关键词： vitamin D   tumor necrosis factor   interleukin-6   interferon gamma   acute respiratory distress syndrome (ARDS)   COVID-19   WEB SERVER  

摘要： Introduction: The role of vitamin in COVID-19 remains controversial. We investigated the association between endogenous vitamin D and the severity of COVID-19 as well as the mechanisms of action of vitamin D supplementation. Methods: 25(OH)D3 in serum was associated with disease severity and outcome in 190 COVID-19 patients. In a COVID-19 animal model using intravenous injection of plasma from patients with COVID-19 ARDS into C57/BL6 mice, mice were treated with 0.25 mu g human 1,25(OH)D3 or vehicle. Mice were sacrificed on day 4. Cytokines and myeloperoxidase (MPO) in tissues were measured. Changes in gene expression after vitamin D supplementation were measured. Results: Vitamin D deficiency and insufficiency were associated with increased severity and unfavourable outcome after 28 days. Vitamin D levels were negatively associated with biomarkers of COVID-19 severity. Vitamin D supplementation after challenge of mice with COVID-19 plasma led to reduced levels of TNF alpha, IL-6, IFN gamma(sic)and MPO in the lung, as well as down-regulation of pro-inflammatory pathways. Conclusion: Normal levels of endogenous Vitamin D are associated with reduced severity and risk of unfavourable outcome in COVID-19, possibly through attenuation of tissue-specific hyperinflammation.

关键词： Adrenal gland   COVID-19   Steroidogenesis   Proteomics   Histopathology   Autopsy  

摘要： Background: The effect of coronavirus disease 2019 (COVID-19) on adrenal endocrine metabolism in critically ill patients remains unclear. This study aimed to investigate the alterations in adrenal steroidogenic activity, elucidate underlying mechanisms, provide in situ histopathological evidence, and examine the clinical implications. Methods: The comparative analyses of the adrenal cortices from 24 patients with fatal COVID-19 and 20 matched controls were performed, excluding patients previously treated with glucocorticoids. SARS-CoV-2 and its receptors were identified and pathological alterations were examined. Furthermore, histological examinations, immunohistochemical staining and ultrastructural analyses were performed to assess corticosteroid biosynthesis. The zona glomerulosa (ZG) and zona fasciculata (ZF) were then dissected for proteomic analyses. The biological processes that affected steroidogenesis were analyzed by integrating histological, proteomic, and clinical data. Finally, the immunoreactivity and responsive genes of mineralocorticoid and glucocorticoid receptors in essential tissues were quantitatively measured to evaluate corticosteroid responsiveness. Findings: The demographic characteristics of COVID-19 patients were comparable with those of controls. SARSCoV-2-like particles were identified in the adrenocortical cells of three patients; however, these particles did not affect cellular morphology or steroid synthesis compared with SARS-CoV-2-negative specimens. Although the adrenals exhibited focal necrosis, vacuolization, microthrombi, and inflammation, widespread degeneration was not evident. Notably, corticosteroid biosynthesis was significantly enhanced in both the ZG and ZF of COVID-19 patients. The increase in the inflammatory response and cellular differentiation in the adrenal cortices of patients with critical COVID-19 was positively correlated with heightened steroidogenic activity. Additionally, the appearance of more dual-ZG/ZF iden

关键词： Traffic flows   Urban big data   COVID-19   Spatial Durbin model   TRAVEL BEHAVIOR   LAND-USE   PATTERNS   MODEL  

