scholarly journals A clinical staging proposal of the disease course over time in non-severe patients with coronavirus disease 2019

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yiting Lin ◽  
Yiqun Wu ◽  
Ping Zhong ◽  
Bingbo Hou ◽  
Jielan Liu ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Clinical Signs ◽  
Clinical Staging ◽  
Disease Course ◽  
Prodromal Phase ◽  
The Third ◽  
Convalescent Phase ◽  
Secondary Damage ◽  
Remission Phase ◽  
Over Time

AbstractInformation on the clinical staging of coronavirus disease 2019 (COVID-19) is still limited. This study aimed to propose a clinical staging proposal of the disease course in non-severe patients with COVID-19. In this retrospective study, 108 non-severe patients with COVID-19 were grouped according to the duration from symptoms onset to hospital admission: ≤ 1 week, > 1 to 2 weeks, > 2 to 3 weeks, > 3 to 5 weeks, respectively. The dynamic changes of clinical signs were profiled across the four groups. A clinical staging proposal of the disease course over time was proposed from the perspective of the interaction between the virus and host. The prodromal phase, characterized by pneumonia, significant lymphopenia, and slightly elevated inflammatory markers, occurred in the first week after symptoms onset. In the second week, all the hematological and inflammatory markers were at the peak or bottom. Meanwhile, progressive pneumonia as well as the secondary damage of other organs (e.g. cardiac damage, coagulopathy, etc.) was significant during this period, making the disease progress into the apparent manifestation phase. In the third week, the improvement of the majority of clinical signs accompanied by a relatively high degree of inflammatory response defined the remission phase. After 3 weeks, patients were in the convalescent phase, in which all the indicators were maintained at a relatively normal level. We concluded that the disease course over time in non-severe patients with COVID-19 could be divided into four phases: the prodromal phase (in the first week), the apparent manifestation phase (in the second week), the remission phase (in the third week), and the convalescent phase (after 3 weeks), respectively. In clinical practice, tailored therapies should be considered seriously in different stages of the disease course.

The Stabilization Process Then and Now

2018 ◽  
Author(s):  
Ben Epstein
Keyword(s):  
Political Communication ◽  
Status Quo ◽  
The Political ◽  
The Internet ◽  
Stabilization Process ◽  
The Third ◽  
Stabilization Phase ◽  
Over Time

This chapter shifts the focus to the third and final stabilization phase of the political communication cycle (PCC). During the stabilization phase, a new political communication order (PCO) takes shape through the building of norms, institutions, and regulations that serve to fix the newly established status quo in place. This status quo occurs when formerly innovative political communication activities become mundane, yet remain powerful. Much of the chapter details the pattern of communication regulation and institution construction over time. In particular, this chapter explores the instructive similarities and key differences between the regulation of radio and the internet, which offers important perspectives on the significance of our current place in the PCC and the consequences of choices that will be made over the next few years.

Coping with longitudinal data in research on developmental psychopathology

2006 ◽  
Vol 30 (1) ◽  
pp. 20-25 ◽  
Author(s):  
David A. Cole
Keyword(s):  
Data Collection ◽  
Longitudinal Data ◽  
Developmental Psychopathology ◽  
Careful Consideration ◽  
Two Dimensions ◽  
The Other ◽  
Outcome Variable ◽  
The Third ◽  
Data Analytic ◽  
Over Time

Many outcome variables in developmental psychopathology research are highly stable over time. In conventional longitudinal data analytic approaches such as multiple regression, controlling for prior levels of the outcome variable often yields little (if any) reliable variance in the dependent variable for putative predictors to explain. Three strategies for coping with this problem are described. One involves focusing on developmental periods of transition, in which the outcome of interest may be less stable. A second is to give careful consideration to the amount of time allowed to elapse between waves of data collection. The third is to consider trait-state-occasion models that partition the outcome variable into two dimensions: one entirely stable and trait-like, the other less stable and subject to occasion-specific fluctuations.

scholarly journals From Uncommon Infection to Multi-Cranial Palsy: Malignant External Otitis Insights

