COVID-19 ICU demand forecasting: A two-stage Prophet-LSTM approach.

Recent literature has revealed a growing interest in methods for anticipating the demand for medical items and personnel at hospital, especially during turbulent scenarios such as the COVID-19 pandemic. In times like those, new variables appear and affect the once known demand behavior. This paper investigates the hypothesis that the combined Prophet-LSTM method results in more accurate forecastings for COVID-19 hospital Intensive Care Units (ICUs) demand than both standalone models, Prophet and LSTM (Long Short-Term Memory Neural Network). We also compare the model to well-established demand forecasting benchmarks. The model is tested to a representative Brazilian municipality that serves as a medical reference to other cities within its region. In addition to traditional time series components, such as trend and seasonality, other variables such as the current number of daily COVID-19 cases, vaccination rates, non-pharmaceutical interventions, social isolation index, and regional hospital beds occupation are also used to explain the variations in COVID-19 hospital ICU demand. Results indicate that the proposed method produced Mean Average Errors (MAE) from 13% to 45% lower than well established statistical and machine learning forecasting models, including the standalone models.

Meteorological and human mobility data on predicting COVID-19 cases by a novel hybrid decomposition method with anomaly detection analysis: A case study in the capitals of Brazil.

In 2020, Brazil was the leading country in COVID-19 cases in Latin America, and capital cities were the most severely affected by the outbreak. Climates vary in Brazil due to the territorial extension of the country, its relief, geography, and other factors. Since the most common COVID-19 symptoms are related to the respiratory system, many researchers have studied the correlation between the number of COVID-19 cases with meteorological variables like temperature, humidity, rainfall, etc. Also, due to its high transmission rate, some researchers have analyzed the impact of human mobility on the dynamics of COVID-19 transmission. There is a dearth of literature that considers these two variables when predicting the spread of COVID-19 cases. In this paper, we analyzed the correlation between the number of COVID-19 cases and human mobility, and meteorological data in Brazilian capitals. We found that the correlation between such variables depends on the regions where the cities are located. We employed the variables with a significant correlation with COVID-19 cases to predict the number of COVID-19 infections in all Brazilian capitals and proposed a prediction method combining the Ensemble Empirical Mode Decomposition (EEMD) method with the Autoregressive Integrated Moving Average Exogenous inputs (ARIMAX) method, which we called EEMD-ARIMAX. After analyzing the results poor predictions were further investigated using a signal processing-based anomaly detection method. Computational tests showed that EEMD-ARIMAX achieved a forecast 26.73% better than ARIMAX. Moreover, an improvement of 30.69% in the average root mean squared error (RMSE) was noticed when applying the EEMD-ARIMAX method to the data normalized after the anomaly detection.

Community-based network analyses reveal emerging connectivity patterns of protein-protein interactions in murine melanoma secretome.

Protein-protein interaction networks (PPINs) are static representations of protein connections in which topological features such as subgraphs (communities) may contain proteins functionally related, revealing an additional layer of interactome complexity. We created two PPINs from the secretomes of a paired set of murine melanocytes (a normal melanocyte and its transformed phenotype). Community structures, identified by a graph clustering algorithm, resulted in the identification of subgraphs in both networks. Interestingly, the underlying structure of such communities revealed shared and exclusive proteins (core and exclusive nodes, respectively), in addition to proteins that changed their location within each community (rewired nodes). Functional enrichment analysis of core nodes revealed conserved biological functions in both networks whereas exclusive and rewired nodes in the tumoral phenotype network were enriched in cancer-related processes, including TGFß signaling. We found a remarkable shift in the tumoral interactome, resulting in an emerging pattern which was driven by the presence of exclusive nodes and may represent functional network motifs. Our findings suggest that the rearrangement in the tumoral interactome may be correlated with the malignant transformation of melanocytes associated with substrate adhesion impediment. The interactions found in core and new/rewired nodes might potentially be targeted for therapeutic intervention in melanoma treatment. SIGNIFICANCE: Malignant transformation is a result of synergistic action of multiple molecular factors in which genetic alterations as well as protein expression play paramount roles. During oncogenesis, cellular crosstalk through the secretion of soluble mediators modulates the phenotype of transformed cells which ultimately enables them to successfully disrupt important signaling pathways, including those related to cell growth and proliferation. Therefore, in this work we profiled the secretomes of a paired set of normal and transformed phenotypes of a murine melanocyte. After assembling the two interactomes, clusters of functionally related proteins (network communities) were observed as well as emerging patterns of network rewiring which may represent an interactome signature of transformed cells. In summary, the significance of this study relies on the understanding of the repertoire of 'normal' and 'tumoral' secretomes and, more importantly, the set of interacting proteins (the interactome) in both of these conditions, which may reveal key components that might be potentially targeted for therapeutic intervention.

