scholarly journals Evaluation of the effectiveness of remdesivir in treating severe COVID-19 using data from the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, national cohort study.

2021 ◽  
Author(s):  
Barbara N Arch ◽  
Dorottya Kovacs ◽  
Janet T Scott ◽  
Ashley P Jones ◽  
Ewen M Harrison ◽  
...  
Keyword(s):  
Effect Sizes ◽  
White Ethnicity ◽  
Early Access ◽  
Diagnostic Threshold ◽  
Mortality Effect ◽  
Hospitalised Patients ◽  
National Cohort ◽  
Using Data ◽  
Protocol Study ◽  
Multivariable Modelling

Background Remdesivir was given UK early-access approval for use in COVID-19 in people aged 12 years and older on 26th May 2020 on the basis of unmet clinical need. Evidence on the side effects, complications of therapy and effectiveness of this therapy is lacking or conflicting. Methods Adults with severe COVID-19 treated with remdesivir were compared with propensity-score matched controls, identified from the ISARIC WHO Clinical Characterisation Protocol study of UK hospitalised patients with COVID-19. Remdesivir patients were matched to controls according to baseline underlying 14-day mortality risk. The effect of remdesivir on short-term outcomes was investigated (primary outcome: 14-day mortality). Effect sizes were estimated and adjusted for potential confounders using multivariable modelling. Results 1,549 patients given remdesivir and 4,964 matched controls were identified satisfying inclusion and exclusion criteria. The balance diagnostic threshold was achieved. Patients had symptoms for a median of 6 days prior to baseline; 62% were male, with mean (SD) age 63.1 (15.6) years, and 80% categorised as White ethnicity. Fourteen-day mortality was not statistically significantly associated with treatment (9.3% remdesivir vs. 11.9% controls, odds-ratio 0.80, [95% CI 0.60-1.07], p=0.116, adjusted for age, sex, number of key comorbidities, dexamethasone use, and diagnosis of viral pneumonia. Findings Treatment with remdesivir was not associated with a reduction in mortality in our primary endpoint at 14 days. Interpretation Remdesivir did not significantly improve mortality in this study. The findings are subject to the limitations of an observational study. Balance was achieved for measured baseline factors, but unmeasured confounders may account for observed treatment effect sizes. Funding Medical Research Council UK & National Institute of Health Research

scholarly journals Changes in Urologic Operative Practice at the Beginning of the COVID-19 Pandemic in a Large, National Cohort

2021 ◽  
Vol 11 ◽  
Author(s):  
Patrick Lewicki ◽  
Camilo Arenas-Gallo ◽  
Spyridon P. Basourakos ◽  
Nahid Punjani ◽  
Siv Venkat ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Elective Surgery ◽  
Population Level ◽  
Reference Region ◽  
Hospital Level ◽  
Urologic Oncology ◽  
Average Change ◽  
The Face ◽  
National Cohort ◽  
Using Data

ObjectiveTo analyze population-level changes in operative practice since the onset of the COVID-19 pandemic to contextualize observations made by individual practices and optimize future responses.Materials and MethodsThis US retrospective analysis used the Premier Perspectives Database. We investigated changes in operative volume through March 2020. Baseline operative volume for urologic surgery was calculated using data from the preceding 12 months and compared on a total and by procedure basis. Multivariable linear regression was used to identify hospital-level predictors of change in response to the pandemic.ResultsAt baseline, we captured 23,788 urologic procedural encounters per month as compared with 19,071 during March 2020– a 19.9% decrease. Urologic oncology-related cases were relatively preserved as compared to others (average change in March 2020: +1.1% versus -32.2%). Northeastern (β = -5.66, 95% confidence interval [CI]: -10.2 to -1.18, p = 0.013) and Midwestern hospitals (β = -4.17, 95% CI: -7.89 to -0.45, p = 0.027; both with South as reference region), and those with an increasing percentage of patients insured by Medicaid (β= -0.17 per percentage point, 95% CI: -0.33 to -0.01, p = 0.04) experienced a significantly larger decrease in volume.ConclusionsThere was a 20% decline in urologic operative volume in March 2020, compared with baseline, that preferentially affected hospitals serving Medicaid patients, and those in Northeast and Midwest. In the face of varying mandates on elective surgery, widespread declines in operative volume may also represent hesitancy on behalf of patients to interface with healthcare during the pandemic.

