scholarly journals Convalescent plasma use in the United States was inversely correlated with COVID-19 mortality

eLife ◽  
2021 ◽  
Vol 10 ◽  
Author(s):  
Arturo Casadevall ◽  
Quigly Dragotakes ◽  
Patrick W Johnson ◽  
Jonathon W Senefeld ◽  
Stephen A Klassen ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Hospital Admissions ◽  
Inverse Correlation ◽  
Population Level ◽  
The United States ◽  
Mortality Data ◽  
The Us ◽  
The Usa ◽  
Excess Deaths ◽  
Strong Inverse Correlation

Background. The US Food and Drug Administration authorized Convalescent Plasma (CCP) therapy for hospitalized COVID-19 patients via the Expanded Access Program (EAP) and the Emergency Use Authorization (EUA), leading to use in about 500,000 patients during the first year of the pandemic for the US.Methods. We tracked the number of CCP units dispensed to hospitals by blood banking organizations and correlated that usage with hospital admission and mortality data.Results. CCP usage per admission peaked in Fall 2020, with more than 40% of inpatients estimated to have received CCP between late September and early November 2020. However, after randomized controlled trials failed to show a reduction in mortality, CCP usage per admission declined steadily to a nadir of less than 10% in March 2021. We found a strong inverse correlation (r = -0.52, P = 0.002) between CCP usage per hospital admission and deaths occurring two weeks after admission, and this finding was robust to examination of deaths taking place one, two or three weeks after admission. Changes in the number of hospital admissions, SARS-CoV-2 variants, and age of patients could not explain these findings. The retreat from CCP usage might have resulted in as many as 29,000 excess deaths from mid-November 2020 to February 2021.Conclusions. A strong inverse correlation between CCP use and mortality per admission in the USA provides population level evidence consistent with the notion that CCP reduces mortality in COVID-19 and suggests that the recent decline in usage could have resulted in excess deaths.Funding. There was no specific funding for this study. AC was supported in part by RO1 HL059842 and R01 AI1520789; MJJ was supported in part by 5R35HL139854. This project has been funded in whole or in part with Federal funds from the Department of Health and Human Services; Office of the Assistant Secretary for Preparedness and Response; Biomedical Advanced Research and Development Authority under Contract No. 75A50120C00096.

scholarly journals Convalescent Plasma Use in the United States was inversely correlated with COVID-19 Mortality: Did Plasma Hesitancy cost lives?

2021 ◽  
Author(s):  
Arturo Casadevall ◽  
Quigly Dragotakes ◽  
Patrick W. Johnson ◽  
Jonathon W. Senefeld ◽  
Steven A. Klassen ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Hospital Admissions ◽  
Inverse Correlation ◽  
Population Level ◽  
The United States ◽  
Mortality Data ◽  
The Us ◽  
The Usa ◽  
Excess Deaths ◽  
Strong Inverse Correlation

AbstractBackgroundThe US Food and Drug Administration authorized Convalescent Plasma (CCP) therapy for hospitalized COVID-19 patients via the Expanded Access Program (EAP) and the Emergency Use Authorization (EUA), leading to use in about 500,000 patients during the first year of the pandemic for the US.MethodsWe tracked the number of CCP units dispensed to hospitals by blood banking organizations and correlated that usage with hospital admission and mortality data.ResultsCCP usage per admission peaked in Fall 2020, with more than 40% of inpatients estimated to have received CCP between late September and early November 2020. However, after randomized controlled trials failed to show a reduction in mortality, CCP usage per admission declined steadily to a nadir of less than 10% in March 2021. We found a strong inverse correlation (r = −0.52, P = 0.002) between CCP usage per hospital admission and deaths occurring two weeks after admission, and this finding was robust to examination of deaths taking place one, two or three weeks after admission. Changes in the number of hospital admissions, SARS-CoV-2 variants, and age of patients could not explain these findings. The retreat from CCP usage might have resulted in as many as 29,000 excess deaths from mid-November 2020 to February 2021.ConclusionsA strong inverse correlation between CCP use and mortality per admission in the USA provides population level evidence consistent with the notion that CCP reduces mortality in COVID-19 and suggests that the recent decline in usage could have resulted in excess deaths.

scholarly journals A SIMPLE SI MODEL WITH TWO AGE GROUPS AND ITS APPLICATION TO US HIV EPIDEMICS: TO TREAT OR NOT TO TREAT?