摘要： Urban traffic analysis has played an important role in urban development, providing insights for urban planning, traffic management, and resource allocation. Meanwhile, the global pandemic of COVID-19 has significantly changed people's travel behaviour in urban areas. This research uses the spatial Durbin model to understand the relationship between traffic flows, urban infrastructure, and socio-demographic indicators before, during, and after pandemic periods. We include factors such as road characteristics, socio-demographics, surrounding built environments (land use and nearby points of interest), and the emerging urban big data source of Google Street View images to understand their influences on time series traffic flows. Taking the city of Glasgow as the case study, we have found that areas with more young and white dwellers are associated with more traffic flows, while natural green spaces are associated with fewer traffic flows. Major roads between cities and towns also show heavier traffic flows. Besides, the application of Google Street View images in this research has revealed the heterogeneous effects of green space on urban traffic flows, as the magnitudes of their effects vary by distance. We also detect that the spatial dependence between adjacent neighbourhoods among the traffic flows and associated urban parameters is variable during the four COVID-19 periods. With the influence of COVID-19, there has been a significant decrease in long-distance travel. The noticeable change in travel behaviour presents a valuable opportunity to encourage active travel in the near future.

关键词： Sampling technique   Ratio type estimator   Unbiased type estimator   Non-response   Covid-19 data   Simulation study   UNBIASED ESTIMATOR   POPULATION   RATIO  

摘要： Sampling is crucial in basic statistics due to the large size of certain populations. Sampling theory focuses on selecting samples based on appropriate population characteristics and approaches to estimating population characteristics from the sample. Firstly, we use the ratio-type estimator proposed by Prasad (1989). We adapt this unbiased ratio-type estimator to two new different estimators using the Hartley-Ross and non-response approaches. Finally, we combine these approaches and propose a new estimator. The theoretical results were supported by COVID-19 data and a simulation study with various scenarios. Based on the COVID-19 data result, it was concluded that the new tN3 estimator is the most effective estimator among those proposed and compared, with the minimum MSE and maximum PRE. Upon examining the changes in the COVID-19 data set in detail, it is evident that the PRE value increases with an increase in sample size, non-response rate, and k values. As in the COVID-19 dataset, the tN3 estimator was the most effective in the simulation study results. It is also important to note that these results are not applicable to only one scenario in simulation study. The tN2 estimator was the most effective in the scenario with rho=0.90, T=1000, n=400, non-response rate=0.30 and k equal to 2, 4 and 5.

关键词： Social media   Smartphones   School-age children   Tweens   Child exploitation   COVID-19 pandemic  

摘要： Smartphone ownership and social media use are increasing worldwide, and children are not exempt from these trends. Past studies on this issue have mainly focused on educational campaigns to prevent the prolonged use of smartphones, social media, and video games. Recently, harm to children from engagement with bad actors through social media has become a major problem in Japan, and preventive measures need to be based on close analysis of the facts. The present study was performed descriptive epidemiology and comparison between two groups. This study investigated the number of children in Japan who fell victim to criminal offense through their use of social media, categorized by level of schooling, type of offense, and means of accessing social media over the 8year period from 2016 to 2023. The 8-year period was divided into 2016-2019 (4 years prior to the COVID-19 pandemic) and 2020-2023 (4 years during the pandemic). Statistical analysis was conducted to compare these periods. The number of elementary school students victimized by criminal offense through social media in Japan increased significantly in 4 years during the pandemic. Furthermore, in 4 years during the pandemic, there was also a notable rise in felony-related incidents, and an increase in the number of victims accessing social media via smartphones. Schools, parents/guardians, and personnel and organizations in relevant fields need to collaborate in addressing and educating students about the proper use of smartphones and the risks of social media starting at the elementary school age.

