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[ABSTRACT]A pneumonia outbreak caused by a novel coronavirus (COVID-19) occurred in Wuhan, China at the end of 2019 and then spread rapidly to the whole country. A total of 81,498 laboratory-confirmed cases, including 3,267 deaths (4.0%) had been reported in China by March 22, 2020, meanwhile, 210,644 laboratory-confirmed cases and 9,517 deaths (4.5%) were reported outside China. Common symptoms of COVID-19 pneumonia included fever, fatigue and dry cough. In face of such a sudden outbreak of emerging novel infectious diseases, we have no history to learn from and no evidence to count on. Traditional models often predict inconsistent results. There is an urgent need to establish a practical data-driven method to predict the evolutionary trend of the epidemic, track and prejudge the current epidemic situation after the COVID-19 outbreak. Here we propose a simple, directly and generally applicable index and we name it epidemic evaluation index (EEI), which is constructed by 7-day moving average of the log-transformed daily new cases (LMA). EEI could be used to support the decision-making process and epidemic prevention and control strategies through the evaluation of the current epidemic situation. First, we used SARS epidemic data from Hong Kong in 2003 to verify the practicability of the new index, which shows that the index is acceptable. The EEI was then applied to the COVID-19 epidemic situation analysis. We found that the trend direction of different districts in China changed on different date during the epidemic. At the national level and at local Hubei Province level, the epidemic both peaked on February 9. While the peak occurred relatively earlier, i.e. on February 5 in other provinces. It demonstrated the effectiveness of decisive action and implementations of control measures made by Chinese governments. While local governments should adjust management measures based on local epidemic situation. Although the epidemic has eased since late February, continued efforts in epidemic control are still required to prevent transmission of imported cases in China. However, the global COVID-19 epidemic outside China continues to expand as indicated by the EEI we proposed. Currently, efforts have been made worldwide to combat the novel coronavirus pandemic. People all over the world should work together and governments of all countries should take efficient measures in the light of Chinas experience and according to national circumstances and local conditions.
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Objective To evaluate the solute clearance characteristics of REXEEDTM series dialyzers during high-flux dialysis, and explore the care characteristics. Methods A randomized crossover study of 3×3 Latin square was designed based on different dialyzers. Eighteen patients with regular hemodialysis underwent dialysis with REXEEDTM-15AC dialyzer, REXEEDTM-15UC dialyzer and controlled APS-15U dialyzer, respectively. Blood samples were obtained from the blood flow entrance and exit of dialyzers, levels of urea nitrogen, creatinine, phosphate and β2-microglobulin were detected, and solute clearance rates were calculated. Before and after the third dialysis with each dialyzer, blood samples were obtained to measure the levels of urea nitrogen and creatinine, and the rates of decrease were calculated. The vital signs of each patient were intensively observed, and the venous pressure and transmembrane pressure were monitored from the dialyzers. Results The urea nitrogen clearance rates of REXEEDTM-15AC dialyzer and REXEEDTM-15UC dialyzer were significantly higher than that of APS-15U dialyzer (P<0.05). The creatinine clearance rate of REXEEDTM-15AC dialyzer was significantly higher than that of APS-15U dialyzer(P<0.05). There was no significant difference in the rate of decrease in blood urea nitrogen among different dialyzers of the same patient(>65 % for all patients). The vital signs were stable with no adverse events during dialysis, and there was no abnormal findings in laboratory security parameters. Conclusion REXEEDTM series dialyzers are effective and safe for clinical application. Great importance should be attached to the complaints from patients during dialysis. For those with less ultrafiltration, fluid as well as uhrafiltration should be supplemented to increase the transmembrane pressure.
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Rates of caesarean section are of concern in both developed and developing countries. We set out to estimate the proportion of births by caesarean section (CS) at national, regional and global levels, describe regional and subregional patterns and correlate rates with other reproductive health indicators. We analysed nationally representative data available from surveys or vital registration systems on the proportion of births by CS. We used local non-parametric regression techniques to correlate CS with maternal mortality ratio, infant and neonatal mortality rates, and the proportion of births attended by skilled health personnel. Although very unevenly distributed, 15% of births worldwide occur by CS. Latin America and the Caribbean show the highest rate (29.2%), and Africa shows the lowest (3.5%). In developed countries, the proportion of caesarean births is 21.1% whereas in least developed countries only 2% of deliveries are by CS. The analysis suggests a strong inverse association between CS rates and maternal, infant and neonatal mortality in countries with high mortality levels. There is some suggestion of a direct positive association at lower levels of mortality. CS levels may respond primarily to economic determinants.