INSIDE INDUSTRY

2017 ◽  
Vol 21 (05) ◽  
pp. 39-47
Keyword(s):  
Neglected Tropical Diseases ◽  
Antineoplastic Agent ◽  
Blood Platelet ◽  
Strategic Partnership ◽  
Cell Therapies ◽  
Early Access ◽  
King's College ◽  
Car T ◽  
Using Data ◽  
Effective Drugs

Cellular Biomedicine Group (CBMG) and GE Healthcare Life Sciences China Announce Strategic Partnership to Establish Joint Technology Laboratory to Develop Control Processes for the Manufacture of CAR-T and Stem Cell Therapies. Zuellig Pharma to Invest over $50 Million in Singapore-Based Innovation Centre. Holmusk: Using Data to Improve Clinical Outcomes for Cardiovascular Disease in Singapore. Singapore Eye Bank Sets Another Record in Local Cornea Donations in 2016. Plasticell and King’s College London to Collaborate in Trials of Blood Platelet Substitute. Merck Partners with University of California, San Diego (UCSD) to Fight Neglected Tropical Diseases. Mundipharma Wins Approval for Antineoplastic Agent mundesine® as Treatment for Relapsed/Refractory Peripheral T-cell Lymphoma in Japan. Asian Myeloma Network (AMN) Brings Clinical Trials to Cancer Patients in Asia and Provides Early Access to Effective Drugs. APBN Interview with Professor Chng Wee Joo.

scholarly journals Understanding extreme mortality among prisoners: a national cohort study in Scotland using data linkage

2015 ◽  
Vol 25 (5) ◽  
pp. 879-885 ◽  
Author(s):  
Lesley Graham ◽  
Colin M. Fischbacher ◽  
Diane Stockton ◽  
Andrew Fraser ◽  
Michael Fleming ◽  
...  
Keyword(s):  
Cohort Study ◽  
Data Linkage ◽  
National Cohort ◽  
Using Data

scholarly journals Good perception of own lifestyle associated with poor attendance at Diabetic RetinaScreen Programme

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
S Syed ◽  
P Fitzpatrick
Keyword(s):  
Logistic Regression ◽  
Diabetic Retinopathy ◽  
Activity Level ◽  
Multivariate Logistic Regression ◽  
Factors Associated ◽  
Diabetic Retinopathy Screening ◽  
Working Age ◽  
National Cohort ◽  
Using Data ◽  
Formed Part

Abstract Background Untreated diabetic retinopathy is the most common cause of sight loss in people of working age. The Diabetic RetinaScreen programme (DRS) is the national diabetic retinopathy screening programme in Ireland which commenced in 2013 with aim to prevent diabetic retinopathy and subsequent blindness, through free screening and ophthalmology services. High uptake is crucial for the effectiveness of the programme. This study aimed to determine the sociodemographic, lifestyle and healthcare factors associated with attendance at the DRS programme in Ireland, using data from a national cohort study, the Irish Longitudinal Study on Ageing (TILDA). Methods The TILDA wave-4 dataset (anonymised) was utilised for the current study. Questions on DRS invitation and attendance formed part of the wave 4 study questionnaire. Multivariate logistic regression was used to examine independent factors associated with attendance. SPSS was used for analysis. Results 418 respondents (7.3%) were invited to DRS and 373 (89.2%) attended. Among all those who were invited to DRS, 244 (58.4%) were male and 174 (41.6%) were female. The mean age was 69.8 years (53-84 years). Following multivariate logistic regression, following a good diet/taking exercise (OR = 0.29, 95% CI 0.10-0.82) was negatively associated with attendance, after adjustment for age, male gender, higher education and medical card. Conclusions Recognising factors linked with uptake is important to develop goal directed strategies. Interestingly those who stated they followed a good diet & took exercise and were compliant with DM prevention were less likely to attend DRS. Previous research has also indicated that a higher physical activity level is associated with higher self-perceived health status Key messages Persons with DM with good compliance to diet and exercise were found to have poor attendance at the DRS programme. Targeted advertising is required to raise awareness of diabetic retinopathy.

scholarly journals SARS-CoV-2 infection in pregnancy in Denmark - characteristics and outcomes after confirmed infection in pregnancy: a nationwide, prospective, population-based cohort study

2021 ◽  
Author(s):  
Anna JM Aabakke ◽  
Lone Krebs ◽  
Tanja G Petersen ◽  
Frank S Kjeldsen ◽  
Giulia Corn ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Hospital Admission ◽  
Severe Infection ◽  
Population Based ◽  
Neonatal Outcomes ◽  
Foreign Born ◽  
Hospitalised Patients ◽  
Using Data ◽  
In Pregnancy

