Integration of fuzzy logic in the SEIRD compartmental model for the analysis of intervention and transmission heterogeneity on SARS-CoV-2 transmission dynamics

Different epidemiological compartmental models have been presented to predict the transmission dynamics of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this study, we have proposed a fuzzy rule-based Susceptible-Exposed-Infectious-Recovered-Death ([Formula: see text]) compartmental model considering a new dynamic transmission possibility variable as a function of time and three different fuzzy linguistic intervention variables to delineate the intervention and transmission heterogeneity on SARS-CoV-2 viral infection. We have analyzed the datasets of active cases and total death cases of China and Bangladesh. Using our model, we have predicted active cases and total death cases for China and Bangladesh. We further presented the correspondence of different intervention measures in relaxing the transmission possibility. The proposed model delineates the correspondence between the intervention measures as fuzzy subsets and the predicted active cases and total death cases. The prediction made by our system fitted the collected dataset very well while considering different fuzzy intervention measures. The integration of fuzzy logic in the classical compartmental model also produces more realistic results as it generates a dynamic transmission possibility variable. The proposed model could be used to control the transmission of SARS-CoV-2 as it deals with the intervention and transmission heterogeneity on SARS-CoV-2 transmission dynamics.

Prevalence of Pneumonia in Children’S Under Five Years in Al Sabbah Hospital Juba – South Sudan

Background: Each year, pneumonia affects about 450 million people globally; it is a major cause of death among all age groups resulting in 4 million deaths (7% of the world’s total death) yearly.Pneumonia is defined as the presence of fever, acute respiratory symptoms, or both, plus evidence of parenchymal infiltration chest radiography. Although, in the past decade the incidence of the disease was reported to have declined by half percent, that alone was considered to be the slowest decline in comparison to other diseasesThe objective of the study is to determine the prevalence of pneumonia in Al Sabah Children Hospital and to assess the risk factor associated. Method: A cross-sectional study design was used to determine the prevalence of pneumonia in children under-five years in Al Sabah hospital, Juba South Sudan. The study ran from 18th September to 5th of October 2021. 241 participants were randomly selected for the study and primary data were obtained through questionnaires. Results: The prevalence of pneumonia in children under-five years was found to be 22.4.7%. The incidence is highest in males 23 (57.5%) compared to females17 (42.5%). The ethnicity of the patients from Dinka (37.5%) and Bari (30%), Shilluk (7.5%), Mundari (2.5%), Madi (5%) Nuer (7.5%), Murli (5%), Lolobo (2.5%) and latoka (2.5%) and the leading ethnicity with high morbidity of pneumonia was found to be in Dinka.Conclusion: The prevalence of pneumonia in children under-five years in Al Sabah hospital is high compared to the previous research done by the students of Upper Nile University at the University of Juba in 2019 with the prevalence of 21%

The Impact of COVID-19 Across Nursing Homes That Disproportionally Serve Minority Residents

The Coronavirus-2019 (COVID-19) pandemic has disproportionally affected communities of color and older adults in the United States. Nursing homes (NHs) have reported over 130,000 COVID-19 deaths (or one-fourth of all US deaths) circa March 2021, a high share of the nation’s total death count (CMS COVID-19 NH Data). These inequities partially driven by barriers to care, segregation and structural racism have resulted in the unequal impact of COVID-19 across NHs (Li et al., 2020). In this presentation, I will describe NHs that disproportionally care for minority residents and the effect of NH composition on COVID-19-related mortality and outcomes. In 2020, minority older adults were less likely to have access to high quality facilities. From June – August, NHs with a high proportion of minority residents reported higher COVID-19 mortality rates per 1000 residents. Equal access to high quality of care across the life-course among racial and ethnic groups is needed.

Sugar Intake and Cancer: A Literature Review

ABSTRACTBackground: Cancer is the second leading cause of death after heart disease globally (total death 9.6 million). Cancer prevalence is increasing in Indonesia from 1.4 per 1000 people in 2013 to 1.79 per 1000 people in 2018. Diet is linked with cancer prognosis, particularly carbohydrate intake which stimulates insulin signals that can be potent mitogens.Purpose: This literature review aims to examine sugar intake and cancer incidence.Method: This literature review (traditional review) using the keywords “cancer”,” sugar”, “carbohydrate”, “insulin” and “hyperinsulinemia” in the Sciencedirect database and Google search engine. The inclusion criteria were peer-review articles or documents from credible national and international institutions, the literature uses English or Bahasa (Indonesian Language). The exclusion criteria were that the literature had similar content or redundant with other literature.Result: Sugar increases insulin resistance which enhances the levels of bioactive IGF-I that contribute to raising the risk of cancer. Prolonged hyperinsulinemia reduces the production of growth-promoting factors such as IGFBP-1 and IGFBP-2 which normally bind to and inhibit the action of IGF-I with resultant increases in the levels of free, bio-active IGF-I, and concomitant changes in the cellular environment that favor cancer development, proliferation, and metastatic cancer cells.Conclusion: The mechanism of insulin and IGF-1 stimulate and accelerate cancer cell proliferation may explain the relationship between sugar intake and cancer incidence. Adopting a balanced diet, changing or decreasing sugar intake with healthier food coupled with increased physical activity reduces the risk of cancer.

