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1.
BMC Bioinformatics ; 21(Suppl 14): 359, 2020 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-32998692

RESUMO

BACKGROUND: The abundance of molecular profiling of breast cancer tissues entailed active research on molecular marker-based early diagnosis of metastasis. Recently there is a surging interest in combining gene expression with gene networks such as protein-protein interaction (PPI) network, gene co-expression (CE) network and pathway information to identify robust and accurate biomarkers for metastasis prediction, reflecting the common belief that cancer is a systems biology disease. However, controversy exists in the literature regarding whether network markers are indeed better features than genes alone for predicting as well as understanding metastasis. We believe much of the existing results may have been biased by the overly complicated prediction algorithms, unfair evaluation, and lack of rigorous statistics. In this study, we propose a simple approach to use network edges as features, based on two types of networks respectively, and compared their prediction power using three classification algorithms and rigorous statistical procedure on one of the largest datasets available. To detect biomarkers that are significant for the prediction and to compare the robustness of different feature types, we propose an unbiased and novel procedure to measure feature importance that eliminates the potential bias from factors such as different sample size, number of features, as well as class distribution. RESULTS: Experimental results reveal that edge-based feature types consistently outperformed gene-based feature type in random forest and logistic regression models under all performance evaluation metrics, while the prediction accuracy of edge-based support vector machine (SVM) model was poorer, due to the larger number of edge features compared to gene features and the lack of feature selection in SVM model. Experimental results also show that edge features are much more robust than gene features and the top biomarkers from edge feature types are statistically more significantly enriched in the biological processes that are well known to be related to breast cancer metastasis. CONCLUSIONS: Overall, this study validates the utility of edge features as biomarkers but also highlights the importance of carefully designed experimental procedures in order to achieve statistically reliable comparison results.


Assuntos
Biomarcadores Tumorais/metabolismo , Neoplasias da Mama/patologia , Máquina de Vetores de Suporte , Área Sob a Curva , Neoplasias da Mama/genética , Feminino , Redes Reguladoras de Genes/genética , Humanos , Modelos Logísticos , Metástase Neoplásica , Mapas de Interação de Proteínas/genética , Curva ROC
2.
Nat Commun ; 11(1): 5033, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33024092

RESUMO

Soaring cases of coronavirus disease (COVID-19) are pummeling the global health system. Overwhelmed health facilities have endeavored to mitigate the pandemic, but mortality of COVID-19 continues to increase. Here, we present a mortality risk prediction model for COVID-19 (MRPMC) that uses patients' clinical data on admission to stratify patients by mortality risk, which enables prediction of physiological deterioration and death up to 20 days in advance. This ensemble model is built using four machine learning methods including Logistic Regression, Support Vector Machine, Gradient Boosted Decision Tree, and Neural Network. We validate MRPMC in an internal validation cohort and two external validation cohorts, where it achieves an AUC of 0.9621 (95% CI: 0.9464-0.9778), 0.9760 (0.9613-0.9906), and 0.9246 (0.8763-0.9729), respectively. This model enables expeditious and accurate mortality risk stratification of patients with COVID-19, and potentially facilitates more responsive health systems that are conducive to high risk COVID-19 patients.


Assuntos
Infecções por Coronavirus/mortalidade , Aprendizado de Máquina , Pandemias , Pneumonia Viral/mortalidade , Idoso , Betacoronavirus , China/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Redes Neurais de Computação , Medição de Risco , Máquina de Vetores de Suporte
3.
An. psicol ; 36(2): 304-312, mayo 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192067

RESUMO

For almost a century now, the concern of universities about student satisfaction with teaching quality has been increasing. A literature review has enabled the attributes of quality teaching to be classified into three main types: pedagogical, generic, and disciplinary. The aim of this paper is to identify the variables that, in the opinion of students, most influence student satisfaction regarding teaching quality. A total of 476 undergraduate students participated from Business Administration and Management of the University of Castilla-La Mancha (Spain). An ad hoc questionnaire was used to assess student satisfaction with teaching. Parametric (Logistic Regression Analysis) and non-parametric (Decision Tree) models were used. Our data indicate that if the professor explains the subject clearly, is concerned to find out whether the explanations have been understood, and carefully prepares the classes; the teaching-quality assessment will be very satisfactory. The identification of the attributes of quality teaching will enable universities to draw up initial and ongoing training plans for their teaching staff, bearing in mind the crucial role played by generic, pedagogical, and disciplinary competences in professor-student interaction


Desde hace casi un siglo la preocupación de las universidades sobre la satisfacción de los estudiantes con la calidad de la docencia recibida se ha ido incrementando. La revisión de la literatura permite clasificar los atributos de una docencia de calidad en tres grandes tipos de competencias: pedagógicas, genéricas y disciplinares. El objetivo de este trabajo es señalar las variables, que a juicio de los estudiantes, más influyen en la satisfacción del alumnado con la calidad de la docencia. Los participantes fueron 476 estudiantes del grado de Administración y Dirección de Empresas de la Universidad Castilla La Mancha. Se utilizó un cuestionario construido ad hoc para valorar la satisfacción de los estudiantes con la docencia. Se utilizaron pruebas paramétricas (Análisis de Regresión Logística) y no paramétricas (árbol de decisión). Nuestros datos indican que si el profesor explica con claridad, se preocupa por averiguar si los conceptos explicados han sido entendidos y prepara sus clases la valoración sobre la calidad de su docencia será muy satisfactoria. El identificar los atributos de una docencia de calidad permitirá a las universidades elaborar planes de formación inicial y permanente de su profesorado teniendo presente el papel crucial que juegan las competencias genéricas, pedagógicas y disciplinares en la interacción profesor-estudiante