Dose-Response ◽  
2020 ◽  
Vol 18 (4) ◽  
pp. 155932582096391
Author(s):  
Salvatore Ferlito ◽  
Antonino Maniaci ◽  
Milena Di Luca ◽  
Calogero Grillo ◽  
Lorenzo Mannelli ◽  
...  
Keyword(s):  
Imaging Techniques ◽  
Clinical Signs ◽  
External Otitis ◽  
Bone Lesions ◽  
Nuclear Medicine Imaging ◽  
Osteoblastic Activity ◽  
Malignant External Otitis ◽  
Remission Phase ◽  
Reading Key ◽  
Base Of The Skull

Purpose: The progression of the otitic infectious process toward diseases of particular severity is often unpredictable, just as it is challenging to manage the patient over time, even after the apparent resolution of the disease. We aim to define a radiological reading key that allows us to correctly and promptly treat the disease, avoiding the possible severe complications. Methods: We conducted a retrospective study of 13 cases of basal cranial osteomyelitis (SBO) due to malignant external otitis, by the ENT Department of the University of Catania. Through a standardized approach and following the latest guidelines, we have evaluated all patients performing a standardized and personalized radiological protocol according to the stage of the patient’s pathology and modulating the treatment consequently. Results: Clinical signs have been observed such as otorrhea (100%), otalgia in 13/13 patients (100%), granulations in external auditory canal (100%), preauricular cellulitis in 9/13 patients (69%) headache 6/13 cases (46%), dysphonia 4/13 cases (31%). HRCT of the temporal bone proved useful in identifying even minimal bone lesions in 13/13 (100%) while improving MRI in vascular and nervous involvement, although in 1/13 patient with nerve palsy clinical symptomatology preceded radiological evidence. The 99mTc 3-phase planar bone scintigraphy was positive for SBO in 9/13 cases (69%) during the initial phase and, in 100% of the cases in images delayed to 2-3 hours. Subsequent checks up to 1 year, using the Ga 67 scintigraphy, excluded the presence of recurrences in 100% of patients. Conclusion: The osteomyelitis of the base of the skull is a severe complication of malignant external otitis, often not always easily diagnosed. Recurrence can occur up to 1 year after stopping therapy. Imaging techniques such as Tc and MRI are relevant for the initial diagnostic approach and the staging of the pathology and its complications. Nuclear medicine imaging plays a fundamental role in the evaluation of related osteoblastic activity, especially in the remission phase of the disease.

scholarly journals Radiation-Induced Metabolic Shifts in the Hepatic Parenchyma: Findings from 18F-FDG PET Imaging and Tissue NMR Metabolomics in a Mouse Model for Hepatocellular Carcinoma

Molecules ◽  
2021 ◽  
Vol 26 (9) ◽  
pp. 2573
Author(s):  
Yi-Hsiu Chung ◽  
Cheng-Kun Tsai ◽  
Ching-Fang Yu ◽  
Wan-Ling Wang ◽  
Chung-Lin Yang ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Liver Parenchyma ◽  
Metabolic Alterations ◽  
Nmr Metabolomics ◽  
Post Irradiation ◽  
The Third ◽  
Radiation Induced ◽  
18F Fdg ◽  
The Right ◽  
Over Time

Purpose: By taking advantage of 18F-FDG PET imaging and tissue nuclear magnetic resonance (NMR) metabolomics, we examined the dynamic metabolic alterations induced by liver irradiation in a mouse model for hepatocellular carcinoma (HCC). Methods: After orthotopic implantation with the mouse liver cancer BNL cells in the right hepatic lobe, animals were divided into two experimental groups. The first received irradiation (RT) at 15 Gy, while the second (no-RT) did not. Intergroup comparisons over time were performed, in terms of 18F-FDG PET findings, NMR metabolomics results, and the expression of genes involved in inflammation and glucose metabolism. Results: As of day one post-irradiation, mice in the RT group showed an increased 18F-FDG uptake in the right liver parenchyma compared with the no-RT group. However, the difference reached statistical significance only on the third post-irradiation day. NMR metabolomics revealed that glucose concentrations peaked on day one post-irradiation both, in the right and left lobes—the latter reflecting a bystander effect. Increased pyruvate and glutamate levels were also evident in the right liver on the third post-irradiation day. The expression levels of the glucose-6-phosphatase (G6PC) and fructose-1, 6-bisphosphatase 1 (FBP1) genes were down-regulated on the first and third post-irradiation days, respectively. Therefore, liver irradiation was associated with a metabolic shift from an impaired gluconeogenesis to an enhanced glycolysis from the first to the third post-irradiation day. Conclusion: Radiation-induced metabolic alterations in the liver parenchyma occur as early as the first post-irradiation day and show dynamic changes over time.

