Notes

Endometriosis Medical procedures through the 1st Say with the COVID-19 Crisis: A Brazil One Institution Experience.
icantly affect anticoagulants doses.

Prescription of anticoagulation is quite variable in patients admitted to ICU for Covid-19 associated ARDS. Anticoagulation dosing strategy has no significant effect on 28-day survival, LOSICU, the occurrence of DVT, PE, or bleeding.
Prescription of anticoagulation is quite variable in patients admitted to ICU for Covid-19 associated ARDS. Anticoagulation dosing strategy has no significant effect on 28-day survival, LOSICU, the occurrence of DVT, PE, or bleeding.
As of June 15, 2020, a cumulative total of 7,823,289 confirmed cases of COVID-19 have been reported across 216 countries and territories worldwide. However, there is little information on the clinical characteristics and outcomes of critically ill patients with severe COVID-19 who were admitted to intensive care units (ICUs) in Latin America. The present study evaluated the clinical characteristics and outcomes of critically ill patients with severe COVID-19 who were admitted to ICUs in Mexico.

This was a multicenter observational study that included 164 critically ill patients with laboratory-confirmed COVID-19 who were admitted to 10 ICUs in Mexico, from April 1 to April 30, 2020. Demographic data, comorbid conditions, clinical presentation, treatment, and outcomes were collected and analyzed. The date of final follow-up was June 4, 2020.

A total of 164 patients with severe COVID-19 were included in this study. The mean age of patients was 57.3 years (SD 13.7), 114 (69.5%) were men, and 6.0% were healced in-hospital mortality risk (OR, 0.89; 95% CI, 0.84-0.94; p<0.001).

This observational study of critically ill patients with laboratory-confirmed COVID-19 who were admitted to the ICU in Mexico demonstrated that age and C-reactive protein level upon ICU admission were associated with in-hospital mortality, and the overall hospital mortality rate was high.

ClinicalTrials.gov, NCT04336345.
ClinicalTrials.gov, NCT04336345.Achieving robust longitudinal speed control for hybrid electric vehicles (HEVs) through precise position tracking of electric throttle control system (ETCS) can improve engine fuel economy and vehicle longitudinal speed performance. Whereas, nonlinearities resulting from friction, gearbox, and return springs of ETCS, uncertain system parameters related to production deviations and device aging, disturbance from the air flow fluctuation on the throttle plate, and unknown road grade and uncertain preceding vehicle acceleration make control design challenging. Aiming at this issue, a speed cascade control scheme considering car-following scenario is investigated for a parallel ETCS controlled HEV in this paper, of which contains a primary speed adaptive controller and a secondary electronic throttle adaptive nonlinear active disturbance rejection controller with the adaptive gains extended state observer. The distinction from the existing relevant literatures is that the inherent characteristics of nonlinearity and uncertainty in the ETCS and longitudinal velocity kinematics, and the car following scenarios are explicitly taken into account in the design of the cascade control for ETCS controlled HEVs. Both simulation and rapid-control-prototype (RCP) experimental results demonstrate the effectiveness and practicality of the proposed scheme and the advantages over other existing research strategies.
Preoperative nutritional and inflammatory indices have been reported to be associated with the prognosis of patients with malignancy. We evaluated clinicopathological factors, including nutritional and inflammatory indices, and recurrence prognosis in patients with stage IIA colon cancer (CC) who underwent curative surgery.

This retrospective study included 197 patients with stage IIA CC who had undergone curative resection. We evaluated the association between prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) with clinicopathological factors and prognosis for recurrence. For the recurrence-free survival (RFS) analysis, receiver operating characteristic (ROC) curves were used to determine appropriate cutoff values for PNI, NLR, and PLR.

Univariate analyses showed that PNI<44.8 (P=0.028) was significantly associated with worse RFS in patients with stage IIA CC patients. In the multivariate analyses, PNI<44.8 (hazard ratio [HR] 2.082; 95% confidence interval [CI] 1.005-4.317; P=0.049) independently and significantly predicted RFS.

PNI is a useful marker for predicting recurrence prognosis in post-resection patients with stage IIA CC.
PNI is a useful marker for predicting recurrence prognosis in post-resection patients with stage IIA CC.
Polypharmacy is common and closely linked to drug interactions. The impact of polypharmacy has not been previously quantified in survivors of critical illness who have reduced resilience to stressors. Our aim was to identify factors associated with preadmission polypharmacy and ascertain whether polypharmacy is an independent risk factor for emergency readmission to hospital after discharge from a critical illness.

A population-wide cohort study consisting of patients admitted to all Scottish general ICUs between January 1, 2011 and December 31, 2013, whom survived their ICU stay. Patients were stratified by presence of preadmission polypharmacy, defined as being prescribed five or more regular medications. The primary outcome was emergency hospital readmission within 1 yr of discharge from index hospital stay.

