Machine Learning Successfully Detects Patients with COVID-19 Prior to PCR Results and Predicts Their Survival Based on Standard Laboratory Parameters in an Observational Study.

INTRODUCTION: In the current COVID-19 pandemic, clinicians require a manageable set of decisive parameters that can be used to (i) rapidly identify SARS-CoV-2 positive patients, (ii) identify patients with a high risk of a fatal outcome on hospital admission, and (iii) recognize longitudinal warning signs of a possible fatal outcome. METHODS: This comparative study was performed in 515 patients in the Maria Sklodowska-Curie Specialty Voivodeship Hospital in Zgierz, Poland. The study groups comprised 314 patients with COVID-like symptoms who tested negative and 201 patients who tested positive for SARS-CoV-2 infection; of the latter, 72 patients with COVID-19 died and 129 were released from hospital. Data on which we trained several machine learning (ML) models included clinical findings on admission and during hospitalization, symptoms, epidemiological risk, and reported comorbidities and medications. RESULTS: We identified a set of eight on-admission parameters: white blood cells, antibody-synthesizing lymphocytes, ratios of basophils/lymphocytes, platelets/neutrophils, and monocytes/lymphocytes, procalcitonin, creatinine, and C-reactive protein. The medical decision tree built using these parameters differentiated between SARS-CoV-2 positive and negative patients with up to 90-100% accuracy. Patients with COVID-19 who on hospital admission were older, had higher procalcitonin, C-reactive protein, and troponin I levels together with lower hemoglobin and platelets/neutrophils ratio were found to be at highest risk of death from COVID-19. Furthermore, we identified longitudinal patterns in C-reactive protein, white blood cells, and D dimer that predicted the disease outcome. CONCLUSIONS: Our study provides sets of easily obtainable parameters that allow one to assess the status of a patient with SARS-CoV-2 infection, and the risk of a fatal disease outcome on hospital admission and during the course of the disease.

Applicability of the Universal Mixture for describing system suitability and quality of analytical data in routine normal phase High Performance Thin Layer Chromatography methods.

The Universal HPTLC Mixture (UHM) consists of eight substances (guanosine, sulisobenzone, thymidine, paracetamol, phthalimide, 9-hydroxyfluorene, thioxanthen-9-one, and 2-(2H-benzotriazol-2-yl)-4-(1,1,3,3-tetramethylbutyl)phenol) and yields separated zones over the whole RF range for a multitude of developing solvents. Therefore, it could be used in a generic system suitability test (SST) as well as for the verification of quality of HPTLC data. In this work, changes caused by ±10% variation of the volume fractions of the developing solvent components were tested on three developing solvents, to investigate the RF shifts of the UHM zones in comparison to established SSTs and results described for test samples in selected pharmacopeia monographs for identification of herbal drugs. Additionally, one of the developing solvents was investigated with different stationary phases. The components of the UHM showed similar prediction intervals as the substances of established SSTs and specific markers. The UHM could, therefore, be considered for use in an alternative SST. Because it covers the whole RF range, the UHM can detect changes in developing solvent gradients or saturation effects, whereas many established SSTs generally describe only a limited RF range. The use of the UHM can help facilitate automation of HPTLC. Furthermore, it can potentially be used for correlating RF shifts across HPTLC plates. The circumstances, under which this is possible, are discussed.

Development of the first universal mixture for use in system suitability tests for High-Performance Thin Layer Chromatography.