Community-based network analyses reveal emerging connectivity patterns of protein-protein interactions in murine melanoma secretome

Protein-protein interaction networks (PPINs) are static representations of protein connections in which topological features such as subgraphs (communities) may contain proteins functionally related, revealing an additional layer of interactome complexity. We created two PPINs from the secretomes of a paired set of murine melanocytes (a normal melanocyte and its transformed phenotype). Community structures, identified by a graph clustering algorithm, resulted in the identification of subgraphs in both networks. Interestingly, the underlying structure of such communities revealed shared and exclusive proteins (core and exclusive nodes, respectively), in addition to proteins that changed their location within each community (rewired nodes). Functional enrichment analysis of core nodes revealed conserved biological functions in both networks whereas exclusive and rewired nodes in the tumoral phenotype network were enriched in cancer-related processes, including TGFβ signaling. We found a remarkable shift in the tumoral interactome, resulting in an emerging pattern which was driven by the presence of exclusive nodes and may represent functional network motifs. Our findings suggest that the rearrangement in the tumoral interactome may be correlated with the malignant transformation of melanocytes associated with substrate adhesion impediment. The interactions found in core and new/rewired nodes might potentially be targeted for therapeutic intervention in melanoma treatment. Significance: Malignant transformation is a result of synergistic action of multiple molecular factors in which genetic alterations as well as protein expression play paramount roles. During oncogenesis, cellular crosstalk through the secretion of soluble mediators modulates the phenotype of transformed cells which ultimately enables them to successfully disrupt important signaling pathways, including those related to cell growth and proliferation. Therefore, in this work we profiled the secretomes of a paired set of normal and transformed phenotypes of a murine melanocyte. After assembling the two interactomes, clusters of functionally related proteins (network communities) were observed as well as emerging patterns of network rewiring which may represent an interactome signature of transformed cells. In summary, the significance of this study relies on the understanding of the repertoire of ‘normal’ and ‘tumoral’ secretomes and, more importantly, the set of interacting proteins (the interactome) in both of these conditions, which may reveal key components that might be potentially targeted for therapeutic intervention.

Household crowding, social mixing patterns and respiratory symptoms in seven countries of the African meningitis belt.

OBJECTIVES: To describe the variation in household crowding and social mixing patterns in the African meningitis belt and to assess any association with self-reported recent respiratory symptoms. METHODS: In 2010, the African Meningococcal Carriage Consortium (MenAfriCar) conducted cross-sectional surveys in urban and rural areas of seven countries. The number of household members, rooms per household, attendance at social gatherings and meeting places were recorded. Associations with self-reported recent respiratory symptoms were analysed by univariate and multivariate regression models. RESULTS: The geometric mean people per room ranged from 1.9 to 2.8 between Ghana and Ethiopia respectively. Attendance at different types of social gatherings was variable by country, ranging from 0.5 to 1.5 per week. Those who attended 3 or more different types of social gatherings a week (frequent mixers) were more likely to be older, male (OR 1.27, p<0.001) and live in urban areas (OR 1.45, p<0.001). Frequent mixing and young age, but not increased household crowding, were associated with higher odds of self-reported respiratory symptoms (aOR 2.2, p<0.001 and OR 2.8, p<0.001 respectively). A limitation is that we did not measure school and workplace attendance. CONCLUSION: There are substantial variations in household crowding and social mixing patterns across the African meningitis belt. This study finds a clear association between age, increased social mixing and respiratory symptoms. It lays the foundation for designing and implementing more detailed studies of social contact patterns in this region.