2007 ◽  
Vol 15 (02) ◽  
pp. 169-184
Author(s):  
ROXANA LÓPEZ ◽  
YANG KUANG ◽  
ABDESSAMAD TRIDANE
Keyword(s):  
Age Groups ◽  
Population Level ◽  
The United States ◽  
Global Dynamics ◽  
Hiv Dynamics ◽  
The Us ◽  
The Usa ◽  
Si Model ◽  
Two Age Groups

The objective of this paper is to study the global dynamics of a simple SI model with two explicit age groups and apply the findings to the HIV dynamics in the United States. Specifically, we would like to explore the long term HIV dynamics to answer questions such as what will happen to human population level if all the demographical and epidemiological parameters stay constant. We also wonder if treatment alone will actually slow the spread of HIV or not. We divide the population into juvenile and adult groups. Only adults are assumed to be sexually active and we implicitly assume that the sex ratio is constant. We also assume that infected adults may produce both susceptible newborns and infected newborns. The model is fit with parameters from the HIV epidemic in the US. It produces an optimistic outcome: if nothing changes, the USA infected population may be halved in about 20 years. However, if treatment is found to extend the life expectance of infected individuals to 30 years or more, then the number of infected adults may actually increase in the next 20 years or so. This creates a dilemma: to treat or not to treat?

scholarly journals Racial inequality in the annual risk of Tuberculosis infection in the United States, 1910–1933

2017 ◽  
Vol 145 (9) ◽  
pp. 1797-1804 ◽  
Author(s):  
J. L. ZELNER ◽  
C. MULLER ◽  
J. J. FEIGENBAUM
Keyword(s):  
African Americans ◽  
Racial Inequality ◽  
The United States ◽  
Mortality Rates ◽  
Mortality Data ◽  
Pulmonary Tb ◽  
The Us ◽  
Northern Cities ◽  
The Usa ◽  
Annual Risk

SUMMARYTuberculosis (TB) mortality rates in the USA fell rapidly from 1910 to 1933. However, during this period, racial disparities in TB mortality in the nation's expanding cities grew. Because of long delays between infection and disease, TB mortality is a poor indicator of short-term changes in transmission. We estimated the annual risk of TB infection (ARTI) in 11 large US cities to understand whether rising inequality in mortality reflected rising inequality in ARTI using city-level TB mortality data compiled by the US Department of Commerce from 1910 to 1933. We estimated ARTI for African-Americans and whites using pediatric extrapulmonary TB mortality data for African-Americans and whites in our panel of cities. We also estimated age-adjusted pulmonary TB mortality rates for these cities. We find that the ratio of ARTI for African-Americans vs. whites increased from 2·1 (95% CI = 1·7, 2·4) in 1910 to 4·2 (95% CI = 3·4, 5·2) in 1933. This change mirrored the increasing inequality in age-adjusted pulmonary TB mortality during this period. These findings may reflect the combined effects of migration, inequality in access to care, increasing population density, and racial residential segregation in northern cities during this period.

Interaction of Ukrainian Diaspora and the USA Government Regarding Celebration of Ukrainian Independence Day on January 22

2018 ◽  
Vol 1 (47) ◽  
pp. 136-145
Author(s):  
Halyna Shchyhelska
Keyword(s):  
United States ◽  
House Of Representatives ◽  
The United States ◽  
100Th Anniversary ◽  
Totalitarian Regime ◽  
The Public ◽  
Us Congress ◽  
The Us ◽  
Public Consciousness ◽  
The Usa

