Age-Related Risk Factors and Complications of Patients With COVID-19: A Population-Based Retrospective Study

Objective: To study the differences in clinical characteristics, risk factors, and complications across age-groups among the inpatients with the coronavirus disease 2019 (COVID-19).Methods: In this population-based retrospective study, we included all the positive hospitalized patients with COVID-19 at Wuhan City from December 29, 2019 to April 15, 2020, during the first pandemic wave. Multivariate logistic regression analyses were used to explore the risk factors for death from COVID-19. Canonical correlation analysis (CCA) was performed to study the associations between comorbidities and complications.Results: There are 36,358 patients in the final cohort, of whom 2,492 (6.85%) died. Greater age (odds ration [OR] = 1.061 [95% CI 1.057–1.065], p < 0.001), male gender (OR = 1.726 [95% CI 1.582–1.885], p < 0.001), alcohol consumption (OR = 1.558 [95% CI 1.355–1.786], p < 0.001), smoking (OR = 1.326 [95% CI 1.055–1.652], p = 0.014), hypertension (OR = 1.175 [95% CI 1.067–1.293], p = 0.001), diabetes (OR = 1.258 [95% CI 1.118–1.413], p < 0.001), cancer (OR = 1.86 [95% CI 1.507–2.279], p < 0.001), chronic kidney disease (CKD) (OR = 1.745 [95% CI 1.427–2.12], p < 0.001), and intracerebral hemorrhage (ICH) (OR = 1.96 [95% CI 1.323–2.846], p = 0.001) were independent risk factors for death from COVID-19. Patients aged 40–80 years make up the majority of the whole patients, and them had similar risk factors with the whole patients. For patients aged <40 years, only cancer (OR = 17.112 [95% CI 6.264–39.73], p < 0.001) and ICH (OR = 31.538 [95% CI 5.213–158.787], p < 0.001) were significantly associated with higher odds of death. For patients aged >80 years, only age (OR = 1.033 [95% CI 1.008–1.059], p = 0.01) and male gender (OR = 1.585 [95% CI 1.301–1.933], p < 0.001) were associated with higher odds of death. The incidence of most complications increases with age, but arrhythmias, gastrointestinal bleeding, and sepsis were more common in younger deceased patients with COVID-19, with only arrhythmia reaching statistical difference (p = 0.039). We found a relatively poor correlation between preexisting risk factors and complications.Conclusions: Coronavirus disease 2019 are disproportionally affected by age for its clinical manifestations, risk factors, complications, and outcomes. Prior complications have little effect on the incidence of extrapulmonary complications.

Efficacy of mupirocin, neomycin and octenidine for nasal Staphylococcus aureus decolonisation: a retrospective cohort study

Background Periprosthetic joint infection (PJI) causes significant morbidity. Methicillin sensitive Staphylococcus aureus (MSSA) is the most frequent organism, and the majority are endogenous. Decolonisation reduces PJIs but there is a paucity of evidence comparing treatments. Aims; compare 3 nasal decolonisation treatments at (1) achieving MSSA decolonisation, (2) preventing PJI. Methods Our hospital prospectively collected data on our MSSA decolonisation programme since 2013, including; all MSSA carriers, treatment received, MSSA status at time of surgery and all PJIs. Prior to 2017 MSSA carriers received nasal mupirocin or neomycin, from August 2017 until August 2019 nasal octenidine was used. Results During the study period 15,958 primary hip and knee replacements were performed. 3200 (20.1%) were MSSA positive at preoperative screening and received decolonisation treatment, 698 mupirocin, 1210 neomycin and 1221 octenidine. Mupirocin (89.1%) and neomycin (90.9%) were more effective at decolonisation than octenidine (50.0%, P < 0.0001). There was no difference in PJI rates (P = 0.452). Conclusions Mupirocin and neomycin are more effective than octenidine at MSSA decolonisation. There was poor correlation between the MSSA status after treatment (on day of surgery) and PJI rates. Further research is needed to compare alternative MSSA decolonisation treatments.

Inverse Molecular Design of Alkoxides and Phenoxides for Aqueous Direct Air Capture of CO2