Methods for identifying Neisseria meningitidis carriers: a multi-center study in the African meningitis belt.

OBJECTIVE: Detection of meningococcal carriers is key to understanding the epidemiology of Neisseria meningitidis, yet no gold standard has been established. Here, we directly compare two methods for collecting pharyngeal swabs to identify meningococcal carriers. METHODS: We conducted cross-sectional surveys of schoolchildren at multiple sites in Africa to compare swabbing the posterior pharynx behind the uvula (U) to swabbing the posterior pharynx behind the uvula plus one tonsil (T). Swabs were cultured immediately and analyzed using molecular methods. RESULTS: One thousand and six paired swab samples collected from schoolchildren in four countries were analyzed. Prevalence of meningococcal carriage was 6.9% (95% CI: 5.4-8.6%) based on the results from both swabs, but the observed prevalence was lower based on one swab type alone. Prevalence based on the T swab or the U swab alone was similar (5.2% (95% CI: 3.8-6.7%) versus 4.9% (95% CI: 3.6-6.4%) respectively (p=0.6)). The concordance between the two methods was 96.3% and the kappa was 0.61 (95% CI: 0.50-0.73), indicating good agreement. CONCLUSIONS: These two commonly used methods for collecting pharyngeal swabs provide consistent estimates of the prevalence of carriage, but both methods misclassified carriers to some degree, leading to underestimates of the prevalence.

Detection of Hepatitis B virus subgenotype A1 in a Quilombo community from Maranhão, Brazil.

BACKGROUND: The Brazilian population is mainly descendant from European colonizers, Africans and Native Americans. Some Afro-descendants lived in small isolated communities since the slavery period. The epidemiological status of HBV infection in Quilombos communities from northeast of Brazil remains unknown. The aim of this study was to characterize the HBV genotypes circulating inside a Quilombo isolated community from Maranhão State, Brazil. METHODS: Seventy-two samples from Frechal Quilombo community at Maranhão were collected. All serum samples were screened by enzyme-linked immunosorbent assays for the presence of hepatitis B surface antigen (HBsAg). HBsAg positive samples were submitted to DNA extraction and a fragment of 1306 bp partially comprising HBsAg and polymerase coding regions (S/POL) was amplified by nested PCR and its nucleotide sequence was determined. Viral isolates were genotyped by phylogenetic analysis using reference sequences from each genotype obtained from GenBank (n = 320). Sequences were aligned using Muscle software and edited in the SE-AL software. Bayesian phylogenetic analyses were conducted using Markov Chain Monte Carlo (MCMC) method to obtain the MCC tree using BEAST v.1.5.3. RESULTS: Of the 72 individuals, 9 (12.5%) were HBsAg-positive and 4 of them were successfully sequenced for the 1306 bp fragment. All these samples were genotype A1 and grouped together with other sequences reported from Brazil. CONCLUSIONS: The present study represents the first report on the HBV genotypes characterization of this community in the Maranhão state in Brazil where a high HBsAg frequency was found. In this study, we reported a high frequency of HBV infection and the exclusive presence of subgenotype A1 in an Afro-descendent community in the Maranhão State, Brazil.

Seroprevalence of Kaposi sarcoma-associated herpesvirus and other serologic markers in the Brazilian Amazon.

To determine the presence of Kaposi sarcoma-associated herpesvirus (KSHV) and other serologic markers, we tested serum specimens of 339 Amerindians, 181 rural non-Amerindians, and 1,133 urban blood donors (13 Amerindians) in the Brazilian Amazon. High KSHV seroprevalence in children and inverse association with herpes simplex virus type 2 indicates predominant nonsexual transmission among Amerindians.

