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Determine risk factors for mortality among COVID-19 patients admitted to a system of community hospitals in the United States.
Retrospective analysis of patient data collected from the routine care of COVID-19 patients.
System of more than 180 acute care facilities in the United States.
All admitted patients with positive identification of COVID-19 and a documented discharge as of May 12, 2020.
Determination of demographic characteristics, vital signs at admission, patient comorbidities and recorded discharge disposition in this population to construct a logistic regression estimating the odds of mortality, particular for those patients characterized as not being critically ill at admission.
A total of 6180 COVID-19+ patients were identified as of May 12, 2020. The majority of COVID-19+ patients (77.8%, 4808) were admitted directly to a medical/surgical unit with no documented critical care or mechanical ventilation within 8 hours of admission. After adjusting for demographic characteristics, comorbidities, and vital signs at admission in this subgroup, the largest driver of the odds of mortality was patient age (OR: 1.07, 95% CI 1.06-1.08, p< 0.001). Decreased oxygen saturation at admission was associated with increased odds of mortality (OR: 1.09, 95% CI 1.06-1.12, p< 0.001) as was diabetes (OR: 1.57, 95% CI 1.21-2.03, p<0.001).
The identification of factors observable at admission that are associated with mortality in COVID-19 patients who are initially admitted to non-critical care units may help care providers, hospital epidemiologists, and hospital safety experts better plan for the care of these patients.
Characteristics of DSM-IV attention-deficit/hyperactivity disorder (ADHD) in adults can also be found as part of other psychiatric disorders. This study investigated the specificity of adult ADHD features in relation to patients with borderline personality disorder (BPD), a syndrome which shares some of its intrinsic features with ADHD and often co-occurs with ADHD. A group of 20 adult patients selected on the basis of a diagnosis of ADHD and 20 patients selected on the basis of a diagnosis of BPD were assessed by the self-report Attention Deficit Scales for Adults (ADSA). The two groups were matched for age, verbal IQ and gender. Of the nine ADSA scales, seven showed significant inter-group differences, in particular involving attention, organisation and persistence. The ‘Consistency/Long-Term’ scale, which mainly reflects impaired task and goal persistence, was the best discriminator between the groups. Furthermore, ratings on this scale correlated significantly with the error score of a computer-administered task of spatial working memory, the performance of which has been reported to be impaired in patients with ADHD. The results provide further validation for the ADSA scales and support a previous claim that ‘long-term consistencies’, i.e., related to task and goal persistence, is ‘the centrepiece behavioural issue’ for adults with ADHD.
Studies estimating the human health impact of the foodborne disease often include estimates of the number of gastroenteritis hospitalisations. The aims of this study were to examine the degree to which hospital discharge data underreport hospitalisations due to bacterial gastroenteritis and to estimate the frequency of stool sample submission among patients presenting with gastroenteritis. Using linked laboratory and hospital discharge data from a healthcare organisation and its affiliated hospital, we examined the International Classification of Disease (ICD-9-CM) diagnosis codes assigned to hospitalised adults with culture-confirmed Campylobacter, Salmonella, or Escherichia coli O157 infections and determined the frequency of stool sample submission. Among 138 hospitalised patients with culture-confirmed infections, 43% of Campylobacter patients, 56% of Salmonella patients and 35% of E. coli O157 patients had that pathogen-specific code listed on the discharge record. Among patients without their infection listed as a diagnosis, 65% were assigned a nonspecific gastroenteritis code. Submitting a specimen for culture ⩾3 days before discharge was significantly associated with having the pathogen-specific diagnosis listed. Of 6181 patients assigned a nonspecific gastroenteritis code, 69% had submitted a stool sample for bacterial culture. This study can be used to understand differences and adjust for the underreporting and underdiagnosed of Campylobacter, Salmonella and E. coli O157 in hospital discharge and surveillance data, respectively.