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Docentes , Satisfação Pessoal , Estudantes/psicologia , Educação , Competência Profissional , Universidades , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Árvores de Decisões , Modelos Logísticos , Curva ROC
4.
Hipertens. riesgo vasc ; 37(3): 108-114, jul.-sept. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193519

RESUMO

INTRODUCCIÓN Y OBJETIVOS: Las alteraciones del sistema nervioso autónomo fueron propuestas como precursoras en la génesis y perpetuación de la aterosclerosis hace ya mucho tiempo. Nuestro objetivo fue determinar si existe asociación entre la presencia de aterosclerosis carotídea y la función autonómica evaluada mediante la variabilidad de la frecuencia cardíaca. MÉTODOS: A través de un estudio prospectivo de casos y controles investigamos la variabilidad de la frecuencia cardíaca en 5 min y la presencia de aterosclerosis carotídea mediante ultrasonografía en 54 pacientes que dividimos en 2 grupos según la presencia (+) o ausencia (−) de placas ateroscleróticas en carótidas (ATE). Se analizó la variabilidad de frecuencia cardíaca en dominio de frecuencia en el espectro de alta frecuencia, baja frecuencia, cociente alta/baja frecuencia y potencia espectral total. RESULTADOS: Sobre una población de 54 individuos sin enfermedad cardiovascular establecida evaluados en forma consecutiva, se detectaron 26 individuos (48%) portadores de ATE+. Se observó una reducción en la variabilidad de la frecuencia cardíaca en el grupo ATE+ representada por el espectro de baja frecuencia (LF) (p < 0,0001). La actividad parasimpática específicamente representada por el componente espectral de alta frecuencia también resultó menor en el grupo ATE+en análisis univariado (p < 0,0001) al igual que la potencia espectral total (p < 0,0001), un índice de regulación autonómica integral. No se encontraron diferencias significativas cuando se analizó el balance autonómico de baja y alta frecuencia (LF/HF) (p = 0,1598). En un modelo de regresión logística solo la presión arterial sistólica y el poder espectral total resultaron predictores independientes de ATE+. CONCLUSIÓN: Verificamos una disminución en la variabilidad de la frecuencia cardíaca en sujetos con aterosclerosis carotídea, que se estableció tanto a través de sus componentes espectrales como de la potencia espectral total, no así a través de la valoración del balance autonómico. La potencia espectral total, en principio, sería un método correcto de evaluación autonómica en este grupo de pacientes


INTRODUCTION AND OBJECTIVES: Alterations of the sympathetic and parasympathetic nervous system have been proposed as precursors of the genesis and perpetuation of atherosclerosis for a long time. The objective of this study is to determine if there is an association between the presence of carotid atherosclerosis and the reduction in heart rate variability. METHODS: Using a prospective case-control design, the heart rate variability and the presence of carotid atherosclerosis was investigated in 54 patients, divided into 2 groups according to the presence or absence of carotid atherosclerosis. An analysis was made of the heart rate variability variables of the frequency (spectral) domain in high frequency band, low frequency band, parasympathetic autonomic balance, and the total spectral band. RESULTS: Of the 54 individuals evaluated without previous cardiovascular disease consecutively, 26 of them (48%) presented with subclinical carotid atherosclerosis (ATE+). A reduction in heart rate variability was observed in the ATE+group represented by the low frequency (LF) spectrum (P < .0001). The parasympathetic activity specifically represented in the high frequency (HF) band was also lower in the ATE+group in the univariate analysis (P < .0001), same as the total spectral power (P < .0001), an index of integral autonomic regulation. No significant differences were found in the LF/HF analysis (P = .1598). After analysing variables with significant differences in the univariate analysis with a logistic regression model, only systolic blood preassure and the total spectral power were shown to be independent predictors of ATE+. CONCLUSION: A reduction in heart rate variability was found in subjects with carotid atherosclerosis. Some spectral components of heart rate variability, like low frequency or total spectral power, were better predictors of carotid atherosclerosis than the parasympathetic autonomic balance. In this study it seems that total spectral power is an adequate measurement for analysing autonomic function


Assuntos
Humanos , Masculino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Doenças do Sistema Nervoso Autônomo/diagnóstico , Sistema Nervoso Autônomo/fisiopatologia , Frequência Cardíaca , Aterosclerose/diagnóstico por imagem , Estudos de Viabilidade , Estudos Prospectivos , Modelos Logísticos , Pressão Sanguínea , Estudos de Casos e Controles , Antropometria , Hipolipemiantes/uso terapêutico , Índice de Massa Corporal , Hipertensão/terapia , Fatores de Risco
5.
J UOEH ; 42(3): 281-290, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32879193