2018 marks the 100th anniversary of the proclamation of Ukrainian independence. OnJanuary 22, 1918, the Ukrainian People’s Republic proclaimed its independence by adopting the IV Universal of the Ukrainian Central Rada, although this significant event was «wiped out» from the public consciousness on the territory of Ukraine during the years of the Soviet totalitarian regime. At the same time, January 22 was a crucial event for the Ukrainian diaspora in the USA. This article examines how American Ukrainians interacted with the USA Government institutions regarding the celebration and recognition of the Ukrainian Independence day on January 22. The attention is focused on the activities of ethnic Ukrainians in the United States, directed at the organization of the special celebration of the Ukrainian Independence anniversaries in the US Congress and cities. Drawing from the diaspora press and Congressional Records, this article argues that many members of Congress participated in the observed celebration and expressed kind feelings to the Ukrainian people, recognised their fight for freedom, during the House of Representatives and Senate sessions. Several Congressmen submitted the resolutions in the US Congress urging the President of United States to designate January 22 as «Ukrainian lndependence Day». January 22 was proclaimed Ukrainian Day by the governors of fifteen States and mayors of many cities. Keywords: January 22, Ukrainian independence day, Ukrainian diaspora, USA, interaction, Congress

scholarly journals Trends in educational mobility: How does China compare to Europe and the United States?

2019 ◽  
Vol 5 (2) ◽  
pp. 214-240
Author(s):  
Rob J Gruijters ◽  
Tak Wing Chan ◽  
John Ermisch
Keyword(s):  
Educational Opportunity ◽  
The United States ◽  
International Standards ◽  
Educational Mobility ◽  
The Us ◽  
The Usa ◽  
Economic Boom ◽  
The Uk ◽  
Large Decline ◽  
Inequality Of Educational Opportunity

Despite an impressive rise in school enrolment rates over the past few decades, there are concerns about growing inequality of educational opportunity in China. In this article, we examine the level and trend of educational mobility in China, and compare them to the situation in Germany, the Netherlands, the UK and the USA. Educational mobility is defined as the association between parents’ and children’s educational attainment. We show that China’s economic boom has been accompanied by a large decline in relative educational mobility chances, as measured by odds ratios. To elaborate, relative rates of educational mobility in China were, by international standards, quite high for those who grew up under state socialism. For the most recent cohorts, however, educational mobility rates have dropped to levels that are comparable to those of European countries, although they are still higher than the US level.

scholarly journals Patterns of dental antibiotic prescribing in 2017: Australia, England, United States, and British Columbia (Canada)

2021 ◽  
pp. 1-8
Author(s):  
Wendy Thompson ◽  
Leanne Teoh ◽  
Colin C. Hubbard ◽  
Fawziah Marra ◽  
David M. Patrick ◽  
...  
Keyword(s):  
United States ◽  
British Columbia ◽  
Broad Spectrum ◽  
Antibiotic Prescription ◽  
Population Level ◽  
The United States ◽  
Antibiotic Prescribing ◽  
Prescribing Behavior ◽  
The Us ◽  
Amoxicillin Clavulanic Acid

Abstract Objective: Our objective was to compare patterns of dental antibiotic prescribing in Australia, England, and North America (United States and British Columbia, Canada). Design: Population-level analysis of antibiotic prescription. Setting: Outpatient prescribing by dentists in 2017. Participants: Patients receiving an antibiotic dispensed by an outpatient pharmacy. Methods: Prescription-based rates adjusted by population were compared overall and by antibiotic class. Contingency tables assessed differences in the proportion of antibiotic class by country. Results: In 2017, dentists in the United States had the highest antibiotic prescribing rate per 1,000 population and Australia had the lowest rate. The penicillin class, particularly amoxicillin, was the most frequently prescribed for all countries. The second most common agents prescribed were clindamycin in the United States and British Columbia (Canada) and metronidazole in Australia and England. Broad-spectrum agents, amoxicillin-clavulanic acid, and azithromycin were the highest in Australia and the United States, respectively. Conclusion: Extreme differences exist in antibiotics prescribed by dentists in Australia, England, the United States, and British Columbia. The United States had twice the antibiotic prescription rate of Australia and the most frequently prescribed antibiotic in the US was clindamycin. Significant opportunities exist for the global dental community to update their prescribing behavior relating to second-line agents for penicillin allergic patients and to contribute to international efforts addressing antibiotic resistance. Patient safety improvements will result from optimizing dental antibiotic prescribing, especially for antibiotics associated with resistance (broad-spectrum agents) or C. difficile (clindamycin). Dental antibiotic stewardship programs are urgently needed worldwide.