scholarly journals Longitudinal assessment of the bovine ocular bacterial community dynamics in calves

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Alison C. Bartenslager ◽  
Nirosh D. Althuge ◽  
John Dustin Loy ◽  
Matthew M. Hille ◽  
Matthew L. Spangler ◽  
...  
Keyword(s):  
Bacterial Community ◽  
Community Composition ◽  
Community Dynamics ◽  
Bacterial Community Composition ◽  
Clinical Signs ◽  
Sampling Time ◽  
Experimental Population ◽  
Opportunistic Pathogens ◽  
Time Periods ◽  
Over Time

Abstract Background Infectious Bovine Keratoconjunctivitis (IBK), commonly known as pinkeye, is one of the most significant diseases of beef cattle. As such, IBK costs the US beef industry at least 150 million annually. However, strategies to prevent IBK are limited, with most cases resulting in treatment with antibiotics once the disease has developed. Longitudinal studies evaluating establishment of the ocular microbiota may identify critical risk periods for IBK outbreaks or changes in the microbiota that may predispose animals to IBK. Results In an attempt to characterize the establishment and colonization patterns of the bovine ocular microbiota, we conducted a longitudinal study consisting of 227 calves and evaluated the microbiota composition over time using amplicon sequence variants (ASVs) based on 16S rRNA sequencing data and culture-based approaches. Beef calves on trial consisted of both male (intact) and females. Breeds were composed of purebred Angus and composites with varying percentages of Simmental, Angus, and Red Angus breeds. Average age at the start of the trial was 65 days ±15.02 and all calves remained nursing on their dam until weaning (day 139 of the study). The trial consisted of 139 days with four sampling time points on day 0, 21, 41, and 139. The experimental population received three different vaccination treatments (autogenous, commercial (both inactivated bacteria), and adjuvant placebo), to assess the effectiveness of different vaccines for IBK prevention. A significant change in bacterial community composition was observed across time periods sampled compared to the baseline (p < 0.001). However, no treatment effect of vaccine was detected within the ocular bacterial community. The bacterial community composition with the greatest time span between sampling time periods (98d span) was most similar to the baseline sample collected, suggesting re-establishment of the ocular microbiota to baseline levels over time after perturbation. The effect of IgA levels on the microbial community was investigated in a subset of cattle within the study. However, no significant effect of IgA was observed. Significant changes in the ocular microbiota were identified when comparing communities pre- and post-clinical signs of IBK. Additionally, dynamic changes in opportunistic pathogens Moraxella spp. were observed and confirmed using culture based methods. Conclusions Our results indicate that the bovine ocular microbiota is well represented by opportunistic pathogens such as Moraxella and Mycoplasma. Furthermore, this study characterizes the diversity of the ocular microbiota in calves and demonstrates the plasticity of the ocular microbiota to change. Additionally, we demonstrate the ocular microbiome in calves is similar between the eyes and the perturbation of one eye results in similar changes in the other eye. We also demonstrate the bovine ocular microbiota is slow to recover post perturbation and as a result provide opportunistic pathogens a chance to establish within the eye leading to IBK and other diseases. Characterizing the dynamic nature of the ocular microbiota provides novel opportunities to develop potential probiotic intervention to reduce IBK outbreaks in cattle.

Explaining the Epigraphic Habit in the Roman Empire: The Evidence of Epitaphs

1990 ◽  
Vol 80 ◽  
pp. 74-96 ◽  
Author(s):  
Elizabeth A. Meyer
Keyword(s):  
Roman Empire ◽  
North Africa ◽  
Legal Status ◽  
The Third ◽  
The Right ◽  
Political Economic ◽  
Over Time