RESUMO

The purpose of this study is to investigate and clarify the relationships between occupational stress, personal factors, buffer factors and stress responses of newly graduated nurses, based on the NIOSH model. A questionnaire survey was conducted on 320 newly graduated nurses working at university hospitals where research cooperation was obtained. Data from 107 people was collected by mail (the response rate of 33.4%). In the results of the analysis, the GHQ-12 scores of the nurses on the three-shift system (23.5 ± 7.04) were found to be higher than those on the two-shift system (18.88 ± 6.03) (P = 0.007). The GHQ-12 score was significantly higher in the high stressor group (24.1 ± 6.20), who had higher job demand and lower work ratings than the low stressor group (18.93 ± 6.14) (P = 0.001, t = -3.44). The results of a multiple logistic regression analysis using high/low GHQ groups defined by a cut-off point of 4 in the GHQ-12 (GHQ method) as the dependent variables and the associated variables as the independent variables showed that the basic role identity and colleague support were found to have a significant relationship. The results of a Hosmer-Lemeshow test were P = 0.643, and the coefficient of determination was as high as 81.0%. This study was conducted approximately 6 months after the nurses entered employment, which is in the middle of the critical transition period from a student to a working member of society and can be assumed to be the most exhausting state of the year both physically and mentally. The results of this study suggest that various stressors might cause serious stress reactions. Also, as shown in previous literature, newly graduated nurses tend not to seek support from their bosses or preceptors throughout the year. Their main sources of support are family members, friends, and colleagues. Taken together, it became clear from our study that support from colleagues in the workplace is the most powerful buffer against stress and an indispensable resource to overcome the "reality shock" of working life.


Assuntos
Saúde Mental , Enfermeiras e Enfermeiros/psicologia , Saúde do Trabalhador , Estresse Ocupacional , Local de Trabalho/psicologia , Adolescente , Feminino , Humanos , Modelos Logísticos , Masculino , Admissão e Escalonamento de Pessoal , Apoio Social , Inquéritos e Questionários , Carga de Trabalho/psicologia , Adulto Jovem
6.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(8): 1266-1271, 2020 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-32867434

RESUMO

Objective: To study the association of duration and quality of sleep with metabolic syndrome. Methods: Multi-stage cluster random sampling method was used to extract data from the '2015 adult chronic disease and nutrition monitoring population project' from 42 communities of 7 districts in Tianjin. A total of 1 388 residents aged 45 to 59 years old were selected to analyze the relationship between both duration and quality of sleep and the metabolic syndrome. χ(2) test, non-conditional logistic regression and classification tree models were used for data analysis. Result: The prevalence of metabolic syndrome appeared as 30.4%, 37.4 % and 43.1% in the poor, common or well sleep groups respectively. The prevalence rates of metabolic syndrome in the sleep time <6.0 h and >7.5 h, 6.0-7.5 h groups were 36.5% and 30.6% respectively. After adjusting for gender and age, results from the logistic regression analysis showed that short or long sleep duration, as well as poor sleep quality all appeared as risk factors on metabolic syndrome (P<0.05). According to the classification tree model, factors as gender (importance: 0.004, standardized importance: 100%), quality of sleep (importance: 0.004, standardized importance: 99.5%), duration of sleep (importance: 0.002, standardized importance: 38.6%), education level (importance: 0.001, standardized importance: 22.3%) and salt intake (importance: 0.001, standardized importance: 22.2%) were all important on metabolic syndrome and with interactive effects. Conclusions: Both quality and duration of sleep were important influencing factors on metabolic syndrome among midlife population in Tianjin. More attention should be paid to sleep and health status among the midlife population. Ability on self-management of health should also be strengthened through health education, to prevent metabolic syndrome and other chronic diseases in this population.


Assuntos
Síndrome Metabólica/epidemiologia , Sono , China/epidemiologia , Árvores de Decisões , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores de Tempo
7.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(8): 1308-1312, 2020 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-32867441

RESUMO

Objective: To explore the prospective association between consumption pattern of sugar-sweetened beverages and childhood periodontal health. Methods: This study was based on a 4-year longitudinal cohort of children from Bengbu, Anhui province. Pattern of sugar-sweetened beverages was determined by group-based trajectory modeling (GBTM) through annual child-reported questionnaire. Association between sugar-sweetened beverages pattern with plague index and gingivitis was explored through multivariate linear and logistic regression. Results: A total of 997 children including 418 boys and 579 girls were included in this study, with an average age of (11.00±0.70) years at the final wave. Four consumption patterns on sugar-sweetened beverages were identified by GBTM: persistent low group (80.70%), gradually decreasing group (12.40%), decreasing after increasing group (2.20%) and gradually increasing group (4.70%). Compared with the persistent low group (1.08±0.70), the Plague index among gradually increasing group (1.73±0.80) was significantly higher (t=4.00, P<0.001). The prevalence of gingivitis was significantly higher among children in the gradually increasing group (12.80%) than that in the persistent low group (3.00%) (χ(2)=12.40, P<0.001). After controlling for related confounders, results suggested that Plague index increased by 0.58 (95%CI: 0.27-0.89) and 0.38 (95%CI: 0.03-0.73) in the gradually increasing group and "decreasing follow the increase" group, respectively when compared with the persistent low group. The risk for gingivitis was 4.42 times (95%CI: 1.65-12.20, P=0.003) higher in the gradually increasing group. Conclusion: Our data suggested that children with higher sugar-sweetened beverages consumption during the transition period from childhood to adolescence were under higher risk for periodontal diseases.