Aqueous direct air capture (DAC) is a key technology toward a carbon negative infrastructure. Developing sorbent molecules with water- and oxygen-tolerance and high CO2 binding capacity is therefore highly desired. In this work, we analyze the CO2 absorption chemistries on amines, alkoxides, and phenoxides with density functional theory (DFT) calculations and search for the optimal sorbent using an inverse molecular design strategy. The alkoxides and phenoxides are found to be more suitable for aqueous DAC than amines thanks to their water-tolerance and capture stoichiometry of 1:1 (2:1 for amines). All three molecular systems are found to obey the same linear scaling relationship (LSR) between pK_(CO_2 ) and pK_a, since both CO2 and proton are bonded to the nucleophilic binding site through a majorly σ bonding orbital. Several high-performance alkoxides are proposed from the computational screening. In contrast, phenoxides have relatively poor correlation between pK_(CO_2 ) and pK_a, showing promise for optimization. We apply genetic algorithm (GA) to search the chemical space of substituted phenoxides for the optimal sorbent. Several promising candidates that break the LSR are discovered. The most promising off-LSR candidate phenoxides feature bulky ortho substituents forcing the CO2 adduct into a perpendicular configuration with respect to the aromatic ring. In this configuration, CO2 utilizes a different molecular orbital for binding than does the proton, and the pK_(CO_2 ) and pK_a are thus decoupled. The pK_(CO_2 )-pK_a trend and off-LSR behaviors are then confirmed by experiments, validating the inverse molecular design framework. This work not only extensively studies the chemistry of the aqueous DAC, but also presents a transferrable computational workflow for understanding and optimization of other functional molecules.

Relationship between pore throat and permeability of porous carbonate reservoir in the Middle East

A significant behavior of carbonate reservoirs is poor correlation between porosity and permeability. With the same porosity, the permeability can vary by three orders of magnitude or more. An accurate estimation of permeability for carbonate reservoir has been a challenge for many years. The aim of this study was to establish relationships between pore throat, porosity, and permeability. This study indicates that pore throat radius corresponding to a mercury saturation of 20% (R20) is the best permeability predictor for carbonates with complex porous pore networks. Quantitative analysis was made to achieve three different patterns of pore throat for 417 carbonate samples which cover all pore types of carbonate rocks. Different relationships between porosity, pore throat radius, and permeability have been identified in different patterns, which are utilized to predict more accurate permeability by different pore throat patterns.

WFD Ecological Quality Indicators Are Poorly Correlated with Water Levels in River Catchments in Tuscany (Italy)

The Water Framework Directive (WFD) requires European countries to achieve a good ecological status of surface water bodies and demands that River District Authorities define ecological flows consistently. Nevertheless, the relationship between ecological and hydrological indicators is not fully understood and not straightforward to apply because ecological and hydrological indicators are monitored by different institutions, with different timings and purposes. This work examines the correlation between a set of ecological indicators monitored by environmental agencies (STAR-ICMi, LIMeco, IBMR, and TDI) and water levels with assigned durations monitored by the hydrologic service in Tuscany (central Italy). Reference water levels are derived from stage-duration curves obtained by the statistical analysis of daily levels in the same year of ecological sampling. The two datasets are paired through a geospatial association for the same river reach and the correlation is measured through Pearson’s r. The results show poor correlation (r between −0.33 and −0.42) between ecological indicators and hydrologic variables, confirming the findings observed in other Italian catchments with different hydrologic regimes, climate, and anthropogenic pressures. Nevertheless, the negative correlations show a decreasing water quality with water depths, i.e., in the lower part of the catchments more affected by anthropogenic pressures. These findings suggests that the determination of ecological flows with a purely hydrological approach is not sufficient for achieving WFD objectives in the study area.

Comparison of forecasting accuracy for Madden Julian Oscillation (MJO) and Convectively Coupled Equatorial Waves (CCEW) using Tropical Rainfall Measuring Mission (TRMM) and ERA-Interim precipitation forecast data for Indonesia

Tropical Rainfall Measuring Mission (TRMM) and ERA-Interim forecast data analyzed using second-order autoregressive AR(2) and space-time-spectra analysis methods (respectively) revealed contrasting results for predicting Madden Julian Oscillation (MJO) and Convectively Coupled Equatorial Waves (CCEW) phenomena over Indonesia. This research used the same 13-year series of daily TRMM 3B42 V7 derived datasets and ERA-Interim reanalysis model datasets from the European Center for Medium-Range Weather Forecasts (ECMWF) for precipitation forecasts. Three years (2016 to 2018) of the filtered 3B42 and ERA-Interim forecast data was then used to evaluate forecast accuracy by looking at correlation coefficients for forecast leads from day +1 through day +7. The results revealed that rainfall estimation data from 3B42 provides better results for the shorter forecast leads, particularly for MJO, equatorial Rossby (ER), mixed Rossby-gravity (MRG), and inertia-gravity phenomena in zonal wavenumber 1 (IG1), but gives poor correlation for Kelvin waves for all forecast leads. A consistent correlation for all waves was achieved from the filtered ERA-Interim precipitation forecast model, and although this was quite weak for the first forecast leads it did not reach a negative correlation in the later forecast leads except for IG1. Furthermore, Root Mean Square Error (RMSE) was also calculated to complement forecasting skills for both data sources, with the result that residual RMSE for the filtered ERA-Interim precipitation forecast was quite small during all forecast leads and for all wave types. These findings prove that the ERA-Interim precipitation forecast model remains an adequate precipitation model in the tropics for MJO and CCEW forecasting, specifically for Indonesia.

