Comparison of Outcomes among Chronic Kidney Disease V Patients with COVID-19 at the National Kidney and Transplant Institute: A Retrospective Cohort Study

Background. There is very little published data on outcomes of COVID-19 among chronic kidney disease (CKD) patients. We compared the outcomes of COVID-19 in a tertiary care renal hospital among CKD V patients on hemodialysis (HD), peritoneal dialysis (PD), and dialysis initiation, in terms of duration of hospitalization, in-patient mortality, and 30-day mortality. Methods. A total of 436 CKD V patients, on either HD, PD, or dialysis initiation, with COVID-19 who were admitted at the National Kidney and Transplant Institute (NKTI) from March 13, 2020, to August 31, 2020, were included. Kaplan–Meier survival analysis was performed. Comparison of probability of mortality by group was performed using Log-Rank test. p values ≤0.05 were considered statistically significant. Results. Among 436 CKD V patients, 298 (68%) were on HD, 103 (24%) were on PD, and 35 (8%) required dialysis initiation. Overall in-hospital mortality was 34%; 38% were on HD, 20% on PD, and 37% on dialysis initiation. Total 30-day mortality was 27%; 32% were on HD, 26% on PD, and 16% on dialysis initiation. Median follow-up was 24 days. Among the 137 deaths recorded, total median time to death was 10 days; 8.5 days, 15.5 days, and 9 days for HD, PD, and dialysis initiation groups, respectively. Probability of mortality was significantly higher in HD patients versus PD patients ( p < 0.00001 ) and in the dialysis initiation group compared to PD patients ( p = 0.0234 ). Mortality probability, however, was not significantly different in HD patients versus the dialysis initiation group ( p = 0.63 ). Conclusion. Among CKD V patients diagnosed with COVID-19 at the NKTI, those on HD and on dialysis initiation had significantly higher in-hospital and 30-day mortality, compared to patients on PD.

PENENTUAN CADANGAN PREMI ASURANSI DWIGUNA MENGGUNAKAN METODE ILLINOIS BERDASARKAN HUKUM MORTALITAS WEIBULL

Endowment insurance provides protection benefit and saving benefits. In the endowment insurance the insured party (insurance participant) must be paid the premiums. In addition to premiums, there is also policy value, which is sum of money that must be collected by the company in preparation for claim payment. The purpose of this study was to determine calculation of policy value in endowment insurance using Illinois method based on Weibull Mortality Law. In this study used secondary data from United States Life Table in the form of mortality probability data. Calculation value using Weibull mortality law, then the policy value calculated by Illinois method. The result of this study is policy value using Illinois Method based on Weibull Mortality Law is bigger than policy value using Illinois method without Weibull mortality law in the first year until year 20th. After year 20th, the policy value using Illinois method based on Weibull mortality law is smaller than policy value using Illinois method without Weibull mortality law, while at the end of the insurance year which is year 30th, the policy value with or without Weibull mortality law generates the same value.

Seedling Survival in Forest Re-vegetation Sites within Wellington Peninsula

<p>Transplanting native seedlings is a widely used restoration tool to enhance biodiversity in urban areas. Due to labour and economic needs of this tool, it is crucial to maximise the survival rates of the transplanted seedlings. In this research, I monitored, over a six month period, the status of wineberry (Aristotelia serrata), cabbage tree (Cordyline australis) and lemonwood (Pittosporum eugenioides) seedlings in their initial years after transplanting. The seedlings, up to 4 years old, were located in 11 forest re-vegetation sites in Wellington city, New Zealand. Using mixed effects models to predict the mortality probability of each species, I analyse the relative importance that variables (e.g. soil conditions or grass competition) have in the mortality of the seedlings. Lemonwood seedlings experienced the lowest mortality rates (<2%), independent of age. The models predicting probability of mortality of wineberry and cabbage tree indicate that grass competition and water availability are crucial variables in the mortality of these species during the initial 6 months after transplanting. Combinations of plant size (e.g. height) and certain environmental variables (e.g. soil conditions or slope) crucially affect mortality of wineberry and cabbage trees from one to three years of age. Based on these results, I provide recommendations, such as appropriate planting date and ideal length of maintenance tasks, to maximise survival rates of native plants within the first years after transplanting. A longer monitoring period and similar research of other species are required to assist forest re-vegetation groups in Wellington city achieving more cost- and labour-efficient re-vegetation management.</p>