Awareness on Heart Diseases among Bangladesh Army Personnel

Introduction: Heart diseases are global public health problem. In 2015, 14.31% of total death in Bangladesh was due to coronary heart disease. Moreover in 2016, 2(two) recruits and 1(one) officer of Bangladesh army encountered sudden death due to cardiac arrest. Objective: To ascertain the level of knowledge, awareness and health practice regarding the threat of cardiovascular diseases among Bangladesh Army personnel. Materials and Methods: This cross-sectional observational study was conducted among 242 members of Bangladesh Army in different training centers and school under Army training and doctrine command (ARTDOC), units of 19 infantry division, Battle group of ARTDOC and Head quarter (HQ) ARTDOC, from February to July 2017. Results: Among the respondents, 56.2%, 45% and 44.6% respectively mentioned tobacco smoking, obesity and sedentary life style are the causes of heart disease and 62%, 42%, 31%, 10% and 2% mentioned that chest pain, shortness of breathing, sweating, radiating pain in jaw and extremity and snoring-sleep apnea are the symptoms and signs of heart disease. Conclusion: From the study it was revealed that, majority of the respondents had poor level of knowledge on awareness of heart disease. Adequate effort may be taken to increase the awareness by expert professionals and social media. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 47-50

Geographic Distribution of Excess Mortality Rate duo to COVID-19 in Iranian Population: An Ecological Study

Introduction: COVID-19 has raised world concern since it emerged in Wuhan, China in December 2019. The direct and indirect death rates in the world and in Iran have increased significantly after the occurrence of this pandemic in the world. Objective: In this study EMR estimated by Multilevel Poison Regression then this estimation compared to the historical trends, to obtain total death related to the COVID-19 in addtion the geographic distribution of EMR has been presented for Iran country. Materials and Methods: All-cause mortality count of each province of Iran from March 21, 2013 to June 20, 2020 downloaded from National Organizationfor Civil Registration (NOCR). The data from spring of 2020 (March 20, 2020 to June 20, 2020) remove from data and then the multilevel poison model has been used to estimate all-cause mortality in spring 2020 then excess mortality attributable to COVID-19 (the difference between the numberof registered and expected deaths) has been calculated. Results: The results of this study showed that Iran’s EMR in spring 2020 was 23% (Male=25%, Female=21%). More result also showed that four category low (EMR≤5%, n=3), moderate (5 %< EMR<20%, n=10), high (20 %< EMR<40%, n=16) and very high (40≤EMR, n=2) EMR. Conclusion: Due to the diverse EMR in different provinces of Iran, the type of management of provinces with low and moderate EMR can be used as a suitable model to control EMR in provinces with high and very high EMR.

Recent Herbal Proprietary Preparations for Liver Diseases: A Comparative Study

Liver is considered to be one of the most vital organs that functions as a centre of metabolism and excretion of waste metabolites. A number of risk factors predispose an individual to hepatic injury and thus liver diseases. Total death worldwide due to liver diseases raised by 50 million per year over two decades, according first ever WHO Study of Liver Disease Mortality. In recent years Indian Traditional Medicines like Ayurveda, Siddha and Unani have gained importance and popularity because of their safety and efficacy in liver diseases. Several Ayurvedic proprietary liver preparations are being extensively used in Ayurveda for the management of liver diseases. About 600 commercial herbal formulations with claimed hepato protective activity are being sold all over the world. In India more than 93 medicinal plants are used in different combinations in the preparation of 40 patented herbal formulations in the form of liquid and tablet. But very little is known when and how these formulations are to be used in present practice. Out of this easily available most commonly used liver preparations Adliv, Amlicure DS, Arkaliv, Ayuliv, Hepjaun, Kamilari, Kamilari plus, Liv Aid, Livercure, Livergen, Liv 52, Livobell, Livokin, Livomyn, Livpar, Nirocil, Stimuliv, Strongliv, Terfoliv and Vasuliv are taken for the study. These preparations are classified on various basis like available market form, Herbo-Herbomineral preparations etc. Kutaki is most commonly used single drug in maximum number of preparations followed by Bhringraj, Bhui Aamalaki, and Kalmegh. Individual drugs of the preparations are studied according to Rasa, Virya and Vipaka. Uses of individual drugs as well as of liver preparations are also studied in relations with liver diseases. Present study will definitely give a clue for standard herbal formulations based on physiopathology of liver disease which is a need of a day Keywords: Liver, Hepato protective, Herbal, Formulations.