The use of chromatographic methods in routine analysis includes System Suitability Tests (SST). This paper presents a novel approach to SST in HPTLC, which allows qualification of the entire RF range of an HPTLC plate independently of the samples. It is based on the Universal HPTLC mix (UHM), a pre-defined mixture of eight reference substances: guanosine, sulisobenzone, thymidine, paracetamol, phthalimide, 9-hydroxyfluorene, thioxanthen-9-one, and 2-(2H-benzotriazol-2-yl)-4-(1,1,3,3-tetramethylbutyl)phenol, selected to cover a broad range of polarities and functional groups. The chromatographic behavior of the UHM was evaluated for 20 different mobile phases on Silica gel 60 F254. At least three constituents were baseline separated. In a collaborative trial with four laboratories the reproducibility of RF values for three representative mobile phases, was found to be within a confidence interval of 0.040 RF units. The response characteristics of the UHM were assessed with respect to changes in chromatographic conditions, such as variation of the relative humidity, improperly employed saturation, or mistakes in the preparation of the mobile phase. Based on the RF values of the individual constituents significant responses were found for most changes. This qualifies the UHM for use in SST.

Impact of geography and surgical approach on recurrence in global pilonidal sinus disease.

Pilonidal sinus disease (PSD) is increasing globally. A recent meta-analysis and merged-data analysis showed that recurrence rates in PSD depend essentially on follow-up time and specific surgical procedures. However, the global distribution of surgical approaches and respective recurrence rates have never been studied in PSD. We aimed at studying the impact of geographic distribution of surgical approaches to treat PSD and subsequent geography-specific recurrence rates. We searched relevant databases as described previously. Recurrence rates were then associated with reported follow-up times and geographic origin. We simulated individual patients to enable analogy across data. Globally, recurrence rates range from 0.3% for Limberg/Dufourmentel approaches (95% CI 0.2-0.4) and flaps (95% CI 0.1-0.5) and up to 6.3% for incision (95% CI 3.2-9.3) at 12 months. Recurrence rates range from 0.3% for Karydakis/Bascom approaches (95% CI 0.0-0.8) up to 67.2% for incision (95% CI 7.5-100) in the USA, and 0.0% for primary asymmetric closure in Germany (95% CI 0.0-0.0). Our analysis shows that recurrence rates in PSD not only depend on therapeutic approaches and follow-up time but also on geography. Primary asymmetric closure and various flap techniques remain superior regardless of the geographical region. Some approaches have extraordinarily good outcomes in specific countries.

Unveiling Excited-State Chirality of Binaphthols by Femtosecond Circular Dichroism and Quantum Chemical Calculations.

Time-resolved circular dichroism (TR-CD) is a powerful tool for probing conformational dynamics of biomolecules over large time scales that are crucial for establishing their structure-function relationship. However, such experiments, notably in the femtosecond regime, remain challenging due to their extremely weak signals, prone to polarization artifacts. By using binol and two bridged derivatives (PL1 and PL2) as chiral prototypes, we present here the first comprehensive study of this type in the middle UV, combining femtosecond TR-CD and quantum mechanical calculations (TD-DFT). We show that excitation of the three compounds induces large variations of their transient CD signals, in sharp contrast to those of their achiral transient absorption. We demonstrate that these variations arise from both the alteration of the electronic distribution and the dihedral angle in the excited state. These results highlight the great sensitivity of TR-CD detection to signals hardly accessible to achiral transient absorption.

Generating laser-pulse enantiomers.

We present an optical setup capable of mirroring an arbitrary, potentially time-varying, polarization state of an ultrashort laser pulse. The incident beam is split up in two and the polarization of one beam is mirrored by reflection off a mirror in normal incidence. Afterwards, both beams are recombined in time and space such that two collinear ultrashort laser pulses with mutually mirrored polarization, i.e., laser-pulse enantiomers, leave the setup. We employ the Jones formalism to describe the function of the setup and analyze the influence of alignment errors before describing the experimental implementation and alignment protocol. Since no wave plates are utilized, broadband pulses in a large wavelength range can be processed. In particular, we show that the setup outperforms broadband achromatic wave plates. Furthermore, since the two beams travel separately through the optical system they can be blocked independently. This opens the possibility for circular dichroism, ellipsometry, and anisotropy spectroscopy with shot-to-shot chopping and detection schemes as well as chiral coherent control applications.

Association of sports club participation with fitness and fatness in children.