Seedling Survival in Forest Re-vegetation Sites within Wellington Peninsula

<p>Transplanting native seedlings is a widely used restoration tool to enhance biodiversity in urban areas. Due to labour and economic needs of this tool, it is crucial to maximise the survival rates of the transplanted seedlings. In this research, I monitored, over a six month period, the status of wineberry (Aristotelia serrata), cabbage tree (Cordyline australis) and lemonwood (Pittosporum eugenioides) seedlings in their initial years after transplanting. The seedlings, up to 4 years old, were located in 11 forest re-vegetation sites in Wellington city, New Zealand. Using mixed effects models to predict the mortality probability of each species, I analyse the relative importance that variables (e.g. soil conditions or grass competition) have in the mortality of the seedlings. Lemonwood seedlings experienced the lowest mortality rates (<2%), independent of age. The models predicting probability of mortality of wineberry and cabbage tree indicate that grass competition and water availability are crucial variables in the mortality of these species during the initial 6 months after transplanting. Combinations of plant size (e.g. height) and certain environmental variables (e.g. soil conditions or slope) crucially affect mortality of wineberry and cabbage trees from one to three years of age. Based on these results, I provide recommendations, such as appropriate planting date and ideal length of maintenance tasks, to maximise survival rates of native plants within the first years after transplanting. A longer monitoring period and similar research of other species are required to assist forest re-vegetation groups in Wellington city achieving more cost- and labour-efficient re-vegetation management.</p>

The Ideal Diet for Humans to Sustainably Feed The Growing Population – Review, Meta-Analyses, and Policies for Change

Introduction: As of now, no study has combined research from different sciences to determine the most suitable diet for humans. This issue is urgent due to the predicted population growth, the effect of this on the environment, and the deterioration of human health and associated costs. Methods: A literature review determined whether an optimal diet for humans exists and what such a diet is, followed by six meta-analyses. The standard criteria for conducting meta-analyses of observational studies were followed. A review of literature reporting Hazard Ratios with a 95% confidence interval for red meat intake, dairy intake, plant-based diet, fiber intake, and serum IGF-1 levels were extracted to calculate effect sizes. Results: Results calculated using NCSS software show that high meat consumption increases mortality probability by 18% on average and increases diabetes risk by 50%. Plant-based and high-fiber diets decrease mortality by 15% and 20% respectively (p < .001). Plant-based diets decreased diabetes risk by 27%, and dairy consumption (measured by increased IGF-1 levels) increased cancer probability by 48% (p < 0.01). A vegetarian or Mediterranean diet was not found to decrease the probability of heart disease. A vegetarian diet can be healthy or not, depending on the foods consumed. A Mediterranean diet with high quantities of meat and dairy products will not produce the health effects desired. The main limitations of the study were that observational studies were heterogeneous and limited by potential confounders. Discussion: The literature and meta-analyses point to an optimal diet for humans that has followed our species from the beginnings of humankind. The optimal diet is a whole food, high fiber, low-fat, 90+% plant-based diet. This diet allowed humans to become the most developed species on Earth. To ensure people’s nutritional needs are met healthily and sustainably, governmental dietary interventions are necessary.

P118 MORBIDITY, MORTALITY AND RECURRENCE FACTORS OF INCARCERATED FEMORAL HERNIA

Aim Aimed to search the factors affecting morbidity, mortality, and recurrence in incarcerated femoral hernia cases. Material and Methods After ethical committee approval, patients operated due to incarcerated femoral hernia between 2010 and 2020 were included in the study. Patients in the pediatric age group (0-18 years), and pregnant patients were excluded from the study. Preoperative, intraoperative, and postoperative factors of the patients were gathered. Morbidity, mortality, and recurrence factors were evaluated with Mann-Whitney U test, χ² test, and Likelihood ratio test, p value lower than 0.05 as significant. Results The mean age of 50 patients was 54.56±19.34 years (19-91) and the female to male ratio was 33/17. Right-sided hernia was present in 27 (54%) patients and recurrent hernia in 5 (10%) patients. The most common surgery type was Mc Vay repair in 33 (66%) patients. Other surgery types were as follows: Lichtenstein procedure in 9 (18%) patients and Rutkow plug procedure in 8 (16%) patients. The morbidity and mortality rates of the study were 14% and 4%, respectively. Postoperative recurrence was seen in only 3 (6%) patients. Patients with preoperative nausea (p = 0.003), vomiting (p &lt; 0.001), and tachycardia (p &lt; 0.001), presence of recurrent hernia (p &lt; 0.001), surgery under general anesthesia (p &lt; 0.001), performing both laparotomy (p = 0.007) and organ resection during surgery (p &lt; 0.001) had more morbidity. Also, patients with preoperative tachycardia (p = 0.005) and organ resection during surgery (p = 0.029) had more mortality. However, no factors affecting recurrence were found in the study. Conclusions Morbidity and mortality probability are higher in patients with preoperative septic and obstructive symptoms.

Estimating SARS-COV-2 Exposure Indoors in Delhi Given Outdoor Pollution Metrics Using Machine Learning

The Global Burden of Disease journal by the Lancet(Ritchie and Roser, 2013) and states that one million deaths have occurred from 1990 to 2017 due to air pollution. In 2018, the WHO estimated a death toll of 3.8 million due to indoor pollution(WHO,2018). In these times of the pandemic, it is quintessential for countries like India, with a huge population and high levels of pollution, to take severe measures for controlling pollution. The 2020 US Policy Report in the Lancet(2020) affirmed that there is a positive correlation between the PM2.5 or PM10 particles concentration and COVID-19 infection as the virus uses the particulate matter as a piggyback. The case study here, is based on the Indian urban locality and aims to analyze and estimate the correlations between PM2.5 particles, the AQI, weather conditions and COVID-19 particles using Machine Learning models. The optimum model is also to be used for predicting the outdoor AQI and Covid-19 infection rates in the suburban localities of northwestern Delhi and the data so obtained, would aid to calculating ,and extrapolating the mortality probability due to Covid-19 infection, indoors, in the metropolitan cities of India, like Delhi.