Assuntos
Doenças Periodontais/epidemiologia , Bebidas Adoçadas com Açúcar/efeitos adversos , Bebidas Adoçadas com Açúcar/estatística & dados numéricos , Criança , China/epidemiologia , Feminino , Humanos , Modelos Lineares , Modelos Logísticos , Estudos Longitudinais , Masculino , Estudos Prospectivos , Medição de Risco
8.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 42(4): 452-458, 2020 Aug 30.
Artigo em Chinês | MEDLINE | ID: mdl-32895096

RESUMO

Objective To understand the family sex education for young children in rural areas of Sichuan province and analyze the influencing factors. Methods A multi-stage random sampling method was used to select 2246 parents of kindergarten children from rural areas in Sichuan province for a questionnaire-based survey.The Chi-square test and Logistic regression model were used for data analysis. Results It was found 1132(52.33%)parents had implemented family sex education for young children and 1031(47.67%)had not.Young children having asked sex-related questions(OR=1.536,95%CI=1.257-1.878),parents thinking that early childhood sex education is necessary(OR=3.691,95%CI=2.029-6.717),and parents having the intention to know early childhood sex education(OR=1.700,95%CI=1.274-2.269),and kindergarten having implemented early childhood sex education(OR=3.316,95%CI=2.515-4.372)were promoting factors for parents to conduct early childhood sex education,whereas a total annual household income at the middle level(OR=0.664,95%CI=0.456-0.968)was a hindering factor for parents to conduct early childhood sex education. Conclusions Parents of young children in rural areas of Sichuan province have poor awareness of sex education,and the proportion of parents who have never conducted sex education for children is high.The total annual income of the family,whether the children have asked about sex-related questions,parents' attitude towards early childhood sex education,and whether the kindergarten has conducted the early childhood sex education are important factors that influence the level of children's family sex education.


Assuntos
Educação Sexual , Criança , China , Humanos , Modelos Logísticos , Pais , Inquéritos e Questionários
9.
Zhonghua Zhong Liu Za Zhi ; 42(8): 660-664, 2020 Aug 23.
Artigo em Chinês | MEDLINE | ID: mdl-32867458

RESUMO

Objective: To understand and explore the risk factors of the death of lymphoma patients from cardiovascular disease. Methods: The medical records and death information of 1 173 patients with lymphoma were collected, cases that died from cardiovascular disease were screened. A binary logistic regression model was used to analyze the independent risk factors of patients with lymphoma died from cardiovascular disease. Results: Among 1 173 patients with lymphoma, 75 (6.4%) died of cardiovascular disease, including 27 cases of coronary heart disease, 25 cases of stroke, 7 cases of hypertension, 5 cases of sudden cardiac death, 4 cases of pulmonary embolism, 3 cases of heart failure, 4 cases of others. Among the patients who survived for more than 5 years, 16.1% (35/217) died of cardiovascular disease. Among those who survived for more than 10 years, 11.7% (7/60) died of cardiovascular disease. Multivariate Logistic regression analysis showed that the primary site of lymphoma (OR=0.521, P=0.039), stage (stage Ⅱ: OR=2.487, P=0.016; stage Ⅲ: OR=3.233, P=0.002) and cardiovascular toxicity in the course of diagnosis and treatment (OR=3.019, P=0.001) are independent influencing factors for the death of cardiovascular disease in patients with lymphoma. Patients whose primary sites of lymphoma were lymph nodes had lower risk of dying from cardiovascular disease, while the patients with stage Ⅱ to Ⅲ stage and cardiovascular toxicity during diagnosis and treatment had higher risk of dying from cardiovascular disease. Conclusions: Cardiovascular disease is an important factor affecting the survival of patients with lymphoma. With the extension of survival time, the risk of dying from cardiovascular disease increases significantly. The primary site, tumor stage, and cardiovascular toxicity that occur during the diagnosis and treatment may be the independent influencing factors for patients with lymphoma that die from cardiovascular disease.


Assuntos
Doenças Cardiovasculares/mortalidade , Linfoma/complicações , Doenças Cardiovasculares/complicações , China/epidemiologia , Humanos , Modelos Logísticos , Linfoma/epidemiologia , Fatores de Risco , Análise de Sobrevida
10.
J Affect Disord ; 276: 446-452, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32871676

RESUMO

BACKGROUND: COVID-19 outbreak happened last December in China and is still continuing. Here, we reported effects of COVID-19 outbreak on the mood of general public and ascertained impacts of psychosocial factors on the plague-related emotional measures. METHODS: During Feb. 4-6, 2020, a self-reported questionnaire Beck Anxiety Inventory (BAI) was disseminated to general public via Wechat, along with a sociodemographic information sheet. BAI score and incidences of moderate and severe anxiety in subgroups of respondents were compared. Multiple linear and logistic regressions were done for correlation analysis and to identify factors predictive of anxiety. RESULTS: Averaged BAI score of all respondents is higher than those of general public in two previous studies. The people quarantined for probable COVID-19 infection presented higher BAI score and incidences of moderate and severe anxiety relative to non-quarantined respondents. People in high epidemic area showed higher BAI score and incidences of moderate and severe anxiety compared to those in low epidemic area. Significant associations existed between anxiety level of the respondents and each of the investigated factors, except for gender. Quarantine was the predictor with a highest OR, followed by divorced/widow. The other factors showed smaller but significant effects on the anxiety level of respondents. LIMITATIONS: This cross-sectional study was unable to track the emotional changes in the respondents over time. It had a relatively small sample and involved some of emotional measures only. CONCLUSION: These data are of help in planning psychological interventions for the different subpopulations in general public during and after COVID-19 outbreak.


