty public health interventions policies of China. The actual growth curve of new cases, the virus infection curve, and the daily transmission replication curve were significantly going down under the current public health interventions. Our results suggest that the current public health interventions of China are effective and should be maintained until COVID-19 is no longer considered a global threat.
Modeling for Corona Virus Outbreak in IRAN
Authors: Moghadami Maryam , Wa Ka , Hassanzadeh Mohammad , Hedayati Aziz
Published: March 2020

Background

As the outbreak of coronavirus disease 2019 (COVID-19) is a worldwide pandemic, it is rapidly expanding in Iran, real-time analyses of epidemiological data are needed to increase situational awareness and inform interventions. In this study, we built a predictive model based on the cumulative trend of new cases and deaths for the top five provinces. we will also look at modeling the trends for confirmed cases, deaths and recovered for the whole country.

Method

In this study, we have chosen to apply the exponential smoothing model to iteratively forecast future values of a regular time seires from weightedaverages of past daily values of the series. This method is exponential because the value of each level is influenced by every preceeding actual value to an exponentially decreasing degree – more recent values are given a greater weight. The available data is too small to identify seasonal patterns and make predictable variation in value, such as annual fluctuation in temperature relative to the season. Trend is a tendency in the data to increase or decrease over time.

Results

If no control measures are put in place, it is expected that over 40,000 would be infected in Tehran around the middle of June. However, if control measures were implemented with a high degree of success, one would expect the spreadof the COV-19 virus would peak at the start of April with a downward trend dropping off by the end of May (70 days). In the scenario, that no further measures are implemented, one would expect the spread of COVID-19 to continue on a gentle incline, reaching 21,000 by mid-June. The same processhas been applied to review the confirmed, deaths and recovered dataset. The forecast has been carried out for the next 30 days, a shorter timeframe has been selected as there is a high probability that the Iranian New Year’s celebration, Farvardin, first month of Spring (30thMarch in Western calendar) will have an impact on the infection rate following the event.

The best predictive model predicts the confirmed cases to be in the range of 35,000-70,000, with the number of reported COVDI-19 deaths to be between 3,000 – 5,000 and 5,000 – 30,000 of recovered cases.

Conclusions

Modeling outbreak of Covid-19 shows that the number of patients and deaths is still increasing. Contagious diseases follow an exponential model and the same be Haves this one. This is because, the virus can spread to others and finally each person turns into a carrier of the virus and transmit it to another person. Disease control depends on disconnection and social distancing. In addition, many factors are effective in stopping the disease. These include citizens’ participation in the prevention process, health education, the effectiveness of instructive traditions, environmental conditions, and so on.
Disparities in Age-Specific Morbidity and Mortality from SARS-CoV-2 in China and the Republic of Korea
Authors: Dudley Joseph P. , Lee Nam Taek
Published: March 2020

We analyzed age-specific and sex-specific morbidity and mortality data from SARS-COV-2 pandemic in China and Republic of Korea (ROK). Data from China exhibit a standard Gaussian distribution with peak morbidity in the 50-59 years cohort, while the ROK data have a bimodal distribution with highest morbidity in the 20-29 years cohort.