It is now notorious that the production of inscriptions in the Roman Empire was not constant over time, but rose over the first and second centuries A.D. and fell in the third. Ramsay MacMullen pointed this out more than five years ago, with conclusions more cautionary than explanatory: ‘history is not being written in the right way’, he said, for historians have deduced Rome's decline from evidence that–since it appears only epigraphically–has merely disappeared for its own reasons, or have sought general explanations of decline in theories political, economic, or even demographic in nature, none of which can, in turn, explain the disappearance of epigraphy itself. Why this epigraphic habit rose and fell MacMullen left open to question, although he did postulate control by a ‘sense of audience’. The purpose of this paper is to propose that this ‘sense of audience’ was not generalized or generic, but depended on a belief in the value of romanization, of which (as noted but not explained by MacMullen's article) the epigraphic habit is also a rough indicator. Epitaphs constitute the bulk of all provincial inscriptions and in form and number are (generally speaking) the consequence of a provincial imitation of characteristically Roman practices, an imitation that depended on the belief that Roman legal status and style were important, and that may indeed have ultimately depended, at least in North Africa, on the acquisition or prior possession of that status. Such status-based motivations for erecting an epitaph help to explain not only the chronological distribution of epitaphs but also the differences in the type and distribution of epitaphs in the western and eastern halves of the empire. They will be used here moreover to suggest an explanation for the epigraphic habit as a whole.

scholarly journals Rapid Spread of the SARS-CoV-2 Variant of Concern 202012/01 in Southern Italy (December 2020–March 2021)

2021 ◽  
Vol 18 (9) ◽  
pp. 4766
Author(s):  
Daniela Loconsole ◽  
Francesca Centrone ◽  
Caterina Morcavallo ◽  
Silvia Campanella ◽  
Anna Sallustio ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Large Scale ◽  
Southern Italy ◽  
Whole Genome ◽  
Third Wave ◽  
Gene Target ◽  
The Third ◽  
Rapid Spread ◽  
Pharmaceutical Interventions ◽  
Over Time

Epidemiological and virological studies have revealed that SARS-CoV-2 variants of concern (VOCs) are emerging globally, including in Europe. The aim of this study was to evaluate the spread of B.1.1.7-lineage SARS-CoV-2 in southern Italy from December 2020–March 2021 through the detection of the S gene target failure (SGTF), which could be considered a robust proxy of VOC B.1.1.7. SGTF was assessed on 3075 samples from week 52/2020 to week 10/2021. A subset of positive samples identified in the Apulia region during the study period was subjected to whole-genome sequencing (WGS). A descriptive and statistical analysis of the demographic and clinical characteristics of cases according to SGTF status was performed. Overall, 20.2% of samples showed SGTF; 155 strains were confirmed as VOC 202012/01 by WGS. The proportion of SGTF-positive samples rapidly increased over time, reaching 69.2% in week 10/2021. SGTF-positive cases were more likely to be symptomatic and to result in hospitalization (p < 0.0001). Despite the implementation of large-scale non-pharmaceutical interventions (NPIs), such as the closure of schools and local lockdowns, a rapid spread of VOC 202012/01 was observed in southern Italy. Strengthened NPIs and rapid vaccine deployment, first among priority groups and then among the general population, are crucial both to contain the spread of VOC 202012/01 and to flatten the curve of the third wave.

scholarly journals Effect of losing a fight on later agonistic behavior toward unfamiliar conspecifics in male Syrian hamsters

2011 ◽  
Vol 57 (4) ◽  
pp. 449-452 ◽  
Author(s):  
Javier Delbarco-Trillo ◽  
Robert E. Johnston
Keyword(s):  
Social Relationships ◽  
Syrian Hamster ◽  
Agonistic Behavior ◽  
Agonistic Interactions ◽  
Syrian Hamsters ◽  
The Third ◽  
Clear Winner ◽  
Male Subjects ◽  
Over Time

Abstract In many species, agonistic interactions result in social relationships that are stable over time. In Syrian hamsters, two unfamiliar males that are placed together will fight vigorously and a clear winner/loser relationship is usually established. In subsequent interactions, the loser will flee soon after detecting the familiar winner. Here we tested the hypothesis that losing a fight with a conspecific will affect future agonistic interactions not only toward that individual (i.e., the familiar winner) but also toward unfamiliar conspecifics. To test this hypothesis we paired two Syrian hamster males in three trials on one day in which the loser had the opportunity to escape the winner. The next day the loser was paired with an unfamiliar male, also for three trials. If he lost again, he was tested on a third day with a third unfamiliar male. Subjects were those males that were losers on all three days. The latency to escape on the first trial on Days 2 and 3 was significantly shorter than on the first trial on Day 1, indicating that losing against the first male affected the response toward unfamiliar males. However, the latency to escape on the first trial on Days 2 and 3 was significantly longer than that on the third trial on the preceding day, indicating that a loser treats unfamiliar males differently than a familiar winner. These results suggest that a defeat during an interaction with one male affects later agonistic behavior towards other, unfamiliar males.