Assuntos
Ansiedade/epidemiologia , Betacoronavirus , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Adolescente , Adulto , Ansiedade/psicologia , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Surtos de Doenças , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Quarentena , Inquéritos e Questionários , Adulto Jovem
11.
World J Gastroenterol ; 26(31): 4694-4702, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32884226

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) has become a worldwide pandemic. We investigated the clinical characteristics and risk factors for liver injury in COVID-19 patients in Wuhan by retrospectively analyzing the epidemiological, clinical, and laboratory data for 218 COVID-19 patients and identifying the risk factors for liver injury by multivariate analysis. AIM: To investigate the clinical characteristics and risk factors for liver injury in COVID-19 patients in Wuhan. METHODS: The 218 patients included 94 males (43.1%), aged 22 to 94 (50.1 ± 18.4) years. Elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were present in 42 (53.2%) and 36 (45.6%) cases, respectively, and 79 (36.2%) patients had abnormally elevated transaminase levels at admission. Patients with liver injury were older than those with normal liver function by a median of 12 years, with a significantly higher frequency of males (68.4% vs 28.8%, P < 0.001) and more coexisting illnesses (48.1% vs 27.3%, P = 0.002). Significantly more patients had fever and shortness of breath (87.3% vs 69.8% and 29.1% vs 14.4%, respectively) in the liver injury group. Only 12 (15.2%) patients had elevated total bilirubin. ALT and AST levels were mildly elevated [1-3 × upper limit of normal (ULN)] in 86.1% and 92.9% of cases, respectively. Only two (2.5%) patients had an ALT or AST level > 5 × ULN. Elevated γ-glutamyl transpeptidase was present in 45 (57.0%) patients, and 86.7% of these had a γ-glutamyl-transpeptidase level < 135 U/L (3 × ULN). Serum alkaline phosphatase levels were almost normal in all patients. Patients with severe liver injury had a significantly higher frequency of abnormal transaminases than non-severe patients, but only one case had very high levels of aminotransferases. RESULTS: Multivariate analysis revealed that male sex, high D-dimer level, and high neutrophil percentage were linked to a higher risk of liver injury. The early stage of COVID-19 may be associated with mildly elevated aminotransferase levels in patients in Wuhan. Male sex and high D-dimer level and neutrophil percentage may be important predictors of liver injury in patients with COVID-19. CONCLUSION: Male sex and high D-dimer level and neutrophil percentage may be important predictors of liver injury in patients with COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Hepatopatias/virologia , Pneumonia Viral/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Feminino , Humanos , Hepatopatias/diagnóstico , Hepatopatias/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Estudos Retrospectivos , Fatores de Risco
12.
PLoS One ; 15(9): e0238492, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32877449

RESUMO

The current novel coronavirus (nCoV) pandemic, COVID-19, was first reported in December 2019 in Wuhan, China, and has spread globally, causing startling loss of life, stalling the global economy, and disrupting social life. One of the challenges to contain COVID-19 is convincing people to adopt personal hygiene, social distancing, and self-quarantine practices that are related to knowledge, attitudes, and practices (KAP) of the residents of respective countries. Bangladesh, a densely populated country with a fast-growing economy and moderate literacy rate, has shown many hiccups in its efforts to implement COVID-19 policies. Understanding KAP may help policy makers produce informed decisions. This study assessed KAP in relation to COVID-19 in Bangladesh. An online survey using a pre-tested questionnaire conducted in late March 2020 attained 1,837 responses across Bangladesh. Ultimately, 1,589 completed responses were included in a statistical analysis to calculate KAP scores and their interrelations with sociodemographic variables. The overall KAP was poor, with only 33% of the participants demonstrating good knowledge, whereas 52.4% and 44.8% of the subjects showed good attitudes and practices, respectively. Sociodemographic factors had strong bearings on the KAP scores. Significantly higher KAP scores were evident in females over males, among aged 45 years and older over younger participants, and among retired workers and homemakers over students and public service employees. This study indicated a panic fuelled by poor understanding of COVID-19 associated facts and the need for the government to ensure more granular and targeted awareness campaigns in a transparent and factual manner to foster public confidence and ensure more meaningful public participation in mitigation measures. This study provides a KAP baseline regarding COVID-19 among Bangladeshis.