关键词： DISEASE   DELAY   INTERVENTIONS   OUTCOMES   CARE  

摘要： Background: COVID-19 confronted medical care with many challenges. During the pandemic, several resources were limited resulting in renouncing or postponing medical care like carotid endarterectomy (CEA) for patients with significant carotid artery stenosis. Although according to international guidelines CEA is the first choice, carotid artery stenting (CAS) could potentially be a reasonable alternative especially during logistical restraints. Purpose: To evaluate outcomes of CAS versus CEA before, during and after the COVID-19 pandemic. Our hypothesis was that a CAS first approach yielded comparable outcomes compared to a CEA first approach. Methods: Retrospective analysis of consecutive patients with significant carotid artery stenosis treated with CEA or CAS between September 2018 and March 2023. Each consecutive period of 1.5 year marked a new (treatment) period: pre-COVID (CEA first strategy), during COVID (CAS first strategy) and post-COVID (patient-tailored approach). Primary outcome was the composite endpoint of stroke, transient ischemic attack or death within 30 days. Secondary outcome consisted of the rate of technical success, cerebral hyperperfusion syndrome, myocardial infarction or other cardiac complications needing intervention, bleeding of the surgical site needing intervention, nerve palsy, unintended IC admission, pseudoaneurysm, restenosis, or occlusion. Results: A total of 318 patients were included. Out of 137 patients treated with CEA, 55, 36 and 46 were treated pre-COVID, during COVID and post-COVID, respectively. Out of 181 CAS procedures, 38, 59 and 84, respectively, were performed in each time period. Primary outcome occurred in 5.5%, 0% and 2.2% in the CEA group and 0%, 1.7% and 3.6% in the CAS group (P = 0.27; P = 1.00; P = 1.00, respectively). Overall technical success was 100% for CEA and 99.4% for CAS (P = 1.00). Rate of restenosis was the only secondary outcome measure which was significantly better after CAS compared to CEA in the

关键词： COVID-19   Nocebo effect   Post COVID-19 condition  

摘要： Objective: Post COVID-19 condition is characterized by persistent symptoms after COVID-19 with yet unknown etiology. To explore whether media-related nocebo effects potentially contribute to post COVID-19 condition, we studied in an observational cohort whether frequencies of media coverage of symptoms after COVID-19 corresponded with prevalence rates of these symptoms in participants from a general population cohort diagnosed with COVID-19. Methods: Prevalence rates and typology of symptoms after COVID-19 in the general population (N N = 4231), adjusted for prevalence rates in a matched non-infected control population (n n = 8462) were calculated by using data on 23 symptoms from the Lifelines COVID-19 Cohort collected between March 2020 and August 2021. Media coverage of post COVID-19 condition was assessed by coding 1266 Dutch post COVID-19-related news articles (inter-rater-kappa >= 0.75), published during the corresponding timeframe. Herein, we assessed whether the same 23 symptoms were mentioned as being related to post COVID-19 condition. Results: Core post COVID-19 condition symptoms were mentioned in 390 (30.8%) articles. Five of the ten core symptoms were mentioned by 10 or fewer articles. Ageusia/anosmia was most often persistently increased in COVID-19-positive participants (7.6%), yet was mentioned in 80 (6.3%) articles. General tiredness and breathing difficulties were frequently mentioned, in 23.9% and 17.1% of the articles respectively, while these were not the most frequently increased symptoms reported by participants (4.9% and 2.4%). Conclusion: If post COVID-19 condition was predominantly attributable to nocebo effects, its symptom profile would be expected to reflect levels of media coverage for symptoms after COVID-19. However, our findings do not support this.

关键词： COVID-19   Chest CT   DRLs   BEIR VII   Lifetime attributable risk (LAR)   REFERENCE LEVELS DRLS   RISK  

摘要： This study examined radiation exposure from CT scans performed on 500 adult COVID-19 patients at two major university hospitals in Morocco. A robust correlation (r = 0.82) was found between patient size and Size-Specific Dose Estimate (SSDE), which ranged from 10.11 to 17.87 mGy. The mean CTDIvol was 6.7 mGy, contrasting markedly with the mean SSDE of 12.81 mGy. This highlights a substantial difference, with the SSDE-to-CTDIvol ratio being approximately 1.91. Notably, the SSDE was nearly twice as high as the CTDIvol, underscoring the vulnerability of obese COVID-19 patients. Evaluation of different CT scanner models showed higher radiation doses associated with the Siemens Somaton Emotion 16 compared to the GE Optima CT520 Series, emphasizing the need to account for scanner-specific factors in dose optimization protocols. A comparison of chest CT reference doses (DRL) from this study with international data showed a lower mean CTDIvol here (6.7 mGy) than reported in other countries. However, the DRL in terms of DLP is in the same range or lower as compared to others. Using the BEIR VII model, the lifetime attributable risk (LAR) of cancer from COVID-19 chest CTs was estimated. Elevated risks of lung cancer in both genders and increased breast cancer risk in females were projected, albeit with limitations regarding overestimated cancer incidence. The high effective dose values, approaching 15.3 mSv, underscore the need for dose optimization, especially in obese COVID-19 patients receiving chest CTs.