scholarly journals Solar Thermochemical Hydrogen Production in the USA

2021 ◽  
Vol 13 (14) ◽  
pp. 7804
Author(s):  
Christoph Falter ◽  
Andreas Sizmann
Keyword(s):  
Hydrogen Production ◽  
Large Scale ◽  
Low Cost ◽  
The United States ◽  
Solar Irradiation ◽  
Transport Sector ◽  
Fossil Energy ◽  
The Us ◽  
The Usa ◽  
Solar Thermochemical

Hydrogen produced from renewable energy has the potential to decarbonize parts of the transport sector and many other industries. For a sustainable replacement of fossil energy carriers, both the environmental and economic performance of its production are important. Here, the solar thermochemical hydrogen pathway is characterized with a techno-economic and life-cycle analysis. Assuming a further increase of conversion efficiency and a reduction of investment costs, it is found that hydrogen can be produced in the United States of America at costs of 2.1–3.2 EUR/kg (2.4–3.6 USD/kg) at specific greenhouse gas emissions of 1.4 kg CO2-eq/kg. A geographical potential analysis shows that a maximum of 8.4 × 1011 kg per year can be produced, which corresponds to about twelve times the current global and about 80 times the current US hydrogen production. The best locations are found in the Southwest of the US, which have a high solar irradiation and short distances to the sea, which is beneficial for access to desalinated water. Unlike for petrochemical products, the transport of hydrogen could potentially present an obstacle in terms of cost and emissions under unfavorable circumstances. Given a large-scale deployment, low-cost transport seems, however, feasible.

External Validation of the Cardiac Surgery Score in a Quaternary Hospital in the United States of America

2021 ◽  
pp. 088506662110668
Author(s):  
Asha Singh ◽  
Chen Liang ◽  
Stephanie L. Mick ◽  
Chiedozie Udeh
Keyword(s):  
United States ◽  
Cardiac Surgery ◽  
United States Of America ◽  
Predictive Accuracy ◽  
External Validation ◽  
Cleveland Clinic ◽  
Area Under The Curve ◽  
The United States ◽  
Mortality Data ◽  
The Usa

Background The Cardiac Surgery Score (CASUS) was developed to assist in predicting post-cardiac surgery mortality using parameters measured in the intensive care unit. It is calculated by assigning points to ten physiologic variables and adding them to obtain a score (additive CASUS), or by logistic regression to weight the variables and estimate the probability of mortality (logistic CASUS). Both additive and logistic CASUS have been externally validated elsewhere, but not yet in the United States of America (USA). This study aims to validate CASUS in a quaternary hospital in the USA and compare the predictive performance of additive to logistic CASUS in this setting. Methods Additive and logistic CASUS (postoperative days 1-5) were calculated for 7098 patients at Cleveland Clinic from January 2015 to February 2017. 30-day mortality data were abstracted from institutional records and the Death Registries for Ohio State and the Centers for Disease Control. Given a low event rate, model discrimination was assessed by area under the curve (AUROC), partial AUROC (pAUC), and average precision (AP). Calibration was assessed by curves and quantified using Harrell's Emax, and Integrated Calibration Index (ICI). Results 30-day mortality rate was 1.37%. For additive CASUS, odds ratio for mortality was 1.41 (1.35-1.46, P <0.001). Additive and logistic CASUS had comparable pAUC and AUROC (all >0.83). However, additive CASUS had greater AP, especially on postoperative day 1 (0.22 vs. 0.11). Additive CASUS had better calibration curves, and lower Emax, and ICI on all days. Conclusions Additive and logistic CASUS discriminated well for postoperative 30-day mortality in our quaternary center in the USA, however logistic CASUS under-predicted mortality in our cohort. Given its ease of calculation, and better predictive accuracy, additive CASUS may be the preferred model for postoperative use. Validation in more typical cardiac surgery centers in the USA is recommended.

