scholarly journals Development and validation of a simplified score to predict neonatal mortality risk among neonates weighing 2000 g or less (NMR-2000): an analysis using data from the UK and The Gambia

2020 ◽  
Vol 4 (4) ◽  
pp. 299-311 ◽  
Author(s):  
Melissa M Medvedev ◽  
Helen Brotherton ◽  
Abdou Gai ◽  
Cally Tann ◽  
Christopher Gale ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Mortality Risk ◽  
The Gambia ◽  
Using Data ◽  
The Uk ◽  
Development And Validation

scholarly journals Period and cohort changes in mortality risk over the twentieth century in the UK: an exploratory analysis

2017 ◽  
Author(s):  
Phil Mike Jones ◽  
Jonathan Minton ◽  
Andrew Bell
Keyword(s):  
Twentieth Century ◽  
Mortality Risk ◽  
Longitudinal Research ◽  
Influenza Pandemic ◽  
Identification Problem ◽  
The United States ◽  
World War ◽  
Post War ◽  
Using Data ◽  
The Uk

This paper explores discrete changes in age--specific mortality risk across periods and cohorts, using data from 40 countries during the twentieth century with a particular focus on the UK.Our interest is in the discrete changes in mortality seen as a result of global events, rather than the overall changes in mortality throughout the twentieth century.We use innovative exploratory visual and statistical methods to explore these changes.First, Lexis surface plots are used to visualise period and cohort 'scars' in age--specific period and cohort mortality in the population across the twentieth century.Second, we use a version of the hierarchical age--period--cohort (APC) model to statistically separate discrete period and cohort effects.We avoid the APC identification problem by analysing only discrete deviations net of any linear APC effects.We find period and cohort effects in mortality associated with the First World War of 1914--18, the influenza pandemic of 1918, the Second World War of 1939--45, and, intriguingly, a decline in mortality in many western countries associated with the 1948 birth cohort.We believe a combination of factors influenced this improvement in mortality, including the developments of post--war social welfare, the economic investment in Europe by the United States, the accessibility of antibiotics such as penicillin, and, in the UK, the NHS.Our findings suggest universal or accessible health care make significant and detectable improvements to population mortality for those born under it.These methods could productively be used by epidemiologists and others to explore deviations from APC trends in other longitudinal research contexts.

scholarly journals 699 Sleep Health Traits and COVID-19: Mortality Risk from the UK Biobank

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A273-A273
Author(s):  
Xi Zheng ◽  
Ma Cherrysse Ulsa ◽  
Peng Li ◽  
Lei Gao ◽  
Kun Hu
Keyword(s):  
Risk Factors ◽  
Sleep Apnea ◽  
Sleep Duration ◽  
Sex Education ◽  
Mortality Risk ◽  
Self Report ◽  
Severe Illness ◽  
Uk Biobank ◽  
Sleep Health ◽  
The Uk

Abstract Introduction While there is emerging evidence for acute sleep disruption in the aftermath of coronavirus disease 2019 (COVID-19), it is unknown whether sleep traits contribute to mortality risk. In this study, we tested whether earlier-life sleep duration, chronotype, insomnia, napping or sleep apnea were associated with increased 30-day COVID-19 mortality. Methods We included 34,711 participants from the UK Biobank, who presented for COVID-19 testing between March and October 2020 (mean age at diagnosis: 69.4±8.3; range 50.2–84.6). Self-reported sleep duration (less than 6h/6-9h/more than 9h), chronotype (“morning”/”intermediate”/”evening”), daytime dozing (often/rarely), insomnia (often/rarely), napping (often/rarely) and presence of sleep apnea (ICD-10 or self-report) were obtained between 2006 and 2010. Multivariate logistic regression models were used to adjust for age, sex, education, socioeconomic status, and relevant risk factors (BMI, hypertension, diabetes, respiratory diseases, smoking, and alcohol). Results The mean time between sleep measures and COVID-19 testing was 11.6±0.9 years. Overall, 5,066 (14.6%) were positive. In those who were positive, 355 (7.0%) died within 30 days (median = 8) after diagnosis. Long sleepers (>9h vs. 6-9h) [20/103 (19.4%) vs. 300/4,573 (6.6%); OR 2.09, 95% 1.19–3.64, p=0.009), often daytime dozers (OR 1.68, 95% 1.04–2.72, p=0.03), and nappers (OR 1.52, 95% 1.04–2.23, p=0.03) were at greater odds of mortality. Prior diagnosis of sleep apnea also saw a two-fold increased odds (OR 2.07, 95% CI: 1.25–3.44 p=0.005). No associations were seen for short sleepers, chronotype or insomnia with COVID-19 mortality. Conclusion Data across all current waves of infection show that prior sleep traits/disturbances, in particular long sleep duration, daytime dozing, napping and sleep apnea, are associated with increased 30-day mortality after COVID-19, independent of health-related risk factors. While sleep health traits may reflect unmeasured poor health, further work is warranted to examine the exact underlying mechanisms, and to test whether sleep health optimization offers resilience to severe illness from COVID-19. Support (if any) NIH [T32GM007592 and R03AG067985 to L.G. RF1AG059867, RF1AG064312, to K.H.], the BrightFocus Foundation A2020886S to P.L. and the Foundation of Anesthesia Education and Research MRTG-02-15-2020 to L.G.