Assuntos
Infecções por Coronavirus/patologia , Conhecimentos, Atitudes e Prática em Saúde , Pneumonia Viral/patologia , Adolescente , Adulto , Bangladesh , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/virologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , Inquéritos e Questionários , Adulto Jovem
13.
J Korean Acad Nurs ; 50(4): 533-540, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32895340

RESUMO

PURPOSE: This study aimed to evaluate nursing students' understanding of the prevention of COVID-19, as well as their anxiety towards the disease and their perception of their professional identity in the wake of the pandemic, in Zhengzhou, China. METHODS: A cross-sectional study was designed to investigate 474 nursing students by cluster sampling using a stratified questionnaire from February 15 to March 31, 2020. Multiple linear regression was used to identify the factors affecting professional identity. Binary and multiple logistic regression were used to identify the factors affecting anxiety. RESULTS: Responders with a high level of understanding of COVID-19 and frequent use of behavioral strategies for its prevention comprised 93.2% and 30.0% of the cohort, respectively. Professional identity was significantly associated with gender and anxiety (p < .050). The prevalence of anxiety among nursing students was 12.4%. Male (odds ratio [OR] = 2.39; 95% confidence interval [CI] = 1.26~4.52), sophomores (OR = 5.30; 95% CI = 1.61~7.45), and infrequent use of prevention measures (OR = 3.49; 95% CI = 1.16~5.19) had a significant effect on anxiety. CONCLUSION: Anxiety during the COVID-19 epidemic gives an adverse effect on the professional identity of nursing in students. Nursing education institutions need to provide psychological counseling services for nursing students, in addition to improving their teaching of COVID-19 prevention strategies.


Assuntos
Ansiedade/etiologia , Infecções por Coronavirus/prevenção & controle , Conhecimento , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Papel Profissional , Estudantes de Enfermagem/psicologia , Ansiedade/epidemiologia , Betacoronavirus/isolamento & purificação , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/patologia , Infecções por Coronavirus/virologia , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Razão de Chances , Pneumonia Viral/epidemiologia , Pneumonia Viral/patologia , Pneumonia Viral/virologia , Inquéritos e Questionários , Adulto Jovem
14.
Nihon Koshu Eisei Zasshi ; 67(8): 509-517, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32879237

RESUMO

Objective To explore health-related and socioeconomic factors that can predict future deterioration in Psychological Distress Scale (K6) scores.Method We conducted a baseline (2010, 2011) self-administered questionnaire survey of the Kobe Orthopedic and Biomedical Epidemiological study (KOBE study) involving 1,117 participants who had no previous history of cancer or cardiovascular diseases and were not under treatment for hypertension, diabetes, or dyslipidemia. We used the Japanese K6 as an indicator of stress and defined K6≧5 points as a high-stress group and K6<5 points as a low-stress group. A four-year follow-up survey (2014, 2015) was conducted on 1,004 people (follow-up rate of 90%). We excluded 39 participants with missing values, and 185 people whose K6 score was higher than 5 points at baseline. A final total of 780 participants' scores were examined for: gender, age, living situation, physical activity level, average sleep time, as well as the K6 score, the Japanese Hearing Handicap Inventory for Elderly (HHIE-S), and the Japanese Oswestry Disability Index (ODI). We conducted a logistic regression analysis using K6≧5 points at the four-year follow-up survey as the dependent variable and each factor at the baseline survey as the independent variable.Results Of the 780 subjects analyzed, 132 (16.9%) were highly stressed (K6≧5 points) at the four-year follow-up point. A logistic regression analysis found age (40s/70s) (odds ratio 3.38, 95% confidence interval 1.45-7.86), living situation (single/living together) (odds ratio 1.98, 95% confidence interval 1.07-3.68), and ODI scores (every 1%) (odds ratio 1.05, 95% confidence interval 1.01-1.09), to all be significantly associated with high stress.Conclusion This study suggests that age, living situation, and ODI scores are related to future stress.


Assuntos
Estresse Psicológico/diagnóstico , População Urbana , Adulto , Fatores Etários , Feminino , Seguimentos , Previsões , Humanos , Japão , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Características de Residência , Fatores Socioeconômicos , Estresse Psicológico/psicologia , Inquéritos e Questionários
15.
Nat Commun ; 11(1): 4727, 2020 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-32948752

RESUMO

The apolipoprotein E (APOE) gene contains both the major common risk variant for late onset Alzheimer's disease (AD), e4, and the major neuroprotective variant, e2. Here we examine the association of APOE e2 with multiple neurodegenerative pathologies, leveraging the NACC v. 10 database of 1557 brains that included 130 e2 carriers and 679 e4 carriers in order to examine potential neuroprotective effects. For AD-related pathologies of amyloid plaques and Braak stage, e2 had large and highly significant protective effects contrasted with e3/e3 and e4 carriers with odds ratios of about 0.50 for e3 contrasts and 0.10 for e4 contrasts. When we separately examined e2/e4 carriers, risk for AD pathologies was similar to that of e4 carriers, not e2 carriers. For multiple fronto-temporal lobar pathologies and tauopathies, e2 was not significantly associated with pathology. In sum, we found that e2 was associated with large but circumscribed protective effects.