The Glasgow area has a combination of highly variable superficial deposits and a legacy of heavy industry, quarrying and mining. These factors create complex foundation and hydrological conditions, influencing the movement of contaminants through the subsurface and giving rise locally to unstable ground conditions. Digital geological three-dimensional models developed by the British Geological Survey are helping to resolve the complex geology underlying Glasgow, providing a key tool for planning and environmental management. The models, covering an area of 3200km2 to a depth of 1.2km, include glacial and post-glacial deposits and the underlying, faulted Carboniferous igneous and sedimentary rocks. Control data, including 95,000 boreholes, digital mine plans and published geological maps, were used in model development. Digital outputs from the models include maps of depth to key horizons, such as rockhead or depth to mine workings. The models have formed the basis for the development of site-scale high-resolution geological models and provide input data for a wide range of other applications from groundwater modelling to stochastic lithological modelling.
The James Webb Space Telescope (JWST) is scheduled for launch in 2018. To operate and observe efficiently, JWST will rely on various external astrometric and photometric catalogues, in particular the HST Guide Star Catalog (GSC), for instance to locate sources accurately on the sky. The incorporation of the Gaia astrometric catalog will improve the absolute astrometry of the GSC and is therefore relevant for JWST operations. We outline how the JWST Science and Operations Center hosted at the Space Telescope Science Institute (STScI) intends to use the Gaia survey results to improve upon operational aspects such as the guiding and the geometric focal plane characterisation of JWST.
A new approach is proposed to analyze Bremsstrahlung X-rays that are emitted from laser-produced plasmas (LPP) and are measured by a stack type spectrometer. This new method is based on a spectral tomographic reconstruction concept with the variational principle for optimization, without referring to the electron energy distribution of a plasma. This approach is applied to the analysis of some experimental data obtained at a few major laser facilities to demonstrate the applicability of the method. Slope temperatures of X-rays from LPP are determined with a two-temperature model, showing different spectral characteristics of X-rays depending on laser properties used in the experiments.
During the Skylab period from June 1973 to January 1974 approximately 1500 type III metre-wave radio bursts or burst groups were reported (Solar Geophysical Data Prompt Reports). The longitudinal distribution of these type III bursts closely resembles that of sunspots and of the coronal transients observed above 2 R⊙ by the white-light coronagraph on Skylab. White light ejection transients appear as large loop or blob-like structures which carry material outward from the Sun and rearrange the corona. In front of the main, bright structures there are weak enhancements of brightness, termed forerunners (Jackson and Hildner 1978; Jackson 1978). In this paper we enquire into whether or not type III bursts are in any way related to the onset of solar mass ejections indicated by coronal transients.
Studies of coronal transients observed in white-light (Gosling et al., 1976) have shown that fast-moving events (≤ 400 km s-1) are closely associated with flares and with type II and IV radio bursts while slow-moving events are not. We now report the first detection of the radio counterpart of a slow-moving transient. The event of 1974 January 21 is shown to be visible on maps of the quiet Sun made at a frequency of 80 MHz.
The principles embodied by the Developmental Origins of Health and Disease (DOHaD) view of ‘life history’ trajectory are increasingly underpinned by biological data arising from molecular-based epigenomic and transcriptomic studies. Although a number of ‘omic’ platforms are now routinely and widely used in biology and medicine, data generation is frequently confounded by a frequency distribution in the measurement error (an inherent feature of the chemistry and physics of the measurement process), which adversely affect the accuracy of estimation and thus, the inference of relationships to other biological measures such as phenotype. Based on empirical derived data, we have previously derived a probability density function to capture such errors and thus improve the confidence of estimation and inference based on such data. Here we use published open source data sets to calculate parameter values relevant to the most widely used epigenomic and transcriptomic technologies Then by using our own data sets, we illustrate the benefits of this approach by specific application, to measurement of DNA methylation in this instance, in cases where levels of methylation at specific genomic sites represents either (1) a response variable or (2) an independent variable. Further, we extend this formulation to consideration of the ‘bivariate’ case, in which the co-dependency of methylation levels at two distinct genomic sites is tested for biological significance. These tools not only allow greater accuracy of measurement and improved confidence of functional inference, but in the case of epigenomic data at least, also reveal otherwise cryptic information.