scholarly journals Validation of the BATT score for prehospital risk stratification of traumatic haemorrhagic death: usefulness for tranexamic acid treatment criteria

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Francois-Xavier Ageron ◽  
Timothy J. Coats ◽  
Vincent Darioli ◽  
Ian Roberts
Keyword(s):  
Tranexamic Acid ◽  
Acid Treatment ◽  
Injury Severity ◽  
External Validation ◽  
Research Network ◽  
Brier Score ◽  
Trauma Patients ◽  
Using Data ◽  
The Uk ◽  
The Impact

Abstract Background Tranexamic acid reduces surgical blood loss and reduces deaths from bleeding in trauma patients. Tranexamic acid must be given urgently, preferably by paramedics at the scene of the injury or in the ambulance. We developed a simple score (Bleeding Audit Triage Trauma score) to predict death from bleeding. Methods We conducted an external validation of the BATT score using data from the UK Trauma Audit Research Network (TARN) from 1st January 2017 to 31st December 2018. We evaluated the impact of tranexamic acid treatment thresholds in trauma patients. Results We included 104,862 trauma patients with an injury severity score of 9 or above. Tranexamic acid was administered to 9915 (9%) patients. Of these 5185 (52%) received prehospital tranexamic acid. The BATT score had good accuracy (Brier score = 6%) and good discrimination (C-statistic 0.90; 95% CI 0.89–0.91). Calibration in the large showed no substantial difference between predicted and observed death due to bleeding (1.15% versus 1.16%, P = 0.81). Pre-hospital tranexamic acid treatment of trauma patients with a BATT score of 2 or more would avoid 210 bleeding deaths by treating 61,598 patients instead of avoiding 55 deaths by treating 9915 as currently. Conclusion The BATT score identifies trauma patient at risk of significant haemorrhage. A score of 2 or more would be an appropriate threshold for pre-hospital tranexamic acid treatment.

scholarly journals Lockdown, slow down: impact of the COVID-19 pandemic on physical activity—an observational study

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001600
Author(s):  
Joanne Kathryn Taylor ◽  
Haarith Ndiaye ◽  
Matthew Daniels ◽  
Fozia Ahmed
Keyword(s):  
Physical Activity ◽  
New York ◽  
Heart Association ◽  
Evaluation Study ◽  
Activity Data ◽  
Cardiac Devices ◽  
Significant Difference ◽  
New York Heart Association ◽  
Using Data ◽  
The Uk

AimsIn response to the COVID-19 pandemic, the UK was placed under strict lockdown measures on 23 March 2020. The aim of this study was to quantify the effects on physical activity (PA) levels using data from the prospective Triage-HF Plus Evaluation study.MethodsThis study represents a cohort of adult patients with implanted cardiac devices capable of measuring activity by embedded accelerometery via a remote monitoring platform. Activity data were available for the 4 weeks pre-implementation and post implementation of ‘stay at home’ lockdown measures in the form of ‘minutes active per day’ (min/day).ResultsData were analysed for 311 patients (77.2% men, mean age 68.8, frailty 55.9%. 92.2% established heart failure (HF) diagnosis, of these 51.2% New York Heart Association II), with comorbidities representative of a real-world cohort.Post-lockdown, a significant reduction in median PA equating to 20.8 active min/day was seen. The reduction was uniform with a slightly more pronounced drop in PA for women, but no statistically significant difference with respect to age, body mass index, frailty or device type. Activity dropped in the immediate 2-week period post-lockdown, but steadily returned thereafter. Median activity week 4 weeks post-lockdown remained significantly lower than 4 weeks pre-lockdown (p≤0.001).ConclusionsIn a population of predominantly HF patients with cardiac devices, activity reduced by approximately 20 min active per day in the immediate aftermath of strict COVID-19 lockdown measures.Trial registration numberNCT04177199.

scholarly journals Convolutional Neural Network-Based Clinical Predictors of Oral Dysplasia: Class Activation Map Analysis of Deep Learning Results

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1291
Author(s):  
Seda Camalan ◽  
Hanya Mahmood ◽  
Hamidullah Binol ◽  
Anna Luiza Damaceno Araújo ◽  
Alan Roger Santos-Silva ◽  
...  
Keyword(s):  
Cross Validation ◽  
Clinical Predictors ◽  
Oral Dysplasia ◽  
Novel Technologies ◽  
Photographic Images ◽  
The Uk ◽  
Map Analysis ◽  
Development And Validation ◽  
Fold Cross Validation ◽  
Activation Map