Of 23 844 ICU patients, 29.9% were identified with polypharmacy (n=7138). Factors associated with polypharmacy included female sex, increasing age, and social deprivation. Emergency 1-yr hospitalsk post-intensive care population.
Traditional formulas to calculate pulse pressure variation (PPV) cannot be used in patients with atrial fibrillation (AF). We have developed a new algorithm that accounts for arrhythmia-induced pulse pressure changes, allowing us to isolate and quantify ventilation-induced pulse pressure variation (VPPV). The robustness of the algorithm was tested in patients subjected to altered loading conditions. We investigated whether changes in VPPV imposed by passive leg raising (PLR) were proportional to the pre-PLR values.

Consenting patients with active AF scheduled for an ablation of the pulmonary vein under general anaesthesia and mechanical ventilation were included. Loading conditions were altered by PLR. ECG and invasive pressure data were acquired during 60 s periods before and after PLR. A generalised additive model was constructed for each patient on each observation period. The impact of AF was modelled on the two preceding RR intervals of each beat (RR
and RR
). The impact of ventilation and the long-term pulse pressure trends were modelled as separate splines. Ventilation-induced pulse pressure variation was defined as the percentage of the maximal change in pulse pressure during the ventilation cycle.

Nine patients were studied. The predictive abilities of the models had a median r
of 0.92 (inter-quartile range 89.2-94.2). Pre-PLR VPPV ranged from 0.1% to 27.9%. After PLR, VPPV decreased to 0-11.3% (P<0.014). The relation between the Pre-PLR values and the magnitude of the changes imposed by the PLR was statistically significant (P<0.001).

Our algorithm enables quantification of VPPV in patients with AF with the ability to detect changing loading conditions.
Our algorithm enables quantification of VPPV in patients with AF with the ability to detect changing loading conditions.The purpose of this study was to examine and quantify spatial mobility among HIV-negative young men who have sex with men (YMSM) within and across high prevalence HIV neighborhoods in New York City (NYC). We completed an analysis with global positioning system (GPS) and survey data to quantify spatial mobility for participants enrolled in the P18 Neighborhood Study (analytic n = 211; 83.4%). Spatial mobility was documented with self-reported survey data and objective GPS data, which was uncorrelated. Nearly one-quarter of participants (26.1%) said that they consider the neighborhood in which they currently live to differ from the neighborhood in which they had sex most frequently. In addition, 62.9% of participants' GPS points were recorded in NYC ZIP Code Tabulation Areas within the highest quartile of HIV prevalence. Future studies of YMSM populations should be conducted to examine how environments beyond the residential neighborhood can influence sexual health, which may guide HIV prevention services.Disease surveillance data are important for monitoring disease burden and occurrence, and for informing a wide range of efforts to improve population health. Surveillance for infectious diseases may be conducted passively, relying on reports from healthcare facilities, or actively, involving surveys of the population at risk. Passive surveillance typically provides wide spatial coverage, but is subject to biases arising from differences in care-seeking behavior, diagnostic practices, and under-reporting. Active surveillance minimizes these biases, but is typically constrained to small areas and subpopulations due to resource limitations. Methods based on linkage of individual records between passive and active surveillance datasets provide a means to estimate and correct for the biases of each system, leveraging the size and coverage of passive surveillance and the quality of data in active surveillance. We develop a spatial Bayesian hierarchical model for bias-correcting data from both systems to yield an improved estimate of disease measures after adjusting for under-ascertainment. We apply the framework to data from a passive and an active surveillance system for pulmonary tuberculosis (PTB) in Sichuan, China, and estimate the average sensitivity of the active surveillance system at 70% (95% credible interval 62%, 78%), and the passive system at 30% (95% CI 24%, 35%). read more Passive surveillance sensitivity exhibited considerable spatial variability, and was positively associated with a site's gross domestic product per capita. Bias-corrected estimates of county-level PTB prevalence in the province in 2010 identified regions in the southeast with the highest PTB burden, yielding different geographic priorities than previous reports.This study used spatiotemporal hot-spot analysis to characterize physical activity on the childcare center playground. Preschool-aged children (N = 34) wore a GPS and accelerometer during 2-3 outdoor periods on one day. A spatiotemporal weights matrix was generated so that points within a specified distance in meters (space) and 3 min (time) were considered neighbors. The Getis-Ord G* statistic was calculated to detect locations of significant hot/cold spots in vector magnitude counts/15‑sec. Hot/cold spots changed within a single outdoor period and between outdoor periods, highlighting the importance of time. This approach can be used to identify points of intervention during provided outdoor time.The effect that traffic congestion has on the service areas of stroke centers has received scarce attention. We aimed to determine the effect of traffic conditions on the characteristics of service areas of stroke centers in Bogotá, Colombia. Using a webservice, we sampled travel times from a set of census blocks to medical centers offering stroke management in the city. We obtained 179.340 transport times under different conditions. The size of service areas was reduced significantly with congestion (up to 94.83%). Overlap in the locations of centers led to large areas covered by only five centers. We identified areas with transport times to the closest center consistently exceeding 30-minutes to 1-hour in the west and south-west. Traffic conditions in Bogotá significantly affect service areas of centers capable of offering comprehensive stroke care. Spatial overlap of centers led to small catchment areas.
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