Cardiomiopatia induzida pela adriamicina: uma revisão / Adriamycin induced cardiomyopathy: a review

A adriamicina (ADR) encontra-se entre os mais importantes agentes antitumorais utilizados na prática oncológica, desempenhando importante papel no tratamento de diversas neoplasias humanas e animais. Seu valor clínico, porém, torna-se limitado diante de seu potencial cardiotóxico dose-dependente capaz de levar à insuficiência cardíaca congestiva irreversível. Por este motivo, estudos experimentais têm sido desenvolvidos em animais com o objetivo de minimizar tais efeitos por meio do melhor entendimento de seus mecanismos de ação, os quais constituem a chave para o estabelecimento de terapias coadjuvantes preventivas da doença cardíaca. Além disso, a adriamicina também tem sido utilizada em animais experimentais na obtenção de modelos de insuficiência cardíaca e cardiomiopatia dilatada, constituindo meio importante de indução e permitindo estudos fisiopatológicos detalhados de tais alterações. Métodos de monitoração de pacientes são fundamentais para a atenuação das graves complicações inerentes ao tratamento com adriamicina, por meio da associação de drogas cardioprotetoras e da adequação do tratamento de acordo com o risco do paciente em desenvolver sintomas de cardiotoxicidade, durante o tratamento. Nesta revisão, são mencionados conceitos básicos sobre a utilização da adriamicina bem como recentes estudos a respeito de seu mecanismo de ação e modulação, em modelos experimentais.

Molecular characterization of Kaposi's sarcoma associated herpesvirus (KSHV) from patients with AIDS-associated Kaposi's sarcoma in Sao Paulo, Brazil.

BACKGROUND: Kaposi's sarcoma (KS) is caused by Kaposi's sarcoma associated herpesvirus (KSHV/HHV-8), the eighth Herpesvirus found to infect humans. The molecular epidemiology of KSHV is related closely to ethnicity and geographical location of studied populations. There is little epidemiological and molecular information about KSHV strains circulating in Brazil. OBJECTIVES: To characterize KSHV strains isolated from AIDS patients with Kaposi's sarcoma (AIDS-KS) in Sao Paulo, Brazil, and to examine associations between KSHV subtypes, ethnicity and HIV risk categories. METHODS: AIDS-KS patients were recruited consecutively at the largest AIDS reference hospital in Sao Paulo. Fragments (420 bp) of the VR1 and VR2 regions of KSHV open reading frame (ORF) K1 were amplified by nested PCR and sequenced directly. RESULTS: We analysed 37 samples from 33 patients, and found subtypes A-C in 48%, 21% and 30% of patients respectively, including two patients infected with subtype A5, a first report from Brazil. Sexual orientation was associated with subtype: 12/14 (86%) patients with subtype A were male homo/bisexual, compared with 3/8 (38%) among patients infected with subtype C (P = 0.05). A higher proportion of male patients with subtype C were of Caucasian origin (7/8 (87%)), compared with 7/16 (44%) among male patients with subtype A (P = 0.08). CONCLUSIONS: This first detailed report of KSHV subtypes among AIDS-KS patients in Brazil reports the first isolation of KSHV subtype A5 in this country, and suggests KSHV strain transmission between different ethnic groups, and association of specific strains with sexual orientation.

Cytomegalovirus glycoprotein B genotypes and central nervous system disease in AIDS patients.

To investigate any association between cytomegalovirus glycoprotein B (CMV gB) subtypes and central nervous system (CNS) disease in AIDS patients, proportions of different gB genotypes detected in AIDS patients with CNS disease were compared with the gB genotypes detected in AIDS patients with no neurological disorder. The patients were matched by CD4+ cell counts. CMV was detected by PCR in cerebrospinal fluid (CSF) samples obtained from AIDS patients with CNS disease and from urine and saliva samples obtained from AIDS patients without CNS disease. CMV strains obtained were digested by restriction enzymes HinffI and RsaI to classify the genotypes. The CMV gB genotype was determined in 26 CSF samples. Of these, 11/26 (42.3%) typed as gB group 1, seven (26.9%) as gB2, four (15.4%) as gB3, and four (15.4%) as gB4. The CMV gB genotype frequency distribution in the 42 AIDS patients without CNS disease showed that 18/42 (42.8%) were classified as gB group 1, 10 (23.8%) as gB2, seven (16.6%) as gB3, and seven (16.6%) as gB4. In the present study, no association was found between CMV gB genotypes and CMV-related central nervous system disease.