A synthesis of the upper Moscovian sedimentological and palaeontological record of terrestrial habitats across the Variscan foreland and adjacent intramontane basins (an area which is referred to here as Variscan Euramerica) suggests a contraction and progressive westward shift of the coal swamps. These changes can be correlated with pulses of tectonic activity (tectonic phases) resulting from the northwards migration of the Variscan Front. This tectonic activity caused disruption to the landscapes and drainage patterns where the coal swamps were growing, which became less suitable to growth of the dominant plants of the swamps, the arborescent lycopsids. They were progressively replaced by vegetation dominated by marattialean ferns, which through a combination of slower growth and larger canopies resulted in less evapo-transpiration. This in turn caused localised reductions in rainfall, which further affected the ability of the lycopsids to dominate the swamp vegetation. These changes were initially localised and where the coal swamps were able to survive the lycopsids and pteridosperms show little change in either species diversity or biogeography, indicating that at this time there was minimal regional-scale climate change taking place. By Asturian times, however, the process had accelerated and the swamps in Variscan Euramerica became progressively replaced by predominantly conifer and cordaite vegetation that favoured much drier substrates. Except in localised pockets in intramontane basins of the Variscan Mountains, the last development of coal swamps in Variscan Euramerica was of early Cantabrian age. Further west, lycopsid-dominated coal swamps persisted for a little longer. The last remnants of the lycopsid-dominated coal swamps in the Illinois Basin disappeared probably by middle-late Cantabrian times, as the cycle of contracting wetlands and regional reductions in rainfall generated its own momentum, and no longer needed the impetus of tectonic instability. This tectonically-driven decline in the Euramerican coal swamps was probably responsible for an annual increase in atmospheric CO2 of c. 0.37 ppm, and may have been implicated in the marked increase in global temperatures near the Moscovian – Kasimovian boundary, and the onset of the Late Pennsylvanian interglacial.
We selected and studied 180 pairs with d V < 800 km s−1 and Dp < 60 kpc containing Markarian (MRK) galaxies to investigate the dependence of galaxies integral parameters, star-formation (SF) and active galactic nuclei (AGN) properties on kinematics of pairs, their structure and large-scale environments. Projected radial separation Dp and perturbation level P are better measures of interaction strength than dV. The latter correlates with the density of large-scale environment and with the morphologies of galaxies. Both galaxies in a pair are of the same nature, the only difference is that MRK galaxies are usually brighter than their neighbors. Specific star formation rates (SSFR) of galaxies in pairs with smaller Dp or d V is in average 0.5 dex higher than that of galaxies in pairs with larger Dp or d V. Closeness of a neighbor with the same and later morphological type increases the SSFR, while earlier-type neighbors do not increase SSFR. Major interactions/mergers trigger SF and AGN more effectively than minor ones. The fraction of AGNs is higher in more perturbed pairs and pairs with smaller Dp. AGNs typically are in stronger interacting systems than star-forming and passive galaxies. There are correlations of both SSFRs and spectral properties of nuclei between pair members.
All languages have unexpected or irregular features, and Greek is no exception. For example, the stems of some Greek verbs undergo changes when forming different tenses. In order to deal with this phenomenon, it is important to understand the difference between verbal stems and roots.
The verbal root represents the original stock of a verb, from which most of its forms developed. In other words, a root is the most basic form of a verb. In this textbook, we will indicate these verbal roots with the symbol √. For example, the root of λύω is √ λυ.
This book provides a general introduction to the grammar and syntax of Hellenistic, or New Testament, Greek. With twenty-four chapters, it is suitable for two-semester courses. Each lesson is structured around equipping students to read passages drawn directly from the Greek New Testament. In addition to the traditional Erasmian system, students are offered the option of using a historical Greek system of pronunciation similar to that used in early Christian preaching and prayer. The book includes extensive reference tools, including paradigms for memorization, grammatical appendices and illustrations. The text is accompanied by a website that offers a workbook of passages for translation. Each chapter of the grammar concludes with a vocabulary list of Greek terms that appear in that lesson's assigned passage for translation, found in the online workbook. Audio recordings of all vocabulary words and translation passages, using the historical Greek system of pronunciation, are provided online.
In previous lessons, most of the verbs we have studied have ended in -ω in the first-person singular. This large family of verbs is called the thematic conjugation because the endings are attached to the verbal stem by means of a thematic vowel (e.g., ο/ε in the present tense). It is also called the ω conjugation.
A second major conjugation is called the athematic conjugation because no thematic vowel is used. Athematic verbs are also called -μι verbs because the first-person singular ends with -μι (e.g., εἰμί).