Oral cancer/oral squamous cell carcinoma is among the top ten most common cancers globally, with over 500,000 new cases and 350,000 associated deaths every year worldwide. There is a critical need for objective, novel technologies that facilitate early, accurate diagnosis. For this purpose, we have developed a method to classify images as “suspicious” and “normal” by performing transfer learning on Inception-ResNet-V2 and generated automated heat maps to highlight the region of the images most likely to be involved in decision making. We have tested the developed method’s feasibility on two independent datasets of clinical photographic images of 30 and 24 patients from the UK and Brazil, respectively. Both 10-fold cross-validation and leave-one-patient-out validation methods were performed to test the system, achieving accuracies of 73.6% (±19%) and 90.9% (±12%), F1-scores of 97.9% and 87.2%, and precision values of 95.4% and 99.3% at recall values of 100.0% and 81.1% on these two respective cohorts. This study presents several novel findings and approaches, namely the development and validation of our methods on two datasets collected in different countries showing that using patches instead of the whole lesion image leads to better performance and analyzing which regions of the images are predictive of the classes using class activation map analysis.

scholarly journals The genetic architecture of structural left–right asymmetry of the human brain

2021 ◽  
Author(s):  
Zhiqiang Sha ◽  
Dick Schijven ◽  
Amaia Carrion-Castillo ◽  
Marc Joliot ◽  
Bernard Mazoyer ◽  
...  
Keyword(s):  
Brain Asymmetry ◽  
Functional Enrichment ◽  
Brain Organization ◽  
Genome Wide ◽  
Brain Expression ◽  
Using Data ◽  
Left Right Asymmetry ◽  
The Uk ◽  
Subcortical Volume

AbstractLeft–right hemispheric asymmetry is an important aspect of healthy brain organization for many functions including language, and it can be altered in cognitive and psychiatric disorders. No mechanism has yet been identified for establishing the human brain’s left–right axis. We performed multivariate genome-wide association scanning of cortical regional surface area and thickness asymmetries, and subcortical volume asymmetries, using data from 32,256 participants from the UK Biobank. There were 21 significant loci associated with different aspects of brain asymmetry, with functional enrichment involving microtubule-related genes and embryonic brain expression. These findings are consistent with a known role of the cytoskeleton in left–right axis determination in other organs of invertebrates and frogs. Genetic variants associated with brain asymmetry overlapped with those associated with autism, educational attainment and schizophrenia. Comparably large datasets will likely be required in future studies, to replicate and further clarify the associations of microtubule-related genes with variation in brain asymmetry, behavioural and psychiatric traits.

scholarly journals Exploring the Relationship Between Palatal Cleft Type and Width With the Use of Relieving Incisions in Primary Repair

2021 ◽  
pp. 105566562110196
Author(s):  
Alex Davies ◽  
Amy Davies ◽  
Yvonne Wren ◽  
Scott Deacon ◽  
Alistair R.M. Cobb ◽  
...  
Keyword(s):  
Oral Mucosa ◽  
Primary Repair ◽  
Fistula Formation ◽  
The United Kingdom ◽  
Using Data ◽  
The Uk ◽  
The Relationship ◽  
Soft Edge ◽  
Intravelar Veloplasty ◽  
Pierre Robin

Objective: The mainstay of palatal repair in the United Kingdom is the intravelar veloplasty (IVVP). It is not always possible to align the oral mucosa in the midline to achieve tension-free repair. The addition of lateral relieving incisions may aid transposition of the oral mucosa to allow closure. The aim of this study was to explore cleft features that may predispose to a requirement for relieving incisions in order to allow palate closure. Design: We performed a national multiinstitutional retrospective study using data from the UK Cleft Collective cohort study. Patients: The study sample consisted of 474 patients who had undergone IVVP at the time of palatal closure across all 16 of the UK cleft units. Results: We found strong evidence for the requirement for relieving incisions in patients with an increased degree of clefting per the Veau classification ( P < .001), increasing palatal soft-edge width ( P < .001) and moderate evidence of an associated use in patients with Pierre Robin sequence ( P = .015). Insufficient data were available to explore the relationship between intertuberosity distance and the presence of fistula formation with the use of relieving incisions. Conclusions: The results of this study identify cleft features that increase the likelihood for requiring lateral relieving incisions to allow palatal closure. The degree to which the addition of relieving incisions to IVVP affects maxillary growth and speech outcomes is unknown. Further study is required to answer this important question.

Funding Local Political Parties in England and Wales: Donations and Constituency Campaigns

2007 ◽  
Vol 9 (3) ◽  
pp. 365-395 ◽  
Author(s):  
Ron Johnston ◽  
Charles Pattie
Keyword(s):  
Political Parties ◽  
England And Wales ◽  
Liberal Democrats ◽  
Using Data ◽  
The Uk ◽  
The Impact

The funding of political parties is an issue of considerable contemporary concern in the UK. Although most attention has been paid to the situation regarding national parties, the new funding regime introduced in 2001 also applies to constituency parties, and some concerns have been raised regarding the limits on spending and expenditure there. Using data released by the Electoral Commission on all donations above a specified minimum to constituency parties, this article looks at the pattern of donations over the period 2001–05. It then analyses the impact of spending on the 2005 constituency campaigns, showing that for the Conservatives and Liberal Democrats substantial donations enhanced their vote-winning performances in seats where their candidates were challengers whereas for Labour substantial donations aided its performance in marginal seats that it was defending.

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