Population-level analysis of antibiotic use and death rates in beef feedlots over ten years in three cattle-feeding regions of the United States

2021 ◽  
pp. 1-7
Author(s):  
Stephanie C. Rutten-Ramos ◽  
Shabbir Simjee ◽  
Michelle S. Calvo-Lorenzo ◽  
Jason L. Bargen
Keyword(s):  
Death Rate ◽  
Live Weight ◽  
Population Level ◽  
Antibiotic Use ◽  
The United States ◽  
Death Rates ◽  
Cattle Feeding ◽  
The Us ◽  
Rate Ratios ◽  
Beef Feedlots

Abstract OBJECTIVE To assess antibiotic use and other factors associated with death rates in beef feedlots in 3 regions of the US over a 10-year period. SAMPLE Data for 186,297 lots (groups) of finished cattle marketed between 2010 and 2019 were obtained from a database representing feedlots in the central, high, and north plains of the US. PROCEDURES Descriptive statistics were generated. Generalized linear mixed models were used to estimate lot death rates for each region, sex (steer or heifer), and cattle origin (Mexico or the US) combination. Death rate was calculated as the (number of deaths/number of cattle placed in the lot) × 100. Lot antibiotic use (TotalActiveMG/KGOut) was calculated as the total milligrams of active antibiotics assigned to the lot per live weight (in kilograms) of cattle marketed from the lot. Rate ratios were calculated to evaluate the respective associations between lot death rate and characteristics of cattle and antibiotic use. RESULTS Mean death rate increased during the 10-year period, peaking in 2018. Mean number of days on feed also increased over time. Mean TotalActiveMG/KGOut was greatest in 2014 and 2015, lowest in 2017, and moderated in 2018 and 2019. Death rate was positively associated with the number of days on feed and had a nonlinear association with TotalActiveMG/KGOut. Feeding medicated feed articles mitigated death rate. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested a balance between disease prevention and control in feedlots for cattle with various risk profiles. Additional data sources are needed to assess TotalActiveMG/KGOut across the cattle lifetime.

The Influence of Personal Factor on US Foreign Policy (Secretary of State John Kerry)

2014 ◽  
pp. 72-83
Author(s):  
A. Borisova
Keyword(s):  
Foreign Policy ◽  
The United States ◽  
Us Foreign Policy ◽  
Political Leader ◽  
Political Issues ◽  
Security Issues ◽  
Road Map ◽  
Secretary Of State ◽  
The Us ◽  
The Usa

The last five years defined an alternative course in the US foreign policy. Obama's reelection caused staff transfers which notably influenced the course. This comprehensive process is based on tremendous work conducted by the Administration of Barak Obama, in particular by John Kerry, who was appointed as a Secretary of State in 2013. His personality plays a significant role in American domestic and foreign policy interrelation. Adoption or rejection of the bills, which are well-known today, depended in large on a range of circumstances, such as personality, life journey and political leader career of the today's Secretary of State. John Kerry’s professional life is mainly associated with domestic policy; nevertheless, he has always been interested in foreign relations and national security issues. Those concerns generally included: non-proliferation, US security, ecological problems, fight against terrorism. The article is intended to highlight Kerry’s efforts in each of these fields, showing not only his actions, but also difficult process of adoption or banning bills in the USA. The author tried to display the whole complicated decision-making process among different parties, businessmen and politicians, law and money clashes. The results of many former endeavors can be seen today, in the modern US policy. Based on assumptions about Secretary of State’s beliefs, certain road map can be predicted. In conclusion, the article offers several courses, where the United States are likely to be most active during the next few years. It can be judged exactly which way some current political issues will develop, how the US foreign policy will be shaped by today's decision-makers in the White House.

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