Assuntos
Doença de Alzheimer/genética , Doença de Alzheimer/metabolismo , Apolipoproteína E2/genética , Apolipoproteína E2/metabolismo , Genótipo , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/patologia , Apolipoproteína E4/genética , Apolipoproteína E4/metabolismo , Apolipoproteínas E/genética , Apolipoproteínas E/metabolismo , Encéfalo/metabolismo , Feminino , Degeneração Lobar Frontotemporal/metabolismo , Humanos , Modelos Logísticos , Masculino , Placa Amiloide/patologia , Tauopatias/metabolismo , alfa-Sinucleína/metabolismo
16.
PLoS One ; 15(9): e0239519, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32970733

RESUMO

The new coronavirus disease 2019 (COVID-19) pandemic has challenged many healthcare systems around the world. While most of the current understanding of the clinical features of COVID-19 is derived from Chinese studies, there is a relative paucity of reports from the remaining global health community. In this study, we analyze the clinical and radiologic factors that correlate with mortality odds in COVID-19 positive patients from a tertiary care center in Tehran, Iran. A retrospective cohort study of 90 patients with reverse transcriptase-polymerase chain reaction (RT-PCR) positive COVID-19 infection was conducted, analyzing demographics, co-morbidities, presenting symptoms, vital signs, laboratory values, chest radiograph findings, and chest CT features based on mortality. Chest radiograph was assessed using the Radiographic Assessment of Lung Edema (RALE) scoring system. Chest CTs were assessed according to the opacification pattern, distribution, and standardized severity score. Initial and follow-up Chest CTs were compared if available. Multiple logistic regression was used to generate a prediction model for mortality. The 90 patients included 59 men and 31 women (59.4 ± 16.6 years), including 21 deceased and 69 surviving patients. Among clinical features, advanced age (p = 0.02), low oxygenation saturation (p<0.001), leukocytosis (p = 0.02), low lymphocyte fraction (p = 0.03), and low platelet count (p = 0.048) were associated with increased mortality. High RALE score on initial chest radiograph (p = 0.002), presence of pleural effusions on initial CT chest (p = 0.005), development of pleural effusions on follow-up CT chest (p = 0.04), and worsening lung severity score on follow-up CT Chest (p = 0.03) were associated with mortality. A two-factor logistic model using patient age and oxygen saturation was created, which demonstrates 89% accuracy and area under the ROC curve of 0.86 (p<0.0001). Specific demographic, clinical, and imaging features are associated with increased mortality in COVID-19 infections. Attention to these features can help optimize patient management.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/mortalidade , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/mortalidade , Adulto , Idoso , Betacoronavirus , Comorbidade , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Irã (Geográfico) , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Pandemias , Radiografia Torácica , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Centros de Atenção Terciária , Tomografia Computadorizada por Raios X
17.
PLoS One ; 15(9): e0239695, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32970753

RESUMO

Wuhan, China was the epicenter of the 2019 coronavirus outbreak. As a designated hospital for COVID-19, Wuhan Pulmonary Hospital has received over 700 COVID-19 patients. With the COVID-19 becoming a pandemic all over the world, we aim to share our epidemiological and clinical findings with the global community. We studied 340 confirmed COVID-19 patients with clear clinical outcomes from Wuhan Pulmonary Hospital, including 310 discharged cases and 30 death cases. We analyzed their demographic, epidemiological, clinical and laboratory data and implemented our findings into an interactive, free access web application to evaluate COVID-19 patient's severity level. Our results show that baseline T cell subsets results differed significantly between the discharged cases and the death cases in Mann Whitney U test: Total T cells (p < 0.001), Helper T cells (p <0.001), Suppressor T cells (p <0.001), and TH/TSC (Helper/Suppressor ratio, p<0.001). Multivariate logistic regression model with death or discharge as the outcome resulted in the following significant predictors: age (OR 1.05, 95% CI, 1.00 to 1.10), underlying disease status (OR 3.42, 95% CI, 1.30 to 9.95), Helper T cells on the log scale (OR 0.22, 95% CI, 0.12 to 0.40), and TH/TSC on the log scale (OR 4.80, 95% CI, 2.12 to 11.86). The AUC for the logistic regression model is 0.90 (95% CI, 0.84 to 0.95), suggesting the model has a very good predictive power. Our findings suggest that while age and underlying diseases are known risk factors for poor prognosis, patients with a less damaged immune system at the time of hospitalization had higher chance of recovery. Close monitoring of the T cell subsets might provide valuable information of the patient's condition change during the treatment process. Our web visualization application can be used as a supplementary tool for the evaluation.


Assuntos
Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Pneumonia Viral/diagnóstico , Pneumonia Viral/mortalidade , Índice de Gravidade de Doença , Subpopulações de Linfócitos T/citologia , Adulto , Idoso , Betacoronavirus , China , Humanos , Internet , Modelos Logísticos , Pessoa de Meia-Idade , Pandemias , Alta do Paciente , Fatores de Risco , Centros de Atenção Terciária
18.
Pediatrics ; 146(3)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32868471

RESUMO

BACKGROUND: Legal performance-enhancing substance(s) (PES) (eg, creatine) are widely used among adolescent boys and young men; however, little is known about their temporal associations with substance use behaviors. METHODS: We analyzed prospective cohort data from the National Longitudinal Study of Adolescent to Adult Health, Waves I to IV (1994-2008). Logistic regressions were used to first assess adolescent substance use (Wave I) and use of legal PES (Wave III) and second to assess use of legal PES (Wave III) and subsequent substance use-associated risk behaviors (Wave IV), adjusting for potential confounders. RESULTS: Among the sample of 12 133 young adults aged 18 to 26 years, 16.1% of young men and 1.2% of young women reported using legal PES in the past year. Adolescent alcohol use was prospectively associated with legal PES use in young men (odds ratio 1.39; 95% confidence interval [CI] 1.13-1.70). Among young men, legal PES use was prospectively associated with higher odds of problematic alcohol use and drinking-related risk behaviors, including binge drinking (adjusted odds ratio [aOR] 1.35; 95% CI 1.07-1.71), injurious and risky behaviors (aOR 1.78; 95% CI 1.43-2.21), legal problems (aOR 1.52; 95% CI 1.08-2.13), cutting down on activities and socialization (aOR 1.91; 95% CI 1.36-2.78), and emotional or physical health problems (aOR 1.44; 95% CI 1.04-1.99). Among young women, legal PES use was prospectively associated with higher odds of emotional or physical health problems (aOR 3.00; 95% CI 1.20-7.44). CONCLUSIONS: Use of legal PES should be considered a gateway to future problematic alcohol use and drinking-related risk behaviors, particularly among young men.