Anatomical Assessment vs. Pullback REsting full-cycle rAtio (RFR) Measurement for Evaluation of Focal and Diffuse CoronarY Disease: Rationale and Design of the “READY Register”

Background: The morphology and functional severity of coronary stenosis show poor correlation. However, in clinical practice, the visual assessment of the invasive coronary angiography is still the most common means for evaluating coronary disease. The fractional flow reserve (FFR), the coronary flow reserve (CFR), and the resting full-cycle ratio (RFR) are established indices to determine the hemodynamic significance of a coronary stenosis.Design/Methods: The READY register (NCT04857762) is a prospective, multicentre register of patients who underwent invasive intracoronary FFR and RFR measurement. The main aim of the registry is to compare the visual estimate of coronary lesions and the functional severity of the stenosis assessed by FFR, as well as the RFR pullback. Characterizations of the coronary vessel for predominantly focal, diffuse, or mixed type disease according to visual vs. RFR pullback determination will be compared. The secondary endpoint of the study is a composite of major adverse cardiac events, including death, myocardial infarction, and repeat coronary revascularization at 1 year. These endpoints will be compared in patients with non-ischemic FFR in the subgroup of cases where the local pressure drop indicates a focal lesion according to the definition of ΔRFR &gt; 0.05 (for &lt;25 mm segment length) and in the subgroup without significant ΔRFR. In case of an FFR value above 0.80, an extended physiological analysis is planned to diagnose or exclude microvascular disease using the CFR/FFR index. This includes novel flow dynamic modeling for CFR calculation (CFRp−3D).Conclusion: The READY register will define the effect of RFR measurement on visual estimation-based clinical decision-making. It can identify a prognostic value of ΔRFR during RFR pullback, and it would also explore the frequency of microvascular disease in the patient population with FFR &gt; 0.80.Clinical Trial Registration:ClinicalTrials.gov (NCT04857762).

Comparison between LDH with Zap-70 and CD38 as prognostic Markers in Chronic Lymphocytic Leukemia Sudanese patients - A Pilot Study in Khartoum State

Background: Several prognostic markers are used in clinical stages of Chronic Lymphocytic Leukemia (CLL); including lactate dehydrogenase enzyme (LDH), CD38 and Zeta associated protein kinase (ZAP70). This study aimed to compare LDH with ZAP70 and CD38 as prognostic markers in Sudanese patients with CLL. Materials and Methods: Fifty newly diagnosed patients with CLL were enrolled in this cross-sectional study, the age of patients ranged between 36 - 85 years, with mean of 62 years. Of total patients; there were 34 males (68%) and 16 females (32%). Blood samples were obtained and LDH measurement was done by using Dirui CS-T240 automated analyzer while CD38 and ZAP-70 were measured by flowcytometry. Data were analyzed by statistical package for social science (SPSS) computer software program version 21. Results: The present study revealed a significant association between LDH and Rai staging (p. value= 0.002), when LDH compared with ZA-70 and CD38 as reference prognostic markers; poor correlation between CD38 and LDH was found (R2= 0.086, P value= 0.034) and no correlation between LDH level and ZAP-70 expression (R2= 000, P value= 0.960). In conclusion: According to the outcomes of this study; ZAP-70 and CD38 cannot be substituted by LDH as a prognostic marker.

Integration of transcriptome and proteome profiles in placenta accreta reveals trophoblast over-migration as the underlying pathogenesis

Background Placenta accreta (PA) is a major cause of maternal morbidity and mortality in modern obstetrics, few studies have explored the underlying molecular mechanisms. Methods In our study, transcriptome and proteome profiling were performed in placental tissues from ten participants including five cases each in the PA and control groups to clarify the pathogenesis of PA. Results We identified differential expression of 37,743 transcripts and 160 proteins between the PA and control groups with an overlap rate of 0.09%. The 33 most-significant transcripts and proteins were found and further screened and analyzed. Adhesion-related signature, chemotaxis related signatures and immune related signature were found in the PA group and played a certain role. Sum up two points, three significant indicators, methyl-CpG-binding domain protein 2 (MeCP2), podocin (PODN), and apolipoprotein D (ApoD), which participate in “negative regulation of cell migration”, were downregulated at the mRNA and protein levels in PA group. Furthermore, transwell migration and invasion assay of HTR-8/SVneo cell indicated the all of them impaired the migration and invasion of trophoblast. Conclusion A poor correlation was observed between the transcriptome and proteome data and MeCP2, PODN, and ApoD decreased in transcriptome and proteome profiling, resulting in increased migration of trophoblasts in the PA group, which clarify the mechanism of PA and might be the biomarkers or therapy targets in the future.