UNLABELLED: Decreased fitness and increased fatness are relevant factors for decreased cardiovascular and bone health in children. One way to increase physical activity and hence fitness and to reduce the risk for overweight might be sports club participation (SCP). PURPOSE: To investigate the association of SCP with fatness and fitness in children in general and in those with increased risk for overweight and/or low fitness. METHODS: A cross-sectional study was conducted in a random sample of 502 first- and fifth-grade primary school children. Fitness components were determined by 10 motor tests and body fatness by the sum of four skinfolds. SCP was defined as participation of at least once a week. RESULTS: Two thirds of all children were participating in a sports club. Girls' and boys' participation rate as well as those of overweight children and of children with overweight parents were comparable to their respective normal weight peers. In contrast, children from migrant families (odds ratio = 0.31; 95% confidence interval = 0.20-0.48) and from inactive parents (odds ratio = 0.16; 95% confidence interval = 0.05-0.45) participated significantly less (all P < 0.001). SCP was associated with endurance (0.53 > beta > 0.37, all P < 0.05) and partly with speed, strength, and coordination (0.41 > beta > 0.18, all P < 0.05). In overweight children and in children from overweight parents and migrant families, this association was not found. There was no association between SCP and fatness in any of the groups. CONCLUSIONS: SCP rates were high and were associated with higher levels of most fitness components in children. Participation rates were lower for children of migrant families and children from inactive parents. In addition, the association between SCP and fitness components was not found in overweight children and in children from overweight parents and migrant families.

A school-based physical activity program to improve health and fitness in children aged 6-13 years ("Kinder-Sportstudie KISS"): study design of a randomized controlled trial [ISRCTN15360785].

BACKGROUND: Childhood obesity is the result of a long lasting imbalance between energy intake and energy expenditure. A major contributing factor is physical inactivity which is closely linked to bone health, cardiovascular disease risk, fitness and psychological factors. The school seems to provide an excellent setting to enhance levels of physical activity (PA). However, there is insufficient data from previous school-based intervention trials on how to enhance overall PA. It is also unknown whether an intervention aimed at increasing PA is effective in improving the children's health. The purpose of this paper is to outline the design of a school-based randomized, controlled trial (RCT) aiming to increase overall PA and to improve fitness and health in 6- to 13-year-old children. METHODS/DESIGN: 15 schools were randomized to the intervention (n = 9) or the control (n = 6) group, stratified by geographic region (urban vs. rural) and by age (1st and 5th grade). Participation was given for all children in the intervention group since in this group the intervention was part of the normal school curriculum. The intervention during one academic year consisted of: 1. two additional physical education classes per week given by trained physical education teachers adding up to a total of five PA classes per week, 2. short PA breaks (2-5 min each) during academic lessons, 3. PA home work, and 4. adaptation of recreational areas around the school. All children underwent anthropometric measurements, blood pressure assessment, fitness testing, measurement of PA and they filled out questionnaires. At least 70% of all children agreed to blood sampling and measurements of body composition and bone mineral measurements by dual energy x-ray absorptiometry. The primary endpoints of the study after one year were an increase in total PA by accelerometry, an increase in aerobic fitness measured by the 20 m shuttle run, a decrease in percent body fat derived from skinfold measurements and an increase in quality of life as assessed by the child health questionnaire in the intervention group compared to the control group. Secondary outcomes were overall fitness, differences in body composition including body fat distribution, cardiovascular risk factors, psychosocial health, bone mineral content and density of femur, lumbar spine and total body and food intake. DISCUSSION: Our preliminary data suggest that the children were representative of Swiss children with respect to sex, socio-demographic status, and body mass index. Short-term results can be expected by the beginning of 2007. We hypothesized that our intervention will lead to an increase in PA, fitness and overall health. Based on our data, we aim to provide important information regarding the influence of such an intervention on these outcome measures in school-aged children and to provide nationwide guidelines to improve PA in children.