Computed tomography-based mathematical modeling of ischemic stroke outcomes based on the focus characteristics

Objective: to identify the prognostic aspects of the ischemic stroke (IS) focus characteristics according to the data of computed tomography of the brain.Patients and methods. We examined 80 patients with hemispheric IS up to 1-day old (50 patients for constructing mathematical models of disease outcomes and 30 patients for subsequent testing of the obtained models) aged 30-84 years.Results and discussion. The analysis of the association between mortality probability and brain midline shift size shown that a brain midline shift of 4.5-5 mm did not increase mortality probability much, which indicates the synergistic stability of this system. System destabilization began after an increase of the brain midline shift for more than 5-5.5 mm. After a mild change in the initial indicator (6-8 mm), mortality probability increased from 25% to 90% and higher. When the brain midline shift was more than 8.5 mm, the system, from the synergistic viewpoint, became stable again but with an unfavorable prognosis. This analysis helps to identify the critical decision-making point when analyzing the IS focus neuroimaging characteristics. Thus, the point for the focus volume is 145 cm3, and for the brain midline shift - 5.0 mm.Conclusion. The results of our study about the prognostic value of the IS focus characteristics according to CT data may have additional value for decision-making in the management of patients with a poor prognosis.

Trends in mortality and life expectancy in Fiji over 20 years

Background Fiji, a Pacific Island nation of 884,887 (2017 census), has experienced a prolonged epidemiological transition. This study examines trends in mortality and life expectancy (LE) in Fiji by sex and ethnicity over 1996–2017, with comparisons to published estimates. Methods Trends in infant mortality rates (IMR), under-5 mortality (U5M), adult mortality (probability of dying), LE (at birth) and directly age-standardised death rates (DASRs) by sex and ethnicity, are calculated (with 95% confidence limits) using unit death records from the Fiji Ministry of Health and Medical Services. The LE gap between populations, or within populations over time, is examined using decomposition by age. Period trends are assessed for statistical significance using linear regression. Results Over 1996–98 to 2014–17: IMR and U5M for i-Taukei and Fijians of Indian descent declined; U5M decline for i-Taukei (24.6 to 20.1/1000 live births) was significant (p = 0.016). Mortality (15–59 years) for i-Taukei males was unchanged at 27% but declined for Indians 33 to 30% (p = 0.101). Mortality for i-Taukei females increased 22 to 24% (p = 0.011) but declined for Indians 20 to 18% (p = 0.240). DASRs 1996–2017 were lower for i-Taukei (9.3 to 8.2/1000 population) than Indian males (10.6 to 9.8/1000). DASRs declined for i-Taukei (both sexes, p < 0.05), and for Indians (both sexes, p > 0.05). Over 22 years, LE at birth increased by 1 year or less (p = 0.030 in male i-Taukei). In 2014–17, LE (years) for males was: i-Taukei 64.9, Indians 63.5; and females: i-Taukei 67.0 and Indians 68.2. Mortality changes in most 5-year age groups increased or decreased the LE gap less than 10 weeks over 22 years. Compared to international agency reports, 2014–17 empirical LE estimates (males 64.7, females 67.8) were lower, as was IMR. Conclusions Based on empirical data, LE in Fiji has minimally improved over 1996–2017, and is lower than some international agencies report. Adult mortality was higher in Indian than i-Taukei men, and higher in i-Taukei than Indian women. Exclusion of stillbirths resulted in IMRs lower than previously reported. Differing mortality trends in subgroups highlight the need to collect census and health data by ethnicity and sex, to monitor health outcomes and inform resource allocation.

GPS collars have an apparent positive effect on the survival of a large carnivore

Are instrumented animals representative of the population, given the potential bias caused by selective sampling and the influence of capture, handling and wearing bio-loggers? The answer is elusive owing to the challenges of obtaining comparable data from individuals with and without bio-loggers. Using non-invasive genetic data of a large carnivore, the wolverine ( Gulo gulo ) in Scandinavia, and an open-population spatial capture–recapture model, we found a 16 (credible interval: 4–30) percentage points lower mortality probability for GPS-collared individuals compared with individuals without GPS collars. While the risk of dying from legal culling was comparable for collared and non-collared wolverines, the former experienced lower probability of mortality due to causes other than legal culling. The aforementioned effect was pronounced despite a potentially lower age—and therefore likely higher natural mortality—of collared individuals. Reports of positive effects of bio-loggers on the survival of individuals are uncommon and we argue that GPS collars could shield animals from poaching. Our results highlight the challenges of drawing population-level inferences for populations subjected to poaching when using data from instrumented individuals.