Beyond scale-free networks: integrating multilayer social networks with molecular clusters in the local spread of COVID-19.

This study evaluates the scale-free network assumption commonly used in COVID-19 epidemiology, using empirical social network data from SARS-CoV-2 Delta variant molecular local clusters in Houston, Texas. We constructed genome-informed social networks from contact and co-residence data, tested them for scale-free power-law distributions that imply highly connected hubs, and compared them to alternative models (exponential, log-normal, power-law with exponential cutoff, and Weibull) that suggest more evenly distributed network connections. Although the power-law model failed the goodness of fit test, after incorporating social network ties, the power-law model was at least as good as, if not better than, the alternatives, implying the presence of both hub and non-hub mechanisms in local SARS-CoV-2 transmission. These findings enhance our understanding of the complex social interactions that drive SARS-CoV-2 transmission, thereby informing more effective public health interventions.

How well controlled are our type 2 diabetic patients in 2002? An observational study in North and Central Trinidad.

OBJECTIVES: To determine the proportion of diabetic patients that achieved glycemic control (HbA1c pound7.0%) and to explore some of the barriers to achieve this control. DESIGN: Cross-sectional, observational study. SETTING: Health centres in North and Central Trinidad. PATIENTS: One hundred and thirty-two type 2 diabetics attending the health centres for more than 1 year. MAIN OUTCOME MEASURES: HbA1c levels and the proportion of patients who achieve glycemic control, HbA1c pound7.0%. RESULTS: The patients were categorized into two groups: well controlled, HbA1c Y7.0% and poorly controlled, HbA1c>7.0%. The majority of patients were poorly controlled (55.3%), duration of diabetes impacted negatively older patients and patients attending the clinics for longer periods were less likely to be well controlled. There was no correlation between pharmacological treatment, availability of individual counselling by a dietician or regular monitoring of blood glucose and glycemic control (p>0.05). CONCLUSION: A 44.7% of patients with type 2 diabetes were found to be well controlled. Old age (51-70 years) and lengthy periods of attendance seem to be barriers to achieving glycemic control. This study highlights the fact that there is a need for re-evaluation of the diabetic program since despite changes in the primary care system over the past 5 years a large proportion of diabetics are still uncontrolled.