Complement component 7 is associated with total- and cardiac death in chest-pain patients with suspected acute coronary syndrome

Background Complement activation has been associated with atherosclerosis, atherosclerotic plaque destabilization and increased risk of cardiovascular events. Complement component 7 (CC7) binds to the C5bC6 complex which is part of the terminal complement complex (TCC/C5b-9). High-sensitivity C-reactive protein (hsCRP) is a sensitive marker of systemic inflammation and may reflect the increased inflammatory state associated with cardiovascular disease. Aim To evaluate the associations between CC7 and total- and cardiac mortality in patients hospitalized with chest-pain of suspected coronary origin, and whether combining CC7 with hsCRP adds prognostic information. Methods Baseline levels of CC7 were related to 60-months survival in a prospective, observational study of 982 patients hospitalized with a suspected acute coronary syndrome (ACS) at 9 hospitals in Salta, Argentina. A cox regression model, adjusting for conventional cardiovascular risk factors, was fitted with all-cause mortality, cardiac death and sudden cardiac death (SCD) as the dependent variables. A similar Norwegian population of 871 patients was applied to test the reproducibility of results in relation to total death. Results At follow-up, 173 patients (17.7%) in the Argentinean cohort had died, of these 92 (9.4%) were classified as cardiac death and 59 (6.0%) as SCD. In the Norwegian population, a total of 254 patients (30%) died. In multivariable analysis, CC7 was significantly associated with 60-months all-cause mortality [hazard ratio (HR) 1.26 (95% confidence interval (CI), 1.07–1.47) and cardiac death [HR 1.28 (95% CI 1.02–1.60)], but not with SCD. CC7 was only weakly correlated with hsCRP (r = 0.10, p = 0.002), and there was no statistically significant interaction between the two biomarkers in relation to outcome. The significant association of CC7 with total death was reproduced in the Norwegian population. Conclusions CC7 was significantly associated with all-cause mortality and cardiac death at 60-months follow-up in chest-pain patients with suspected ACS. Clinical trial registration ClinicalTrials.gov Identifier: NCT01377402, NCT00521976.

Determination of utility of 3 minute and 6 minute walk tests in assessment of progression of mild COVID-19 infection at a tertiary hospital in North India

Introduction: There have been 214 million confirmed cases of COVID-19 worldwide with a total death tally of 4.4 million. The current study aims to determine the predictive value of 3 minute and 6-minute walk tests in assessment of progression of mild COVID-19 infection at a tertiary care hospital in North India. Methods: The study population consisted of adults (age more than 18 years) with a confirmed diagnosis of Covid-19 by RT-PCR on nasopharyngeal specimens. Patients with only mild illness were enrolled. After the patients were admitted to the isolation ward, the presenting history, comorbidity status, vital signs and laboratory parameters were recorded. The 3 and 6 minute walk test was performed daily from admission till discharge or progression of severity of COVID-19 and it was used to calculate BDS and NEWS2 scores. Results: Our study consisted of 50 patients with 34 (68%) males and the mean (SD) age of the patient population being 28.1 (6.4) years. The most common symptoms were fever, sore throat, and cough. All laboratory parameters were within normal ranges for all the patients. 96% recovered without progression, while only 4% of them progressed to moderate illness. Results of the 3 and 6 minutes walk tests, BDS and NEWS2 scores showed improvement over the course of hospital stay. Conclusions: Although the walk tests and the scores improved over time, they failed to predict the disease progression.

Serum Levels of Dihomo-Gamma (γ)-Linolenic Acid (DGLA) Are Inversely Associated with Linoleic Acid and Total Death in Elderly Patients with a Recent Myocardial Infarction

Dihomo-gamma-linolenic acid (DGLA) is an n-6 polyunsaturated fatty acid (PUFA) derived from linoleic acid (LA). The LA:DGLA ratio reflects conversion from LA to DGLA. Low levels of DGLA in serum have been related to poor outcome in myocardial infarction (MI) patients. Aims: To assess the association of DGLA and LA:DGLA with total death as a primary aim and incident cardiovascular events as a secondary objective. Methods: Baseline samples from 1002 patients, aged 70 to 82 years, included 2–8 weeks after an MI and followed for 2 years, were used. Major adverse clinical events (MACE) consisted of nonfatal MI, unscheduled coronary revascularization, stroke, hospitalization for heart failure or all-cause death. Cox regression analysis was used to relate serum n-6 PUFA phospholipid levels (%wt) to the risk of MACE, adjusting for the following: (1) age, sex and body mass index (BMI); (2) adding baseline cod liver oil supplementation; (3) adding prevalent hypertension, chronic kidney disease and diabetes mellitus. Results: Median DGLA level in serum phospholipids was 2.89 (Q1–Q3 2.43–3.38) %wt. DGLA was inversely related to LA and LA:DGLA ratio. There were 208 incident cases of MACE and 55 deaths. In the multivariable analysis, the hazard ratio (HR) for the total death in the three higher quartiles (Q2–4) of DGLA as compared to Q1 was 0.54 (0.31–0.95), with p = 0.03 (Model-1), 0.50 (0.28–0.91), with p = 0.02 (Model-2), and 0.47 (0.26–0.84), with p = 0.012 (Model-3), and non-significant for MACE. Risk of MACE (Model 3) approached borderline significance for LA:DGLA in Q2–4 vs. Q1 [HR 1.42 (1.00–2.04), p = 0.052]. Conclusions: Low levels of DGLA were related to a high LA:DGLA ratio and risk of total death in elderly patients with recent MI.