关键词： Vaccination ineffectiveness and infection differences   Lyapunov function   Barbalat's lemma   Parameter estimation and sensitivity analysis   DYNAMICS  

摘要： To explore the impact of the COVID-19 vaccination rate and immune loss rate on the pandemic, this paper proposes a fractional-order SIV 1 V 2 S epidemic model with vaccination ineffectiveness and infection differences. And we compare and analyze the dynamic differences between integer-order and Caputo fractional-order operators. First, we show the non-negativity and boundedness of solutions for the Caputo fractional-order model. Based on the basic reproduction number, we use the fractional-order matrix eigenvalue method and the Routh-Hurwitz criterion to determine the local asymptotic stability of disease-free equilibrium points and endemic equilibrium points, construct Lyapunov functions, and use the fractional-order Barbalat's Lemma to prove the global asymptotic stability of the two equilibrium points. Second, real data from India were used to fit the model parameters and get the optimal fractional-order parameter, and then sensitivity analysis was performed on the basic reproduction number. Further, through numerical simulation of different fractional-order parameter epidemic models, we verify the global asymptotic stability of the equilibrium point of the fractional-order SIV 1 V 2 S COVID19 model. The comparison shows that the fractional-order model is more closely related to actual virus transmission than the integer-order model. In the case of the SIV 1 V 2 S model, which only considers vaccination measures, simultaneously increasing the vaccination rate of susceptible individuals and reducing the rate of immunization loss can effectively control epidemic transmission.

关键词： Klebsiella pneumoniae   Whole genome sequence   COVID-19   hypervirulent   carbapenem-resistant   INFECTIONS   EMERGENCE   ALGORITHM  

摘要： Background: Klebsiella pneumoniae (Kp) is a common community-acquired and nosocomial pathogen. Carbapenem-resistant and hypervirulent (CR-hvKp) variants can emerge rapidly within healthcare facilities and impacted by other infectious agents such as COVID-19 virus. Methods: To understand the impact of COVID-19 virus on the prevalence of CR-hvKp, we accessed Kp genomes with corresponding metadata from GenBank. Sequence types (STs), antimicrobial resistance genes, and virulence genes, and those scores and CR-hvKp were identified. We analyzed population diversity and phylogenetic characteristics of five most common STs, measured the prevalence of CR-hvKp, identified CR-hvKp subtypes, and determined associations between carbapenem resistance gene subtypes with STs and plasmid types. These variables were compared pre- and during the COVID-19 pandemic. Findings: The proportion of CR-hvKp isolates increased within multiple STs in different continents during the COVID-19 pandemic and persistent CR-hvKp subtypes were found in common STs. blaKPC was dominant in CG258, blaKPC-2 was detected in 97% of the ST11 CR-hvKp, blaNDM subtypes were prominent in ST147 (87.4 %) and ST307 (70.8 %); blaOXA-48 and its subtypes were prevalent in ST15 (80.5 %). The possession of carbapenemase genes was different among subclades from different origins in different periods of time within each ST. IncFIB/IncHI1B hybrid plasmids contained virulence genes and carbapenemase genes and were predominant in ST147 (67.37 %) and ST307 (56.25 %). Interpretation: The prevalence of CR-hvKp increased during the COVID-19 pandemic, which was evident by an increase in local endemic clones. This process was facilitated by the convergence of plasmids containing carbapenemase genes and virulence genes. These findings have implications for the appropriate use of antimicrobials and infection prevention and control during outbreaks of respiratory viruses and pandemic management.