Introduction Assessing the risk factors for and consequences of infection with SARS-CoV-2 during pregnancy is essential to guide clinical guidelines and care. Previous studies on the influence of SARS-CoV-2 infection in pregnancy have been among hospitalised patients, which may have exaggerated risk estimates of severe outcomes because all cases of SARS-CoV-2 infection in the pregnant population were not included. The objectives of this study were to identify risk factors for and outcomes after SARS-CoV-2 infection in pregnancy independent of severity of infection in a universally tested population, and to identify risk factors for and outcomes after severe infection requiring hospital admission. Material and Methods This was a prospective population-based cohort study in Denmark using data from the Danish National Patient Register and Danish Microbiology Database and prospectively registered data from medical records. We included all pregnancies between March 1 and October 31, 2020 and compared women with a positive SARS-CoV-2 test during pregnancy to non-infected pregnant women. Cases of SARS-CoV-2 infection in pregnancy were both identified prospectively and through register linkage to secure that all cases were identified and that cases were pregnant during infection. Main outcome measures were pregnancy, delivery, maternal, and neonatal outcomes. Severe infection was defined as hospital admission due to COVID-19. Results Among 82 682 pregnancies, 418 women had SARS-CoV-2 infection during pregnancy, corresponding to an incidence of 5.1 per 1000 pregnancies, 23 (5.5%) of which required hospital admission due to COVID-19. Risk factors for infection were asthma (OR 2.19 [1.41-3.41]) and being foreign born (OR 2.12 [1.70-2.64]). Risk factors for hospital admission due to COVID-19 included obesity (OR 2.74 [1.00-7.51]), smoking (OR 4.69 [1.58-13.90]), infection after gestational age (GA) 22 weeks (GA 22-27 weeks: OR 3.77 [1.16-12.29]; GA 28-36 weeks: OR 4.76 [1.60-14.12]) and having asthma (OR 4.53 [1.39-14.79]). We found no difference in any obstetric or neonatal outcomes. Conclusions Only 1 in 20 women with SARS-CoV-2 infection during pregnancy require admission to hospital due to COVID-19. And severe outcomes of SARS-CoV-2 infection in pregnancy are rare.

scholarly journals Neighbourhood characteristics at birth and positive and negative psychotic symptoms in adolescence: findings from the ALSPAC birth cohort

2018 ◽  
Author(s):  
Francesca Solmi ◽  
Glyn Lewis ◽  
James Bowes Kirkbride
Keyword(s):  
Negative Symptoms ◽  
Sensitivity Analyses ◽  
Risk Scores ◽  
Psychotic Symptoms ◽  
Logistic Regression Models ◽  
White Ethnicity ◽  
Parents And Children ◽  
Increased Risk ◽  
Using Data ◽  
Multivariable Adjustment

Objective: Urban birth is associated with risk of non-affective psychoses. While emerging evidence suggests that this association is also apparent for subclinical positive psychotic phenomena in the general population, few studies have considered which specific aspects of the urban environment predict risk, or whether these factors also increase the likelihood of negative symptoms. Method: Using data from the Avon Longitudinal Study of Parents and Children, linked to census geographical indicators, we examined whether population density, deprivation, inequality, and social fragmentation at birth were associated with negative and positive psychotic symptoms at age 16 and 18 years, respectively. We used logistic regression models, controlling for child’s ethnicity, maternal age, education, marital status, social class, depressive symptoms, other neighbourhood exposures, and, in sensitivity analyses, polygenic risk scores (PRS) for schizophrenia in a sub-sample of children of white ethnicity (N=10,283). Results: Amongst 11,879 adolescents, those born in the most densely populated tertile had greater odds of reporting positive psychotic experiences, after multivariable adjustment (odds ratio (OR): 1.57, 95% confidence intervals (CI): 1.14 – 2.17). Adolescents born in the most socially fragmented neighbourhoods had greater odds of negative symptoms, after multivariable adjustment (OR: 1.43, 95%CI: 1.06 – 1.85). These associations were not confounded by schizophrenia PRS. There was no evidence of any other associations. Discussion: Birth into more densely populated and socially fragmented environments increased risk of positive and negative psychotic phenomena in adolescence. Our findings suggest that different forms of neighbourhood social adversity impinge on different psychopathophysiologies associated with the clinical expression of psychosis.

scholarly journals Prevalence of Psychological Frailty in Japan: NCGG-SGS as a Japanese National Cohort Study

2019 ◽  
Vol 8 (10) ◽  
pp. 1554 ◽  
Author(s):  
Hiroyuki Shimada ◽  
Sangyoon Lee ◽  
Takehiko Doi ◽  
Seongryu Bae ◽  
Kota Tsutsumimoto ◽  
...  
Keyword(s):  
Older Adults ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Depressive Mood ◽  
Cognitive Stimulation ◽  
Physical Frailty ◽  
Term Care ◽  
National Cohort ◽  
Using Data ◽  
Lifestyle Activities