scholarly journals Effective but fragile? Responses to repeated nudge-based messages for preventing the spread of COVID-19 infection

2021 ◽  
Author(s):  
Shusaku Sasaki ◽  
Hirofumi Kurokawa ◽  
Fumio Ohtake
Keyword(s):  
Behavioral Change ◽  
Infection Prevention ◽  
Online Survey ◽  
Behavioral Changes ◽  
Survey Experiment ◽  
The Third ◽  
Compliance Level ◽  
Change Effect ◽  
Loss Frame ◽  
Over Time

AbstractNudge-based messages have been employed in various countries to encourage voluntary contact-avoidance and infection-prevention behaviors to control the spread of COVID-19. People have been repeatedly exposed to such messages; however, whether the messages keep exerting a significant impact over time remains unclear. From April to August 2020, we conducted a four-wave online survey experiment to examine how five types of nudge-based messages influence Japanese people’s self-reported preventive behaviors. In particular, we investigate how their behaviors are affected by repeated displays over time. The analysis with 4241 participants finds that only a gain-framed altruistic message, emphasizing their behavioral adherence would protect the lives of people close to them, reduces their frequency of going out and contacting others. We do not find similar behavioral changes in messages that contain an altruistic element but emphasize it in a loss-frame or describe their behavioral adherence as protecting both one’s own and others’ lives. Furthermore, the behavioral change effect of the gain-framed altruistic message disappears in the third and fourth waves, although its impact of reinforcing intentions remains. This message has even an adverse effect of worsening the compliance level of infection-prevention behaviors for the subgroup who went out less frequently before the experiment. The study’s results imply that when using nudge-based messages as a countermeasure for COVID-19, policymakers and practitioners need to carefully scrutinize the message elements and wording and examine to whom and how the messages should be delivered while considering their potential adverse and side effects.

scholarly journals Reinfection as a cause of complications and relapses in scarlet fever wards

1937 ◽  
Vol 37 (2) ◽  
pp. 153-171 ◽  
Author(s):  
V. D. Allison ◽  
W. A. Brown
Keyword(s):  
Scarlet Fever ◽  
Primary Infection ◽  
Secondary Infection ◽  
Clinical Signs ◽  
Late Complications ◽  
Isolation Method ◽  
Fever Patient ◽  
The Third ◽  
Serological Type ◽  
Mode Of Transmission

1. The term “reinfection” has been defined as the secondary infection of a scarlet fever patient during hospitalization withStr. pyogenesbelonging to a serologically different type from that producing the primary infection.2. Of forty-seven scarlet fever patients nursed in a multiple-bed ward and swabbed twice weekly during their period of isolation, thirty-three (70.2 per cent) became reinfected with a serological type ofStr. pyogenesdifferent from that causing the primary disease.3. In fifteen out of the thirty-three patients reinfected, the reinfection was “latent”, i.e. gave rise to no clinical signs, while in the remaining eighteen the reinfection was “manifest”, i.e. was accompanied by clinical signs or complications.4. Patients nursed in cubicles or in a ward confined to infections with a single serological type did not show reinfection; their convalescence was progressive and there were no late complications.5. The majority of complications occurring during the third week of hospitalization and subsequently, in multiple-bed wards devoted to scarlet fever, are due to reinfection.6. Most reinfections occur during the third week in hospital at a time when patients are as a rule convalescent from their primary infection.7. The most frequent mode of transmission of reinfection appears to be by direct contact of patient with patient.8. Ten instances of “relapse” in scarlet fever (only three in the present series) are quoted; in all of them the patients were nursed in multiple-bed wards. In each instance the “relapse” coincided with the isolation of a fresh serological type ofStr. pyogenesfrom the throat, and must therefore be regarded as a second attack of scarlet fever.9. The various systems of nursing patients in isolation hospitals are discussed and it is suggested that scarlet fever patients should be cubicle-nursed if possible. Failing this they should be nursed by the bed-isolation method in multiple-bed wards. By setting aside small wards it might be possible to keep together patients who are all infected by the same serological type ofStr. pyogenes; the number of such wards would vary with the number (usually three or four) of epidemic types current at the time.

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