Assuntos
Substâncias para Melhoria do Desempenho/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/etiologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Intoxicação Alcoólica/complicações , Aminoácidos/efeitos adversos , Atletas/estatística & dados numéricos , Índice de Massa Corporal , Intervalos de Confiança , Creatina/efeitos adversos , Desidroepiandrosterona/efeitos adversos , Feminino , Humanos , Modelos Logísticos , Masculino , Fumar Maconha/efeitos adversos , Razão de Chances , Estudos Prospectivos , Assunção de Riscos , Fatores Sexuais , Fumar/efeitos adversos , Esteroides/efeitos adversos , Consumo de Álcool por Menores , Adulto Jovem
19.
Epidemiol Serv Saude ; 29(4): e2020413, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32997070

RESUMO

OBJECTIVE: To analyze factors associated with the deaths of individuals hospitalized with COVID-19 in the state of Espírito Santo, Brazil. METHODS: This was a cross-sectional study using secondary data. Logistic regression models were used to estimate crude and adjusted odds ratios (OR). RESULTS: As at May 14, 2020, 200 individuals had been discharged and 220 had died. Of the total number of people studied, 57.1% were male, 46.4% were >60 years old, 57.9% were cases notified by a private institution, and 61.7% had >1 comorbidity. In the adjusted analysis, hospital mortality was higher for the 51-60 age group (OR=4.33 - 95%CI 1.50;12.46), the over 60 age group (OR=11.84 - 95%CI 4.31;32.54), cases notified by public institutions (OR=8.23 - 95%CI 4.84;13.99) and cases with a greater number of comorbidities (two [OR=2.74 - 95%CI 1.40;5.34] and three [OR=2.90 - 95%CI 1.07;7.81]). CONCLUSION: Higher mortality was found in older individuals, those with comorbidities and users of public hospitals.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Mortalidade Hospitalar , Pneumonia Viral/mortalidade , Adulto , Distribuição por Idade , Idoso , Brasil/epidemiologia , Causas de Morte , Comorbidade , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pandemias , Alta do Paciente/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Distribuição por Sexo , Adulto Jovem
20.
PLoS One ; 15(9): e0239536, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32997700

RESUMO

BACKGROUND: The 2019 novel coronavirus disease (COVID-19) has created unprecedented medical challenges. There remains a need for validated risk prediction models to assess short-term mortality risk among hospitalized patients with COVID-19. The objective of this study was to develop and validate a 7-day and 14-day mortality risk prediction model for patients hospitalized with COVID-19. METHODS: We performed a multicenter retrospective cohort study with a separate multicenter cohort for external validation using two hospitals in New York, NY, and 9 hospitals in Massachusetts, respectively. A total of 664 patients in NY and 265 patients with COVID-19 in Massachusetts, hospitalized from March to April 2020. RESULTS: We developed a risk model consisting of patient age, hypoxia severity, mean arterial pressure and presence of kidney dysfunction at hospital presentation. Multivariable regression model was based on risk factors selected from univariable and Chi-squared automatic interaction detection analyses. Validation was by receiver operating characteristic curve (discrimination) and Hosmer-Lemeshow goodness of fit (GOF) test (calibration). In internal cross-validation, prediction of 7-day mortality had an AUC of 0.86 (95%CI 0.74-0.98; GOF p = 0.744); while 14-day had an AUC of 0.83 (95%CI 0.69-0.97; GOF p = 0.588). External validation was achieved using 265 patients from an outside cohort and confirmed 7- and 14-day mortality prediction performance with an AUC of 0.85 (95%CI 0.78-0.92; GOF p = 0.340) and 0.83 (95%CI 0.76-0.89; GOF p = 0.471) respectively, along with excellent calibration. Retrospective data collection, short follow-up time, and development in COVID-19 epicenter may limit model generalizability. CONCLUSIONS: The COVID-AID risk tool is a well-calibrated model that demonstrates accuracy in the prediction of both 7-day and 14-day mortality risk among patients hospitalized with COVID-19. This prediction score could assist with resource utilization, patient and caregiver education, and provide a risk stratification instrument for future research trials.


Assuntos
Infecções por Coronavirus/mortalidade , Modelos Logísticos , Pneumonia Viral/mortalidade , Medição de Risco/métodos , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Feminino , Mortalidade Hospitalar , Hospitalização , Humanos , Masculino , Massachusetts , Pessoa de Meia-Idade , New York , Pandemias , Curva ROC , Análise de Regressão , Estudos Retrospectivos , Fatores de Risco , Estados Unidos
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