There has been less research conducted on the psychological aspects of frailty than on the physical and cognitive characteristics of frailty. Thus, we aimed to define psychological frailty, clarify its prevalence, and investigate the relationship between psychological frailty and lifestyle activity or disability incidence in older adults in Japan. The participants in our study were 4126 older adults (average age 71.7 years) enrolled in the National Center for Geriatrics and Gerontology-i87uStudy of Geriatric Syndromes (NCGG-SGS). We characterized physical frailty of the following as ≥ 3: slow walking speed, muscle weakness, exhaustion, low physical activity, and weight loss. We used the Geriatric Depression Scale 15 items version (GDS-15) to screen for depressive mood, indicated by 5 points or more on the scale. The co-presence of physical frailty and depressive mood was defined as psychological frailty. The incidence of disability was determined using data from the Japanese long-term care insurance system over 49 months. We found that the prevalence of physical frailty, depressive mood, and psychological frailty were 6.9%, 20.3%, and 3.5%, respectively. Logistic regression indicated that the odds ratios for loss of lifestyle activities were significantly higher in participants with psychological frailty for going outdoors using the bus or train, driving a car, using maps to go to unfamiliar places, reading books or newspapers, cognitive stimulation, culture lessons, giving advice, attending community meetings, engaging in hobbies or sports, house cleaning, fieldwork or gardening, and taking care of grandchildren or pets. During the follow-up period, 385 participants (9.3%) developed a disability. The incidence of disability was associated with both physical and psychological frailty in the fully adjusted model. However, no significant association between disability and depressive mood was found. We conclude that individuals with psychological frailty had the highest risk of disability. Future policies should implement disability prevention strategies among older adults with psychological frailty.

scholarly journals Health and development of children born after assisted reproductive technology and sub-fertility compared to naturally conceived children: data from a national study

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Alastair G. Sutcliffe ◽  
Edward Melhuish ◽  
Jacqueline Barnes ◽  
Julian Gardiner
Keyword(s):  
Assisted Reproductive Technology ◽  
Hospital Admissions ◽  
Reproductive Technology ◽  
National Study ◽  
Control Group ◽  
Deprived Neighborhoods ◽  
National Cohort ◽  
Health And Development ◽  
Matched Case ◽  
Using Data

In a non-matched case-control study using data from two large national cohort studies, we investigated whether indicators of child health and development up to 7 years of age differ between children conceived using assisted reproductive technology (ART), children born after sub-fertility (more than 24 months of trying for conception) and other children. Information on ART use/sub-fertility was available for 23,649 children. There were 227 cases (children conceived through ART) and two control groups: 783 children born to sub-fertile couples, and 22,639 children born to couples with no fertility issues. In models adjusted for social and demographic factors there were significant differences between groups in rate of hospital admissions before the children were 9 months old (P=0.029), with the ART group showing higher rates of hospital admission than the <em>no fertility issues</em> control group, the sub-fertile control group being intermediate between the two. Children born after ART had comparable health and development beyond 9 months of age to their naturally conceived peers. This applied to the whole sample and to a sub-sample of children from deprived neighborhoods.

scholarly journals Moderation of Classic Social Psychological Effects by Demographics in the U.S. Adult Population: New Opportunities for Theoretical Advancement

2019 ◽  
Author(s):  
David Scott Yeager ◽  
Jon Krosnick
Keyword(s):  
College Students ◽  
Adult Population ◽  
Effect Sizes ◽  
Laboratory Research ◽  
Future Research ◽  
Social Judgments ◽  
Social Psychological ◽  
Psychological Phenomena ◽  
Using Data ◽  
The One

For decades, social psychologists have collected data primarily from college undergraduates and, recently, from haphazard samples of adults. Yet researchers have routinely presumed that thusly observed treatment effects characterize “people” in general. Tests of seven highly-cited social psychological phenomena (two involving opinion change resulting from social influence and five involving the use of heuristics in social judgments) using data collected from randomly sampled, representative groups of American adults documented generalizability of the six phenomena that have been replicated previously with undergraduate samples. The one phenomenon (a cross-over interaction revealing an ease of retrieval effect) that has not been replicated successfully previously in undergraduate samples was also not observed here. However, the observed effect sizes were notably smaller on average than the meta-analytic effect sizes documented by past studies of college students. Furthermore, the phenomena were strongest among participants with the demographic characteristics of the college students who typically provided data for past published studies, even after correcting for publication bias in past studies using a new method, called the behaviorally-informed file-drawer adjustment (BIFDA). The six successful replications suggest that phenomena identified in traditional laboratory research also appear as expected in representative samples but more weakly, so observed effect sizes should be generalized with caution. The evidence of demographic moderators suggests interesting opportunities for future research to better understand the mechanisms of the effects and their limiting conditions.

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